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Nyemgah CA, Ranganathan M, Nabukalu D, Stöckl H. Prevalence and severity of physical intimate partner violence during pregnancy among adolescents in eight sub-Saharan Africa countries: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002638. [PMID: 39012924 PMCID: PMC11251595 DOI: 10.1371/journal.pgph.0002638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 06/23/2024] [Indexed: 07/18/2024]
Abstract
Globally, intimate partner violence (IPV) is highly prevalent, with adolescents being particularly vulnerable, especially during pregnancy. This study examines the prevalence and severity of physical IPV among pregnant adolescents in sub-Saharan Africa (SSA). We analyzed data from Demographic Health Surveys collected between 2017-2021 from eight SSA countries, involving 2,289 ever-pregnant adolescents aged 15-19. Physical IPV during pregnancy was defined as experiencing physical harm while pregnant by a husband, former partner, current boyfriend, or former boyfriend. Severity of physical IPV included experiences such as kicking, choking, weapon threats, and serious injuries. Logistic regression analysis was conducted, with results presented as unadjusted and adjusted odds ratios with 95% confidence intervals. The prevalence of physical IPV during pregnancy among adolescents in the eight SSA countries ranged from 2.9% to 12.6%, with 5.6% experiencing severe lifetime physical IPV and 6.3% severe physical injuries. We found a strong association between physical IPV during pregnancy and severe lifetime physical IPV (aOR: 6.8, 95% CI: 4.5-10.4) and severe injuries (aOR: 9.2, 95% CI: 6.0-14.2), even after adjusting for covariates. Physical IPV during pregnancy is common among adolescents in SSA and is associated with severe physical lifetime IPV. Addressing this issue in low-resource settings requires collaborative efforts among community stakeholders, health system practitioners, and policymakers to protect vulnerable adolescent girls during pregnancy.
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Affiliation(s)
- Caroline Adjimi Nyemgah
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Meghna Ranganathan
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Doreen Nabukalu
- Department of Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Heidi Stöckl
- Institute of Medical Information Processing, Biometry and Epidemiology, Public Health and Health Services Research, Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Finnbogadóttir HR, Henriksen L, Hegaard HK, Halldórsdóttir S, Paavilainen E, Lukasse M, Broberg L. The Consequences of A History of Violence on Women's Pregnancy and Childbirth in the Nordic Countries: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241253044. [PMID: 38805432 DOI: 10.1177/15248380241253044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Violence against women (VAW) is a global challenge also in the childbearing period. Despite high gender equality, there is a high prevalence of VAW in the Nordic countries. This scoping review aims to explore predictors for and consequences of a history of violence on women's pregnancy and childbirth in the Nordic countries, including women's experience of the impact of violence and the interventions used to detect, address consequences, and prevent further violence. The framework by Arksey and O'Malley was followed, and English, Finnish, Icelandic, Norwegian, Danish, and Swedish literature was included. The population was women aged ≥18 residing in the Nordic countries during the perinatal period. Eight databases were searched: MEDLINE, CINAHL, PubMed, PsycINFO, Web of Science, ASSIA, Social Services-, and Sociological abstracts. There was no limitation of the search time frame. The initial screening resulted in 1,104 records, and after removing duplicates, 452 remained. Finally, 61 papers met the inclusion criteria. The results covering the past 32 years indicated that childbearing women with a history of violence are at greater risk of common complaints and hospitalization during pregnancy, fear of childbirth, Cesarean section, breastfeeding difficulties, and physical and mental health problems. While extensive research was found on the associations between a history of and current violence and outcomes related to pregnancy, there was a lack of intervention studies and studies from Finland. Efforts must be made to scientifically test the methods used to reduce and treat the adverse effects of a history of violence and prevent further violence.
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Affiliation(s)
| | | | - Hanne Kristine Hegaard
- Copenhagen University Hospital-Rigshospitalet, Denmark
- The University of Copenhagen, Denmark
| | | | | | | | - Lotte Broberg
- Bispebjerg and Frederiksberg Hospital, Denmark
- Slagelse Hospital, Denmark
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Kpordoxah MR, Adiak AA, Issah AN, Yeboah D, Abdulai N, Boah M. Magnitude of self-reported intimate partner violence against pregnant women in Ghana's northern region and its association with low birth weight. BMC Pregnancy Childbirth 2024; 24:29. [PMID: 38178015 PMCID: PMC10765694 DOI: 10.1186/s12884-023-06229-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/27/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Low birth weight (LBW) rates are high in the northern region of Ghana, as is tolerance for intimate partner violence (IPV). However, the relationship between the two incidents has not been established. This study assessed the magnitude of IPV against pregnant women and its association with LBW in the northern region of Ghana. METHODS A cross-sectional study was conducted among 402 postnatal women from five public health care facilities in the Tamale Metropolitan Area, northern Ghana. Data were collected electronically during face-to-face interviews. Validated methods were used to determine IPV exposure during pregnancy and birth weight. Multivariable logistic regression was used to identify the independent association between prenatal exposure to IPV and LBW. RESULTS Of the 402 women, 46.5% (95% CI: 41.7, 51.4) experienced IPV during their most recent pregnancy. Of these, 34.8% were psychologically abused, 24.4% were sexually abused, and 6.7% were physically abused. Prenatal IPV exposure was found to be significantly associated with birth weight. Low birth weight was twice as likely among exposed women as among unexposed women (AOR = 2.42; 95% CI: 1.12, 5.26, p < 0.05). Low birth weight risk was also higher among women with anaemia in the first trimester (AOR = 3.47; 95% CI: 1.47, 8.23, p < 0.01), but was lower among women who made at least four antenatal care visits before delivery (AOR = 0.35; 95% CI: 0.14, 0.89, p < 0.05) and male newborns (AOR = 0.23; 95% CI: 0.11, 0.49, p < 0.001). CONCLUSION AND RECOMMENDATION IPV during pregnancy is prevalent in the research population, with psychological IPV being more widespread than other kinds. Women who suffered IPV during pregnancy were more likely to have LBW than those who did not. It is essential to incorporate questions about domestic violence into antenatal care protocols. In particular, every pregnant woman should be screened for IPV at least once during each trimester, and those who have experienced violence should be closely monitored for weight gain and foetal growth in the study setting to avert the LBW associated with IPV. In the northern region of Ghana, the number of babies born with low birth weight is high, as is the number of adults who are willing to put up with intimate partner violence. However, there has not been any proof that these two incidents are connected. This study looked at how frequently intimate partner violence occurs among pregnant women and how it is linked to low birth weight in northern Ghana's Tamale Metropolitan Area. A cross-sectional study was conducted with 402 postnatal women from five public health care facilities in the study setting. Information on exposure to intimate partner violence during pregnancy and the birth weight of babies was collected electronically during face-to-face interviews. The study found that of the 402 women, 46.5% had experienced violence by an intimate partner during their most recent pregnancy. Out of these, 34.8% were abused psychologically, 24.4% were abused sexually, and 6.7% were abused physically. Women who were abused were more likely than those who were not to have babies with low birth weight. We concluded that intimate partner violence is common during pregnancy in the study setting and that more women suffered psychological intimate partner violence than other types of violence. Intimate partner violence during pregnancy was linked to low birth weight in the study setting. It is important for antenatal care plans to include questions about intimate partner violence. In particular, every pregnant woman should be assessed for intimate partner violence at least once during each trimester for monitoring.
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Affiliation(s)
- Mary Rachael Kpordoxah
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | | | - Abdul-Nasir Issah
- Department of Health Services, Policy, Planning, Management, and Economics, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Daudi Yeboah
- Department of Epidemiology, Biostatistics, and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Nashiru Abdulai
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
- Nanton District Assembly, Tamale, P.O. Box 1, Ghana
| | - Michael Boah
- Department of Epidemiology, Biostatistics, and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana.
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Dal Moro APM, Soecki G, de Fraga FS, Petterle RR, Rückl SZ. Fear of childbirth: prevalence and associated factors in pregnant women of a maternity hospital in southern Brazil. BMC Pregnancy Childbirth 2023; 23:632. [PMID: 37660013 PMCID: PMC10474709 DOI: 10.1186/s12884-023-05948-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 08/22/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND The fear of childbirth (FOC) harms maternal and fetal health, however it has been little studied in Brazil. This research aimed to determine the prevalence of FOC in a maternity hospital in southern Brazil and identify its associated factors. METHODS The Wijma Delivery Expectancy Questionnaire - W-DEQ(A) was used to assess the prevalence of FOC, and its relationship with sociodemographic variables, gestational history, aspects of the current pregnancy, knowledge about childbirth, anxiety symptoms (Beck Anxiety Inventory), depressive symptoms (Edinburgh Postnatal Depression Scale), and perception of social support (Multidimensional Scale of Perceived Social Support) was investigated. Questionnaires about the content of FOC and information sources regarding childbirth were also applied. RESULTS We interviewed 125 pregnant women between 28 and 36 weeks of pregnancy between July and September of 2021, and 12% of them scored ≥ 85 on the W-DEQ(A), indicating severe FOC. There was a significant correlation between FOC and anxiety symptoms (r = 0.50, p < 0.001), depressive symptoms (r = 0.34, p < 0.001), and poor social support (r = -0.23, p = 0.008). FOC was lower in pregnant women with complete elementary education when compared to those with higher education (p = 0.003), however, those with negative experiences in previous deliveries had more FOC than those who had had positive experiences (p = 0.001). More than 85% of them fear fetal distress. CONCLUSIONS FOC is a prevalent condition that impacts the mental health of pregnant women. Therefore, health professionals should recognize and address it during prenatal care to provide integral maternal-fetal care and improve the childbirth experience.
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Affiliation(s)
| | - Gabriella Soecki
- Medicine Student, Federal University of Paraná, Curitiba, Paraná, Brazil
| | | | | | - Sarah Zanghellini Rückl
- Departament of Psychiatry and Forensic Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil
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Zapata-Calvente AL, Martín-de-las-Heras S, Bueno Cavanillas A, Andreasen K, Rasch V, Khan KS. E-health psychological intervention in pregnant women exposed to intimate partner violence (eIPV): A protocol for a pilot randomised controlled trial. PLoS One 2023; 18:e0282997. [PMID: 36930616 PMCID: PMC10022801 DOI: 10.1371/journal.pone.0282997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 12/09/2022] [Indexed: 03/18/2023] Open
Abstract
Intimate partner violence (IPV) during pregnancy, a condition as common as obstetrics conditions like gestational diabetes, is associated with maternal and neonatal complications. Systematic detection of IPV is not well established in antenatal screening probably because the effectiveness of protective interventions has not been evaluated. E-health interventions may be beneficial among mothers exposed to IPV. Prior to performing a full-scale effectiveness trial for such an intervention, a pilot study is required to assess the feasibility of randomising a sufficiently large number of women exposed to IPV during pregnancy. The eIPV trial is a randomised pilot study nested within a cohort of consenting mothers who screen positive for IPV in the first antenatal visit at <12 weeks' gestation and accept an e-health package (psychological counselling by videoconference) in Spain and Denmark. Twenty eligible mothers from the above cohort will be randomised to either intervention or control. The intervention group will receive the e-health package as part of the cohort. The control group will be invited to accept a delay in the intervention (e-health package eight weeks later). After consenting to delay, the control group will provide comparative data without losing the opportunity of obtaining the intervention. We will determine estimates of rates of informed consent to randomization, and the rates of adherence and dropout following randomization. Qualitative interviews will be conducted to examine the women's perception about the benefit of the intervention, reasons for acceptability and non-adherence, and obstacles to recruitment, randomisation and consent. The results will inform the trial feasibility and variance of key clinical outcome measures for estimation of sample size of the full-scale effectiveness trial.
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Affiliation(s)
| | - Stella Martín-de-las-Heras
- Department of Forensic Medicine, University of Malaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
- * E-mail:
| | - Aurora Bueno Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Karen Andreasen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Vibeke Rasch
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Khalid S. Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Henriksen L, Kisa S, Lukasse M, Flaathen EM, Mortensen B, Karlsen E, Garnweidner-Holme L. Cultural Sensitivity in Interventions Aiming to Reduce or Prevent Intimate Partner Violence During Pregnancy: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:97-109. [PMID: 34109872 PMCID: PMC9660282 DOI: 10.1177/15248380211021788] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem. Ethnic minorities and immigrant pregnant women experiencing IPV require culturally responsive health services. The aim of this scoping review was to identify aspects of cultural sensitivity in interventions to prevent or reduce IPV among ethnic minorities and immigrant pregnant women in high-income countries. Eight databases were searched in November 2019. Any type of scientific research, quantitative, qualitative, or mixed methods studies regarding interventions against IPV among pregnant women were considered for inclusion. Resnicow et al.'s definition of cultural sensitivity was used to identify aspects of cultural sensitivity. Ten papers relating to nine interventions/studies met our inclusion criteria. These studies, which included randomized controlled trials, a mixed methods study, a program evaluation, and a longitudinal study, were conducted in Australia, Belgium, Norway, and the United States. Aspects of surface cultural sensitivity, including the translation of intervention content into the language of the target group(s) and the involvement of bilingual staff to recruit participants, were identified in eight studies. Deep structure aspects of cultural sensitivity were identified in one study, where the intervention content was pretested among the target group(s). Results that could be related to the culture-sensitive adaptions included successful recruitment of the target population. Three studies were planning to investigate women's experiences of interventions, but no publications were yet available. This scoping review provides evidence that culturally sensitive interventions to reduce or prevent IPV among immigrant pregnant women are limited in number and detail.
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Affiliation(s)
- Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
- Division of General Gynaecology and Obstetrics, Oslo University
Hospital, Norway
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
- Department of Nursing and Health Sciences, University of
South-Eastern Norway, Kongsberg, Norway
| | - Eva Marie Flaathen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
| | - Berit Mortensen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
| | - Elisabeth Karlsen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
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Yokobori H, Iwasaki-Motegi R, Naruse T, Yamamoto-Mitani N. Public Health Nurses' Activities toward Child Abuse Prevention before Childbirth in Japan. Public Health Nurs 2022; 39:1346-1354. [PMID: 35899984 DOI: 10.1111/phn.13122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/23/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
As child abuse becomes increasingly serious, the activities of nursing professionals during pregnancy have become more important. This study aimed to describe public health nurses' (PHNs) activities for child abuse prevention, focusing on how they approach pregnant women at possible risk to enable early prevention. A qualitative design was applied. Fifteen PHNs in Japan participated and were interviewed about 23 cases using semistructured interviews focus on the series of PHN's activity. Transcripts were coded, and the codes were categorized into several categories, and content analysis was conducted. PHNs' activities included exploring at-risk cases by various means, creating opportunities to begin individual support, examining the risk of abuse specifically to predict suspected abuse after childbirth, encouraging behavior to reduce the risk of abuse, waiting consciously for a while, expanding support systems for cases. If PHNs anticipated that the situation would not stabilize, they returned to creating an opportunity to begin individual support and repeated the process. PHNs' had six activities, which were repeated depending on the magnitude of the risk of abuse. It was suggested that these activities are aimed at long-term child-rearing support. PHNs belonging to municipal governments conducted these activities; further support can be provided by utilizing municipal governments.
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Affiliation(s)
- Haruka Yokobori
- Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Riho Iwasaki-Motegi
- Department of Health Promotion, National Institute of Public Health, Saitama, Japan
| | - Takashi Naruse
- Graduate School of Medicine, Global Nursing Research Center, The University of Tokyo, Tokyo, Japan
| | - Noriko Yamamoto-Mitani
- Division of Health Sciences and Nursing, Department of Gerontological Home Care and Long-term Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Shafiei S, Chegeni M, Afrashteh S, Shoraka HR, Bazrafshan A, Bagherinezhad Z, Ghazanfarpour M, Sharifi H. Prevalence of Violence in Iranian Pregnant Women: A Systematic Review and Meta-Analysis. Matern Child Health J 2022; 26:1983-2019. [PMID: 35947277 DOI: 10.1007/s10995-022-03463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/30/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS Violence against pregnant women is a significant public health problem, resulting in disability and various physical and mental health disorders. This systematic review and meta-analysis explored the prevalence of physical, verbal, sexual, psychological, emotional, economic, and other types of violence among pregnant women in Iran. METHODS Bibliographic databases including PubMed, Embase, Web of Science (WoS), and Scopus, and also Iranian databases including Scientific Information Database (SID), Magiran, and Civilica were searched from 2002 to September 16, 2020. Following a random-effects meta-analysis, we estimated the pooled prevalence of exposure to different types of violence among Iranian pregnant women. Overall, 61 articles that met the inclusion criteria were analyzed in this systematic review. RESULTS The prevalence of physical violence was 19.0% (95% confidence intervals [CI]: 14.0, 24.0), verbal violence was 42.0% (95% CI: 24.0, 61.0), sexual violence was 26.0% (95% CI: 20.0, 32.0), psychological violence was 37.0% (95% CI: 28.0, 46.0), emotional violence was 51.0% (95% CI: 40.0, 62.0), economic 39.0% (95% CI: 19.0, 60.0), and the prevalence of other types of violence was 54.0% (95% CI: 46.0, 62.0). CONCLUSIONS This study revealed that Iranian pregnant women are often exposed to different types of violence. Therefore, screening for violence in this vulnerable group seems necessary due to the sensitive nature of pregnancy and its importance in maternal health. This alarming rate of violence calls for adopting upstream policies and interventions to reduce violent practices against pregnant women in Iran.
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Affiliation(s)
- Shohreh Shafiei
- Clinical Research Development Center of Imam Khomeini Hospital , Jiroft University of Medical Sciences, Jiroft, Iran
| | - Maryam Chegeni
- Department of Public Health, Khomein University of Medical Sciences,, Khomein, Iran
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran
| | - Sima Afrashteh
- Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hamid Reza Shoraka
- Department of Public Health, Esfarayen Faculty of Medical Science, Esfarayen, Iran
| | - Azam Bazrafshan
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | | | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Melby TC, Sørensen NB, Henriksen L, Lukasse M, Flaathen EME. Antenatal depression and the association of intimate partner violence among a culturally diverse population in southeastern Norway: A cross-sectional study. Eur J Midwifery 2022; 6:44. [PMID: 35935753 PMCID: PMC9289962 DOI: 10.18332/ejm/150009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Antenatal depression and intimate partner violence (IPV) are independently associated with adverse short- and long-term health effects for women and their children. The main aim of the study was to investigate the prevalence of antenatal depression and the association between symptoms of antenatal depression and physical, emotional and sexual abuse in a culturally diverse population attending antenatal care. METHODS A cross-sectional study was conducted with 1812 culturally diverse pregnant women from Safe Pregnancy, a randomized controlled trial to test the effect of an intimate partner violence intervention for abused women in southeastern Norway. RESULTS More than one in ten women (14%) reported symptoms of antenatal depression. Women with symptoms of antenatal depression were significantly younger and single, had lower educational level, more limited economic resources and were more likely to use tobacco and to report negative experiences regarding alcohol consumption, including that of her partner, compared to women with no symptoms of depression. A total of 15.4% of the women reported experiences of some form of IPV during their lifetime. Most women reported previous experiences of IPV rather than recent experiences. Women with a history of IPV were significantly more likely to report symptoms of antenatal depression, after adjusting for confounding factors (AOR=1.96; 95% CI: 1.35–2.83). CONCLUSIONS Women who reported symptoms of antenatal depression were significantly more likely to have experienced physical, emotional and sexual IPV than women with no history of IPV. It is important to identify women at risk of antenatal depression in order to offer appropriate services during pregnancy.
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Affiliation(s)
- Thea Cathrine Melby
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nina Benedicte Sørensen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Division of General Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Eva Marie E Flaathen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Al-Khushayban FA, Alharbi MK, Alsheha MA, Bedaiwi MF, Alolayan SS, Aljasser RI, Alanazi AM, Bedaiwi BF, Almuhaimeed FA, Almeathem FK. The Prevalence of Violence Against Women During Pregnancy and After Delivery in Saudi Arabia: A Cross-Sectional Study. Cureus 2022; 14:e26417. [PMID: 35915681 PMCID: PMC9337790 DOI: 10.7759/cureus.26417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Violence against pregnant women has become a public health issue and a violation of human rights. The World Health Organization (WHO) defines violence as any act (physical or verbal) that causes physical or psychological harm. Obstetric violence committed by healthcare providers can lead to significant health consequences harming both mother and child. During pregnancy, violence is more frequent than some obstetric complications that are routinely recorded or screened. Therefore, this study aims to assess the prevalence of violence against women during pregnancy and labor, and postpartum. Materials and methods In this cross-sectional study, our study population consisted of women who have experienced pregnancy and labor in the Najd region. We used both face-to-face and online questionnaires that evaluated the knowledge and practice outcomes of women who have experienced violence during labor, in addition to the behavior of healthcare providers toward these women. Results In our analysis of demographic data, we found a significant association between age and having experienced violence before/during birth. Most women who experienced violence were between 25 and 45 years old (p=0.002). Furthermore, the history analysis revealed a significant association between follow-up regularity and violence experiences (p=0.010). Nursing students delivered most women (71%), and they did not provide information regarding the women’s rights or procedures. Of the respondents, 39.6% did not feel comfortable and were afraid of the healthcare providers’ words, phrases, or behaviors. Conclusion Our study concluded that many women experience violence committed by healthcare providers before, during, and after labor without realizing it. As a result of the ignorance of their rights, violence is more prevalent among these women. As a recommendation, to expand on the rights, women organizations should dedicate more efforts and throw campaigns to raise the awareness of violence among other women.
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Safe Pregnancy intervention for intimate partner violence: a randomised controlled trial in Norway among culturally diverse pregnant women. BMC Pregnancy Childbirth 2022; 22:144. [PMID: 35189843 PMCID: PMC8862262 DOI: 10.1186/s12884-022-04400-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/10/2022] [Indexed: 01/10/2023] Open
Abstract
Background Intimate partner violence (IPV) during pregnancy is a global health problem with adverse consequences for mothers, infants and families. We hypothesise that information about IPV and safety behaviours during pregnancy has the potential to increase quality of life and the use of safety behaviours and prevent IPV. Methods A multicentre randomised controlled trial among culturally diverse pregnant women in Norway, to test the effect of a tablet-based video intervention about IPV and safety behaviours. Women attending routine antenatal check-ups alone (baseline) were screened for violence (Abuse Assessment Screen) by responding to questions on a tablet, and randomised (1:1) by computer to receive an intervention or a control video. The intervention video presented information about IPV and safety behaviours. The controls viewed a video promoting healthy pregnancy in general. Outcome measures were assessed three months post-partum: The World Health Organization Quality of Life-BREF, the Composite Abuse Scale on violence during the last 12 months and use of safety behaviours based on a 15-item checklist. A general linear model for repeated measures was used to examine the intervention’s effect. The analyses were conducted by intention to treat. Results Among 1818 eligible women, 317 reported IPV and were randomised to an intervention (157) or a control group (160). A total of 251 (79.2%) women completed the follow-up questionnaire: 120 (76.4%) in the intervention group and 131 (81.9%) in the control group. At follow-up, 115 (45.8%) women reported a history of IPV. Few women (n = 39) reported IPV during the last 12 months. No differences in quality-of-life domains and overall quality of life and health were found between the intervention and the control groups. We detected no differences between the use of safety behaviours or IPV frequency and severity during the last 12 months. Conclusion Our intervention did not improve women’s quality of life, use of safety behaviours or exposure to violence. Nevertheless, a tablet-based tool may motivate women experiencing IPV to seek help and support. More research is needed regarding tablet-based interventions for women experiencing IPV, particularly culturally sensitive interventions. Trial registration NCT03397277 registered in clinicaltrials.gov on 11/01/2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04400-z.
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12
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Román-Gálvez RM, Martín-Peláez S, Fernández-Félix BM, Zamora J, Khan KS, Bueno-Cavanillas A. Worldwide Prevalence of Intimate Partner Violence in Pregnancy. A Systematic Review and Meta-Analysis. Front Public Health 2021; 9:738459. [PMID: 34527656 PMCID: PMC8435609 DOI: 10.3389/fpubh.2021.738459] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/09/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Intimate partner violence (IPV) affects outcomes of mothers and their offspring. This systematic review collated the worldwide literature on the prevalence rates of different types of IPV in pregnancy. Methods: Two reviewers independently identified cross sectional and cohort studies of IPV prevalence in pregnancy in online databases (PubMed, WOS and Scopus), selected and extracted data [participants' country, study quality, measurement tool (validation and purpose) and rates of IPV in pregnancy]. We considered a high quality study if it had a prospective design, an adequate sampling method, a sample size estimation, a response rate > 90%, a contemporary ascertainment of IPV in the index pregnancy, and a well-developed detailed IPV tool. We performed random effects meta-analysis and explored reasons for heterogeneity of rates. Results: One hundred fifty-five studies were included, of which 44 (28%) met two-thirds of the quality criteria. Worldwide prevalence of physical (126 studies, 220,462 participants), psychological (113 studies, 189,630 participants) and sexual (98 studies, 155,324 participants) IPV in pregnancy was 9.2% (95% CI 7.7–11.1%, I2 95.9%), 18.7% (15.1–22.9%, I2 98.2%), 5.5% (4.0–7.5%, I2 93.4%), respectively. Where several types of IPV were reported combined, the prevalence of any kind of IPV (118 studies, 124,838 participants) was 25.0% (20.3, 30.5%, I2 98.6%). IPV rates varied within and between continents, being the highest in Africa and the lowest in Europe (p < 0.001). Rates also varied according to measurement purpose, being higher for diagnosis than for screening, in physical (p = 0.022) and sexual (p = 0.014) IPV. Conclusions: IPV prevalence in pregnancy varies across countries, with one-quarter of mothers exposed on average globally. Routine systematic antenatal detection should be applied worldwide. Systematic Review Registration: identifier: CRD42020176131.
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Affiliation(s)
- Rosario M Román-Gálvez
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada, Granada, Spain.,Unidad Asistencial Alhama de Granada, Servicio Andaluz de Salud, Granada, Spain
| | - Sandra Martín-Peláez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada IBS, Granada, Spain
| | - Borja M Fernández-Félix
- Clinical Biostatistics Unit, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Zamora
- Clinical Biostatistics Unit, Hospital Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Khalid S Khan
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Aurora Bueno-Cavanillas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, Granada, Spain.,Instituto de Investigación Biosanitaria de Granada IBS, Granada, Spain.,Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
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Jonsdottir IV, Sigurdardottir S, Halldorsdottir S, Jonsdottir SS. 'We experienced lack of understanding in the healthcare system'. Experiences of childhood sexual abuse survivors of the childbearing process, health and motherhood. Scand J Caring Sci 2021; 36:673-685. [PMID: 34390257 DOI: 10.1111/scs.13024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 06/07/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Childhood sexual abuse (CSA) has widespread and long-lasting impact on women's lives and health. Increased knowledge and deeper understanding are needed of survivors' experiences of the childbearing process, health and motherhood. METHODS In this phenomenological study, 16 in-depth interviews were conducted with nine female CSA survivors. The interviews were recorded, transcribed verbatim and thematically analysed. RESULTS The overarching theme of the study is: 'more understanding is needed', which refers to the participants' experience that greater understanding is needed from health professionals of the long-term effects of CSA on childbearing women. Most of the women had suffered from poor health, especially chronic pain associated with fibromyalgia and gynaecological diseases. All of them had suffered mental health consequences particularly anxiety, depression and PTSD. The majority had experienced flashbacks to the violence and disassociation. Many had experienced miscarriages, had deviations from normal pregnancies and births, such as prolonged labour, caesarean sections, induction of labour, vacuum extraction, bleeding and exaggerated pregnancy problems, such as great nausea and pelvic pain. All but one had a negative experience in one of their births. All of them had experienced a lack of understanding in the healthcare system, perceived abuse of power and felt vulnerable in those situations. All of them had a strong need for a sense of control and participation in decision-making in the childbearing process. Most of them had experienced problems in bonding with their children and some have had difficulties touching them. All of them were in dire need of protecting their children from potential violence and many expressed a tendency to overprotect them. CONCLUSIONS Healthcare professionals need to have more knowledge and greater understanding of how healthcare services can be improved so that CSA survivors can have a better experience of the childbearing process.
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Affiliation(s)
- Inga Vala Jonsdottir
- Akureyri Hospital, Eyrarlandsvegi, Akureyri, Iceland.,Akureyri Health Clinic, The Health Care Institution of North Iceland, Akureyri, Iceland
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Flaathen EME, Lukasse M, Cvancarova Småstuen M, Garnweidner-Holme L, Henriksen L. Intimate partner violence and the association of pregnancy intendedness - A cross-sectional study in southeastern Norway. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100651. [PMID: 34364196 DOI: 10.1016/j.srhc.2021.100651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 07/06/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Unintended pregnancy in the context of intimate partner violence (IPV) is a public health issue. It is associated with increased health risks for women and their children. Our objective was to investigate the association between unintended pregnancy and emotional, physical and sexual IPV in a multi-cultural population attending routine antenatal care. STUDY DESIGN A prospective cross-sectional study of 1788 pregnant women who filled out a questionnaire during pregnancy as part of a randomized controlled trial conducted in southeastern Norway. MAIN OUTCOME MEASURES Pregnancy intendedness was measured by asking women if their pregnancy was planned or not. The Abuse Assessment Screen and the Composite Abuse Scale R-SF, consisting of descriptive questions, were used to measure IPV. Chi-square tests, a Mann-Whitney U test, and binary logistic regression analysis were used. RESULTS Almost one in five women (17.4%) reported that their current pregnancy was unintended. Women with unintended pregnancy were significantly younger, had lower educational backgrounds, more limited economic resources and were more likely to be non-native Norwegian speakers. A total of 15.3% of the women reported some experience of IPV in their lifetime. These women were significantly more likely to experience an unintended pregnancy than women who had not experienced IPV, after adjusting for confounding factors: AOR = 1.74 (95% CI [1.23-2.47]). CONCLUSIONS Women who had experienced IPV were significantly more likely to have an unintended pregnancy than women who had not experienced IPV. It is of major importance to identify those women and offer appropriate services during pregnancy.
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Affiliation(s)
- Eva Marie Engebakken Flaathen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, PO Box 235, 3603 Kongsberg, Norway.
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Lisa Garnweidner-Holme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway.
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Walter B, Indreboe H, Lukasse M, Henriksen L, Garnweidner-Holme L. Pregnant Women's Attitudes Toward and Experiences With a Tablet Intervention to Promote Safety Behaviors in a Randomized Controlled Trial: Qualitative Study. JMIR Form Res 2021; 5:e28680. [PMID: 34283023 PMCID: PMC8335599 DOI: 10.2196/28680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/13/2021] [Accepted: 05/29/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is recognized as a global health problem. Women with low education and limited resources are more vulnerable, as are immigrant women. There is a lack of evidence on how health care professionals should communicate about and intervene against IPV during pregnancy. Earlier research has shown that when women manage digital questionnaires, they are more likely to disclose IPV. However, little is known about how women experience eHealth interventions with safety behaviors to prevent IPV. OBJECTIVE The aim of this study was to explore pregnant women's attitudes toward and experiences with a tablet intervention to promote safety behaviors in a randomized controlled trial (RCT) in antenatal care. METHODS Individual semistructured interviews were conducted with 10 women who participated in the Safe Pregnancy Study. The Safe Pregnancy Study was a randomized controlled trial (RCT) using a tablet intervention containing IPV questions and a film to promote safety behaviors. Six women from the intervention group and four women from the control group were recruited. The content was available in Norwegian, Somali, and Urdu. Five of the women participating in the interviews spoke Norwegian at home and five spoke another language. The majority of the women who did not speak Norwegian at home perceived themselves as relatively well integrated. The interviews were conducted at different maternal and child health centers (MCHCs) in Norway between March 2020 and June 2020. The analysis was guided by thematic analysis. RESULTS Women who participated in the tablet intervention appreciated being asked questions about IPV on a tablet. However, it was important to supplement the tablet intervention with face-to-face communication with a midwife. The MCHC was regarded as a suitable place to answer questions and watch a film about safety behaviors. Women suggested making the tablet intervention available in other settings where women meet health care professionals. Some women expressed uncertainty about their anonymity regarding their answers in the questionnaire. We found no real differences between ethnic Norwegian and immigrant women's attitudes toward and experiences with the tablet intervention. CONCLUSIONS Questions about IPV and a film about safety behaviors on a tablet, as a supplement to face-to-face communication, might initiate and facilitate communication about IPV in antenatal care. Uncertainty regarding anonymity has to be addressed when questions about IPV are being asked on a tablet. TRIAL REGISTRATION ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277.
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Affiliation(s)
- Bente Walter
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Hege Indreboe
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Vestfold, Norway
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Plamondon A, Racine N, McDonald S, Tough S, Madigan S. Disentangling adversity timing and type: Contrasting theories in the context of maternal prenatal physical and mental health using latent formative models. Dev Psychopathol 2021; 34:1-13. [PMID: 34016211 DOI: 10.1017/s0954579421000353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Research on the effects of adversity has led to mounting interest in examining the differential impact of adversity as a function of its timing and type. The current study examines whether the effects of different types (i.e., physical, sexual, and emotional abuse) and timing (i.e., early, middle childhood, adolescence, or adulthood) of adversity on maternal mental and physical health outcomes in pregnancy, are best accounted for by a cumulative model or independent effects model. Women from a prospective pregnancy cohort (N =3,362) reported retrospectively on their experiences of adversity (i.e., physical, sexual, and emotional abuse) in early childhood (0-5 years], middle childhood (6-12 years], adolescence (13-18 years], and adulthood (19+ years]. Measures of overall health, stress, anxiety, and depression were gathered in pregnancy. Results showed that a cumulative formative latent model was selected as more parsimonious than a direct effects model. Results also supported a model where the strength of the effect of adversity did not vary across abuse timing or type. Thus, cumulative adversity resulted in greater physical and mental health difficulties. In conclusion, cumulative adversity is a more parsimonious predictor of maternal physical and mental health outcomes than adversity at any one specific adversity timing or subtype.
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Affiliation(s)
- André Plamondon
- Department of Educational Fundamentals and Practices, Université Laval, Québec, Canada
| | - Nicole Racine
- Department of Psychology, Faculty of Arts, University of Calgary and Alberta Children's Hospital Research Institute, Calgary, Canada
| | - Sheila McDonald
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne Tough
- Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, Faculty of Arts, University of Calgary and Alberta Children's Hospital Research Institute, Calgary, Canada
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Lippus H, Laanpere M, Part K, Ringmets I, Karro H. Polyvictimization and the Associations Between Poor Self-Perceived Health, Dissatisfaction With Life, and Sexual Dysfunction Among Women in Estonia. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:3922-3940. [PMID: 29884111 DOI: 10.1177/0886260518780412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The severe impact of different forms of violence on health has been demonstrated in a substantial number of studies. At the same time, it has been acknowledged that different forms of violence tend to co-occur, such that many survivors of violence have been exposed to more than one violent event and/or more than one form of violence. Despite mounting evidence concerning the associations between polyvictimization and health, there are still important gaps in this knowledge concerning adult female population's sexual health, including both physical and mental aspects associated with it. The aim of this study was to evaluate the exposure to emotional, physical, and sexual violence among women and associations with poor self-perceived health, dissatisfaction with life, stress, and worry due to sex life and sexual dysfunction. The term polyvictimization is used in this article to express the exposure to more than one form of violence. We used data from a cross-sectional study carried out in Estonia in 2014 among women aged 16 to 44 years. Responses of 2,333 women were analyzed for this article. Of all the respondents, 27.9% were polyvictimized. Women who had been exposed to all three forms of violence had, after adjusting for confounding factors, the highest risk of reporting poor self-perceived health, limited daily activities due to chronic health problems, feelings of depression, dissatisfaction with life, stress, and worry due to sex life and sexual dysfunction. The results of this study demonstrate that exposure to violence is associated with poorer health outcomes and that the association is stronger among those who have been polyvictimized.
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Affiliation(s)
- Hedda Lippus
- University of Tartu, Estonia
- Emory University, Atlanta, GA, USA
| | - Made Laanpere
- University of Tartu, Estonia
- Sexual Health Clinic of Tartu, Estonia
- Tartu University Hospital, Estonia
| | - Kai Part
- University of Tartu, Estonia
- Sexual Health Clinic of Tartu, Estonia
- Tartu University Hospital, Estonia
| | | | - Helle Karro
- University of Tartu, Estonia
- Tartu University Hospital, Estonia
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18
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Fenne Fredriksen M, Nevland L, Dahl B, Sommerseth E. Norwegian midwives' experiences with screening for violence in antenatal care - A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 28:100609. [PMID: 33773144 DOI: 10.1016/j.srhc.2021.100609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 02/12/2021] [Accepted: 02/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study is to gain a better insight into and understanding of Norwegian midwives' experiences of screening for violence during antenatal care. METHODS We conducted a qualitative study of semi-structured interviews including midwives working in ten Norwegian municipalities. The interviews were analysed using systematic text condensation. RESULTS Four main themes can be drawn from the analysis. First, midwives found it difficult to raise the subject of violence, especially in the early phases of the screening programme. Second, the midwives were often provided with information about past experiences of violence, but little on ongoing violence. Third, according to the midwives, building trust was key to initiating direct questions about violence. Finally, more experience and collaboration reduced the barriers for raising the subject of violence. CONCLUSION Findings from this study suggest that screening for violence entails more than just asking a question. Furthermore, ongoing violence is difficult to identify, and women are more likely to relate stories of past violence. To overcome this issue, the midwives underlined the necessity to ask questions and have the capacity to listen to the potentially challenging answers. Findings from this study show that the training received by the midwives in relation to violence varied considerably. Hence, the study demonstrates the need for reinforced and standardised training in how to address violence in antenatal care.
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Affiliation(s)
- Mariann Fenne Fredriksen
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway
| | - Line Nevland
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway
| | - Bente Dahl
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway.
| | - Eva Sommerseth
- Centre for Women's, Family and Child Health, Faculty of Health Sciences, University of South-Eastern Norway, PO Box 235, N-3603 Kongsberg, Norway.
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Mojahed A, Alaidarous N, Kopp M, Pogarell A, Thiel F, Garthus-Niegel S. Prevalence of Intimate Partner Violence Among Intimate Partners During the Perinatal Period: A Narrative Literature Review. Front Psychiatry 2021; 12:601236. [PMID: 33633606 PMCID: PMC7900188 DOI: 10.3389/fpsyt.2021.601236] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/12/2021] [Indexed: 01/19/2023] Open
Abstract
Intimate partner violence (IPV) affects individuals and families from all backgrounds, regardless of their ethnicity, socio-economic status, sexual orientation, or religion. Pregnancy and childbirth could be a time of vulnerability to violence because of changes in physical, emotional, social, and economic demands and needs. Prevalence of IPV against women during the perinatal period is increasingly researched and documented. However, evidence on IPV prevalence among intimate partners as well as on the course of IPV over the perinatal period is scarce. The purpose of this review was to provide a narrative synthesis of the existing literature regarding the prevalence estimates of IPV among intimate partners over the perinatal period. Through this review, we also gained better insight into associated factors, as well as the various forms of IPV. Of the 766 studies assessing prevalence estimates identified, 86 were included, where 80 studies focused on unidirectional IPV (i.e., perpetrated by men against women) and six studies investigated bidirectional IPV (i.e., IPV perpetrated by both partners). Most of the included studies reported lower overall prevalence rates for unidirectional IPV postpartum (range: 2-58%) compared to pregnancy (range: 1.5-66.9%). Psychological violence was found to be the most prevalent form of violence during the entire perinatal period. Studies on bidirectional IPV mostly reported women's perpetration to be almost as high as that of their partner or even higher, yet their findings need to be interpreted with caution. In addition, our results also highlighted the associated factors of IPV among partners, in which they were assimilated into a multi-level ecological model and were analyzed through an intersectional framework. Based on our findings, IPV is found to be highly prevalent during the entire perinatal period and in populations suffering from social inequalities. Further research exploring not only the occurrence, but also the motivations and the context of the bidirectionality of IPV during the perinatal period may facilitate better understanding of the detrimental consequences on partners and their families, as well as the development of effective intervention strategies. Public health prevention approaches intervening at optimal times during the perinatal period are also needed.
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Affiliation(s)
- Amera Mojahed
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Nada Alaidarous
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, ON, Canada
| | - Marie Kopp
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
| | - Anneke Pogarell
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Freya Thiel
- Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Medical Faculty, Technical University of Dresden, Dresden, Germany
- Department of Medicine, Faculty of Medicine, Medical School Hamburg, Hamburg, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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20
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Teshome A, Gudu W, Bekele D, Asfaw M, Enyew R, Compton SD. Intimate partner violence among prenatal care attendees amidst the COVID-19 crisis: The incidence in Ethiopia. Int J Gynaecol Obstet 2021; 153:45-50. [PMID: 33368273 PMCID: PMC9087760 DOI: 10.1002/ijgo.13566] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 11/10/2022]
Abstract
Objective To assess the incidence and predictors of intimate partner violence (IPV) during pregnancy amidst the coronavirus disease 2019 pandemic. Methods This cross‐sectional study was conducted at the prenatal care clinic of St. Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia, among pregnant women from 31 August to 2 November 2020. Participants were interviewed using Open Data Kit. Logistic regression was used to assess predictors. Results Among the 464 pregnant women, 33 (7.1%) reported IPV during pregnancy, and among these 24 (72.7%) reported emotional violence, 16 (48.5%) reported sexual violence, and 10 (30.3%) reported physical violence. Among the study participants, only 8 (1.7%) were screened for IPV. IPV was reported 3.27 times more often by women who reported that their partner chewed Khat compared with those women whose partner did not (adjusted odds ratio [aOR] 3.27; 95% confidence interval [CI] 1.45–7.38), and 1.52 times more often women who reported that their partner drank alcohol compared with those women whose partner did not (aOR 1.52; 95% CI 1.01–2.28). Conclusion Very few women were screened for IPV. Partners drinking alcohol and chewing Khat are significantly positively associated with IPV during pregnancy. IPV screening should be included in the national management protocol of obstetric cases of Ethiopia. Very few women were screened for intimate partner violence during pregnancy, a finding that has implications for policy moving forward.
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Affiliation(s)
- Abel Teshome
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Wondimu Gudu
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Delayehu Bekele
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mariamawit Asfaw
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ruhama Enyew
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sarah D Compton
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
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Lippus H, Laanpere M, Part K, Ringmets I, Karro H. What do we know about the impact of sexual violence on health and health behaviour of women in Estonia? BMC Public Health 2020; 20:1897. [PMID: 33302901 PMCID: PMC7727120 DOI: 10.1186/s12889-020-09953-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 11/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexual violence against women is a major public health issue and a breach of human rights. Although various consequences of sexual violence on health have been described in a large number of scientific publications, very little is known about this topic in Estonia. The aim of this study was to examine the prevalence of sexual violence and associations between exposure to sexual violence and risky health and sexual behaviours among women in Estonia. METHODS A population-based cross-sectional study was carried out in Estonia in 2014. Self-reported data regarding selected indicators of risky health and sexual behaviours were collected from 1670 women, aged 18-44 years, via a self-administered questionnaire. To measure the prevalence of sexual violence, questions from the NorVold Abuse Questionnaire were included. Chi-square and multivariate logistic regression were used to analyse the data. RESULTS Of the respondents, 22.7% (n = 379) reported being exposed to sexual violence during their lifetime, and over half of these women had had these experiences before the age of 18. Statistically significant associations were found between sexual violence and smoking (adjusted odds ratio (AOR) 1.32, 95% CI 1.03-1.70), alcohol consumption (AOR 1.52, 95% CI 1.18-1.95), illicit drug use (AOR 2.21, 95% CI 1.70-2.89), sexual intercourse for money or other material reward (AOR 3.51, 95% CI 1.62-7.61), concurrent sexual relationships (AOR 2.64; 95% CI 1.80-3.86), and being diagnosed with sexually transmitted infections (AOR 1.48, 95% CI 1.09-2.01). CONCLUSIONS In Estonia, sexual violence against women is widespread and is associated with several risky health and sexual behaviours. Efforts should be made, both among the general public and professionals, to raise awareness regarding the prevalence and negative impact of sexual violence. Women who have been exposed to sexual violence are in need of professional medical, legal and psychological help free from prejudice to help them recover from such traumatic events.
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Affiliation(s)
- Hedda Lippus
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Made Laanpere
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
| | - Kai Part
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
| | - Inge Ringmets
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Helle Karro
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, 8 Puusepa, 51014 Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
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Flaathen EME, Lukasse M, Garnweidner-Holme L, Angelshaug J, Henriksen L. User-Involvement in the Development of a Culturally Sensitive Intervention in the Safe Pregnancy Study to Prevent Intimate Partner Violence. Violence Against Women 2020; 27:2235-2354. [PMID: 32985376 PMCID: PMC8404717 DOI: 10.1177/1077801220954274] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Intimate partner violence (IPV) during pregnancy has negative health impacts on the woman and the fetus. There is a lack of evidence supporting effective interventions to prevent IPV during pregnancy. This user-involvement study was conducted to get feedback on a culturally sensitive, tablet intervention containing questions about violence and safety-behaviors and a video promoting safety behaviors. This resulted in important feedback on the intervention content. Our findings show that women are in favor of disclosing IPV via a tablet. They suggested ways to address barriers for disclosure, such as safeguarding anonymity and creating a trustful relationship with the midwife.
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Lippus H, Soo K, Laanpere M, Yount KM, Part K, Ringmets I, Ainsaar M, Karro H. The prevalence and patterns of exposure to interpersonal violence among men and women in Estonia. PLoS One 2020; 15:e0237562. [PMID: 32797115 PMCID: PMC7428354 DOI: 10.1371/journal.pone.0237562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Background To understand better the total burden of interpersonal violence on society, it is useful to assess the prevalence of interpersonal violence among both, men and women. Exposure to multiple forms of interpersonal violence, referred to as polyvictimization, has been associated with more severe health consequences than exposure to any form separately. The aims of this study were to assess the prevalence of emotional, physical and sexual interpersonal violence in childhood, adulthood and at both childhood and adulthood among men and women in Estonia, analyze the patterns of interpersonal violence and socio-demographic correlates of polyvictimization in adulthood by gender. Methods The analysis was based on two population-based, cross-sectional, self-administered surveys carried out among men and women in Estonia in 2014. In both surveys, the NorVold Abuse questionnaire was used to measure exposure to interpersonal violence. Men and women aged 18–44 were included to the analysis. Results Among men 66.6% and among women 54.2% had been exposed to at least one form of interpersonal violence during lifetime. Men had been more often exposed to isolated physical interpersonal violence, among women the distribution of different forms of interpersonal violence was more even and exposure to sexual violence was more common. The prevalence of polyvictimization in adulthood was two times higher among women compared to men and more socio-demographic correlates, were associated with it. Exposure to violence in childhood was associated with polyvictimization in adulthood across gender. Conclusions The prevalence of interpersonal violence in Estonia is high among men and women. The most prevalent forms and patterns of interpersonal violence, however, differ by gender, as do the socio-demographic correlates. Screening for interpersonal violence, in childhood and adulthood, and gender-specific interventions are needed, especially for high-risk groups identified in this study. Primary prevention of childhood violence should be a priority, as it was associated with higher risk for exposure to violence later in life across gender.
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Affiliation(s)
- Hedda Lippus
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Kadri Soo
- Institute of Social Studies, University of Tartu, Tartu, Estonia
| | - Made Laanpere
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
| | - Kathryn M. Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Department of Sociology, Emory University, Atlanta, Georgia, United States of America
| | - Kai Part
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
- Sexual Health Clinic of Tartu, Tartu, Estonia
| | - Inge Ringmets
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Mare Ainsaar
- Institute of Social Studies, University of Tartu, Tartu, Estonia
| | - Helle Karro
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Women’s Clinic, Tartu, Estonia
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Henriksen L, Borgen A, Risløkken J, Lukasse M. Fear of birth: Prevalence, counselling and method of birth at five obstetrical units in Norway. Women Birth 2020; 33:97-104. [DOI: 10.1016/j.wombi.2018.11.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/13/2018] [Accepted: 11/19/2018] [Indexed: 11/24/2022]
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Orpin J, Papadopoulos C, Puthussery S. The Prevalence of Domestic Violence Among Pregnant Women in Nigeria: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2020; 21:3-15. [PMID: 29333978 DOI: 10.1177/1524838017731570] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To identify, appraise, and synthesize research evidence on the prevalence of domestic violence (DV) among pregnant women in Nigeria. METHOD We conducted a systematic review of all published studies between April 2004 and June 2016. Comprehensive searches were conducted on electronic databases such as PubMed, CINAHL, Global Health, MEDLINE, PsycINFO, Directory of Open Access Journals, Google Scholar, and electronic libraries of the authors' institution. Identified articles were screened in two stages against the inclusion criteria with titles and abstract screened first followed by full-text screening. Selected articles were assessed using the "guidelines for evaluating prevalence studies," and findings were synthesized narratively. RESULTS Among 19 studies that met the inclusion criteria, two articles were excluded due to low methodological quality and 17 articles were included in the review. The prevalence of DV during pregnancy in Nigeria ranged between 2.3% and 44.6% with lifetime prevalence rates ranging between 33.1% and 63.2%. Physical, sexual, psychological, and verbal abuses were the most frequent types of DV reported in this review. The most common perpetrators were husbands, as reported in 11 of the 17 studies. Pregnant women between the ages of 20 and 30 years were the most common victims of DV. CONCLUSION Our review suggests high prevalence of DV in pregnancy among women in Nigeria and higher lifetime prevalence. However, determining an overall, synthesized accurate prevalence rate of DV within this population based on existing evidence presents a challenge. The findings have important implications for stakeholders such as planners, policy makers, maternity care providers, and researchers in public health and social policy at national, regional, and international levels toward combating the issue.
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Affiliation(s)
- Joy Orpin
- Institute for Health Research, University of Bedfordshire, Luton, Bedfordshire, United Kingdom
| | - Chris Papadopoulos
- School of Health Care Practice & Institute for Health Research, University of Bedfordshire, Luton, Bedfordshire, United Kingdom
| | - Shuby Puthussery
- School of Health Care Practice & Institute for Health Research, University of Bedfordshire, Luton, Bedfordshire, United Kingdom
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Richens Y, Campbell M, Lavender T. Fear of birth-A prospective cohort study of primigravida in the UK. Midwifery 2019; 77:101-109. [PMID: 31306998 DOI: 10.1016/j.midw.2019.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/07/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE An increase in the number of women who have fear of birth [FOB] has been reported globally; yet, how these women are identified varies. This study aimed to identify the most effective way of measuring FOB in clinical practice. DESIGN This paper reports on a prospective cohort study; a core element of an explanatory mixed-methods study. This element explored the appropriateness of measures of anxiety (biomarkers and validated questionnaires) and observed any relationship between anxiety levels and clinical outcomes. PARTICIPANTS A purposive sampling strategy was used. One hundred and forty-eight primigravida, during the 1st trimester, in two tertiary maternity units in England were included. METHODS Demographic and baseline data were collected from participants in the first trimester of pregnancy along with FOB scores, and a saliva sample to measure cortisol level. In the third trimester, a second FOBS score, and saliva sample were collected, and the Personal Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were administered to measure depression and anxiety respectively. FINDINGS The FOBS was completed by 148 women in the first trimester and 80 in the third. Using a cut-off of 54, 30/148 (20%) women had a FOB in the first trimester; 21/80 (26%) had a FOB in the third trimester, 15 (19%) of whom also had a FOB in the first. Compared with the first trimester, 51/80 women showed an increase in FOBS score, with 14 scores increasing above and 8 scores decreasing below the cut-off of 54. FOBS scores were not correlated with salivary cortisol in either trimester (first trimester Spearman's ρ=0.08, p = 0.354, n = 144; third trimester ρ=0.12, p = 0.309, n = 71) but they were correlated with PHQ-9 and GAD-7 scores in the third trimester (PHQ-9 ρ=0.53, p = 0.010, n = 23; GAD-7 ρ=0.45, p = 0.033, n = 23) although not sufficiently high enough to demonstrate convergent validity against those measures of depression and anxiety. They were also associated with a previous history of depression but only in the first trimester (p = 0.011). FOBS scores showed considerable variability and a high measurement error, indicating a need for further refinement and psychometric testing. CONCLUSION The FOBS is a potentially effective way of measuring FOB in clinical practice and research, but it requires refining. Scores are not related to salivary cortisol levels but are correlated with validated scores for anxiety and depression. An enhanced version of the FOBS could be used in clinical practice to measure FOB.
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Affiliation(s)
- Yana Richens
- University College Hospital London, Elizabeth Garrett Anderson Wing, 1st Floor Antenatal Clinic, 235 Euston Road, London, United Kingdom.
| | | | - Tina Lavender
- Centre of Global Women's Health, Division of Nursing Midwifery and Social Work, The University of Manchester, Manchester, United Kingdom
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Henriksen L, Flaathen EM, Angelshaug J, Garnweidner-Holme L, Småstuen MC, Noll J, Taft A, Schei B, Lukasse M. The Safe Pregnancy study - promoting safety behaviours in antenatal care among Norwegian, Pakistani and Somali pregnant women: a study protocol for a randomized controlled trial. BMC Public Health 2019; 19:724. [PMID: 31182062 PMCID: PMC6558870 DOI: 10.1186/s12889-019-6922-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem with damaging consequences. However, little is known about the effect of violence assessment and intervention during pregnancy. We hypothesise that routine enquiry about IPV during pregnancy, in combination with information about IPV and safety behaviours, has the potential to increase the use of these behaviours and prevent and reduce IPV. METHODS The Safe Pregnancy study is a randomised controlled trial (RCT) to test the effectiveness of a tablet-based intervention to promote safety behaviours among pregnant women. Midwives include women who attend routine antenatal care. The intervention consists of a screening questionnaire for violence and information about violence and safety behaviours through a short video shown on a tablet. The materials are available in different languages to ensure participation of Norwegian, Urdu, Somali and English-speaking women. Eligible women answer baseline questions on the tablet including the Abuse Assessment Scale (AAS). Women who screen positive on the AAS will be randomized to an intervention video that contains information about violence and safety behaviours and women in the control group to a video with general information about a healthy and a safe pregnancy. All women receive information about referral resources. Follow up will be at three months post-partum, when the woman attends the maternal and child health centre (MCHC) for the baby's check-up. Outcome measures are: Use of safety behaviours and quality of life (primary outcomes), prevalence of violence, mental health measures and birth outcomes (secondary outcomes). Intention to treat analysis will be performed. DISCUSSION The project will provide evidence on whether enquiry about violence and a short video intervention on a tablet is effective and feasible to prevent or reduce harm from IPV among women who attend antenatal care. TRIAL REGISTRATION This study is registered in ClinicalTrials.gov. Identifier: NCT03397277 (Registered 11th January 2018).
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Affiliation(s)
- Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130 Oslo, Norway
| | - Eva Marie Flaathen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130 Oslo, Norway
| | - Jeanette Angelshaug
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130 Oslo, Norway
| | - Lisa Garnweidner-Holme
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130 Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130 Oslo, Norway
| | - Josef Noll
- Department of Technology Systems, University of Oslo, P.O box 20, 2007 Kjeller, Norway
| | - Angela Taft
- Judith Lumley Centre, La Trobe University, Bundoora, Melbourne, VIC 3086 Australia
| | - Berit Schei
- Department of Public Health and General Practice at the Faculty of Medicine, The Norwegian University of Science and Technology (NTNU), Håkon Jarls gate 11, N-7489 Trondheim, Norway
- Department of Gynaecology at the Women’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Sluppen, Postbox 3250, N-7006 Trondheim, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, 0130 Oslo, Norway
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Komori K, Komori M, Eitoku M, Joelle Muchanga SM, Ninomiya H, Kobayashi T, Suganuma N. Verbal abuse during pregnancy increases frequency of newborn hearing screening referral: The Japan Environment and Children's Study. CHILD ABUSE & NEGLECT 2019; 90:193-201. [PMID: 30807899 DOI: 10.1016/j.chiabu.2019.01.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/13/2019] [Accepted: 01/31/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Verbal abuse during pregnancy has a greater impact than physical and sexual violence on the incidence of postnatal depression and maternal abuse behavior towards their children. In addition, exposure of children (aged 12 months to adolescence) to verbal abuse from their parents exerts an adverse impact to the children's auditory function. However, the effect of verbal abuse during pregnancy on fetal auditory function has not yet been thoroughly investigated. OBJECTIVE The objective of the study was to examine the relationship between intimate partner verbal abuse during pregnancy and newborn hearing screening (NHS) referral, which indicates immature or impaired auditory function. PARTICIPANTS AND SETTING The Japan Environment and Children's Study is an ongoing nationwide population-based birth-cohort study designed to determine environmental factors during and after pregnancy that affect the development, health, or wellbeing of children. Pregnant women living in 15 areas of Japan were recruited between January 2011 and March 2014. METHODS Multiple imputation for missing data was performed, followed by multiple logistic regression using 16 confounding variables. RESULTS Of 104,102 records in the dataset, 79,985 mother-infant pairs submitted complete data for questions related to verbal and physical abuse and the results of NHS. Of 79,985 pregnant women, 10,786 (13.5%) experienced verbal abuse and 978 (1.2%) experienced physical abuse. Of 79,985 newborns, 787 (0.98%) received a NHS referral. Verbal abuse was significantly associated with NHS referral (adjusted odds ratio: 1.44; 95% confidence interval: 1.05-1.98). CONCLUSIONS Verbal abuse should be avoided during pregnancy to preserve the newborn's auditory function.
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Affiliation(s)
- Kaori Komori
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
| | - Masahiro Komori
- Department of Otorhinolaryngology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan.
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
| | - Sifa Marie Joelle Muchanga
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan; Department of Obstetrics and Gynecology, Medical Faculty, University of Kinshasa, Kinshasa 11, lemba, Kinshasa, Democratic Republic of the Congo
| | - Hitoshi Ninomiya
- Department of Civil and Environmental Engineering, Toyo University, 2100, Kujirai, Kawagoe, Saitama, Japan
| | - Taisuke Kobayashi
- Department of Otorhinolaryngology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, Japan
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Wangel AM, Ouis P. Reflections on the Translation Into Arabic and Validation Process of the NorAQ Abuse Questionnaire. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:585-598. [PMID: 27094009 DOI: 10.1177/0886260516644595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The use of validated instruments and questionnaires on abuse is of great importance to evaluate and compare the prevalence in different populations worldwide. However, most of the questionnaires available and published are in English. For example, the NorVold Abuse Questionnaire (NorAQ) instrument which was used for the Bidens study in six European countries. A substantial proportion of the pregnant population in the catchment area of the clinical site in Sweden is Arabic-speaking women. As abuse and violence against women is a global concern, it is important to translate these questionnaires to other languages. This process is not just merely a matter of finding a correlating word but also needs to be validated for content and consider the wording in a linguistic and cultural context. This article gives an account of the translation and content validity process and its challenges and pitfalls from Swedish and English into the Arabic language version.
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Yu H, Jiang X, Bao W, Xu G, Yang R, Shen M. Association of intimate partner violence during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China. BMC Pregnancy Childbirth 2018; 18:469. [PMID: 30509253 PMCID: PMC6276257 DOI: 10.1186/s12884-018-2113-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 11/22/2018] [Indexed: 12/03/2022] Open
Abstract
Background Intimate partner violence (IPV) among pregnant women constitutes a global public health problem and a potential risk factor for adverse maternal and fetal outcomes. The present study aimed to examine the associations among IPV during pregnancy, prenatal depression, and adverse birth outcomes in Wuhan, China. Methods A cross-sectional study was performed from April 2013 to March 2014 in Wuhan, China. Sociodemographic characteristics, IPV during pregnancy, and depressive symptoms during pregnancy were assessed in the third trimester of pregnancy. Birth outcomes were collected after delivery using medical records. Chi-square tests and logistic regression analysis were used to examine the association between IPV and prenatal depression, as well as the association between IPV combined with prenatal depression and adverse birth outcomes. Results After adjustment for covariates, there was a statistically significant association between IPV during pregnancy and prenatal depression (adjusted odds ratio [aOR] = 2.50, 95% confidence interval [CI]: 1.60–3.90). IPV during pregnancy (aOR = 1.67, 95% CI: 1.08–2.56) and prenatal depression (aOR = 1.72, 95% CI: 1.11–2.68) were significantly associated with adverse birth outcomes. Women experiencing psychological abuse had a significantly higher odds of prenatal depression (aOR = 2.04, 95% CI: 1.19–3.49) and of adverse birth outcomes (aOR = 2.13, 95% CI: 1.08–2.58), compared with women who did not experience IPV and prenatal depression. Conclusions IPV during pregnancy and prenatal depression were significantly associated with adverse birth outcomes, after adjustment for socio-demographic and behavior factors. The findings suggest that early recognition of IPV and prenatal depression during antenatal care may protect pregnant women and improve birth outcomes.
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Affiliation(s)
- Honghui Yu
- Department of Anesthesiology, Tongji Hospital affiliated Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xueyan Jiang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA
| | - Guifeng Xu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, 52242, USA.,Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, IA, 52242, USA
| | - Rong Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430015, China
| | - Min Shen
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Pengpid S, Peltzer K, Laosee O, Suthisukon K. Intimate partner sexual violence and risk for femicide, suicidality and substance use among women in antenatal care and general out-patients in Thailand. BMC Womens Health 2018; 18:37. [PMID: 29409489 PMCID: PMC5802095 DOI: 10.1186/s12905-018-0526-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about the occurrence and health consequences of intimate partner sexual assault. The aim of this study was to assess the prevalence and correlates of sexual assault in the context of intimate partner violence (IPV) in Thailand. METHODS In a cross-sectional survey adult female participants were systematically screened (self-administered or interview administered) for IPV in antenatal care and general outpatient clinics in nine randomly selected hospitals in two provinces in the central region. Measures included the Abuse Assessment Screen, Severity of Violence Against Women Scale, Danger assessment and suicidal behaviour. RESULTS From 14,288 women screened, 1.5% were positive for IPV and 207 participated in the study. The mean age of the study participants was 26.8 years (SD = 9.3). Fifty-seven women, 27.5% of the sample, reported sexual assault, one or more times, during the relationship in the past 12 months. Most reported some form of psychological abuse (82.1%), physical violence (67.1%) and danger (72.0%). In all, 21.3% reported psychological, physical and sexual violence. Bivariate analyses found that older age, being recruited in the general out-patient department, greater number of children, high psychological abuse, high physical violence, danger and suicidal behaviour in the past 12 months were associated with sexual assault. In multivariable backward conditional logistic regression physical violence (OR = 5.32, CI = 2.52-11.24) and suicidal behaviour (OR = 3.28, CI = 1.37-7.83) were found to be associated with sexual assault. CONCLUSIONS The study found a moderate rate of sexual assault in intimate violent partner relationships and those sexual assaults are more likely to co-occur with physical intimate partner violence and suicidal behaviour. This knowledge may be helpful in the detection and management of sexual assault in intimate violent partner relationships of women in health care settings in Thailand.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom, 73170 Thailand
- Department of Research & Innovation, University of Limpopo, Sovenga, 0727 South Africa
| | - Karl Peltzer
- Department of Research & Innovation, University of Limpopo, Sovenga, 0727 South Africa
- HIV/AIDS/STI/and TB (HAST), Human Sciences Research Council, Pretoria, 0001 South Africa
| | - Orapin Laosee
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom, 73170 Thailand
| | - Kawinarat Suthisukon
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom, 73170 Thailand
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Henriksen L, Grimsrud E, Schei B, Lukasse M. Factors related to a negative birth experience – A mixed methods study. Midwifery 2017; 51:33-39. [DOI: 10.1016/j.midw.2017.05.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/19/2017] [Accepted: 05/06/2017] [Indexed: 01/22/2023]
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Finnbogadóttir H, Mellgren C. The degree of suffering among pregnant women with a history of violence, help-seeking, and police reporting. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:23-28. [PMID: 28844354 DOI: 10.1016/j.srhc.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 04/13/2017] [Accepted: 05/23/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To explore the degree of self-reported suffering following violent incidents and the prevalence of police reporting as well as other help-seeking behaviour among women in early pregnancy with history of violence. STUDY DESIGN A cross-sectional design. 1939 pregnant women≥18years were recruited prospectively between March 2012 and September 2013 in south-west Sweden. Of those, 761 (39.5%) reported having a history of violence, and they comprised the cohort investigated in the present study. Descriptive statistics, Chi-square analysis, and T-test were used for the statistical calculations. RESULTS More than four of five women (80.5%) having a history of emotional abuse (n=374), more than half (52.4%) having history of physical abuse (n=561), and almost three of four (70.6%) who experienced sexual abuse (n=302) reported in the early second trimester of their pregnancy that they still suffered from their experience. Of those women who had experienced emotional, physical, and sexual abuse, 10.5%, 25.1%, and 18.0%, respectively, had never disclosed their experiences to anyone. At most, a quarter of the abused women had reported a violent incident to the police. CONCLUSIONS All midwives and other actors who meet women with experience of abuse need to have increased knowledge about the long-term consequences of all types of abuse. Increased routine questioning of pregnant women about history of violence would help to prevent experiences of violence from affecting pregnancy and childbirth negatively and facilitate the provision of help and support.
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Affiliation(s)
- Hafrún Finnbogadóttir
- Faculty of Health and Society, Department of Care Science, Malmö University, Sweden.
| | - Caroline Mellgren
- Faculty of Health and Society, Department of Criminology, Malmö University, Sweden.
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Tomasdottir MO, Kristjansdottir H, Bjornsdottir A, Getz L, Steingrimsdottir T, Olafsdottir OA, Sigurdsson JA. History of violence and subjective health of mother and child. Scand J Prim Health Care 2016; 34:394-400. [PMID: 27822978 PMCID: PMC5217285 DOI: 10.1080/02813432.2016.1249060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child's health. SETTING AND SUBJECTS In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5-6 months after delivery. Data were collected by postal questionnaires. MAIN OUTCOME MEASURES Women's reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child's perceived health. RESULTS In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p < 0.001), compared to those who did not report violence. Their pregnancies were more frequently unplanned (p < 0.001), deliveries more often by caesarean section (p < 0.05), and their self-perceived health was worse (p < 0.001). They reported more mental and somatic health complaints, and their use of antidepressant drugs was higher (p < 0.001). Furthermore, women with a history of violence considered their child's general health as worse (p = 0.008). CONCLUSIONS Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18-24 months after birth. KEY POINTS Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda. • The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland. • Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history. • Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history. • The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.
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Affiliation(s)
- Margret O. Tomasdottir
- Department of Family Medicine, University of Iceland, Reykjavik, Iceland
- Center of Development, Primary Health Care of the Capital Area, Reykjavik, Iceland
- General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- CONTACT Margret Olafia Tomasdottir Department of Family Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | - Linn Getz
- General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Thora Steingrimsdottir
- Department of Obstetrics and Gynaecology, Landspitali University Hospital, and Faculty of Medicine, University of Iceland
| | | | - Johann A. Sigurdsson
- Department of Family Medicine, University of Iceland, Reykjavik, Iceland
- Center of Development, Primary Health Care of the Capital Area, Reykjavik, Iceland
- General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Larsson Å, Wärnå-Furu C, Näsman Y. The meaning of caring in prenatal care from Swedish women's perspectives. Scand J Caring Sci 2016; 31:702-709. [PMID: 27859526 DOI: 10.1111/scs.12383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 07/19/2016] [Indexed: 11/30/2022]
Abstract
AIM To deepen understanding of the meaning of caring in prenatal care from Swedish women's perspectives. METHOD Ten women, who had given birth between 1 and 2 months previously, were interviewed. The women have taken part in the routine programme that constitutes maternity care Sweden. A hermeneutic approach inspired by Gadamer was used to analyse the data and gain a deeper understanding of the women's experiences. FINDINGS Three themes were identified in the hermeneutical analysis. The themes highlight an existential and ontological aspect for caring as experienced of the women in the study: invitation and caring promise, witnessing and confirmation, and caring emerges in vulnerability. CONCLUSION The life-changing gravidity and vulnerability motivates caritative care during pregnancy. Reception of caring is not just a superficial feeling, but gives a new understanding of life on an ontological level. In a genuine caring relationship, the pregnant woman not only receives something but also a power and an opportunity to go further and find her own inner strength.
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Affiliation(s)
- Åsa Larsson
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
| | - Carola Wärnå-Furu
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
| | - Yvonne Näsman
- Faculty of Education and Welfare Studies, Åbo Akademi University, Vasa, Finland
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Finnbogadóttir H, Dykes AK. Increasing prevalence and incidence of domestic violence during the pregnancy and one and a half year postpartum, as well as risk factors: -a longitudinal cohort study in Southern Sweden. BMC Pregnancy Childbirth 2016; 16:327. [PMID: 27784283 PMCID: PMC5081903 DOI: 10.1186/s12884-016-1122-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 10/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Domestic violence is a global health problem as well as a violation against human rights. The aim of this study was to explore prevalence and incidence of domestic violence during pregnancy and 1 to 1.5 years postpartum as well as to explore the history of violence among new mothers in the southwestern region of Sweden. In addition, the aim was to explore the association between domestic violence postpartum and possible risk factors. METHODS This is a longitudinal cohort-study including pregnant women ≥ 18 years of age. Total 1939 pregnant women were recruited to the study and requested to answer three questionnaires (QI-III) during pregnancy and postpartum. Statistical analysis were descriptive statistics, logistic regression and multiple regression with Odds ratios (OR) and 95 % confidence intervals (95 % CI). RESULTS The response rate for those who received the Q-III (n = 755) at a Child Welfare Center was almost 97 % (n = 731). When all three questionnaires were answered the prevalence of domestic violence during pregnancy irrespective of type or severity was reported by 2.5 % (n = 40/1573). At 1 to 1.5 years postpartum the prevalence of domestic violence had increased to 3.3 % (n = 23/697). The incidence was 14 per 1000 women during pregnancy and 17.2 per 1000 women postpartum. The strongest risk factor for domestic violence reported at1-1.5 years postpartum was a history of violence whereby all of the women (n = 23) who had revealed their exposure to domestic violence postpartum also reported a history of violence (p < 0.001). Being single/living apart gave a 12.9 times higher risk for domestic violence postpartum (AOR 12.9; 95 % CI: 4.5-37.1). Having several symptoms of depression and a low score on the SOC-scale gave a 3.5 and 3.0 times higher risk respectively (AOR 3.5; 95 % CI: 1.2-10.4) and (AOR 3.0; 95 % CI 1.1-8.3). CONCLUSION Domestic violence increases as the pregnancy develops and postpartum. A history of violence and being single/living apart may be strong indicators for domestic violence during pregnancy as well as postpartum. Also, having symptoms of depression are associated with domestic violence both during pregnancy and postpartum. Collaboration between health care providers at Antenatal and Welfare centres is essential.
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Affiliation(s)
- Hafrún Finnbogadóttir
- Department of Care Science, Faculty of Health and Society, Malmoe University, Malmoe, Sweden
| | - Anna-Karin Dykes
- Department of Care Science, Faculty of Health and Society, Malmoe University, Malmoe, Sweden
- Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden
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Ryding EL, Lukasse M, Kristjansdottir H, Steingrimsdottir T, Schei B. Pregnant women's preference for cesarean section and subsequent mode of birth - a six-country cohort study. J Psychosom Obstet Gynaecol 2016; 37:75-83. [PMID: 27269591 DOI: 10.1080/0167482x.2016.1181055] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The rate of cesarean section (CS) for non-medical reasons has risen and it is a concern for health care. Women's preferences may vary across countries for psychosocial or obstetric reasons. METHODS A prospective cohort study of 6549 women in routine antenatal care giving birth in Belgium, Iceland, Denmark, Estonia, Norway or Sweden. Preference for mode of birth was self-reported in mid-pregnancy. Birth outcome data were collected from hospital records. RESULTS A CS was preferred by 3.5% of primiparous women and 8.7% of the multiparous women. Preference for CS was associated with severe fear of childbirth (FOC), with a negative birth experience in multiparous women and with depressive symptoms in the primiparous. Women were somewhat more prone to prefer a cesarean in Iceland, odd ratio (OR) 1.70 (1.02-2.83), adjusted for age, education, depression, FOC, history of abuse, previous cesarean and negative birth experience. Out of the 404 women who preferred CS during pregnancy, 286 (70.8%) delivered by CS, mostly for a medical indication. A total of 9% of the cesareans in the cohort had a non-medical indication only. CONCLUSIONS Women's preference for CS often seems to be due to health concerns. Both medical and psychological factors need to be addressed in antenatal counseling. Obstetricians need to convey accurately to women the risks and benefits of CS in her specific case. Maternity professionals should identify and explore psychosocial reasons for women's preferences.
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Affiliation(s)
- Elsa Lena Ryding
- a Department of Women's and Children's Health, Division of Obstetrics and Gynecology , Karolinska Institutet , Stockholm , Sweden
| | - Mirjam Lukasse
- b Department of Health, Nutrition and Management , Oslo and Akershus University College of Applied Sciences , Oslo , Norway
| | - Hildur Kristjansdottir
- c Department of Midwifery, Faculty of Nursing , Landspitali University Hospital , Reykjavik , Iceland ;,d Department of Obstetrics and Gynecology , Landspitali University Hospital , Reykjavik , Iceland
| | - Thora Steingrimsdottir
- d Department of Obstetrics and Gynecology , Landspitali University Hospital , Reykjavik , Iceland
| | - Berit Schei
- e Department of Public Health and General Practice , Norwegian University of Science and Technology , Trondheim , Norway ;,f Department of Obstetrics and Gynecology , St. Olav's University Hospital , Trondheim , Norway
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Finnbogadóttir H, Dykes AK, Wann-Hansson C. Prevalence and incidence of domestic violence during pregnancy and associated risk factors: a longitudinal cohort study in the south of Sweden. BMC Pregnancy Childbirth 2016; 16:228. [PMID: 27530993 PMCID: PMC4988038 DOI: 10.1186/s12884-016-1017-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 08/05/2016] [Indexed: 11/19/2022] Open
Abstract
Background Domestic violence during pregnancy is not only a severe public health issue that jeopardizes maternal and foetal health but also violates human rights. The aim was to explore the prevalence and incidence of domestic violence among pregnant women, in the southwestern region of Scania in Sweden, and their experience of a history of violence. In addition, to explore the association between domestic violence during pregnancy and possible risk factors. Methods This is a longitudinal cohort-study including pregnant women ≥18 years of age, registered at antenatal care when pregnant. A cohort of 1939 pregnant women answered Questionnaire I (QI) in gestational week 13 (mean 12.8 week, SD 5.11). Response rate of Questionnaire II (QII) in gestation week 34 (mean 33.9 week, SD 2.2) was 78.8 % (n = 1527). Statistical analysis was descriptive statistics, logistic regression and multiple regression with Odds ratios (OR) and 95 % confidence intervals (95 % CI). Results Both QI and QII were completed by 77.8 % (n = 1509) of the women and 44.3 % (n = 668) reported a lifetime experience of abuse irrespective of type, severity or perpetrator. Also, 5.1 % (n = 77) reported some experience of abuse past year. Prevalence of domestic violence during pregnancy was 2.0 % (n = 29) and the incidence was 7.3 new cases per 1000 women. The strongest risk factor for domestic violence, during early and late pregnancy, was history of violence whereby all women who disclosed exposure had also reported history of violence (p < 0.001). To be single/living apart gave 8.4 times more risk associated with domestic violence during pregnancy (AOR 8.4; 95 % CI: 2.2–32.6). Having several symptoms of depression and lack of sleep gave 3.8 times more risk respectively (AOR 3.8; 95 % CI: 1.1–13.6) and (AOR 3.8; 95 % CI 1.1–12.9). Conclusions Pregnant women with a history of violence as well as being single/living apart and/or having several symptoms of depression during pregnancy should be alerts for clinical working midwives and obstetricians. Further, this is important knowledge for health care providers to develop or upgrade guidelines and plans of action for pregnant women exposed to violence.
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Affiliation(s)
- Hafrún Finnbogadóttir
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmoe, Sweden.
| | - Anna-Karin Dykes
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmoe, Sweden.,Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden
| | - Christine Wann-Hansson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmoe, Sweden
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Henriksen L, Schei B, Lukasse M. Lifetime sexual violence and childbirth expectations - A Norwegian population based cohort study. Midwifery 2016; 36:14-20. [PMID: 27106939 DOI: 10.1016/j.midw.2016.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/13/2016] [Accepted: 02/23/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE this study aimed to explore the association between lifetime sexual violence and expectations about childbirth. DESIGN Norwegian population-based cohort study. SETTING women presenting for routine ultrasound examinations were recruited to the Norwegian Mother and Child Cohort Study between 1999 and 2008. POPULATION 78,660 pregnant women. METHODS sexual violence and expectations about childbirth were self-reported during pregnancy using postal questionnaires. Risk estimations were performed using multivariable logistic regression analysis and stratified by parity. MAIN OUTCOME MEASURES fear of childbirth, the thoughts about pain relief, worries about the infant's health and looking forward to the arrival of the infant. FINDINGS of 78,660 women, 18.4% reported a history of sexual violence and 0.9% were exposed to sexual violence within the last 12 months, including during the current pregnancy. We found that nulliparous women who reported previous or recent sexual violence had a decrease in the odds of looking forward to the arrival of the infant with an AOR of 0.8 (95% CI 0.7-0.9) and 0.4 (95% CI 0.3-0.6), respectively, compared to non-abused women. The same pattern was observed among multiparous women and they were more likely to report worries about the infant's health. Severe sexual violence (rape) was associated with concerns about childbirth, especially for nulliparous women that were more likely to express fear of birth, a hope for a pain-free birth, a desire for caesarean section and worries about the infant's health than non-exposed women. CONCLUSIONS women with a lifetime exposure to sexual violence, both past experiences and within the last 12 months, were less likely to look forward to the arrival of the infant than non-exposed women, and they were more likely to worry about the infant's health. Women with experiences of severe sexual violence (rape) had more concerns about childbirth than women without this experience. This finding shows that exploring women's attitudes toward childbirth may work as an approach when examining exposure to violence.
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Affiliation(s)
- Lena Henriksen
- Section of Obstetrics at the Department for Women's and Children's Health, Oslo University Hospital, Postboks 4950 Nydalen, N-0424 Oslo, Norway.
| | - Berit Schei
- Department of Public Health and General Practice at the Faculty of Medicine, The Norwegian University of Science and Technology (NTNU), Håkon Jarls gate 11, N-7489 Trondheim, Norway; Department of Gynecology at the Women's Clinic, St.Olavs Hospital, Trondheim University Hospital, Postbox 3250 Sluppen, N-7006 Trondheim, Norway.
| | - Mirjam Lukasse
- Department of Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Postboks 364 Alnabru, N-0614 Oslo, Norway.
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Inter-relationships between sexual abuse, female sexual function and childbirth. Midwifery 2015; 31:1087-95. [DOI: 10.1016/j.midw.2015.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 06/13/2015] [Accepted: 07/20/2015] [Indexed: 12/31/2022]
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Escribà-Agüir V, Ruiz-Pérez I, Artazcoz L, Martín-Baena D, Royo-Marqués M, Vanaclocha-Espí M. Validity and Reliability of the Spanish Version of the "Abuse Assessment Screen" among Pregnant Women. Public Health Nurs 2015; 33:264-72. [PMID: 26464044 DOI: 10.1111/phn.12232] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the reliability, accuracy, and construct validity of the Spanish Abuse Assessment Screen (AAS) among pregnant women using the Spanish version of Index of Spouse Abuse (ISA) as a reference standard. DESIGN AND SAMPLE Cross-sectional survey. A total of 1,329 pregnant women were selected in nine primary care centers during 2008-2009. MEASURES The Spanish ISA was self-administered first, followed by the AAS, administered by the midwife. Sensitivity, specificity, and predictive values of the Spanish AAS were compared with the Spanish version of the ISA as a reference standard. RESULTS Percentage of agreement between initial and retest administration of the Spanish AAS was high, from 96.4% to 100%. Specificity was for all types of abuse above 97%, but sensitivity values were much lower (33.3%, 22.9%, 6.9%, for severe physical abuse, minor psychological abuse, and minor physical abuse, respectively). The sensitivity of severe psychological abuse was perfect. Construct validity was good. CONCLUSION The Spanish AAS has good test-retest reliability, specificity, and construct validity. The sensitivity was good for severe psychological abuse and moderate for severe physical abuse. Further formal psychometric evaluations, in other languages from countries with low prevalence of abuse, remains a priority for clinical and research efforts in pregnancy domestic violence screening.
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Affiliation(s)
- Vicenta Escribà-Agüir
- Health Promotion and Biomedical Research Fundation (FISABIO), Valencia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Nursing, University of Valencia, Valencia, Spain
| | - Isabel Ruiz-Pérez
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Andalusia School of Public Health, Granada, Spain
| | - Lucía Artazcoz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Agència de Salut Pública, Barcelona, Spain
| | | | | | - Mercedes Vanaclocha-Espí
- Health Promotion and Biomedical Research Fundation (FISABIO), Valencia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Lukasse M, Laanpere M, Karro H, Kristjansdottir H, Schroll AM, Van Parys AS, Wangel AM, Schei B. Pregnancy intendedness and the association with physical, sexual and emotional abuse - a European multi-country cross-sectional study. BMC Pregnancy Childbirth 2015; 15:120. [PMID: 26008119 PMCID: PMC4494794 DOI: 10.1186/s12884-015-0558-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 05/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unintended pregnancies are common and when not resulting in a termination of pregnancy may lead to unintended childbirth. Unintended pregnancies are associated with increased health risks, also for women for whom pregnancy continues to childbirth. Our objective was to present the prevalence of unintended pregnancy in six European countries among pregnant women attending routine antenatal care, and to investigate the association with a history of physical, sexual and emotional abuse. METHODS A prospective cross-sectional study, of 7102 pregnant women who filled out a questionnaire during pregnancy as part of a multi-country cohort study (Bidens) with the participating countries: Belgium, Iceland, Denmark, Estonia, Norway and Sweden. A validated instrument, the Norvold Abuse Questionnaire (NorAq) consisting of 10 descriptive questions measured abuse. Pregnancy intendedness was assessed using a single question asking women if this pregnancy was planned. Cross-tabulation, Chi-square tests and binary logistic regression analysis were used. RESULTS Approximately one-fifth (19.2 %) of all women reported their current pregnancy to be unintended. Women with an unintended pregnancy were significantly younger, had less education, suffered economic hardship, had a different ethnic background from the regional majority and more frequently were not living with their partner. The prevalence of an unintended pregnancy among women reporting any lifetime abuse was 24.5 %, and 38.5 % among women reporting recent abuse. Women with a history of any lifetime abuse had significantly higher odds of unintended pregnancy, also after adjusting for confounding factors, AOR for any lifetime abuse 1.41 (95 % CI 1.23-1.60) and for recent abuse AOR 2.03 (95 % CI 1.54-2.68). CONCLUSION Women who have experienced any lifetime abuse are significantly more likely to have an unintended pregnancy. This is particularly true for women reporting recent abuse, suggesting that women living in a violent relationship have less control over their fertility.
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Affiliation(s)
- Mirjam Lukasse
- Institutt for Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
| | - Made Laanpere
- Department of Obstetrics and Gynaecology,, University of Tartu, Tartu, Estonia. .,Tartu University Hospital Women's Clinic, Tartu, Estonia.
| | - Helle Karro
- Department of Obstetrics and Gynaecology,, University of Tartu, Tartu, Estonia. .,Tartu University Hospital Women's Clinic, Tartu, Estonia.
| | | | | | - An-Sofie Van Parys
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium.
| | | | - Berit Schei
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. .,Department of Obstetrics and Gynaecology, St. Olav's University Hospital, Trondheim, Norway.
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Lukasse M, Schroll AM, Karro H, Schei B, Steingrimsdottir T, Van Parys AS, Ryding EL, Tabor A. Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries. Acta Obstet Gynecol Scand 2015; 94:508-17. [DOI: 10.1111/aogs.12593] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/18/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Mirjam Lukasse
- Department of Health, Nutrition and Management; Faculty of Health Sciences; Oslo and Akershus University College of Applied Sciences; Oslo Norway
| | - Anne-Mette Schroll
- Center of Fetal Medicine; Department of Obstetrics; Copenhagen University Hospital; Rigshospitalet; Copenhagen Denmark
| | - Helle Karro
- Department of Obstetrics and Gynecology; University of Tartu; Tartu Estonia
| | - Berit Schei
- Department of Public Health and General Practice at the Faculty of Medicine; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Obstetrics and Gynecology; St. Olav's University Hospital; Trondheim Norway
| | - Thora Steingrimsdottir
- Department of Obstetrics and Gynecology; Landspitali University Hospital; Reykjavik Iceland
| | | | - Elsa Lena Ryding
- Department of Women's and Children's Health; Division of Obstetrics and Gynecology; Karolinska Institute; Solna Sweden
| | - Ann Tabor
- Center of Fetal Medicine; Department of Obstetrics; Copenhagen University Hospital; Rigshospitalet; Copenhagen Denmark
- Faculty of Health Sciences; Copenhagen University; Copenhagen Denmark
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Byrskog U, Olsson P, Essén B, Allvin MK. Being a bridge: Swedish antenatal care midwives' encounters with Somali-born women and questions of violence; a qualitative study. BMC Pregnancy Childbirth 2015; 15:1. [PMID: 25591791 PMCID: PMC4299129 DOI: 10.1186/s12884-015-0429-z] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 01/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Violence against women is associated with serious health problems, including adverse maternal and child health. Antenatal care (ANC) midwives are increasingly expected to implement the routine of identifying exposure to violence. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. Thus, the aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence. METHODS Qualitative individual interviews with 17 midwives working with Somali-born women in nine ANC clinics in Sweden were analyzed using thematic analysis. RESULTS The midwives strived to focus on the individual woman beyond ethnicity and cultural differences. In relation to the Somali born women, they navigated between different definitions of violence, ways of handling adversities in life and social contexts, guided by experience based knowledge and collegial support. Seldom was ongoing violence encountered. The Somali-born women's' strengths and contentment were highlighted, however, language skills were considered central for a Somali-born woman's access to rights and support in the Swedish society. Shared language, trustful relationships, patience, and networking were important aspects in the work with violence among Somali-born women. CONCLUSION Focus on the individual woman and skills in inter-cultural communication increases possibilities of overcoming social distances. This enhances midwives' ability to identify Somali born woman's resources and needs regarding violence disclosure and support. Although routine use of professional interpretation is implemented, it might not fully provide nuances and social safety needed for violence disclosure. Thus, patience and trusting relationships are fundamental in work with violence among Somali born women. In collaboration with social networks and other health care and social work professions, the midwife can be a bridge and contribute to increased awareness of rights and support for Somali-born women in a new society.
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