Health behavior in Mexican pregnant women with a history of violence

Women's Experiences of Domestic Violence during Pregnancy: A Qualitative Research in Greece

This qualitative research is the second part of a quantitative research that aims at recording the phenomenon of violence in pregnancy. The first part was carried out during August and September 2009 (N = 546). It was found out that the rate partner’s violence was 6%, while for 3.4% of the pregnant women, abuse started after the pregnancy. In the second part of this research, the semi-structured interview was used to investigate the way pregnant women experience violence. The sample comprised seven women abused by their partner (Ν = 7) at the women’s shelters of “Mitera” Babies’ Center and the National Social Solidarity Center between September 2010 and December 2011 and who accepted to participate in the research. The targets of the research were the investigation of the risk factors for the manifestation of violence, the profile of the victim and the perpetrator, the consequences of abuse for the woman, her reproductive health and the fetus. The majority of the abused pregnant women were foreigners and only two were Greek. The latter had experienced severe traumas (physical and psychological) since their childhood. Violence in their lives is the main characteristic of the foreign women seeking a better life in Greece, too. Alcohol use or abuse by the partners, poor socioeconomic background of the mothers and their partners, and pregnancy per se are the main risk factors of the violence against women in this period of their lives. Violence resulted in miscarriage in one case, while abortion was the alternative chosen by another as a solution to social exclusion and possible domestic violence. Anxiety and despair were the main psychological consequences. The small number of women included in the collection of qualitative data is a limitation for the research and decreases the reliability index of its results.

Domestic Violence During Pregnancy in Greece

There are no data about the prevalence of domestic violence during pregnancy in Greece. The purpose of this study is to determine the prevalence and the associated factors of domestic violence in a representative population of pregnant women in Greece. Five hundred and forty-six consecutive women, in outpatient clinics of two Public General Regional Hospitals in Athens, agreed to answer anonymously the Abuse Assessment Screen (AAS) questionnaire, translated into the Greek language. Five hundred and forty-six questionnaires were returned (100% response rate), revealing that the prevalence of domestic violence in pregnancy is 6%, with 3.4% of the sample having being abused since the beginning of pregnancy, mainly by their husband/partner. The factors associated with higher risk of abuse during pregnancy were nationality, socio-economic background, and educational level. Foreign women or women with a foreign partner, unemployed individuals, housewives, and university students faced a higher risk of being abused. A substantial age difference (≥10 years) in the couple, a history of abortions, and an undesired pregnancy also increased the risk of violence in pregnancy. These findings suggest that prenatal care is an important period for discussing abuse and, in the end, encouraging women to seek help.

EXCLUSIVE BREASTFEEDING AND MATERNAL SELF-EFFICACY AMONG WOMEN OF INTIMATE PARTNER VIOLENCE SITUATIONS

ABSTRACT This study aims to evaluate the practice of breastfeeding among women in intimate partner violence situation during the current pregnancy for the duration of exclusive breastfeeding, the level of self-efficacy in breastfeeding, related factors from the beginning, the establishment of breastfeeding and early weaning. Cross-sectional study. 63 women in intimate partner violence situation in the current pregnancy participated, identified by survey in antenatal service. Data collection was performed in the prenatal and postpartum period. We used a questionnaire to identify the intimate partner violence, the Breastfeeding Self-Efficacy Scale and medical record information. The average days of exclusive breastfeeding was 19.08. There was no statistically significant association between the duration of exclusive breastfeeding at 30 and 70 days postpartum and intimate partner violence and care practices with level of self-efficacy to breastfeed. We found association between the type of breastfeeding at 30 and 70 days postpartum and better conditions vital of newborns with level of self-efficacy to breastfeed.

Stereotypes of Intimate Partner Violence: Do Sex and Sexual Orientation Matter?

Abstract This study analyzed stereotypes on intimate partner violence (IPV) of heterosexual and same-sex couples. The participants, 232 Mexican college students, evaluated physical and psychological IPV exerted by men and women with different sexual orientations. The data were analyzed using the Wilcoxon test. The results indicate that men evaluated women and gay men as having a similar IPV, while men´s perceptions of IPV for these groups were higher than those of women. Women viewed heterosexual men as the most violent and evaluated the other groups with different degrees of IPV. Physical violence is regarded as natural in men, both gay and heterosexual. To conclude, the results suggest that IPV stereotypes are affected by the sex of the evaluators and by their sexual orientation. It is relevant to expand the scope of prevention programs.

Maternal and fetal outcomes of intimate partner violence associated with pregnancy in the Latin American and Caribbean region

BACKGROUND

Very high rates of intimate partner violence during pregnancy (IPV-P) are reported in Latin America and the Caribbean (LAC) but data on prevalence and obstetric-related outcomes are limited.

OBJECTIVES

To conduct a literature review on risk factors, prevalence, and adverse obstetric-related outcomes of IPV-P in LAC.

SEARCH STRATEGY

Systematic review of studies in MEDLINE (1946-2012) and LILACS (1982-2012), and hand searching of reference lists of included studies. Search terms were variations of partner abuse and pregnancy in LAC.

SELECTION CRITERIA

Studies were excluded if they did not include IPV-P prevalence or if the perpetrator was not an intimate partner.

DATA COLLECTION AND ANALYSIS

Study quality was assessed via US Preventive Services Task Force criteria.

MAIN RESULTS

In the 31 studies included, prevalence rates ranged from 3% to 44%. IPV-P was significantly associated with unintended pregnancies and adverse maternal (depression, pregnancy-related symptom distress, inadequate prenatal care, vaginal bleeding, spontaneous abortion, gestational weight gain, high maternal cortisol, hypertension, pre-eclampsia, STIs) and infant (prematurity, low birth weight, neonatal complications, stillbirth) outcomes (grade II-2 and 3 evidence).

CONCLUSIONS

IPV-P is highly prevalent in LAC, with poor obstetric-related outcomes. Clinicians must identify women experiencing IPV-P and institute appropriate interventions and referrals to avoid its deleterious consequences.

Violence against women and postpartum depression: the experience of Chilean women

This article is based on the findings from a cross-sectional study of women (N = 163) who were at least two weeks postpartum and attending primary care clinics in Arica, Chile. The researcher in this study examined the prevalence of history of violence and its association with postpartum depression. The Women Abuse Screen and the Postpartum Depression Screening Scale-Spanish version were used to assess interpersonal violence and postpartum depression. A history of violence was reported by 64% of the women. Of those who experienced abuse, 44% reported ongoing abuse during their pregnancy. Women who experienced violence screened positive for elevated symptoms categories of postpartum depression such as anxiety/insecurity, emotional lability, and mental confusion compared to women who had not experienced violence. Postpartum depression symptom reporting decreased with increasing number of pregnancies (OR = 0.70, 95% CI 0.54-0.97) and greater social support (OR = 0.64, 95% CI 0.46-0.88). Postpartum depression symptom reporting increased with smoking (OR = 1.71, 95% CI 1.00-2.86), and with reporting history of violence (OR = 1.79, 95% CI 1.24-2.34). Acknowledgment of the strong association between domestic violence and postpartum depression should lead to routine screening during prenatal and postpartum periods as a way to isolate risk for postpartum depression.

Impacts of domestic violence on child growth and nutrition: a conceptual review of the pathways of influence

Domestic violence against women is a global problem, and young children are disproportionate witnesses. Children's exposure to domestic violence (CEDV) predicts poorer health and development, but its effects on nutrition and growth are understudied. We propose a conceptual framework for the pathways by which domestic violence against mothers may impair child growth and nutrition, prenatally and during the first 36 months of life. We synthesize literatures from multiple disciplines and critically review the evidence for each pathway. Our review exposes gaps in knowledge and opportunities for research. The framework also identifies interim strategies to mitigate the effects of CEDV on child growth and nutrition. Given the global burden of child malnutrition and its long-term effects on human-capital formation, improving child growth and nutrition may be another reason to prevent domestic violence and its cascading after-effects.

Physical intimate partner violence during gestation as a risk factor for low quality of prenatal care

OBJECTIVE

To evaluate physical intimate partner violence during gestation as an independent risk factor for low quality of prenatal care.

METHODS

A cross-sectional study was carried out at three public maternity wards of the municipality of Rio de Janeiro (Southeastern Brazil). The 528 puerperal women included in the study were selected by simple random sampling from all babies born at term in 2000. Prenatal care information was collected through the pregnant woman's card and face-to-face interviews. The Kotelchuck index was employed to assess the quality of prenatal care. In order to identify violence situations, the Brazilian version of the instrument Revised Conflict Tactics Scales was used. Non-conditional logistic regression was used to assess the effect of exposure, after controlling for confounding variables.

RESULTS

Even after adjustment for socioeconomic, demographic, reproductive, and couple's lifestyle variables, physical intimate partner violence during gestation remained associated with low quality of prenatal care. Women exposed to physical violence during gestation had 2.2 times more chance of presenting inadequate prenatal care compared to those without history of physical violence.

CONCLUSIONS

These findings point to the need of identifying family conflict situations since the beginning of prenatal care in order to address the issue and enable higher adherence to follow-up among victimized pregnant women.

Prevalence of violence against pregnant women and associated maternal and neonatal complications in Leon, Mexico

OBJECTIVES

to determine the prevalence of violence against women and associated maternal and neonatal complications in a developing country setting.

DESIGN

cross-sectional study using a face-to-face questionnaire.

SETTING

postpartum area at a tertiary care referral hospital in Leon, Mexico.

PARTICIPANTS

1623 postpartum women.

DATA COLLECTION

women were recruited at 24-72 h post partum. The diagnosis and severity of violence were assessed using a modified questionnaire based on the Index of Spouse Abuse and Severity of Violence against Women Scale.

FINDINGS

of 1623 women, 711 (43.8%) were diagnosed with violence during pregnancy; 563 (79.1%) experienced mild violence and 148 (20.9%) experienced severe violence. Of the women who experienced violence, 72.9% experienced psychological violence, 15.8% experienced physical violence and 11.3% experienced sexual violence. Maternal complications were higher in women who experienced violence (30.2% vs 23.6%, p = 0.004). Women who experienced sexual violence had more maternal complications (43.2%), and women who experienced psychological violence had more neonatal complications (54.2%).

KEY CONCLUSIONS

violence during pregnancy is quite common in the study setting. Maternal complications are higher in women who experience violence during pregnancy. The type of violence has different effects on maternal and neonatal health.

IMPLICATIONS FOR PRACTICE

it is recommended that pregnant women who are experiencing violence should be identified during antenatal care to avoid maternal or neonatal complications.