Quality of life in women who were exposed to domestic violence during pregnancy

Relationship of domestic violence with pregnancy symptoms and pregnancy experience in Iranian pregnant women: a cross-sectional study

OBJECTIVE

Violence has had adverse effects on the physical and psychological dimensions of pregnant women. This study was conducted with the aim of determining the relationship of domestic violence with pregnancy symptoms and pregnancy experience.

DESIGN

In this cross-sectional study, pregnant women were selected through two-stage cluster sampling method. Data were collected using the domestic violence questionnaire of the WHO, pregnancy symptoms inventory (PSI) and pregnancy experience scale (PES). To determine the relationship between domestic violence with pregnancy symptoms and pregnancy experience, adjusted general linear model was used in multivariate analysis.

SETTING

Health centres in Urmia-Iran in 2022.

PARTICIPANTS

415 pregnant women.

RESULTS

The frequency of emotional, physical and sexual violence was 86.0%, 67.7% and 79.5%, respectively. The mean (SD) of PSI was 49.45 (14.38) with attainable score of 0-123 and PES including happiness and worry was 14.32 (6.48) and 16.21 (2.51) with attainable score of 0-30, respectively. Based on the adjusted general linear model, the mean score of PSI in women who experienced physical violence (mild (p<0.001) and moderate (p<0.001)); sexual violence (mild (p<0.001), moderate (p<0.001) and severe (p<0.001)); and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly higher than women without experiencing violence. The mean score of happiness during pregnancy in women who experienced physical violence (moderate (p=0.011)) and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly lower than women without experience of violence. Also, the mean score of worry scores in women with experience of sexual violence (mild (p=0.001) and moderate (p=0.012)) and emotional violence (mild (p<0.001), moderate (p<0.001)) and severe (p<0.001)) was significantly higher than women without experiencing violence.

CONCLUSION

Considering the relationship between violence and pregnancy symptoms and pregnancy experiences, it is necessary to use appropriate strategies to prevent violence in pregnant women.

Intimate partner violence and quality of life among mothers in Jordan during COVID-19 era

AIMS

The study aims to examine the correlation between intimate partner violence [IPV] and quality of life [HRQoL] of mothers during COVID-19 era.

METHOD

This study is a cross-sectional correlational study. The inclusion criteria was Jordanian women with at least 18 years old, who read and write in Arabic language and able to participate. The collection of data was done through a self-reported questionnaire distributed and completely filled with 300 married Jordanian women using social media. This study was conducted between the months of October and December 2020. The participants signed consent after being informed of their rights to exit at any point during the study and the study methods.

RESULTS

The prevalence of IPV among women was 28.3. The mean of quality of life is 86.0 [SD = 13.1) and the mean of violence is 11.9 [SD = 3.01). There was a significant negative relationship between violence and quality of life (r2 = .224, p = .001). This means as the violence increases, the quality-of-life decreases.

CONCLUSION

In conclusion, there is an association between IPV and HRQoL among married people. Providing an education program and vital resources for women with the goal of preventing COVID-19 violence and assisting Jordanians become very essential.

The prevalence of intimate partner violence among Iranian pregnant women: a systematic review and meta-analysis

BACKGROUND

Intimate partner violence against pregnant women is an important public health concern and human rights issue. According to the various findings of previous studies, this study was conducted to assess the pooled prevalence of intimate partner violence against Iranian women.

METHODS

In this systematic review and meta-analysis, a literature search was conducted in databases such as PubMed, Scopus, Web of Science, MagIran, and Scientific Information Database without a time limit. Heterogeneity was assessed by Cochrane Q test statistics and the I2 test, and the results were incorporated into a random effects model to estimate the prevalence of intimate partner violence. Data analysis was performed using R software version 4.3.2.

RESULTS

The overall prevalence of intimate partner violence was reported to be 51.5% (95% confidence interval (CI) 45.0-58.1), and the prevalence rate of physical, sexual, and psychological intimate partner violence was 18.0% (95% CI 15.1-20.9), 22.1% (95% CI 17.7-26.60) and 43.2% (95% CI 36.6-49.8), respectively. The lowest level of physical, sexual, and emotional intimate partner violence rate was observed in district 1 of Iran (includes Tehran, the capital of Iran and the surrounding provinces). The rate of physical and sexual intimate partner violence prevalence decreased with the increased mean age of the husband (P=0.005) and the mean age of the wife (P=0.035), respectively.

CONCLUSIONS

Studies included in this review report that more than half of Iranian women experience violence during pregnancy. In order to prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support centres.

Domestic Violence Against Women in North African and Middle Eastern Countries: A Scoping Review

This scoping review aimed to identify the scope of the current literature on the prevalence, consequences, and risk factors of domestic violence (DV) against women by their husbands or male partners in North African and Middle Eastern countries. The methodology for this scoping review was based on the framework outlined by Arksey and O'Malley. Studies published on DV against women over the age of 15 by partner or husband and published in peer-reviewed scientific journals between January 1970 and April 2018 were included in the review. The databases MEDLINE, PsychINFO, CINAHL, HealthSTAR, EMBASE, Scopus, African Journals Online, Turkish Journal Database, and gray literature sources were searched. On completion of the review process, 151 full-text articles were identified for charting. This review demonstrated that women's age, women's education level, duration of marriage, history of childhood abuse/witnessing family violence, living in the rural region, and family income level were negatively associated with DV, indicating that younger women, women with lower education, a longer marriage duration, and a lower income level had a higher risk of exposure to DV in this region. Anxiety, depression/insomnia, and physical injury were the most common health problems reported by victims in the region. The highest proportion of women with no response to violence was reported in Jordan, Saudi Arabia, and Turkey. The findings of this scoping review represent the first attempt to summarize the literature from North African and Middle Eastern countries and demonstrate the similarity in DV-related behaviors among women despite the cultural and regional diversity of the studies.

Spousal Violence among Reproductive Age Group Women - A Community-Based Cross-Sectional Study

Background

Spousal or intimate partner violence is the most common form of domestic violence and is a preventable cause of morbidity and mortality in women. The aim of this study was to estimate the prevalence of spousal violence, various types of spousal violence, and the factors associated with it among reproductive age group women.

Materials and Methods

This was an analytical cross-sectional study conducted in the Urban Health Training Center area of a tertiary care teaching hospital in Nagpur, India, among married women between 15 and 49 years of age who were selected using systematic random sampling. The data was collected from a sample of 373 women by face-to-face interview and analyzed using Statistical Package for the Social Sciences (SPSS) v21.

Results

The prevalence of spousal violence among reproductive age group (15-49 years) women was found to be 59.7%, with emotional violence (54.1%) being the most common, followed by physical (51.2%) and sexual (43.4%) violence in that order. Regular alcohol consumption of husband had the highest odds of spousal violence among women (odds ratio [OR] 12.51, 95% confidence interval [CI] 6.51-24.03). Other factors associated with spousal violence among reproductive age group women were early age at marriage, literacy and employment of women and husband, lack of emotional support from the family members, and dowry-related problems in the family.

Conclusion

A multifaceted approach including legal measures, empowerment of women, and sociocultural factors involving families, institutions, governmental, nongovernmental, and civil society organizations is the need of the hour.

Estimating the effects of physical violence and serious injury on health-related quality of life: Evidence from 19 waves of the Household, Income and Labour Dynamics in Australia Survey

OBJECTIVE

This study aims to investigate the effect of physical violence and serious injury on health-related quality of life in the Australian adult population.

METHODS

This study utilised panel data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. HRQoL was measured through the physical component summary (PCS), mental component summary (MCS), and short-form six-dimension utility index (SF-6D) of the 36-item Short-Form Health Survey (SF-36). Longitudinal fixed-effect regression models were fitted using 19 waves of the HILDA Survey spanning from 2002 to 2020.

RESULTS

This study found a negative effect of physical violence and serious injury on health-related quality of life. More specifically, Australian adults exposed to physical violence and serious injury exhibited lower levels of health-related quality of life. Who experienced physical violence only had lower MCS (β = -2.786, 95% CI: -3.091, -2.481) and SF-6D (β = -0.0214, 95% CI: -0.0248, -0.0181) scores if switches from not experiencing physical violence and serious injury. Exposed to serious injury had lower PCS (β = -5.103, 95% CI: -5.203, -5.004), MCS (β = -2.363, 95% CI: -2.480, -2.247), and SF-6D (β = -0.0585, 95% CI: -0.0598, -0.0572) score if the adults not experiencing physical violence and serious injury. Further, individuals exposed to both violence and injury had substantially lower PCS (β = -3.60, 95% CI: -4.086, -3.114), MCS (β = -6.027, 95% CI: -6.596, -5.459), and SF-6D (β = -0.0716, 95% CI: -0.0779, -0.0652) scores relative to when the individuals exposed to none.

CONCLUSION

Our findings indicate that interventions to improve Australian adults' quality of life should pay particular attention to those who have experienced physical violence and serious injury. Our findings suggest unmet mental health needs for victims of physical violence and serious injuries, which calls for proactive policy interventions that provide psychological and emotional therapy.

Locked Down: Experiences of Domestic Violence in Central India

INTRODUCTION

The National Family Health Survey (NFHS-4) data show that 31.1% of women faced domestic violence in 2015-2016, with no reduction since 2005-2006. Emerging data show that since the outbreak of the coronavirus disease (COVID-19), reports of intimate partner violence have increased worldwide because of mandatory lockdowns to curb the spread of the virus. The nature of the current pandemic, which has forced women to spend time with their abusers and restricted their mobility, has made them more vulnerable to abuse. We aimed to determine the proportion of domestic violence among Indian women during the lockdown period.

METHODS

This is a cross-sectional study, conducted in June-August 2020 on married, Indian women of reproductive age who attended the obstetrics-gynecology outpatient department during the COVID-19 pandemic. The Abuse Assessment Screening questionnaire validated during NFHS-4 (2015-2016) was used as a data collection tool. Our primary objective was to determine the proportion of women presenting to the hospital who were exposed to domestic violence during the lockdown period. Analysis was done using SPSS Statistics V22.0.

RESULTS

A total of 412 women were recruited for the study. The mean age was 23 years (range 19-52 years). The prevalence of domestic violence in any form was found to be 32.5%, with the majority being verbal abuse in the form of insults, threats of physical violence, or public humiliation.

CONCLUSION

The results of this study indicated a high proportion of women with a history of domestic violence during the pandemic. Thus, health care policy makers and experts involved in women's care-particularly during crisis conditions such as the COVID-19 pandemic-should be aware of the extent of this problem and take measures to properly address it.

Improving Quality of Life Among Latina Intimate Partner Violence Survivors Through Economic Empowerment

This study examined the relationship between (1) quality of life and forms of intimate partner violence (IPV) (i.e., psychological abuse, physical violence, sexual violence, and types of economic abuse), and (2) quality of life and economic empowerment among Latina IPV survivors. The authors used data from the Moving Ahead financial literacy program evaluation (n = 200). Nested random-effects models were conducted. Findings indicated that psychological abuse and economic control were significantly and negatively associated with quality of life. Economic empowerment (i.e., financial knowledge, economic self-efficacy, and economic self-sufficiency) was significantly and positively related to Latinas' quality of life. Financial strain was inversely associated with Latina's quality of life. These findings highlight the importance of identifying strategies for increasing the overall well-being of Latina IPV survivors. Economic empowerment interventions can be an effective mechanism for improving their quality of life. As such, domestic violence organizations should include economic empowerment as part of the services offered to survivors.

Self-efficacy and social support as mediators of mental health among abused women

Supportive counseling and facilitated referrals to support organizations have shown positive effects on mental health and coping with domestic and family violence. However, the reasons why and how such effects are significant remain unknown. The current paper used data from a randomized controlled trial of a psychosocial intervention implemented in Nepal among 140 abused pregnant women. The hypothesized mediating effects of self-efficacy and social support on mental health and quality of life of abused pregnant women were tested using serial mediation analyses. Significance of parameter estimates and bias-corrected 95% confidence intervals (CIs) for the indirect effects were generated using bootstrapping. The postintervention changes in self-efficacy and social support were found to have significant mediating effects on the relationship between the intervention and changes in both mental health and quality of life of participants post intervention. The positive effects on outcomes were seen at follow-up as well, though to a lesser extent. Further interventions should focus on enhancing abused women's self-efficacy and social support to ensure their positive mental health and better lives.

Antenatal-Based Pilot Psychosocial Intervention to Enhance Mental Health of Pregnant Women Experiencing Domestic and Family Violence in Nepal

Survivors of domestic and family violence (DFV) report poorer quality of life and worsening mental health. This study evaluated the effect of a counseling and education intervention on the mental health and help-seeking behaviors among pregnant women living with DFV. A parallel pilot randomized controlled trial was performed among 140 pregnant women attending an antenatal clinic of a tertiary hospital of Nepal. Using computer-generated random numbers, participants were randomized to the intervention group (a counseling session, an information booklet about DFV, and contact details of the counselor) or a control group (usual care plus a booklet containing contact details of local DFV support services). Outcome measures included mental health, quality of life (QOL), self-efficacy, social support, and safety planning behaviors. Analyses followed intention-to-treat, using the generalized estimating equation model. Intervention participants showed significant improvements in anxiety (β = -3.24, p < .001) and depression (β = -3.16, p < .001) at postintervention. Such improvements were also sustained at follow-up assessment (p < .001). Significant group and time interaction for QOL, social support, use of safety behaviors, and self-efficacy (p < .05) revealed a greater increase in these outcome measures among intervention participants at both follow-up assessments compared with the control group. This pilot integrated intervention showed promising outcomes in improving the mental health, social support, and the use of safety behaviors among women with DFV. This intervention could be incorporated into regular antenatal care as a strategy to identify and support victims of DFV. Larger controlled trials with longer follow-up are needed to support and expand on the current findings regarding the effectiveness of a psychosocial intervention targeting victims of DFV in resource-constrained settings.

Propensity score analysis of psychological intimate partner violence and preterm birth

Psychological intimate partner violence (IPV), a global public health problem, affects mothers during pregnancy. We evaluated its relationship with preterm birth. We established a cohort of 779 consecutive mothers receiving antenatal care and giving birth in 15 public hospitals in Spain. Trained midwives collected IPV data using the Index of Spouse Abuse validated in the Spanish language. Preterm was defined as birth before 37 completed weeks of gestation. Gestational age was estimated by early ultrasound. With multivariate logistic regression we estimated the relative association of IPV with preterm birth as adjusted odds ratios (AOR), with 95% confidence intervals (CI). In propensity score analysis, using weighting by inverse probability of exposure to IPV, the whole sample was used for estimating the absolute difference in probability of preterm amongst offspring born to mothers with and without IPV. Socio-demographic and other pregnancy characteristics served as covariates in both analyses. Preterm occurred in 57 (7.3%) pregnancies. Psychological IPV, experienced by 151 (21%) mothers, was associated with preterm birth (11.9% vs 6.5%; AOR = 2.4; 95% CI = 1.1–5.0; p = 0.01). The absolute preterm difference in psychological IPV compared to normal was 0.08 (95% CI = 0.01–0.16; p = 0.04). The probability of preterm birth was 8% higher on average in women with psychological IPV during pregnancy. As our analysis controlled for selection bias, our findings give credence to a causal inference. Screening and management for psychological IPV during pregnancy is an important step in antenatal care to prevent preterm birth.

Perception, Prevalence, and Determinants of Intimate Partner Violence During Pregnancy in Urban Slums of Pune, Maharashtra, India

There is limited evidence on the prevalence and determinants of violence against pregnant women in India. Previous studies were entirely restricted to the violence against women in the reproductive age group. There is lack of evidence about the factors affecting violence against women during pregnancy. Understanding such factors, women's perception regarding violence during pregnancy and their justification of such violence could manifest an important aspect of violence. Women living in slum communities particularly are victims of violence. In this context, this study intended to examine women's perception, prevalence of, and factors affecting the violence against women during pregnancy in the slum communities of Pune. A community-based cross-sectional study of 1-year duration was undertaken in urban slums of Pune city, Maharashtra, India. The study participants were women who have delivered 2 years preceding the survey. Using simple random sampling, 500 women were selected from 10 purposively selected slums. House-to-house visits were made and face-to-face interviews conducted using a pretested structured questionnaire. Univariate, bivariate, and logistic regression analyses were applied. The study results show that 15.3% of women have experienced violence during their recent pregnancy. Furthermore, 9.2% of women experienced physical violence, 1.8% sexual violence, and 11.2% psychological violence. Education level of women, husband's education and alcohol consumption, history of violence in the family, and provision of spurious justification for violence have emerged as some of the leading factors associated with the violence inflicted during pregnancy. Effective interventions at both community and health care settings are needed urgently to reduce the violence inflicted during pregnancy.

Women's Intention to Consent to Universal Screening for Intimate Partner Violence (IPV) at Well Baby Clinics

The Israeli Ministry of Health requires medical and nursing staff in both hospitals and community settings, screen all women for Intimate Partner Violence (IPV). This study explored factors associated with the intention of Israeli women to consent to universal IPV screening during their visits to well baby clinics, using the Theory of Planned Behavior (TPB). Two hundred Jewish women of childbearing age completed a questionnaire based on the TPB. Only 52% of the women reported that they had undergone IPV screening conducted by nurses at well baby clinics in the last year. The TPB was found to predict 44% of the variance in women's intention to consent to universal IPV screening, whereas control beliefs, perceived behavioral control, and normative beliefs with regard to universal screening, were found to be the most significant predictors. These findings may help design interventions aimed at raising women's intentions to consent to universal IPV screening.

Exploring modifiable risk-factors for premature birth in the context of COVID-19 mitigation measures: A discussion paper

During the COVID-19 pandemic, parents with sick or premature babies have faced challenges following admission to a neonatal unit due to the imposed lock-down restrictions on social contact, hospital visitation and the wearing of personal protective equipment. The negative short-term impact on neonatal care in relation to the prevention of close proximity, contact and bonding between parents and babies is potentially significant. However, an interesting finding has been reported of a reduction in premature birth admissions to the neonatal intensive care unit during the pandemic, raising important questions. Why was this? Was it related to the effect of the modifiable risk-factors for premature birth? This discussion paper focuses on an exploration of these factors in the light of the potential impact of COVID-19 restrictions on neonatal care. After contextualising both the effect of premature birth and the pandemic on neonatal and parental short-term outcomes, the discussion turns to the modifiable risk-factors for premature birth and makes recommendations relevant to the education, advice and care given to expectant mothers.

The effect of solution-focused counseling on violence rate and quality of life of pregnant women at risk of domestic violence: a randomized controlled trial

BACKGROUND

Domestic violence during pregnancy as one of the most common social problems and major challenges of health systems can affect the health of the mother and fetus. The study aimed to compare the two groups of intervention based on solution-focused counseling and control in terms of violence and quality of life amounts in women who had experienced domestic violence.

METHODS

A randomized controlled trial on 90 pregnant women was blocked into two intervention groups (n = 45) and a control (n = 45). The intervention group received six counseling sessions with a solution-focused approach. Study tool included conflict tactics scale (CTS- 2) and short form health survey (SF-36). The tools were completed once before the intervention and again 6 weeks after the end of the counseling sessions by the participants of both groups. The P-value less than 0.05 was considered statistically significant.

RESULTS

A total of 82/90 pregnant women were analyzed. The results showed that median and interquartile range (IQR) of physical, psychological and sexual violence significantly decreased in the intervention group than the control group (Ps = 0.001). Moreover, quality of life scores significantly improved in the intervention group compared to the control group (P = 0.001).

CONCLUSION

Solution-focused counseling could be an effective approach to reduce the amount of violence and increase the quality of life in women exposed to domestic violence.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials IRCT2017040628352N4 . Date of registration: August 20th 2017.

Social determinants of domestic violence against suburban women in developing countries: a systematic review

OBJECTIVE

In addition to the many social, economic, cultural, security, and environmental problems in the metropolitan areas, suburbanization has led to the growth and spread of domestic violence against women, and is still increasing. Different social determinants can play a role in violence against suburban women, so this study was designed to investigate the social determinants of domestic violence in suburban women of developing countries.

METHODS

According to PRISMA guideline, the keywords, which were determined considering MESH, were searched in Google Scholar, MEDLINE, SID, Web of Science, Pubmed, Scopus and Science Direct with the 2009 to 2019 time limit. STROBE checklist was used for evaluating quantitative studies and JBI for qualitative studies. Finally 30 high quality studies were included.

RESULTS

The prevalence of general domestic violence among women of different ages was reported between 2.3-73.78% in the suburban regions of developing countries. The prevalence of physical, emotional and psychological violence was about 11.54-61.6% and 7.8-84.3%. The prevalence of sexual,economic and the verbal violence was about 0.8-58.8%, 13.7- 43.7% and 33.21-86.1%. The most common factors affecting violence against women were the structural factors of early marriage, the husband's addiction to alcohol and drugs.

CONCLUSION

General domestic violence and its various types are prevalent in different parts of the world and the factors affecting domestic violence such as age, marriage age, low literacy, husband addiction to alcohol and drugs are all things that can be prevented by special health planning in these areas to improve women's health and thus prevent violence against suburban women.

The effect of family-based counseling on domestic violence in pregnant women referring to health centers in Sahneh city, Iran, 2018

BACKGROUND

Domestic violence is a term that shows aggressive behavior with different physical, psychological, economic, and social dimensions. This concept is considered as one of the health priorities regarding its significant effects on pregnancy, postpartum, and the outcome of pregnancy. The present study was conducted to investigate the effect of family-based counseling on domestic violence against pregnant women.

METHODS

An intervention trial was conducted on 92 pregnant women exposed to domestic violence, selected among 274 pregnant women accessible in Sahneh, Iran. Data collection was performed using the standard questionnaire of domestic violence against women of Mohseni Tabrizi. The pregnant women exposed to violence were randomly assigned to intervention and control groups (in two groups of 45 people). In the intervention group, three 45-min individual counseling sessions were held for the pregnant women and their spouses according to Greeting, Ask, Tell, Help, Explain, and Refer (GATHER) principles. Four weeks after the end of the sessions, the two groups again completed the questionnaire.

RESULTS

Family-based counseling intervention reduced the mean score of domestic violence in the intervention group from 68.58 ± 9.21 before the intervention to 49.56 ± 8.83 after intervention. Also, various domains of violence including mental, verbal, financial, physical, sexual, and social violence were significantly declined in the intervention group (P < 0.001); however, there was no significant decrease in emotional violence score (P > 0.001).

CONCLUSION

Family-based counseling plays a significant role in reducing the various types of violence against women through increasing the awareness of couples and by improving the relationship between couples during pregnancy. It will reduce the incidence of violence against a pregnant woman and consequently reduce complications on the mother and pregnancy outcomes. Family-oriented counseling played a significant role in deterring all forms of violence against women by increasing awareness of couples and improving their relationship during pregnancy. Moreover, family-oriented counseling reduced the incidence of violence against pregnant women and thus deterred maternal complications associated with pregnancy.

Domestic violence and its relationship with quality of life in pregnant women during the outbreak of COVID-19 disease

BACKGROUND

During the COVID-19 pandemic, pregnant women bear considerable physical and psychological stress because of their special conditions, which combined with other stress factors such as violence, makes their situation even more critical. This study aimed to investigate the prevalence of domestic violence and its relationship with quality of life in pregnant women during the COVID-19 pandemic.

METHODS

This cross-sectional study was performed with the participation of 250 pregnant women in the obstetrics clinic of 29-Bahman Hospital, Tabriz city. Using a three-part questionnaire consisting of the socio-demographic and obstetrics information, the domestic violence questionnaire developed by WHO, and the SF-12 quality of life questionnaire, the required information was collected. A general linear model was then used to determine the relationship between domestic violence and quality of life, while adjusting the socio-demographic and obstetrics information.

RESULTS

According to the data, more than one-third of pregnant women (35.2 %) had experienced domestic violence. The most common type of violence experienced was emotional violence (32.8 %), followed by sexual violence (12.4 %), and physical violence (4.8 %). The mean score of the physical health department of quality of life in the group of women exposed to violence (50.21) was lower compared to the unexposed group (53.45), though there was no significant difference between them (P = 0.25). However, the mean score of the mental health department of quality of life in women exposed to violence (46.27) was significantly lower compared to unexposed women (61.17) (P < 0.001). Based on the general linear model, the mean score for quality of life in the mental health dimension was significantly higher among unexposed women compared to those exposed to violence (β = 9.3, 95 %CI: 3.5 to 15.0, P = 0.002).

CONCLUSIONS

The findings of this study indicate a high prevalence of domestic violence and its relationship with a low quality of life during the COVID-19 pandemic. Therefore, the findings signify the importance of screening pregnant women in terms of domestic violence in respective centers as well as the necessity of conducting proper interventions to address domestic violence to improve the quality of life in women.

Associations between intimate partner violence and pregnancy complications: A cross-sectional study in India

BACKGROUND

The high prevalence rates of violence of the intimate partner affects the maternal health of the woman that sometimes ends in maternal mortality as well as the possibility of an adverse effect on the newborn. The purpose of this study was to assess the prevalence and determinants of intimate physical and sexual intimate partner violence (IPV) on mothers and examine the association between IPV and pregnancy complications.

MATERIALS AND METHODS

Data for the present study were retrieved from the National Family Health Survey-IV (2015-2016). In total, 79,729 women completed the domestic violence questions, but 24,882 were considered for this analysis. The study was restricted to currently married women aged 15-49 who had given birth to at least one child in the 5 years preceding the survey. The association between self-reporting pregnancy complications with the experience of IPV was examined using Chi-square test, followed by multivariate logistic regression.

RESULTS

The study findings show that IPV, specifically physical and sexual violence, are associated with pregnancy complications. The results show that 31.6% of the women had experienced some form of IPV. The factors associated with IPV included husband's alcohol habit, women who had witnessed parental violence, and women whose husbands had shown high marital controlling behavior. The high level of pregnancy complications was reported by women who had experienced sexual violence, emotional violence, and women whose husbands display three or more specific behaviors.

CONCLUSION

Confidential screening for IPV and prompt referral to support services could be crucial in improving women's reproductive health.

Domestic violence and its relationship with depression, anxiety and quality of life: A hidden dilemma of Pakistani women

Objectives:

To find out the relationship of domestic violence with depression, anxiety and quality of life in married women in hospitals of Rawalpindi and Islamabad.

Methods:

This co-relational study was conducted in Rawalpindi Institute of Health Sciences from January 2019 to December 2019. All the females’ patients who were the victim of domestic violence were the population of the study. Consecutive non-probability sampling technique was used for selection of sampling from the target population. The inclusion criterion for this study was diagnosed case of domestic violence. DASS 21 (The Depression, Anxiety and Stress Scale) and Quality of life (WHO) scales were administered to 116 patients.

Results:

The study’s key results were that domestic abuse has positive relationship with depression, anxiety, and stress. It was also found that domestic abuse has a negative relationship with quality of life of those who have been subjected to domestic violence of this sort.

Conclusion:

It was concluded that domestic violence whether verbal, physical, emotional or sexual has strongly effects the mental health and quality of life of abused women.

Quality of life, psychological distress and violence among women in close relationships: a population-based study in Finland

BACKGROUND

The aim of this study was to examine associations between exposure to violence, quality of life, and psychological distress. Women aged 19-54 years who had been exposed to violence by someone in a close relationship were compared with women unexposed to violence in Finland. We also aimed to investigate associations between different forms of violence (physical, sexual, emotional, or any combination of these) with quality of life and psychological distress.

METHODS

We selected a sample of 22,398 women who had returned self-completed questionnaires from a Finnish population-based health survey between 2013 and 2016. Exposure to violence during the past year was assessed through specific questions from the survey. The EUROHIS-QOL 8-item index was used to measure quality of life, and ordinary least square regressions were fitted. The mental health inventory (MHI-5) was used to measure psychological distress. We investigated associations with multivariate logistic regression analysis.

RESULTS

Among women in Finland, the prevalence of exposure to violence in any type of close relationship during the past year was 7.6%. Women who had been exposed to violence had significantly worse scores of the EUROHIS-QOL 8-item index, and psychological distress was significantly worse (p < 0.001), compared with unexposed women. Strong associations were found between combinations of violence and both quality of life (coefficient - 0.51, p < 0.001) and mental health (odds ratio 4.16, 95% confidence interval 3.44-5.03). Compared with women who had been exposed to violence by a stranger, women who had been exposed to violence by someone in a close relationship had significantly lower quality-of-life scores (p < 0.001).

CONCLUSIONS

This study found that experience of close relationship violence had a negative influence on both quality of life and psychological distress among women in the general Finnish population. Comparison with victims of violence by strangers shows that some of the lower quality-of-life scores among victims are driven by the perpetrator and victim being in a close relationship. Preventive policies in primary care settings aimed at screening and educating young people should be considered as an early form of intervention to reduce the negative mental health consequences of violence.

'We don't see because we don't ask': Qualitative exploration of service users' and health professionals' views regarding a psychosocial intervention targeting pregnant women experiencing domestic and family violence

Introduction

Given the relative recency of Domestic and Family Violence (DFV) management as a field of endeavour, it is not surprising that interventions for addressing DFV is still in its infancy in developing countries. In order to maximise the success of an intervention, it is important to know which aspects of the intervention are considered important and helpful by service providers and service users. This study, therefore, examined the acceptability of an antenatal-based psychosocial intervention targeting DFV in Nepal and explored suggestions for improving the program in future.

Materials and methods

Intervention participants and health care providers (HCPs) were interviewed using semi-structured interviews. Data were audio-recorded and thematic analysis was used to analyse the data. Final codes and themes were identified using an iterative review process among the research team.

Results

Themes emerging from the data were grouped into domains including perceptions towards DFV, impact of the intervention on women’s lives and recommendations for improving the program. DFV was recognised as a significant problem requiring urgent attention for its prevention and control. Intervention participants expressed that they felt safe to share their feelings during the counselling session and got opportunity to learn new skills to cope with DFV. The majority of the participants recommended multiple counselling sessions and a continued provision of the service ensuring the intervention’s accessibility by a large number of women.

Discussion

This is the first study to document the perspectives of women and HCPs regarding an antenatal-based intervention targeting psychosocial consequences of DFV in Nepal. There was a clear consensus around the need to engage, support and empower victims of DFV and the intervention was well received by the participants. Ensuring good mental health and wellbeing among victims of DFV requires work across individual, organisational and community levels.

Maternal outcomes associated to psychological and physical intimate partner violence during pregnancy: A cohort study and multivariate analysis

Intimate partner violence (IPV) is a public health problem that affects millions of women worldwide and can occur during both pregnancy and the perinatal period. We aimed to evaluate if the experience of psychological and physical intimate partner violence (IPV) adversely affects pregnancy outcomes. We established a cohort of 779 consecutive mothers receiving antenatal care including ultrasound and giving birth in 15 public hospitals, drawn using cluster sampling of all obstetric services in Andalusia, Spain (February-June 2010). Trained midwives gathered IPV data using the Index of Spouse Abuse validated in the Spanish language (score ranges: 0-100, higher scores reflect more severe IPV; cut-offs: physical IPV = 10, psychological IPV = 25). Socio-demographic data, including lack of kin support, maternal outcomes, and hospitalization were collected. Multivariate logistic regression estimated adjusted odds ratios (AOR), with 95% confidence intervals (CI), of the relationship between psychological and physical IPV and maternal outcomes, controlling for socio-demographic characteristics. Response rate was 92.2%. Psychological IPV, reported by 21.0% (n = 151), was associated significantly with urinary tract infection (127 (23%) vs 56 (37%); AOR = 1.9; 95%CI = 1.2-3.0), vaginal infection (30 (5%) vs 20 (13%); AOR = 2.4; 95%CI = 1.2-4.7) and spontaneous preterm labour (32 (6%) vs 19 (13%); AOR = 2.2; 95%CI = 1.1-4.5). Physical IPV, reported by 3.6% (n = 26), was associated with antenatal hospitalizations (134 (19%) vs 11 (42%); AOR = 2.6; 95%CI = 1.0-7.1). Lack of kin support was associated with spontaneous preterm labour (AOR = 4.7; 95%CI = 1.7-12.8). Mothers with IPV have higher odds of complications. Obstetricians, gynaecologists and midwives should act as active screeners, particularly of the undervalued psychological IPV, to reduce or remedy its effects.

Poor antenatal care attendance is associated with intimate partner violence: Multivariate analysis of a pregnancy cohort

OBJECTIVE

Intimate partner violence (IPV) is a common, neglected public health problem and pregnancy is a period of vulnerability. We evaluated the relationship of attendance for antenatal care with the experience of psychological and physical IPV.

STUDY DESIGN

We established a cohort of 779 consecutive mothers who received antenatal care and gave birth in 15 public hospitals, Andalusia, Spain. Trained midwives gathered IPV data using the Index of Spouse Abuse validated in the Spanish language (score ranges: 0-100, higher scores reflect more severe IPV; cut-offs: physical IPV = 10, psychological IPV = 25). Less than eight visits defined the threshold for poor antenatal care attendance. Multivariate logistic regression estimated crude (COR) and adjusted odds ratios (AOR), with 95% confidence intervals (CI), of the relationship between antenatal care attendance and psychological and physical IPV, controlling for socio-demographic and other pregnancy characteristics.

RESULTS

Response rate was 92.2%. Poor antenatal clinic attendance, observed in 76 (9.8%) women, was associated with both physical IPV (n = 26, 39% vs 9%; COR = 6.2, 95%CI = 2.7-14.3; AOR = 3.3, 95%CI = 1.1-9.4) and psychological IPV (n = 149, 20% vs 8%; COR = 2.9, 95%CI = 1.7-4.8; AOR = 1.6, 95%CI = 0.9-3.1), though the latter was not significant in multivariate analysis.

CONCLUSION

Women with a poor antenatal care attendance have higher risk of suffering physical IPV during pregnancy. Clinicians should be vigilant about the risk of IPV in mothers with poor attendance for antenatal care.

Intimate partner violence and its associated factors among pregnant women in Bale Zone, Southeast Ethiopia: A cross-sectional study

BACKGROUND

Intimate partner violence (IPV) against women is a major public health concern in low income countries. Violence against pregnant women has adverse effects on maternal and newborn outcomes. This study aimed to assess the prevalence and associated factors of intimate partner violence in Southeast Ethiopia pregnant women.

METHODS

Institutional based cross-sectional study was conducted on pregnant women who were attending antenatal care (ANC) in Bale Zone health institution during study period. Face to face interviews were conducted using a pre-tested structured questionnaire. Data related to socio-demographic characteristic, pregnancy and reproductive history, intimate partner behavior and IPV encountered during recent pregnancy was gathered for this study. Descriptive analysis and logistic regression were used for the data analysis. Odds ratio with 95% CI was computed to determine the presence and strength of associated factors with IPV.

RESULTS

A total of 612 pregnant women participated in the study. Of these, 361 (59.0%) pregnant women faced at least one type of IPV during the recent pregnancy. Physical violence (20.3%), sexual violence (36.3%), psychological/emotional violence (33.0), controlling behavior violence (30.4%) and economic violence (27.0) were the type of IPV encountered by participants. An intimate partners who were drank alcohol [AOR = 2.9; 95% CI: (1.5-5.4)], partners who were chewed Khat [AOR = 1.7; 95% CI: (1.1-2.6)], partners who were smoked cigarette [AOR = 2.6; 95% CI: (1.4-4.9)], partners who had aggressive behavior [AOR = 2.8; 95% CI: (1.7-4.6)], having partner age ≥30 year old [AOR = 1.8; 95% CI: (1.2-2.9)], unwanted pregnancy [AOR = 3.3; 95% CI: (1.9-5.5)] and history of adverse pregnancy outcome [AOR = 2.1; 95% CI: (1.2-3.6)] that were the factors that significantly associated with IPV of the pregnant women.

CONCLUSION

The prevalence of IPV during pregnancy was high among the study participants. Intimate partners' use of substance, intimate partners' aggressive behavior, older intimate partners, unwanted pregnancy and history of adverse birth outcome were identified as associated factors for IPV. IPV needs to be considered during ANC service and integrated into the sexual and reproductive health education. Community-based interventions should be advocated as a way of health promotion. Counseling, awareness creation, service provision and program design on IPV is mandatory to minimize the victim.

Breastfeeding avoidance following psychological intimate partner violence during pregnancy: a cohort study and multivariate analysis

OBJECTIVE

To evaluate if the experience of psychological intimate partner violence (IPV) adversely affects breastfeeding rates.

DESIGN

A cohort study.

SETTING

Maternities in 15 public hospitals, drawn using cluster sampling of obstetric services in Andalusia, Spain.

POPULATION

A total of 779 consecutive mothers receiving antenatal care including ultrasound and giving birth during February-June 2010.

METHODS

Trained midwives gathered IPV data using the Index of Spouse Abuse validated in the Spanish language (score ranges: 0-100, higher scores reflect more severe IPV; cut-off: psychological IPV = 25). Sociodemographic data including lack of kin support, and obstetric and neonatal outcomes were collected. Multivariate logistic regression estimated adjusted odds ratios (aOR), with 95% confidence intervals (CI), of the relationship between psychological IPV and breastfeeding, controlling for sociodemographic characteristics and obstetric complications.

MAIN OUTCOME MEASURE

Breastfeeding avoidance defined as lack of breastfeeding or pumping of breast milk to feed the new baby in the immediate post-partum period.

RESULTS

Response rate was 92.2%. A total of 70% (n = 545) of women initiated breastfeeding. Psychological IPV, reported by 21.0% (n = 151), increased the odds of breastfeeding avoidance (aOR = 2.0; 95% CI = 1.2-3.3) adjusting for the presence of obstetric complications (aOR = 1.6; 95% CI = 1.0-2.4).

CONCLUSIONS

Mothers with psychological IPV avoid breastfeeding. Clinicians should be aware of the risks to infant arising from this deficiency due to IPV in pregnancy.

TWEETABLE ABSTRACT

Psychological intimate partner violence, reported by one in five mothers in this study, on average doubles the avoidance of breastfeeding.

Factors influencing the quality of life of pregnant women: a systematic review

Background

Pregnancy is a period of transition with important physical and emotional changes. Even in uncomplicated pregnancies, these changes can affect the quality of life (QOL) of pregnant women, affecting both maternal and infant health. The objectives of this study were to describe the quality of life during uncomplicated pregnancy and to assess its associated socio-demographic, physical and psychological factors in developed countries.

Methods

A systematic review was performed according to the PRISMA guidelines. Searches were made in PubMed, EMBASE and BDSP (Public Health Database). Two independent reviewers extracted the data. Countries with a human development index over 0.7 were selected. The quality of the articles was evaluated on the basis of the STROBE criteria.

Results

In total, thirty-seven articles were included. While the physical component of QOL decreased throughout pregnancy, the mental component was stable and even showed an improvement during pregnancy. Main factors associated with better QOL were mean maternal age, primiparity, early gestational age, the absence of social and economic problems, having family and friends, doing physical exercise, feeling happiness at being pregnant and being optimistic. Main factors associated with poorer QOL were medically assisted reproduction, complications before or during pregnancy, obesity, nausea and vomiting, epigastralgia, back pain, smoking during the months prior to conception, a history of alcohol dependence, sleep difficulties, stress, anxiety, depression during pregnancy and sexual or domestic violence.

Conclusions

Health-related quality of life refers to the subjective assessment of patients regarding the physical, mental and social dimensions of well-being. Improving the quality of life of pregnant women requires better identification of their difficulties and guidance which offers assistance whenever possible.

Broken dreams of a better life in Sweden: Thai women's lived experiences of intimate partner violence by Swedish men in international marriages

Background: Intimate partner violence by men against women has detrimental effects on equality, health and integration. Migrated and ‘imported’ wives experience an increased risk of intimate partner violence.

Objectives: The purpose of this study was to explore Thai immigrant women’s lived experiences of intimate partner violence in Sweden.

Method: Semi-structured interviews based on the critical incident technique with specific questions about experiences of male-to-female intimate partner violence were used to collect data. The participants were Thai immigrant women who had lived in Sweden for more than five years. Qualitative content analysis was used to identify patterns and variations in the transcribed data material.

Results: Eighteen interviewees reported psychological, physical, economic and/or sexual violence in their international marriages. These Thai women described being faithful and silent and reliable housewives. However, this did not keep them from being replaced and losing dignity as a result of intimate partner violence, including experiencing broken dreams and deception. Although their dreams were broken, they did not give up their efforts to achieve better lives in Sweden.

Conclusions: The vulnerability of imported wives in international marriages needs to be further recognised by health and welfare agencies in Sweden, as elsewhere, to ensure that these women have equal access to human rights, welfare and health as other citizens. From a health promotion perspective, home-based health check-ups are needed to stop the exploitation of imported wives. In Thailand, information and education about the unrecognised negative conditions of the Mia farang role (Imported wife role) need to be disseminated.

Relationship between Demographic Factors and Violence during Pregnancy in Iran: A Meta-Analysis Study

Objective: Domestic violence is the most common form of violence against women and a major health problem worldwide. The aim of this study was to examine the relationship between demographic factors and domestic violence during pregnancy through meta-analysis. Method : This meta-analysis study was conducted in Iran. All the articles published during 2001 up to Jun 2018 were extracted independently by 2 trained investigators from domestic and foreign databases including, Science Medlib, SID, Web of Science, PubMed, Science Direct, Irandoc, Medline, Scopus, Magiran, and Google Scholar with keywords and their compounds. The results of studies pooled using the random effects model Cochran and I2 tests were used to check heterogeneity. Data were analyzed using Stata Ver. 11.2. Results: A total of 28 articles with the sample size of 15 020 people were included in the study. The findings of the meta-analysis showed that low level of maternal education (OR:1.68) (CI 95%:1.15, 2.46), low education level of the spouse (OR:1.73) (CI 95%:1.31, 2.29), unemployment of the husband (OR:1.61) (CI 95%: 1.05, 2.48), and smoking of the husband (OR:2.51) (CI 95%: 1.64, 3.84) were important factors in the increase in domestic violence during pregnancy. Having 3 children or fewer (OR: 0.30) (CI 95%: 0.16, 0.56) and enough and regular visits to physicians to receive adequate prenatal care (OR: 0.31) (CI 95%: 0.16, 0.57) were deterrent for violence during pregnancy. Conclusion: Based on our findings, level of education, unemployment, prenatal care, smoking, and number of children are associated with violence during pregnancy. Thus, paying attention to these factors and controlling them can reduce violence during pregnancy and its adverse consequences.

Abuse of pregnant women in the healthcare system

Objective: The purpose of this study was to determine the incidence of abuse in healthcare system during pregnancy and its impact on pregnancy outcomes.Materials and methods: A validated screening Norvold Abuse Questionnaire for the identification of female victims of four kinds of abuse: emotional, physical, sexual, and the abuse in the healthcare system was anonymously offered to all women in the first 2 days postpartum.Results: The study group consisted of 1018 women, 6.2% of which reported experiencing abuse in healthcare system during pregnancy. Affected women had a higher incidence of preterm delivery (OR 2.4; 95% CI 1.2-4.8) and cesarean section rate (OR 2.0; 95% CI 1.1-3.6). Sexual abuse and abuse in healthcare system during childhood were associated with abuse in healthcare system during pregnancy (OR 4.4; CI 95% 1.2-16.2 and OR 6.9; CI 95% 1.3-35.4, respectively).Conclusions: Our study indicates that as many as 6.2% of pregnant women experience abusive encounters with perinatal care providers. These pregnancies eventually end more often preterm and by cesarean section. This possibly causal relationship should be further explored.

Intimate partner violence associated with low quality of life - a cross-sectional study

Background

Quality of life among abused women in Norway in 2006 was found to be significantly low compared to women at the same age in general. The aim of this study was to examine how quality of life is associated with experience of psychological and physical violence intimate partner violence among abused women seeking help after domestic partner abuse comparted to quality of life in a random sample of women in Norway.

Methods

A cross-sectional study in a random sample of 1500 women (response rate 36%, n = 469) in Norway were performed. In addition, 191 women who sought help after domestic partner abuse were invited (44%, n = 84). The experience of intimate partner violence (IPV) and health-related quality of life were measured in both samples. The participants were divided into: “Women seeking help” after domestic partner abuse (n = 84); “Random sample, abused women” (n = 127); and “Random sample, not abused women” (n = 342).

Results

The experience of psychological and physical violence was significantly different between the groups (p <  0.0001). The domains in SF-12 were significantly below (p <  0.001) the norm for the female population in Norway in all dimensions among the abused women in the random population sample, and even lower among the women seeking help because of IPV.

Conclusion

Intimate partner violence is clearly associated with low quality of life. The pattern found in this study is similar to the pattern found in the previous Norwegian study among abused women seeking help.

Trajectories and predictors of women's health-related quality of life during pregnancy: A large longitudinal cohort study

The objective of this study was to identify distinct trajectories and their predictors of health-related quality of life (HRQOL) of women during pregnancy in a prospective mother and child cohort. Analyses were based on 3936 Dutch pregnant women in Rotterdam area, the Netherlands. Information on potential predictors was collected in early pregnancy by questionnaire. Latent Class Mixture Modelling and Multinomial Logistic Regression were applied to assess the trajectory and predictors of HRQOL during pregnancy. HRQOL was measured by SF-12 in early, mid- and late pregnancy; physical and mental component summary (PCS-12/MCS-12) scores were calculated. Four physical HRQOL trajectories were identified: a healthy trajectory (‘healthy’) in 63.3%, consistently low (‘vulnerable’) in 10.8%; a small increase (‘recovering’) in 12.8% and a large decrease (‘at risk’) in 13.1%. Three mental HRQOL trajectories were identified: a healthy trajectory (‘healthy’) in 86.1%; a large increase (‘recovering’) in 7.5%; and a large decrease (‘at risk’) in 6.4%. Compared with healthy trajectories, the likelihood of following the ‘vulnerable’ physical HRQOL trajectory rather than a healthy trajectory was increased by daily fatigue(OR: 4.82[2.76, 8.40]), pelvic pain (OR:4.76[2.91, 7.78]) and back pain (OR:5.29[3.21, 8.70]); pregnancy-specific anxiety increased the likelihood of following the ‘at risk’ mental HRQOL trajectory (OR:7.95[4.84, 13.05]). Healthy physical and mental HRQOL trajectories during pregnancy were most common. Predictors indicative of poor HRQOL trajectories included pregnancy-related symptoms and anxiety.

Factors Associated With Domestic Violence Against Women in Iran: An Exploratory Multicenter Community-Based Study

Domestic violence against women committed by intimate partners is a worldwide concern especially in developing countries. The aim of this study was to assess the problem among Iranian women and identify associated risk factors. Using a cross-sectional multicenter design, 1,600 women in six different areas of Iran were surveyed. A measure of domestic violence against women was administered and demographic information collected. Logistic regression models were used to identify factors associated with domestic violence. The prevalence of domestic violence among participants were emotional (64%), physical (28%), and sexual (18%). Higher education (both women and their partners), employment status of partner (being employed), and lower number of children lowered the risk, whereas history of previous marriage (for either women or their partners), unstable marriage, substance abuse, crowded family situation, and lower socioeconomic status increased the risk of domestic violence. There is a high prevalence of domestic violence, particularly emotional, against women by their partners. Preventive measures are recommended such as increasing public awareness, improving in socioeconomic status of families, educating women about what they can do, and encouraging counseling for the couple or the woman alone.