Violence during pregnancy and substance use

Assessment of Blood Lead Levels in Mothers Addicted to Opium and Their Neonates in Kerman: A Cross-sectional Study

Background

High blood lead levels (BLLs) in pregnant women are associated with poor outcome in neonates. One of the newest non-occupational sources of lead contamination is opium consumption. Accordingly, this study aimed to assess BLLs in mothers addicted to opium and their neonates in Kerman.

Methods

This cross-sectional was conducted in Afzalipour hospital in Kerman, from February 2019 to February 2020. The BLLs were measured in 100 opium-addicted and non-addicted mothers and their newborns, and the lead levels higher than 5 μg/dL were considered contamination. Then, the demographic and anthropometric data were compared.

Findings

Based on the results of the present study, the BLLs of opium-addicted mothers (33.40±9.22 μg/dL vs 3.2±1.5 μg/dL) and their neonates (13.46±4.86 vs 1.1±0.9) were significantly higher (P=0.001) than those of non-addicts. Moreover, the average birth weight of the newborns in the addicted group was significantly lower than in the non-addicted group (2572.8±77.49 vs 2946±46.87) (P=0.001). Besides, there was a significant relationship between the average birth weight and the BLL of the mother and baby, and the average weight of the babies was significantly lower at higher levels of lead. However, no correlation was observed regarding the average height and head circumference of the neonates (P>0.05).

Conclusion

It seems that the serum level of lead in neonates of opium-addicted mothers contaminated with lead is significantly higher than that of non-addicts, but their anthropometric characteristics at birth were not different from those of the nonaddicted group.

Domestic violence against pregnant women is a potential risk factor for low birthweight in full-term neonates: A population-based retrospective cohort study

Domestic violence's most frequently reported outcomes are preterm delivery and low birthweight, both of which are the strongest correlates of mortality and morbidity. Several studies have shown that pregnant women with domestic violence during pregnancy were more likely to deliver low-birthweight and preterm neonates. However, there has been no consensus on associations between domestic violence and low-birthweight and preterm delivery. To examine the impact of domestic violence on birthweight stratified by preterm or full-term delivery, a population-based retrospective cohort study was conducted that linked four national databases in Taiwan. A total of 1,322 subjects associated with a report of domestic violence during pregnancy were compared with 485,981 subjects without any record of reported domestic violence. The percentage of low birthweight in the group exposed to domestic violence was significantly higher than in the unexposed group with full-term delivery (4.9% vs. 3.3%, p = 0.001). Multivariable logistic regression analysis showed that pregnant women exposed to domestic violence had an OR of 1.37 (95% CI 1.05, 1.79) for low birthweight in full-term delivery. However, domestic violence was not significantly associated with low birthweight in preterm delivery. Screening for intimate partner violence in the perinatal health care system should be seen as especially important for women who have had full-term low-birthweight neonates.

Khat use and associated factors during pregnancy in eastern Ethiopia: A community-based cross-sectional study

INTRODUCTION

Women of reproductive age are increasingly using khat. The use of khat is associated with prelabor rupture of membranes, anemia among pregnant women, and other problems related to motherhood and infanthood. Most of the previous studies performed at the facility level revealed that different factors were associated with khat use among pregnant women. Lower educational status, low wealth index, and the age of the mother were the factors significantly associated with maternal khat use. Partner substance use also has a significant association with maternal khat use. However, there is limited information about khat use and its associated factors among pregnant women in the study area.

OBJECTIVE

This study aims at assessing the prevalence of khat use and associated factors among pregnant women in Kersa and Haramaya Health and Demographic Surveillance System Sites, eastern Ethiopia.

METHODS

A community-based cross-sectional study design was employed among randomly selected 1,015 pregnant women from an open cohort from Kersa and Haramaya Health and Demographic Surveillance System Sites in Ethiopia. Data were collected through face-to-face interviews from January 30 to April 30, 2021, using Open Data Kit (ODK) software and analyzed using SPSS v-26. Descriptive statistics were used to summarize the characteristics of pregnant women. Factors associated with khat use were identified by bivariate and multivariable logistic regression analyses; an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated. Statistical significance was declared at p < 0.05.

RESULTS

The prevalence of khat use among pregnant women was 15.5% (95% CI, 13.3-17.7). Age of the pregnant women; being in the age group between 25 and 35 years (AOR = 2.27, 95% CI, 1.33-4.89) and 35 years and greater (AOR = 2.33, 95% CI, 1.29-4.20); having a chronic medical illness (AOR = 3.28, 95% CI, 1.27-8.48); and having a history of abortion (AOR = 2.87 95% CI, 1.73-4.76) significantly increased the likelihood of khat use among pregnant women.

CONCLUSION

The current study revealed a relatively high magnitude of khat use in pregnant women as compared with previous studies. The age of the pregnant women, history of medical illness, and history of abortion were significantly associated with khat use during pregnancy.

Risk Factors Associated with Perinatal Relapse to Opioid Use Disorder

The recent opioid epidemic in the United States has led to rising prevalence of maternal opioid use disorder (OUD). First-line treatment for maternal OUD involves the use of opioid agonist pharmacotherapy, such as methadone or buprenorphine, in addition to cognitive behavioral therapy and counseling. The management of maternal OUD can become overwhelming for both patients and clinicians, especially during the early postpartum period. Therefore, it is imperative that clinicians understand the impact of additional stressors in caring for these patients. Maternal chronic opioid dependence can lead to neonatal opioid withdrawal syndrome after birth. This multisystem condition affects neonatal neurobehavioral functioning and has significant human and socioeconomic consequences. First-line treatment for this syndrome involves intensive nonpharmacologic comforting measures, with maternal presence and involvement being central to ensuring the success of such measures. In this review, we describe the factors that place pregnant and postpartum women with OUD at risk of returning to illicit opioid use. We evaluate these multifaceted personal, social, societal, and systemic factors to inform the development of future clinical care initiatives.

Alcohol and other substance use disorder recovery during pregnancy among patients with posttraumatic stress disorder symptoms: A qualitative study

Background

About 5% of women are pregnant at substance use disorder (SUD) treatment entry, and pregnant women with SUD often belong to marginalized groups experiencing social, economic, and health care barriers associated with stigma from prenatal substance use. Pregnant women in SUD treatment have high rates of trauma and posttraumatic stress disorder (PTSD). This study sought to (1) examine the lived experiences of pregnant individuals with PTSD symptoms in SUD treatment and (2) understand the roles of systematic or contextual barriers to the pursuit of prenatal abstinence.

Methods

We draw upon in-depth semi-structured interviews to examine relationships between SUD, psychological trauma/PTSD experience, social resources, and lived experiences among patients in prenatal SUD treatment with PTSD symptoms. Our sample was pregnant patients (N = 13) with prior DSM-5 Criterion A trauma and current PTSD symptoms enrolled in a comprehensive program integrating prenatal care, substance use counseling, medication for opioid use disorder and case management at three sites affiliated with an urban academic medical center in New Mexico.

Results

Using thematic analysis, four main themes identified structural forces influencing alcohol and drug use: (a) lack of access or ability to obtain resources, (b) substance use to cope with negative affect, (c) social stigma, and (d) interpersonal relationships.

Conclusions

Despite receiving high-quality integrated prenatal and SUD care, these pregnant patients with PTSD symptoms in SUD treatment still experienced substantial social and structural hurdles to achieving abstinence during pregnancy.

Screening for domestic violence during pregnancy follow-up: evaluation of an intervention in an antenatal service

To assess the impact of a brief training for obstetricians and midwives about screening for domestic violence during pregnancy follow-up and to identify barriers to a routine enquiry. A monocentric quasi-experimental study was performed in an obstetrics department in Paris, France. We asked patients during their pregnancy follow-up to complete a survey describing their demographic characteristics. They were also asked if a health professional had screened them for domestic violence during the current pregnancy. Exclusion criteria were refusal and inability to complete the survey alone. Health professionals attended a brief training about domestic violence. The intervention provided general information about domestic violence to alert health professionals (prevalence, risk factors, consequences on women's health, pregnancy, and children) and guidelines on screening and how to deal with women disclosing domestic violence. They also had to complete a survey about their knowledge and practice concerning domestic violence. Two months later, patients consulting for their pregnancy follow-up completed the same survey. Health professionals were not aware of the study's aim throughout its course. The primary outcome was the rate of patients screened for domestic violence during pregnancy follow-up. The secondary outcome was the identification of barriers to a routine enquiry. Four hundred ninety-five patients completed the first survey (control group): 21 patients (4.8%) had been screened for domestic violence. Twenty-one health professionals attended the intervention. Eight (38.1%) stated that they never screened for domestic violence, and 3 (14.3%) stated that they always did. Three hundred ninety-five patients completed the second survey (experimental group): 17 patients (4.3% vs 4.8%, p = 0.53) stated that they had been screened for domestic violence. The main barriers to screening mentioned by health professionals were the presence of the partner, the lack of awareness of the need to screen, uncomfortable feelings, and the difficulty to identify victims. There was no increased screening for domestic violence during pregnancy follow-up after a brief training of obstetricians and midwives. An early training during medical studies or more extensive training for professionals could be more efficient.

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.

Drug overdose among women in intimate relationships: The role of partner violence, adversity and relationship dependencies

BACKGROUND

This study examines the relationship between experiencing intimate partner violence (IPV), exposure to prior childhood adversity, lifetime adverse experiences, drug-related relationship dependencies with intimate partners and overdose, hospitalization for drug use, friends and family members who overdosed and witnessing overdose.

METHODOLOGY

This paper included a sample of 201 women who use drugs in heterosexual relationships with criminal justice-involved men in New York City. We included measures of experiencing overdose, hospitalization for drug use, witnessing overdose, and having friends and family who overdosed. Intimate partner violence consisted of either 1) none/verbal only, 2) moderate and 3) severe abuse. Dichotomous indicators of drug-related relationship dependencies included financial support, drug procurement, splitting and pooling drugs. A scale measured cumulative exposure to childhood adversity and lifetime exposures to adverse events. This paper hypothesized that experiencing moderate and severe IPV, drug-related dependencies and exposure to prior childhood and lifetime adversity would be associated with a greater risk of experiencing overdose, hospitalization for drug use, witnessing overdose and having friends and family members who overdosed. Generalized linear modeling with robust variance estimated relative risk ratios that accounted for potential bias in confidence intervals and adjusted for race, ethnicity, education and marital status.

RESULTS

We found experiencing moderate or severe IPV was associated with ever being hospitalized for drug use and having a family member who experienced overdose. Experiencing moderate IPV was associated with increased risk of witnessing overdose, Partner drug dependencies were associated with overdose, ever being hospitalized for drug use, witnessing overdose, and having a family member or friend who experienced overdose. Childhood and lifetime adversity exposures were significantly associated with increased risk of overdose, ever being hospitalized for drug use, ever witnessing overdose and having a friend and family member who overdosed.

CONCLUSION

Findings underscore the intersection of experiencing IPV and drug-related relationship dependencies, childhood adversity and lifetime adversity in shaping experiences of and witnessing overdose among women who use drugs. They highlight the urgent need to address IPV, adversity experiences and drug-related relationship dependencies in overdose prevention for women who use drugs.

Sexual violence as a predictor of unintended pregnancy among married young women: evidence from the 2016 Nepal demographic and health survey

BACKGROUND

Sexual violence in marital relationship is higher among women married at young age. Although sexual violence has been found to increase risk for unintended pregnancy, there is a limited published data from Nepal linking sexual violence with unintended pregnancy. The current study aimed to investigate association of partner sexual violence with unintended pregnancy among young married women who experienced child birth in last 5 years.

METHODS

Using data from Nepal Demographic and Health Survey, we studied the prevalence of sexual violence and unintended pregnancy, and their association among 560 married women (weighted sample) of 15-24 years who gave childbirth in last 5 years of the survey. We used multivariate logistic regression to analyse the association of sexual violence and other factors with unintended pregnancy. Analysis was conducted considering inverse probability weighting, clustering, and stratification to provide unbiased estimates of the population parameters.

RESULTS

Nearly a quarter of women (22.7%) reported to have experienced unintended pregnancy in the last 5 years of the survey and almost one in 10 women (9%) reported to have ever experienced sexual violence from their husbands. Women who ever experienced sexual violence from their husbands were at 2.3 times higher odds to report an unintended pregnancy (aOR = 2.3; 95% CI = 1.1-4.8) compared to women who did not experience sexual violence from their husbands independent of important socio-demographic variables and ever use of contraception.

CONCLUSION

The strong association of sexual violence within marital relationship with unintended pregnancy among young women in Nepal necessitates the provision of comprehensive sexual and reproductive health services. Women need routine assessment, and referral to appropriate services for sexual violence to reduce unintended pregnancy and its consequences.

Informal Control by Family and Risk Markers for Alcohol Abuse/Dependence in Seoul

Although previous research documents a reliable relationship between physical intimate partner violence (IPV) victimization and alcoholism, relatively little research has examined new theoretical constructs in IPV research that may increase risk for or help buffer women from alcohol abuse/dependence. The purpose of the present study was to examine informal social control of IPV by family members as a protective factor against and coercive control as a risk factor for alcohol abuse/dependence in a small population sample of married women in Seoul, South Korea. We hypothesized that (a) informal social control by family members would be negatively associated with victim alcohol abuse/dependence and (b) husband's coercive control would be positively associated with victim alcohol abuse/dependence. We measured alcohol abuse/dependence (CAGE scale), IPV and coercive control by husbands, and informal social control of IPV (ISC_IPV) by extended family members in a three-stage random cluster sample of 462 married women in Seoul, South Korea. Both random effects regression and zero-inflated Poisson regression models found that ISC_IPV by extended family members was associated with a significantly lower CAGE scores, and coercive control was associated with significantly higher CAGE scores. Interventions to boost ISC_IPV by extended family members may mitigate some of the risk of alcohol abuse/dependence by victims.

Stability and Change in Types of Intimate Partner Violence Across Pre-pregnancy, Pregnancy, and the Postpartum Period

Computer-assisted telephone interviews were conducted after childbirth with 2,709 female residents of Iowa to examine experience of intimate partner violence (IPV) across pre-pregnancy, pregnancy, and postpartum. IPV was most prevalent during the postpartum period, followed by pre-pregnancy, and pregnancy. Violence in one period increased the likelihood of violence in subsequent periods. Latent Transition Analysis revealed three classes of women: those who experienced No IPV, Predominantly Sexual IPV, or Physical IPV Only. Change in IPV type across time was associated with whether women had intended, and whether their partners wanted, the pregnancy and with marital status. Findings suggest a continuity of violence for childbearing women who experience IPV prior to conception and have numerous implications for clinicians, researchers, and policymakers.

Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study

BACKGROUND

Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the contextual elements pertaining to domestic violence.

METHODS

We recruited adult women attending antenatal services at a primary-level maternity facility. Demographic, socioeconomic and psychosocial data were collected by questionnaire. The Expanded Mini- International Neuropsychiatric Interview (MINI) Version 5.0.0 was used to assess mental health status and the Revised Conflict Tactic Scale (CTS2) used to assess IPV in the six months prior to the study. Non-parametric tests, Wilcoxon sum of rank test, Fisher Exact and two sample T test and multicollinearity tests were performed. Descriptive, bivariate and logistic regression analyses were conducted to identify associations between the outcome of interest and key predictors. A probability value of p ≤ 0.05 was selected. From counselling case notes, a thematic content analysis was conducted to describe contextual factors pertaining to forms of domestic violence (DV).

RESULTS

The prevalence of IPV was 15% of a sample of 376 women. Women who were food insecure, unemployed, in stable but unmarried relationships, had experienced any form of past abuse and were not pleased about the current pregnancy were more likely to experience IPV. MINI-defined mental health problems and a history of mental illness were significantly associated with IPV. Qualitative analysis of 95 counselling case notes revealed that DV within the household was not limited to intimate partners and, DV in this context was often perceived as 'normal' behaviour by the participants.

CONCLUSIONS

This study contributes towards a greater understanding of the risk profile for IPV amongst pregnant women in low-income settings. Adversity, including food insecurity and mental ill-health are closely associated with IPV during the antenatal period. Advocates against violence against pregnant women are advised to consider that violence in the home may be perpetrated by non-intimate partners and may by enabled by a pervasive belief in the acceptability of the violence.

Life Course Adversity and Prior Miscarriage in a Pregnancy Cohort

BACKGROUND

Prior studies indicate associations between preconception adversities and risk of miscarriage, but few have considered type (e.g., financial, substance use, abuse) or timing (e.g., childhood, adulthood) of adversities. We examined relationships between life course adversities in multiple domains and probability of miscarriage.

METHODS

Data came from women with at least one previous pregnancy in the Pregnancy Outcomes and Community Health (1998-2004) study (n = 2,106). Life course adversities in domains of abuse/witnessing violence, loss of someone close, economic hardship, and substance abuse were assessed via questionnaire and categorized as occurring during childhood only, adulthood only, both childhood and adulthood, or neither. We also calculated a cumulative adversity score. We used logistic regression models to estimate associations between life course adversity measures and the probability of miscarriage, and examined effect modification by race/ethnicity and maternal education. All models were adjusted for maternal age, race/ethnicity, education, and marital status.

RESULTS

The odds of miscarriage were higher among women experiencing legal adversities during both childhood and adulthood (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.3-2.8) compared with women not experiencing legal adversities, and higher among women experiencing substance use adversities in childhood only (OR, 1.4; 95% CI, 1.1-1.7) compared with women not experiencing substance use adversities. Each additional adversity was marginally significantly associated with a 10% increase in odds of preterm birth (OR, 1.1; 95% CI, 1.0-1.1). Among women with only one prior miscarriage, no adversity measures were associated with miscarriage.

CONCLUSIONS

Exposure to adversity in certain domains and across the life course modestly increased the odds of miscarriage.

After the Escape: Physical Abuse of Offspring, Posttraumatic Stress Disorder, and the Legacy of Political Violence in the DPRK

What is the relationship between victimization by political violence against women in North Korea and later physical abuse of offspring? This article examines the relationships between victimization by political violence, posttraumatic stress disorder (PTSD), alcohol abuse/dependence, and abuse of offspring after arrival in South Korea. A random sample of 204 female North Korean defectors was used to test hypotheses. An oral history conducted with a survivor of North Korean political violence is provided in an appendix to contextualize the results. Analyses established a significant link between previous victimization by political violence and abuse of offspring but not mediation by either PTSD or alcohol abuse/dependence.

Risk Factors for Recent Intimate Partner Violence among Methamphetamine-Using Men and Women

The Substance Abuse, Violence, and HIV/AIDS (SAVA) syndemic model describes how the confluence of the three epidemics of substance abuse, violence, and HIV risk work synergistically to create excess burden among populations. We sought to identify risk factors associated with recent intimate partner violence (IPV) victimization among heterosexual methamphetamine (meth)-using men (n = 108) and women (n = 122) enrolled in FASTLANE-II, an HIV behavioral intervention in San Diego, CA. Women and men reported high rates of physical-only (women: 20%; men: 18%) and sexual (women: 25%; men: 23%) IPV. Multinomial regression analysis revealed that individuals who reported lower social support and individuals who reported a greater likelihood of engaging in risky sexual behaviors while high on meth were more likely to report IPV versus no IPV. Women who reported a greater likelihood of engaging in risky sexual behaviors while high on meth were 1.58 times more likely to report physical-only IPV versus no IPV, while men who reported similar behaviors were 1.15 times more likely to report physical-only IPV versus no IPV. Our findings highlight the influence of interpersonal factors on IPV. This research supports further study on gender-specific risk/protective factors and the development of gender-specific interventions targeting the SAVA syndemic among meth users.

Coercive Control and the Stay-Leave Decision: The Role of Latent Tactics Among a Sample of Abused Pregnant Women

Prior research on intimate partner violence (IPV) and a survivor's decision whether to remain in or leave a violent relationship has often been framed by the question "why do they stay?" This study looks reframe the discussion and examine one facet of this stay-leave decision: abusers' use of coercive control tactics. Using a qualitative approach with a sample of pregnant women exposed to IPV, we sought to expand on the current knowledge by looking at coercive control more broadly via an open-ended assessment. Interview responses show that (a) coercive control was experienced by most of the women in this sample and (b) coercion most often took the form of "latent" or hidden control, including such tactics as providing incentives, showing remorse, and making promises. However, such latent coercive tactics are rarely assessed in IPV survivors and represent an important factor deserving of further research and recognition.

Does violence affect the use of contraception? Identifying the hidden factors from rural India

Purpose:

The objective of this study is to investigates the relationship between domestic violence and use of contraception among married women in rural India.

Data:

Third round of National Family Health Survey (NFHS-III).

Methodology:

Cross tabulation as bivariate analysis and Binary Logistic Regression as multivariate analysis has been employed to fulfill the objective.

Findings:

The result shows that there are several hidden factors. between physical violence and contraception use. Alternate explanatory variables are significantly affected the use of contraception. With physical violence which reflects that there is a relationship between physical violence and socioeconomic status such as education, awareness, empowerment of women and subsequently the use of contraception.

Originality/value:

The paper throws light on the hidden factors which are obstacle in use of contraception with physical violence. Results of this study have potentially important implications for programs aimed at preventing violence and promoting family planning programs.

Domestic Violence in the Workplace

In Minneapolis on Valentine's Day, a man walked into the second floor offices of his ex-girlfriend and loudly confronted her. He followed her as she fled into the women's restroom where they argued briefly and he shot her. He then fled the building and the state. She died ( Star Tribune, February 15, 1996).

Examining Intimate Partner Violence and Health Factors Among Rural Appalachian Pregnant Women

Among pregnant women, intimate partner violence (IPV) is recognized as a critical risk factor in adverse health outcomes for the mother and newborn alike. This pilot study examined IPV and health for rural Appalachian pregnant women, a particularly vulnerable high-risk and high-needs group. Participants were 77 rural, Appalachian pregnant women entering a hospital-based inpatient detoxification unit primarily for Opiate Dependence. Study participants gave informed consent to a face-to-face interview and secondary data abstraction from hospital medical records. IPV was measured via questions from the National Violence Against Women Survey, the Revised Conflict Tactics Scale (CTS2), and the Psychological Maltreatment of Women Inventory (PMWI). The majority of the sample reported lifetime psychological (89.6%) and physical (64.9%) violence. A little over three fourths (75.3%) experienced IPV in the past year. Furthermore, over one third (39.0%) experienced stalking, physical, or sexual violence in the past year. Most participants (71.4%) experienced psychological abuse in the past year. IPV experiences, in conjunction with pervasive substance use, mental and physical health problems, and poverty present in rural Appalachia, culminate in a particularly high-risk and high-needs group of pregnant women. These women present unique opportunities and challenges for prevention, intervention, and treatment.

Military/Civilian Risk Markers for Physical Intimate Partner Violence: A Meta-Analysis

This meta-analysis compared risk markers for perpetration of physical intimate partner violence (IPV) among military and civilian males. We also examined strength of risk markers among male and female service members. In total, 36 military studies and 334 civilian studies, which reported 883 effect sizes, were included in the analyses. Results revealed more similarities than differences in risk markers for IPV among military and civilian males and among military males and females. Of the risk markers examined, relationship satisfaction and alcohol problems were significantly stronger risk markers for IPV among civilian males compared to military males. Perpetrating emotional abuse was a significantly stronger risk marker for IPV perpetration among military females compared to military males. Recommendations for IPV prevention and intervention are discussed.

‘Opening the door’: A qualitative interpretive study of women’s experiences of being asked about intimate partner violence and receiving an intervention during perinatal home visits in rural and urban settings in the USA

This study explored women’s experiences of being screened for intimate partner violence and receiving an intervention during perinatal home visits in urban and rural settings in the USA. Twenty-six women were recruited from the DOVE (Domestic Violence Enhanced Home Visit) intervention trial to participate in a nested qualitative interpretive study. Women valued the opportunity to discuss their intimate partner violence experiences and access support. Disclosure was a staged process and home visitor communication style and the development of a trusting relationship were influencing factors. Safety planning was an important feature of the DOVE intervention, whether the abuse was past or ongoing. Women highlighted the need for post-abuse support services. Perinatal home visitors require training in intimate partner violence that supports the development of good communication skills and provides opportunities for experiential learning and feedback with regards to asking about and responding to intimate partner violence. Reinforcement training activities are necessary in order to enhance home visitor’s confidence and comfort, and sustain practice. Rigorous protocols are needed to ensure the safety of home visitors and women.

Acculturation, Drinking, and Intimate Partner Violence among Hispanic Couples in the United States: A Longitudinal Study

This article examines the 5-year association between acculturation, drinking, and maleto-female partner violence and female-to-male partner violence among Hispanic couples in the United States. A national representative sample of Hispanic couples 18 years of age or older was interviewed in 1995 and 2000. Both members of the couple were independently interviewed. Differences in prevalence rates of male-to-female partner violence and female-to-male partner violence, incidence, and recurrence across acculturation groups are not significant. Drinking is associated with acculturation among women. Couples with mixed acculturation level (high-medium) are less at risk for maleto-female partner violence. An increase of five standard drinks per week in men’s drinking decreases the risk of female-to-male partner violence by 10%. Acculturation level at Time 1 is not associated with male-to-female partner violence and female-to-male partner violence status 5 years later.

Intimate Partner Violence and Women's Depression Before and During Pregnancy

Depressive symptoms of 95 prenatal care patients were examined relative to thewomen's experiences of intimate partner violence. Women who were victims of psychological aggression during the year before pregnancy were not at elevated risk for depression except when the psychological aggression was very frequent. However, during pregnancy, psychological aggression was more closely tied to women's depression levels, regardless of its frequency. In addition, women who experienced any level of physical assault or sexual coercion by their intimate partners (before or during pregnancy) had higher levels of depressive symptoms compared to nonvictims.

Trauma Exposure and Alcohol Use in Battered Women

The purpose of the present study was to examine the relationship between battering severity and alcohol use among battered women. The study used multiple regression analyses to examine predictive relationships between three forms of trauma exposure—childhood physical and sexual abuse and domestic violence—and alcohol use. This study is among the first to investigate these relationships, using a sample of 78 battered women drawn from both shelter and nonresidential community agencies. Both battering severity and childhood sexual abuse were positively correlated with alcohol use. Multiple regression analysis showed that childhood sexual abuse was the stronger predictor when collinearity was controlled.

Utilization of Police by Abused Pregnant Hispanic Women

Three hundred twenty-nine Hispanic prenatal patients at urban public health clinics who were assessed during routine prenatal care as abused completed the Severity of Violence Against Women Scales and were asked about frequency and effectiveness of their utilization of police. Of the 23% who had used the police, 72% reported that police were very or somewhat effective. Of the women who had used police, 37% said that the violence had ended compared with 22% of the nonusers. Women who had used the police in the past 12 months had experienced more severe abuse than those women who had not. Longitudinal research is needed to determine whether increased severity precedes or follows abused women's use of the police so that the women may be counseled appropriately.

Correlates of Poverty and Partner Abuse Among Women on Methadone

This study explores the association between poverty and experiences of partner abuse among 204 women recruited from methadone maintenance treatment programs. Logistic regressions were used to examine the associations between extreme poverty and indicators of partner abuse. The findings show that extreme poverty was prevalent and associated with partner abuse. The study findings suggest that providers of methadone maintenance programs need to incorporate poverty indicators in their assessment because extreme poverty seems to correlate with all forms of partner abuse. The impact of welfare reform on partner violence should be on the agendas of policy makers and researchers.

The Relationship Between Intimate Partner Violence and the Use of Addictive Substances in Poor and Homeless Single Mothers

This study examines the contributions of adult partner violence, childhood physical abuse and sexual molestation, post-traumatic stress disorder (PTSD), and partners'sub-stance use on poor women's use of addictive substances. Utilizing a longitudinal data set, researchers found that women with histories of partner violence had nearly three times the odds of using illegal drugs at follow-up. Reverse causation (i.e., substance use increases the likelihood of violent relationships) did not explain the association. Confounding by childhood sexual molestation and mediation by PTSD also did not fully account for the violence–drug use link. Partners' substance use was independently related to women's follow-up drug and alcohol use. Program and policy implications are reviewed

Women's Sexual Health: The Need for Feminist Analyses in Public Health in the Decade of Behavior

Women's sexual health is directly affected by women's low status in society. This low status, and subsequent lack of sexual autonomy not only increases risk for sexual health problems, it also decreases ability to obtain treatment and support when a sexual health concern arises. This has clearly been demonstrated in the HIV epidemic within the U.S. Earlier in the epidemic, women were simply ignored by public health research and practice. Once they could no longer be ignored, they were blamed and viewed as vectors. Current seroprevalence rates among men reveal that women are not significant vectors. In contrast, rates among women indicate that infection from men is the primary mechanism by which women are contracting HIV, and male-controlled sexual decision-making, male partner violence against women, and histories of sexual assault all contribute to increased HIV risk for women. Once infected, women are not given the support and resources they need as mothers and caretakers of HIV-positive partners and/or children. These findings are especially true for marginalized women such as women of color, poor women, women addicted to alcohol or drugs, and women who exchange sex for drugs or money. Findings from this review demonstrate the need for feminist approaches in understanding and addressing this issue in the Decade of Behavior. Such approaches must include an understanding of the needs of diverse women. An empowerment approach is needed to better contend with the sexual health needs of women; this must include the goal of ensuring women's control of their own bodies.

Prenatal, perinatal, and adolescent exposure to marijuana: Relationships with aggressive behavior

This manuscript reviews research exploring the relationship between prenatal, perinatal, and adolescent exposure to marijuana and aggressive behavior, including physical aggression. Areas of inquiry include animal research, as well as human research, on prenatal exposure and on marijuana use during adolescence. Potential psychosocial and psychopharmacological mechanisms are identified, as well as relevant confounds. The prenatal marijuana exposure literature provides minimal support for a direct relationship with aggressive behavior in childhood. The adolescent use literature suggests a marginal (at best) association between acute intoxication and aggressive behavior, and an association between chronic use and aggressive behavior heavily influenced by demographic variables, rather than direct, psychopharmacological mechanisms. Cannabis withdrawal symptoms also may include aggression and anger, but there is little evidence to suggest that these effects are large or specific to withdrawal from marijuana compared to other substances. This review will offer recommendations for clinical care and public policy, as well as important questions for future research.

Multilevel correlates of broadly- and narrowly-defined intimate partner violence among pregnant women in Los Angeles

Studies have identified correlates of intimate partner violence (IPV) during pregnancy at the individual and neighborhood levels, but have used inconsistent definitions of IPV. We aimed to compare correlates based on two IPV definitions: broad (physical, sexual, or psychological violence) and narrow (physical or sexual violence only). Our analysis included 12,358 women in 2,110 census tracts (weighted to represent 269,671 women) who recently gave birth and responded to the Los Angeles Mommy and Baby (LAMB) survey. We linked 2007 and 2010 LAMB data to American Community Survey 2006-2010 census tract data, and conducted separate logistic multilevel analyses to identify correlates of IPV based on each definition. Prevalence of IPV during pregnancy was much higher by the broad (18.3 %) than the narrow definition (3.9 %). No independent neighborhood-level correlates were identified. Some individual-level correlates were associated with both IPV definitions, including substance abuse (OR 3.15, 95 % CI 2.47-4.00 for broad definition; OR 3.60, 95 % CI 2.30-5.64 for narrow definition) and medical problems (OR for ≥3 vs. 0 medical problems 2.03, 95 % CI 1.61-2.55 for broad definition, OR 2.40, 95 % CI 1.54-3.74 for narrow definition). Other correlates associated only with the broad definition, such as car accidents (OR 1.44, 95 % CI 1.04-2.00) and moving during pregnancy (OR 1.35, 95 % CI 1.12-1.62). Differences in correlates of IPV during pregnancy for a broad versus narrow IPV definition may illustrate the situations or mechanisms by which different types of IPV arise. Individual-level characteristics may outweigh neighborhood influences in a diverse population.

Alcohol Consumption Practices among Married Women of Reproductive Age in Nepal: A Population Based Household Survey

Background

Alcohol chemically known as ethanol, causes several health, economic and social consequences across the world. Literatures suggest potential harm of alcohol drinking by pregnant women especially to the fetus and the mother. Despite anumber of significant public health problems related to alcohol consumption, this area has been ignored in Nepal and information at the national level is limited. Thus this study aimed at finding the prevalence of alcohol consumption among married women of reproductive age.

Methods

A nationally representative household survey was carried out from April to August 2013 by taking 16 districts across all 15 eco administrative regions. From the selected districts, 86 village development committees and 14 municipalities were selected as primary sampling units using probability proportionate to size, followed by random selection of 3 wards from each primary sampling unit. Finally, 30 households within each ward were selected using systematic random sampling, and one married women of reproductive age from each household. A total of 9000 married women of reproductive age were interviewed using a semi-structured questionnaire, on alcohol consumption practices including environmental factors and socio demographic characteristics and were included in the analysis.

Results

National prevalence of alcohol consumption ever among married women of reproductive age was 24.7% (95% CI:21.7–28.0), last 12 months 17.9% (95% CI:15.3–20.7) and last 30 days (current drinking) 11.8% (95% CI:9.8–14.1). There was substantial variation among the districts ranging from 2% to 60%. Multivariable analysis suggests women with no education or within formal education, dalit and janajatis ethnicity, whose husbands drink alcohol, who brew alcohol at home and women from mountains were significantly at higher risk of consuming alcohol. Among the women who drank alcohol in last 12 months, a substantial proportion of them drank home brewed alcoholic beverages (95.9%, 95% CI:94.3–97.4).

Conclusion

Alcohol consumption was common practice among married women of reproductive age in Nepal with variation among the subgroups of population. Thus, further investigation and behavior change communication interventions to reduce alcohol consumption especially among the women with higher risk of drinking is essential.

Intimate partner violence and maternal cigarette smoking before and during pregnancy

OBJECTIVE

To determine the association of intimate partner violence with maternal cigarette smoking before and during pregnancy.

METHODS

Data were obtained for 196,391 U.S. mothers who delivered live neonates from 2004-2008 and completed the Pregnancy Risk Assessment Monitoring System survey 2-9 months postpartum. Intimate partner violence was defined as being physically hurt by a current or expartner in the year before or during pregnancy. Weighted descriptive and multivariate analyses were performed.

RESULTS

Compared with nonphysically abused women, those who experienced physical abuse were 2.1 times more likely to smoke before pregnancy (44.0% compared with 21.0%, P<.001) and 2.6 times more likely to smoke during pregnancy (29.6% compared with 11.4%, P<.001). Smoking prevalence during pregnancy was highest for abused women who were non-Hispanic white (42.3% smoked) and lowest for nonabused college graduates (2.2% smoked). Smoking rates more than tripled for college graduates in abusive relationships (2.2% compared with 7.1%). After adjusting for potential confounding factors, abused women were significantly more likely to smoke during pregnancy than nonabused women (adjusted odds ratio 1.95, P<.001, 95% confidence interval 1.80-2.12).

CONCLUSION

Women who experienced intimate partner violence had significantly higher rates of smoking before pregnancy and were less likely to quit during pregnancy than women who did not experience intimate partner violence. The American College of Obstetricians and Gynecologists and the U.S. Public Services Task Force recommend routine intimate partner violence screening with appropriate interventions to prevent violence against women, optimize safety, and improve health. Additional and targeted intimate partner violence assessment of women who smoke during pregnancy may prove especially beneficial.

Domestic violence against pregnant women: A prospective study in a metropolitan city, İstanbul

OBJECTIVE

Violence against women, particularly against pregnant women, is increasingly being recognized as a significant problem around the world. Limited studies were found about domestic violence among pregnant women. The aim of this study was to determine the prevalence of domestic violence during pregnancy and the factors affecting it.

MATERIAL AND METHODS

This prospective study was conducted at the Department of Obstetrics and Gynecology, between January 2012 and April 2013. A total of 1349 pregnant women, irrespective of age and socioeconomic status, were interviewed using a questionnaire in the local language.

RESULTS

The incidence of domestic violence in this study was 2.37%. The mean age of women who reported violence was 29.06±5.53 years. Age, marriage duration, gravidity, parity, educational level, partner's educational level, and monthly income exerted no significant influences on women who experienced domestic violence during their pregnancies (p>0.05). Women who resided in the same houses with large extended families were at significantly higher risk of domestic violence during pregnancy in comparison with the pregnant women who lived within a core family (p=0.018).

CONCLUSION

Domestic violence during pregnancy is a potential public health problem. Education, improvements in economic autonomy, and society's attitudes may reduce domestic violence. Health-care providers should increase their awareness of risk factors to protect women from domestic violence.

A comparative study of the prevalence of domestic violence in women requesting a termination of pregnancy and those attending the antenatal clinic

OBJECTIVE

To compare the prevalence of domestic violence (DV) in women requesting antenatal care (ANC) and termination of pregnancy (TOP) in North East England.

DESIGN

This was a cross-sectional comparative prevalence study using self-administered questionnaires, with women selected as opportunistic samples over a concurrent period.

SETTING

The participants were screened anonymously and confidentially in the ANC and TOP clinics.

SAMPLE

Pregnant women in the first trimester requesting a TOP or ANC.

METHODS

The participants were screened for a history of DV using a modified version of the Abuse Assessment Screening tool.

MAIN OUTCOME MEASURES

Prevalence of DV between ANC and TOP populations, and any differences in the characteristics of the women, such as age, level of education, or marital status. We aimed to determine the reasons for requesting a TOP.

RESULTS

There were 507 respondents, with 233 attending ANC and 274 requesting a TOP. Of the ANC population, 219 completed the questionnaire. In the TOP population, all the questionnaires were fully or partially completed. Women requesting a TOP were six times as likely to suffer physical abuse in the current relationship (5.8 versus 0.9%; χ(2) = 10.2 (2); P < 0.05), and were five times as likely to suffer emotional abuse (9.9 versus 1.8%; χ(2) = 13.6 (2); P < 0.0001), than those attending ANC. Of the 274 women requesting a TOP, only ten mentioned DV as a contributing factor.

CONCLUSIONS

There is a higher prevalence of DV in the TOP population than in the ANC population, but very few women stated that DV influenced their request for a TOP.

Examining the Prevalence, Bidirectionality, and Co-Occurrence of Sexual Intimate Partner Violence among Women During Pregnancy and Postpartum

OBJECTIVES

This longitudinal study examined the prevalence of women's sexual intimate partner violence (IPV) perpetration, the extent to which women experienced both sexual IPV victimization and perpetration, and the overlap between women's experiences of sexual IPV with psychological and physical IPV victimization and perpetration.

METHODS

Data were collected via self-report survey from 180 women during the first 18 weeks of pregnancy and 122 participants completed follow-up assessments at six weeks postpartum.

RESULTS

At both time points, the prevalence of sexual IPV victimization and perpetration were similar in this sample. Bidirectional sexual IPV was more common than sexual IPV victimization or perpetration only. The majority of participants who experienced sexual IPV victimization at baseline and follow-up also experienced psychological or physical IPV victimization. No participants at either time point reported sexual IPV perpetration only, those participants who perpetrated sexual IPV also perpetrated psychological or physical IPV.

CONCLUSIONS

Future research should investigate women's sexual IPV victimization and perpetration as they relate to other areas of mental and physical health during this time period.

Intimate partner violence and depressive symptoms before pregnancy, during pregnancy, and after infant delivery: an exploratory study

Women who experience intimate partner violence (IPV) during pregnancy also tend to experience depressive symptoms. Unfortunately, little is known about how victimized women's levels of depressive symptoms change longitudinally before pregnancy, during pregnancy, and after infant delivery. In addition, few studies have used a comparison group of women to determine if levels of depressive symptoms among victimized women differ from depressive symptom levels in women who have not experienced IPV. To help address these knowledge gaps, we examined longitudinal trends in levels of depressive symptoms among a sample of 76 women who did (n = 33) and did not (n = 43) experience physical IPV during pregnancy. Using multilevel analysis, we estimated the relationship of physical IPV victimization and women's depressive symptom levels across six time periods: (a) the year before pregnancy, (b) first and second trimesters, (c) third trimester, (d) the first month postpartum, (e) Months 2 to 6 postpartum, and (f) Months 7 to 12 postpartum. Women who experienced physical IPV victimization during pregnancy had significantly higher levels of depressive symptoms during each time period (p < .05). No significant difference between the two groups was found in the rate of change in levels of depressive symptoms over time. These findings point to the importance of screening for IPV within health care settings and suggest that women physically abused during pregnancy need safety interventions that are coordinated with interventions targeting symptoms of depression.

Correlation of domestic violence during pregnancy with plasma amino-acid neurotransmitter, cortisol levels and catechol-o-methyltransferase Val(158)Met polymorphism in neonates

INTRODUCTION

To explore the correlation between domestic violence during pregnancy and glutamate (Glu), r-aminobutyric acid (GABA), plasma cortisol levels and catechol-o-methyltransferase (COMT) gene polymorphism (rs4818) in neonates.

METHODS

Using the Abuse Assessment Survey, 64 abused pregnant women (DV) and 117 non-abused pregnant women (non-DV) were screened for two study groups. Blood in neonatal umbilical vein was collected immediately after delivery. Plasma Glu, GABA, cortisol levels and rs4818 polymorphism in the genotypes and alleles of the two neonatal groups were compared.

RESULTS

In the DV group, 49 women (76.6%) experienced emotional abuse, 29 women (45.3%) experienced sexual abuse, 28 (43.8%) women experienced emotional abuse plus sexual abuse, and two women (3.1%) experienced emotional abuse plus physical abuse. We found that plasma Glu, GABA and cortisol levels were higher in DV neonates than in non-DV neonates. Furthermore, we observed a significantly positive correlation between maternal emotional abuse, sexual abuse and plasma levels of Glu, GABA and cortisol in neonates. By genetic analysis we found a significant difference in rs4818SNP genotype and allele between the two neonatal groups. The ratios of CC genotype and C allele were higher in DV neonates than in non-DV neonates, and the ratios of GG genotype and G allele were lower in DV neonates than in non-DV neonates. One-way ANOVA test showed that GABA level was lower in CC carriers than CG carriers.

DISCUSSION

Domestic violence during pregnancy might be associated with increased plasma levels of glutamate, GABA, cortisol and COMT gene polymorphism in neonates.

Risk factors for intimate partner violence during pregnancy and postpartum

This longitudinal investigation examined potential risk factors for intimate partner violence (IPV) among women during pregnancy and 6 weeks postpartum. A sample of 180 pregnant women was collected in order to investigate (1) whether associations between partner alcohol misuse, partner jealousy, partner suspicion of infidelity, and stress were associated with IPV victimization; (2) the indirect effects of alcohol misuse on these relationships; and (3) factors related to changes in IPV victimization over time. At baseline, partner alcohol misuse was associated with each type of IPV victimization and the combination of partner alcohol misuse, partner jealousy, and partner suspicion of infidelity was most strongly associated with severe physical victimization. Partner alcohol misuse mediated the relationship between partner jealousy and psychological and severe physical victimization. At follow-up, partner jealousy and stress were related to women's psychological victimization and partner alcohol misuse was related to women's severe physical victimization. Findings suggest that partner alcohol misuse is a risk factor for women's IPV victimization during pregnancy and jealousy and that stress may increase risk for some types of IPV. Findings also suggest that intervention should target parents early in pregnancy in order to reduce the risk for future IPV.

Comparison of the Addiction Severity Index (ASI) and the Global Appraisal of Individual Needs (GAIN) in predicting the effectiveness of drug treatment programs for pregnant and postpartum women

This study conducts a within-subject comparison of the Addiction Severity Index (ASI) and the Global Appraisal of Individual Needs (GAIN) to assess change in alcohol and other drug treatment outcomes for pregnant and postpartum women. Data are from 139 women who were pregnant or who had children under 11 months old and were admitted to residential drug treatment, then re-interviewed 6 months postdischarge (83% follow-up rate). The ASI and GAIN change measures were compared on their ability to detect changes in alcohol and drug use, medical and HIV risk issues, employment issues, legal problems, family and recovery environment characteristics, and psychological/emotional issues. The measures were similar in their ability to detect treatment outcomes, and ASI and GAIN change scores were moderately correlated with each other. The GAIN scales had equal or slightly higher coefficient alpha values than the ASI composite scores. The GAIN also includes an HIV risk scale, which is particularly important for pregnant and postpartum women. These results suggest that the GAIN is comparable with the ASI and can be used for treatment research with pregnant and postpartum women.

Risk factors for domestic violence during pregnancy: a meta-analytic review

This article presents the results of a meta-analysis of the existing research literature, in an effort to increase our understanding of the prevalence of domestic violence (DV) among pregnant women, and of risk factors associated with DV during pregnancy. Across 92 independent studies, the average reported prevalence of emotional abuse was 28.4%, physical abuse was 13.8%, and sexual abuse was 8.0%. Composite odds ratio effect sizes were calculated for the demographic, behavioral, and social risk factors identified by 55 independent studies. Both victimization and perpetration risk factors were analyzed. Abuse before pregnancy and lower education level were found to be strong predictors of abuse during pregnancy. Pregnancy being unintended by either the victim or the perpetrator, lower socioeconomic status, and being unmarried were found to be moderate predictors of abuse during pregnancy.

Pregnant women experiencing IPV: impact of supportive and non-supportive relationships with their mothers and other supportive adults on perinatal depression: a mixed methods analysis

The current study explored the views of women experiencing interpersonal violence (IPV) and their relationship with their mothers or other supportive adult, and determines how this relationship affected perinatal depressive symptoms. The sample consisted of 30 urban and rural pregnant women enrolled in a larger ongoing randomized controlled trial. Data from quantitative instruments that measured depressive symptoms were examined in combination with qualitative interview data collected at baseline and six months post-natal. Women describing positive relationships with their mothers or another supportive adult reported statistically significant lower depressive symptoms scores (p < .05).

Personal and psychosocial predictors of psychological abuse by partners during and after pregnancy: a longitudinal cohort study in a community sample

OBJECTIVE

To describe the incidence and risk factors of psychological intimate partner violence (IPV) during pregnancy and the first year after childbirth.

DESIGN

Longitudinal cohort study.

SETTING

Nine primary care centers in the Valencia Region (Spain).

POPULATION

A consecutive sample of 1400 women in the first trimester of pregnancy, attending the prenatal programme in the Valencia Region of Spain in 2008, with follow-up in the third trimester of pregnancy, and at 5 and 12 months postpartum. A total of 888 women (66.5%) participated in all four phases.

METHODS

A logistic regression model was fitted using generalised estimating equations to assess the effects of previous partner violence, consumption of alcohol or illicit drugs and social support on subsequent psychological partner violence.

MAIN OUTCOME MEASURE

Psychological IPV during follow-up.

RESULTS

We observed an increase in the incidence of psychological IPV after birth, particularly at 5 months postpartum. The strongest predictor of psychological IPV was having experienced abuse 12 months before pregnancy (OR 10.46, 95%CI 2.40-45.61). Other predictors were consumption of alcohol or illicit drugs by the partner or a family member (OR3.50, 95%CI 1.38-8.85) and lack of affective social support (OR2.83, 95%CI 1.31-6.11).

CONCLUSIONS

Previous abuse and psychosocial risk factors predict partner psychological abuse after birth. Monitoring psychological IPV and effective interventions are needed not only during pregnancy but also during the postpartum period.

Domestic violence screening of obstetric triage patients in a military population

OBJECTIVE

The objective was to estimate the self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care, and to determine the acceptability of domestic violence screening.

STUDY DESIGN

A prospective observational survey of patients presenting for obstetric emergency care. Women were anonymously screened for domestic violence using the Abuse Assessment Screen.

RESULT

A total of 499 surveys were distributed, with 26 duplicate surveys. After excluding the 12 blank surveys, a total of 461 surveys were included in the final analysis. The lifetime prevalence of domestic violence (including physical, emotional and sexual abuse) was 22.6% (95% CI=19.0 to 26.4) with 4.1% (95% CI=2.3-6.0) of women reporting physical abuse in the past year and 2.8% (95% CI=1.3-4.3) reporting abuse since becoming pregnant. The majority of women 91.8% (95% CI=88.7-94.2) were not offended by domestic violence screening and 88.8% (95% CI=82.0-88.9) felt that patients should be routinely screened.

CONCLUSION

The self-reported prevalence of domestic violence in a pregnant military population presenting for emergency care was 22.6%. Most women are not offended by domestic violence screening and support routine screening.

Intimate partner violence and unintended pregnancy among Bangladeshi women

This study examined the relationship between intimate partner violence (IPV) and unintended pregnancy using data from women reporting IPV in the 2007 Bangladesh Demographic Health Survey. The analysis included 4,695 married women, aged 15 to 40 years, who had at least one birth in the last 5 years. Bivariate and multiple logistic regression analyses were performed to assess the relationship between IPV and pregnancy. About one third (30.4%) of women were abused physically and/or sexually and about one third (30.9%) of their births in the last 5 years were unintended. Compared with women who suffered no IPV, women who were abused sexually had a 1.64-fold increased risk of unintended pregnancy, which is higher than those who suffered physical abuse only (odds ratio: 1.35). The prevalence of unintended pregnancy among those who experienced severe physical violence was 1.60 times higher than those who reported no abuse. The findings indicate a significant relationship between IPV and unintended pregnancy among Bangladeshi women.