Intimate partner violence: psychological and verbal abuse during pregnancy

Maternal and Fetal Outcomes Among Pregnant Women Exposed to Violence

Introduction Domestic violence against women is now widely recognized as a public health issue and a major human rights violation on a global scale. It is a significant risk factor for women's health problems. Pregnancy places a woman under significant physical and psychological pressure, even without additional stressors like abuse. This pressure can have a negative impact on both the mother's and the child's health. This study aims to assess the prevalence of violence among pregnant women and to determine the maternal and fetal outcomes among pregnant women exposed to violence. Materials and methods This cross-sectional study was conducted among 347 postpartum women to assess maternal and fetal outcomes among those who were exposed to violence during their pregnancy. A face-to-face interview was done using one tool with three parts to collect the necessary data. Part one included socio-demographic characteristics and reproductive history for participants, part two included safe and validated dates-physical violence victimization scale, and part three included maternal and fetal outcomes. Result The findings of this study showed that the prevalence of victimization occurred one to three times (28.8%), while 11.5% of victimization occurred four to nine times, and 2.6% of victimization occurred 10 times or more. Many factors play a role in violence, including family income, husband's jobs, husband smoking, being forced into marriage, a higher number of children, and parity. Additionally, it was discovered that adverse pregnancy and fetal outcomes include preterm birth (PTB), early onset of labor, low birth weight (LBW), and neonatal admission to the intensive care unit. Conclusion The result indicates that violence against pregnant women is at a significant rate. Their findings show that there are several factors that may have caused this percentage. Among the factors that contributed to violence in this study were family income, smoking, husbands' work, forced marriage, the number of pregnancies, and the number of children. To reduce violence during pregnancy, it is crucial to empower women, especially those without a source of income of their own. It is also critical to educate partners and foster healthy relationships between partners.

Exploring the relationship between intimate partner violence during pregnancy and stillbirths

INTRODUCTION

The relationship between intimate partner violence (IPV) in pregnancy and stillbirths is poorly understood. We aimed to determine if there was any association between stillbirths and IPV during pregnancy.

METHODS

A community-based, matched, case-control study was conducted in 2014, nested within the Maternal and Newborn Health Registry of the Global Network for Women's and Children's Health Research in Pakistan. Using a WHO questionnaire, IPV in pregnancy was ascertained from 256 cases (women with stillbirths) and 539 controls (women with live births), individually matched on parity. Multivariable conditional logistic regression analysis assessed the association of IPV in pregnancy ending in stillbirths compared to those with live births.

RESULTS

The effect of physical and psychological IPV was modified by maternal age. Among women 25-34 years old with stillbirths, the odds of experiencing physical IPV in pregnancy were four times greater than those with live births, after controlling for confounders [odds ratio 4.1 (95% CI: 1.5, 11.2)]. A negative association was observed between psychological IPV in pregnancy and stillbirths among women younger than 25 years, and no association was observed between sexual IPV during pregnancy and stillbirths.

CONCLUSION

Study results show that women 25-34 years of age with stillbirths were four times more likely to experience physical IPV during pregnancy. Further studies replicating the effect modification of IPV by maternal age are warranted.

How Valid is the Question of Fear of a Partner in Identifying Intimate Partner Abuse? A Cross-Sectional Analysis of Four Studies

Intimate partner abuse (IPA) affects women's health, requiring accurate questions to identify the abuse. We investigated the accuracy of three questions about fear of an intimate partner in identifying exposure to IPA. We compared the sensitivity and specificity of these questions with the Composite Abuse Scale (CAS) using secondary data analysis of four existing studies. All studies recruited adult women from clinical settings, with sample sizes ranging from 1,257 to 5,871. We examined associations between demographic factors and fear through multivariate logistic regression, and analysis of the sensitivity and specificity of the questions about fear and IPA (CAS), generating a receiver operating curve (ROC). The prevalence of lifetime fear of a partner ranged from 9.5% to 26.7%; 14.0% of women reported fear in the past 12 months; and current fear ranged from 1.3% to 3.3%. Comparing the three questions, the question "afraid of a partner in the past 12 months" was considered the best question to identify IPA. This question had the greatest area under the ROC (0.80, 95% confidence interval (CI) = [0.78-0.81]) compared with "are you currently afraid" (range 0.57-0.61) or "have you ever been afraid" (range 0.66-0.77); and demonstrated better sensitivity (64.8%) and specificity (94.8%). Demographic factors associated with "fear of a partner in the past 12 months" included being divorced/separated (odds ratio [OR] = 8.49, 95% CI = [6.70-10.76]); having a low income (OR = 4.21, 95% CI = [3.46-5.13]); and having less than 12 years of education (OR = 2.48, 95% CI = [2.04-3.02]). The question "In the last 12 months did you ever feel frightened by what your partner says or does?" has potential to identify a majority of women experiencing IPA, supporting its utilization where more comprehensive measures are not possible.

Association between intimate partner psychological violence and psychological distress among nurses: The role of personality traits and social support

AIM

This study proposes investigating the risk and protective factors of intimate partner (IP) psychological violence and psychological distress to better promote psychological wellbeing for nurses and health outcomes for patients.

DESIGN

A cross-sectional study.

METHOD

This cross-sectional study was carried out chiefly in Guangdong, Hunan, and Shaanxi provinces, in the east, central, and west of the Chinese economic areas, respectively. It was conducted in October 2021 using convenience sampling. A total of 843 nurses were eligible for the final analysis. Single-factor linear regression models were used to identify potential factors associated with IP psychological violence and psychological distress. In addition, the structural equation model was used to explore the role of personality traits and social support in the association between IP psychological violence and psychological distress.

RESULTS

The predictors for the score of IP psychological violence among nurses were participants' married status, contact frequency with a partner, perceived past-year psychological and physical violence experience, the alcohol consumption of partners, and personality traits and social support of partners. Moreover, the alcohol consumption of participants, the past-year experience of IP psychological violence, the score of psychological violence, personality traits, social support, and the personality traits of partners were associated factors affecting the psychological distress of nurses. In the structural model, the personality trait of partners had a direct pathway to psychological violence and social support. The results demonstrated that psychological violence significantly increased psychological distress.

CONCLUSION

Personality traits and social support are essential factors influencing the relationship between IP psychological violence and psychological distress.

IMPACT

The findings of this study emphasize the possibility and importance of identification and intervention for reducing IP psychological violence based on personality traits and social support.

[Epidemiological profile of female victims of psychological violence during the pre and postpartum periods in the Sédhiou region, Senegal]

BACKGROUND

In Senegal, psychological violence remains a taboo subject insofar as it often arises in the closed circle of family life. It has a highly negative impact on the health of pregnant women. The objective of this work was to study the epidemiological profile of female victims of psychological violence before and after birth in the Sédhiou region.

METHOD

An observational, cross-sectional and analytical study was carried out from December 4, 2018 to April 4, 2019. The study population consisted of all the women received for postnatal consultation in one of the referral health structures in the Sédhiou region. Data were collected using a survey form and a questionnaire administered to the women having met the inclusion criteria. The data were entered using CS Pro software and subsequently analyzed using R 3.4.4 software.

RESULTS

The mean age of the women was 25.4±7.8 (14-43 years). A total of 222 women (55.5 %) had suffered psychological violence during the prepartum period. Isolated psychological violence represented 44.3 % of the surveyed population, while psychological violence associated with sexual or physical violence represented 8.0 % and 5.4 % of the respondent population, respectively. The factors associated with psychological violence during the prepartum period were pursuit of a professional activity [ORaj=4.7 (1.3-17.0)], high educational status [ORaj=7.0 (4.2-11.5)] and performance of fewer than 3 antenatal consultations (ANC) [ORaj=2.2 (1.2-4.0)]. Maternal, fetal and neonatal complications were more frequent among victims of psychological violence (P<0.05). During the postpartum period, 26.5 % of the women who had been victims of violence during the prepartum period mentioned the fact that the aggression had ceased. The other women continued to endure violence, which was even more intense among 2.5 %.

CONCLUSION

Psychological violence among pregnant women has a negative impact on the health of the mother and the newborn. This state of affairs should induce health care providers to increase popular awareness of its detrimental effects. Communication efforts aimed at behavioral change will need to be combined during prenatal consultations with strengthened screening for violence, the objective being to achieve improved care.

Propriedades Psicométricas de uma Medida de Abuso Psicológico na Parceira

O abuso psicológico é caracterizado pela degradação e pelo controle do parceiro que levam ao desrespeito entre eles.Objetivou-se reunir evidências de validade da Escala de Abuso Psicológico na Parceira (EAP-P) em mulheres brasileiras. O estudo foi dividido em dois. Do Estudo 1, participaram 303 mulheres e realizaram-se análise fatorial exploratória e consistência interna. Os achados corroboraram para uma estrutura bifatorial: estratégias diretas do abuso psicológico e estratégias indiretas do abuso psicológico, com alfas iguais a .92 e .89, respectivamente. Do Estudo 2, participaram 380 mulheres, com a realização de análise confirmatória, e avaliaram-se os parâmetros dos itens mediante a Teoria deResposta ao Item (TRI). Os resultados apontaram que o modelo bifactor apresentou melhores índices de ajuste, além de bons índices de confiabilidade composta de .90 e variância média extraída (.51 e .50), e indicaram, através da TRI, boa capacidade de avaliar a porção central do contínuo de abuso psicológico. A eap-p se apresentou como um instrumento válido e consistente para detectar e medir a violência psicológica em mulheres.

Effects of Socioeconomic Status and Social Support on Violence against Pregnant Women: A Structural Equation Modeling Analysis

Few studies have used structural equation modeling to analyze the effects of variables on violence against women. The present study analyzed the effects of socioeconomic status and social support on violence against pregnant women who used prenatal services. This was a cross-sectional study based on data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA). The sample of the municipality of São Luís (Maranhão/Brazil) consisted of 1,446 pregnant women interviewed in 2010 and 2011. In the proposed model, socioeconomic status was the most distal predictor, followed by social support that determined general violence, psychological violence or physical/sexual violence, which were analyzed as latent variables. Violence was measured by the World Health Organization Violence against Women (WHO VAW) instrument. The São Luis model was estimated using structural equation modeling and validated with 1,378 pregnant women from Ribeirão Preto (São Paulo/Brazil). The proposed model showed good fit for general, psychological and physical/sexual violence for the São Luís sample. Socioeconomic status had no effect on general or psychological violence (p>0.05), but pregnant women with lower socioeconomic status reported more episodes of physical/sexual violence (standardized coefficient, SC = -0.136; p = 0.021). This effect of socioeconomic status was indirect and mediated by low social support (SC = -0.075; p<0.001). Low social support was associated with more episodes of general, psychological and physical/sexual violence (p<0.001). General and psychological violence indistinctly affected pregnant women of different socioeconomic status. Physical/sexual violence was more common for pregnant women with lower socioeconomic status and lower social support. Better social support contributed to reduction of all types of violence. Results were nearly the same for the validation sample of Ribeirão Preto except that SES was not associated with physical/sexual violence.