The Influence of Intimate Partner Violence on Pregnancy Symptoms

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.

Taking Practical Steps: A Feminist Participatory Approach to Cocreating a Trauma- and Violence-Informed Physical Activity Program for Women

Trauma- and violence-informed physical activity (TVIPA) is a feasible approach to improve access/engagement in physical activity for pregnant/parenting women with experiences of trauma. Through feminist participatory action research, 56 semistructured interviews were completed to understand TVIPA. Four themes were identified: (1) "I have to be on edge": Trauma and violence pervade women's lives, (2) "It should be mandatory that you feel safe": Emotional safety is essential, (3) "The opportunity to step up and be decision-makers and leaders": Choice, collaboration, and connection create safety, and (4) "It's a good start for healing," strengths-based and capacity building foster individual and community growth.

Relationship between health practices with attitudes towards pregnancy and motherhood and pregnancy symptoms in Iranian pregnant women: a cross-sectional study

OBJECTIVES

Pregnancy is a vulnerable period for women's health, and health practices play an essential role in this period. This study aimed to determine the relationship between health practices with attitudes toward pregnancy and motherhood and pregnancy symptoms.

DESIGN

It was a cross-sectional study using cluster sampling conducted on 351 pregnant women in 2021-2022. Data were collected using questionnaires of socio-demographic characteristics, health practices in pregnancy (Health Practices Questionnaire-II), attitude towards motherhood and pregnancy (Prenatal Attitudes Towards motherhood and Pregnancy) and pregnancy symptoms (Pregnancy Symptoms Inventory). The general linear model (GLM), with the adjustment of socio-demographic characteristics, was used to determine the relationship of the health practices with attitudes towards motherhood and pregnancy and pregnancy symptoms.

SETTING

Health centres in Tabriz city, Iran.

PARTICIPANTS

Women were eligible if living in the Tabriz city, Iran, were pregnant and had a personal health record at the health centre.

RESULTS

The mean (SD) of the total health practices score was 117.9 (20.5) out of 34-170. The mean (SD) of the attitudes towards motherhood and pregnancy was 33.4 (4.5) out of 11-44. The mean (SD) of the pregnancy symptoms was 28.0 (12.1) out of 0-123. According to the Pearson correlation test, there was a significant direct correlation between health practices with attitudes towards motherhood and pregnancy (r=0.39; p<0.001) and a significant inverse correlation with pregnancy symptoms (r=-0.29; p<0.001). Based on the GLM with an increase in the score of health practices, the mean score of the attitude towards motherhood and pregnancy increased (B=0.07; 95% CI: 0.05 to 0.1), and the mean score of pregnancy symptoms decreased (B=-0.1; 95% CI: -0.2 to -0.05).

CONCLUSION

Considering the relationship between health practices with the attitude towards motherhood and pregnancy symptoms, healthcare providers better use educational and counselling strategies to promote health practices in pregnant women.

Someone you can count on: Examining the mediating effect of social support on economic abuse and depression

The aim of this study was to examine whether social support mediated the relationship between economic abuse, a form of intimate partner violence, and mental health, specifically depression, among pregnant women. This cross-sectional study used a sample of 193 pregnant women living in the United States who participated in an online Qualtrics panel survey in January 2021. Hayes Process Macro was used to assess a mediation model. Economic abuse was associated with increased odds of depressive sympto ms and fewer perceived social supports. Social support mediated the relationship between economic abuse and depression. Implications for research, policy, and practice are discussed. Notably, research focused on economic abuse and efforts to respond to it need to pay particularly close attention to the role that social supports may play in survivor's overall well-being, as well as the impact that economic abuse may have on survivors' perceptions of social support. This may be particularly true for pregnant women experiencing economic abuse for whom social support-related interventions have yielded positive health outcomes.

The relationship between domestic violence against women, adaptation to pregnancy and maternal-fetal antenatal attachment

PURPOSE

This study aimed to determine the relationship between domestic violence against women, adaptation to pregnancy, and maternal-fetal antenatal attachment.

DESIGN AND METHODS

The study consisted of 385 pregnant women who were referred to the antenatal clinics of a public hospital in eastern Turkey. The data were collected using the Domestic Violence against Women Scale (DVAWS), the Maternal-Fetal Antenatal Attachment Scale (MAAS), and the Prenatal Self-Evaluation Questionnaire (PSEQ) to assess adaptation to pregnancy.

FINDINGS

Pregnant women were exposed to low level of violence (Mean ± SD: 64.42 ± 5.30). A statistically significant positive correlation was found between their DVAWS and PSEQ mean scores. There was also a statistically significant positive correlation between their DVAWS and MAAS mean scores.

PRACTICE IMPLICATIONS

Findings show that as domestic violence against women increased, adaptation to pregnancy decreased and maternal-fetal attachment increased.

Examining the impact of economic abuse on survivors of intimate partner violence: a scoping review

Background

Economic abuse is a unique form of intimate partner violence (IPV) and includes behaviors that control a survivor’s ability to acquire, use, and maintain resources. These tactics can result in someone becoming economically dependent on their partner and may limit their ability to leave the relationship and establish independence. The aim of this study was to conduct a scoping review focused on the impact of economic abuse on survivors of IPV.

Methods

A total of 14 databases were reviewed, which resulted in 35 peer-reviewed manuscripts for inclusion in the study. Manuscripts were included if they were: written in English, published since the year 2000, focused specifically on the impact of economic abuse perpetrated by an intimate partner, economic abuse was measured as an independent variable, and if economic abuse was looked at separately from other forms of IPV. Both convenience and population-based samples were included in the review. Information was extracted using a data charting form. The data were analyzed using a combination of grouping techniques and constant comparison methods to identify key findings.

Results

Studies found significant associations between economic abuse and a range of outcomes, such as mental and physical health, financial impacts, parent-child interactions, and quality of life. The most frequently examined were mental health, followed by financial issues.

Conclusions

Limitations of these studies included a lack of longitudinal research and a focus on heterosexual relationships with male-perpetrated violence toward female survivors. Study findings highlight the wide-ranging potential impacts of economic abuse on survivors and the need for additional research to better understand potential outcomes and implement and evaluate interventions to address them.

Worldwide Prevalence of Intimate Partner Violence in Pregnancy. A Systematic Review and Meta-Analysis

Background: Intimate partner violence (IPV) affects outcomes of mothers and their offspring. This systematic review collated the worldwide literature on the prevalence rates of different types of IPV in pregnancy.

Methods: Two reviewers independently identified cross sectional and cohort studies of IPV prevalence in pregnancy in online databases (PubMed, WOS and Scopus), selected and extracted data [participants' country, study quality, measurement tool (validation and purpose) and rates of IPV in pregnancy]. We considered a high quality study if it had a prospective design, an adequate sampling method, a sample size estimation, a response rate > 90%, a contemporary ascertainment of IPV in the index pregnancy, and a well-developed detailed IPV tool. We performed random effects meta-analysis and explored reasons for heterogeneity of rates.

Results: One hundred fifty-five studies were included, of which 44 (28%) met two-thirds of the quality criteria. Worldwide prevalence of physical (126 studies, 220,462 participants), psychological (113 studies, 189,630 participants) and sexual (98 studies, 155,324 participants) IPV in pregnancy was 9.2% (95% CI 7.7–11.1%, I² 95.9%), 18.7% (15.1–22.9%, I² 98.2%), 5.5% (4.0–7.5%, I² 93.4%), respectively. Where several types of IPV were reported combined, the prevalence of any kind of IPV (118 studies, 124,838 participants) was 25.0% (20.3, 30.5%, I² 98.6%). IPV rates varied within and between continents, being the highest in Africa and the lowest in Europe (p < 0.001). Rates also varied according to measurement purpose, being higher for diagnosis than for screening, in physical (p = 0.022) and sexual (p = 0.014) IPV.

Conclusions: IPV prevalence in pregnancy varies across countries, with one-quarter of mothers exposed on average globally. Routine systematic antenatal detection should be applied worldwide.

Systematic Review Registration: identifier: CRD42020176131.

The Road to Resilience: Strength and Coping Among Pregnant Women Exposed to Intimate Partner Violence

Pregnancy is a period of heightened risk for exposure to intimate partner violence (IPV), which is characterized by actual or threatened emotional, physical, or sexual violence committed by a past or current intimate partner. Pregnancy also represents a unique period in which women may be highly motivated to address IPV, to improve not only her health and well-being but also that of her child. Accordingly, the prenatal period affords an important opportunity for intervention among women experiencing IPV. Focus groups were conducted to evaluate coping strategies utilized by women exposed to IPV during pregnancy in addition to the strengths these women exhibit. Via thematic analysis, focus group data were evaluated from 10 women exposed to IPV proximal to their pregnancy and 46 service providers (e.g., medical personnel, family resource coordinators and case managers) who work directly with pregnant women experiencing IPV. When participants were queried about the personal strengths of IPV-exposed women, two domains emerged: (a) understanding and ending the cycle of IPV and (b) strengths achieved as a result of leaving the violent relationship (i.e., personal growth, enhanced self-esteem, improved attentiveness as a parent and resilience). With respect to coping, three central domains emerged: (a) the necessity of ensuring physical safety as a precondition for coping, (b) maladaptive coping strategies (e.g., substance use, avoidance), and (c) adaptive coping strategies (e.g., seeking support from others via both formal and informal relationships). These findings reinforce the importance of engaging with women before, during, and after they leave a violent relationship to provide support, affirmation and hope.

Intimate partner violence during pregnancy in turkey: A systematic review and meta-analysis

PURPOSE

The objective of the present research was to identify the prevalence of and risk factors for intimate partner violence during pregnancy (IPVP) in Turkey by conducting a systematic review and meta-analysis.

DESIGN AND METHODS

In the current research, 22 primary studies published between January 2005 and January 2019 were investigated.

FINDINGS

Low educational and income levels of both the woman and her partner, unintended marriage and pregnancy, living in a crowded family, a high number of children and a history of violence, unemployment of the partner, and the consumption of alcohol are the most significant risk factors of IPVP.

PRACTICE IMPLICATIONS

This study shows that violence against women, which is a serious problem in Turkey as well as all over the world, also continues in a critical period, such as the pregnancy period.

Effect of Intimate Partner Violence on Maternal and Birth Outcomes of Pregnancy among Antenatal Clinic Attendees in Delhi: A Prospective Observational Study

Context

Violence against women is a major public health problem and a violation of their human rights. Intimate partner violence (IPV) during pregnancy has been linked to various adverse maternal health outcomes and birth outcomes.

Aims

The aim of this study is to assess the magnitude of maternal complications and adverse birth outcomes in relation to IPV.

Settings and Design

Prospective observational study was conducted from April 2015 to May 2018 in the antenatal clinic of a Tertiary Care Hospital in Delhi.

Subjects and Methods

Sample of 1500 pregnant women (≤20 weeks gestation) were recruited and followed up at regular intervals, up to the birth outcome.

Statistical Analysis Used

Data were analyzed using the Statistical Package for the Social Sciences version 25. Value of P < 0.05 was considered statistically significant.

Results

Prevalence of IPV at baseline was 29.7%. Significantly higher proportion of IPV victims (47.2%) had poor weight gain during the pregnancy. Subjects reporting violence at any of the study contacts had a higher incidence of preterm delivery (12.7%), and a significantly higher incidence of low birth weight in the newborns (32.1% vs 22.3%) (P < 0.05).

Conclusions

The findings reveal that IPV during pregnancy is common and significantly associated with adverse maternal and birth outcomes. The findings stress need for research and development of a screening tool to identify violence early in pregnancy and thus prevent its consequences.

Imaging of Violence Against the Elderly and the Women

Emergency department assessment is a critical opportunity to identify elder abuse and violence against women, which represent a growing problem, requiring the attention of health care systems. Elder abuse is most frequently perpetrated by family members because of the higher levels of stress, burnout, and financial problems affecting the caregivers that can even lead to deadly consequences. Intimate partner violence is defined as physical, sexual, or psychological harm caused to another by a current or former partner or spouse, and can range from a single acute hit to chronic battering, varying in frequency and severity. Radiologists have a critical role in detecting those injury findings suggestive of abuse and violence. When appropriate, additional information about the social circumstances in which an injury took place, linked with imaging findings, may also be helpful in diagnosing abuse. The purpose of this article is to highlight the role of diagnostic imaging in the detection of lesions compatible with domestic abuse in elderly patients and women, and to allow the recognition of the alterations most frequently associated with this type of violence.