Intimate partner violence and women's reproductive health

Intimate partner violence (IPV) is common among women. An estimated 30% of all women globally report having experienced physical or sexual violence by a husband, intimate partner or ex-partner. It is important for those working in reproductive health settings to be aware that sexual assault can occur in the context of relationships. IPV can also include reproductive and sexual coercion. Reproductive coercion includes behaviours that interfere with contraception use and/or pregnancy, while sexual coercion includes behaviours related to pressuring or coercing a person to have sex without using physical force. Past or current IPV in a woman's life can have profound implications for her reproductive and general health, and healthcare providers need to have the skills to identify IPV, and provide appropriate support and referrals as required.     

Intimate partner violence and unplanned pregnancy in the Pacific Islands Families Study.

OBJECTIVE: To examine the association between maternal intimate partner violence (IPV) victimization and unplanned pregnancy. METHOD: Mothers of the Pacific Islands Families (PIF) Study cohort of Pacific infants born in Auckland, New Zealand during 2000 were interviewed when the children were 6 weeks old. A total of 1088 mothers cohabiting in married or de-facto partnerships were questioned about IPV and whether their pregnancy had been planned. RESULTS: Women identified as victims of physical violence were more likely to report an unplanned pregnancy than those who were not victims (68.7% vs 55.1%, odds ratio [OR] 1.78; 95% confidence interval [CI], 1.32-2.40). The adjusted odds remained statistically significant (OR 1.52; 95% CI, 1.01-2.26). CONCLUSION: The findings of this study suggest an association between IPV and unplanned pregnancy in the Pacific birth cohort.     

Intimate partner violence and HIV risk behaviors among socially disadvantaged Chilean women

The objective of this study was to determine if a relationship exists between intimate partner violence (IPV) and HIV risk among socioeconomically disadvantaged Chilean women. A correlational analysis with data from the NIH-funded project, "Testing an HIV/AIDS Prevention Intervention for Chilean Women," was conducted. Two hundred and sixty-one women were included in this analysis (n = 261). Those women who had experienced any type of IPV in the past 3 months had significantly higher risk for HIV than those who had not (t = -2.016, p < .05). Also a linear trend was found among those women who had experienced more than one type of IPV in the past 3 months and HIV risk.     

Comparative Analyses of Stressors Experienced by Rural Low-Income Pregnant Women Experiencing Intimate Partner Violence and Those Who Are Not

Objective: To describe the daily lives of rural pregnant women who smoked during pregnancy, with a focus on their sources of stress and the compounding effects of intimate partner violence.
Design: A qualitative study using content analysis of research nurses' telephone logs from a large smoking cessation randomized controlled trial ( N =695) in which 33% of the sample ( n =227) experienced intimate partner violence in the past year.
Participants: Fifty pregnant women, 25 who had experienced intimate partner violence in the past year and 25 who had never experienced intimate partner violence, were randomly selected from those who received a nurse-delivered telephone intervention for smoking cessation ( n =345). The mean age of the sample was 22 years, and the majority were White and living in a married-like relationship.
Results: Women experiencing intimate partner violence discussed certain stressors significantly more often than nonabused women. These stressors included finances, lack of social support, legal issues, transportation issues, and abuse by the intimate partner and others.
Conclusion: Health care providers need to recognize that intimate partner violence creates a stress, which can compound the stressors of pregnancy and poverty in rural areas. Offering these women a chance to talk about their lives can help them not only to locate necessary resources, but also to break down the barriers of isolation.     

Intimate partner violence and women's contraceptive use

Intimate partner violence has been hypothesized as a factor associated with women's risk for problems in contraception use or access. This article explores differences in contraceptive use between abused and nonabused women, using a case-control study of 225 women. Women experiencing physical and emotional abuse were more likely to report not using their preferred method of contraception in the past 12 months compared with nonabused women (OR = 1.9; 95% CI = 1.0 to 3.7). Health care providers need to consider how intimate partner violence may influence their patients' use of contraceptives, which has implications for the high risk of unintended pregnancies among abused women.     

Intimate partner violence among pregnant Thai women

The purposes of this study are to describe intimate partner violence (IPV) among pregnant women in Thailand and compare maternal characteristics, health practices during pregnancy, and maternal health between abused and nonabused pregnant women. Of 475 pregnant Thai women, 13.1% report ever being abused, whereas 4.8% report physical abuse during pregnancy. Women abused during pregnancy, compared to nonabused women, are more likely to be younger, unmarried, have low income, be unemployed, and report that the pregnancy was unwanted. They also report lower levels of positive health practices and higher levels of depressive symptoms. Results demonstrate a need for screening of IPV among pregnant Thai women.     

Physical health and posttraumatic stress disorder symptoms in women experiencing intimate partner violence

This correlational-predictive study addresses the associations between intimate partner violence (IPV) and physical health and posttraumatic stress disorder (PTSD) symptoms, including: 1) detailed physical health symptoms reported and health care sought by women in intimate abusive relationships, 2) relationships between physical health symptoms, IPV, and PTSD, and 3) unique predictors of physical health symptoms. An ethnically diverse sample of 157 abused women was recruited from crisis shelters and the community. The women averaged almost 34 years of age and had been in the abusive relationship for slightly more than 5 years. The women experienced physical health symptoms falling into 4 groups: neuromuscular, stress, sleep, and gynecologic symptoms. Women experiencing more severe IPV reported more physical health and PTSD symptomatology. PTSD avoidance and threats of violence or risk of homicide uniquely predicted physical health. More than 75% of the women had sought treatment from a health care professional in the previous 9 months. Implications for practice are discussed.     

Intimate partner violence among Latinas in eastern North Carolina

This article explores the correlates of intimate partner violence (IPV) among rural, southern Latinas. A sample of 1,212 women in blue-collar work sites in rural North Carolina completed a questionnaire assessing IPV and other social, demographic, and health-related variables. Social and demographic correlates of IPV were examined. Adult lifetime prevalence of IPV in Latinas was 19.5%, similar to that of non-Latinas. As compared to Latinas who did not experience IPV and non-Latinas who experienced IPV, Latinas who experienced IPV were more likely to lack social support and to have children in the home. Agencies that provide services to victims of IPV in the rural South need to be prepared to meet the unique needs of Latina immigrants.     

Women who have sex with women: their sexual biography, reproductive health and experience with violence

OBJECTIVE: To compare sociodemographic characteristics, sexual and reproductive biographies and experience of violence according to the fact that women have or have not had homosexual relationship. PATIENTS AND METHODS: From the national survey on violence against women in France carried out in 2000 by phone, two groups have been compared: 78 women who have had at least one woman sexual partner and 6332 women who have had only male partners during lifetime. RESULTS: Women who have had sexual relationships with women more often have high level social positions and live in large cities. They have a more diverse sexual life that they begin younger and more partners, mainly men. They use contraception less often. They have more sexually transmitted infections and are more often tested for HIV. They visit gynaecologists as often as other women. They are more often victims of violence, especially physical violence as adults. DISCUSSION AND CONCLUSION: These results, in an understudied field in France, are consistent with findings from the international literature. They attest to the difficulties women may be confronted with in situations where autonomy and marginality are combined. Doctors need to be better informed about the diversity of their trajectories in order to provide appropriate medical care.     

Contraception,reproductive health and pregnancy outcomes among women exposed to intimate partner violence in Nigeria

Objectives?To examine the association between reproductive health practices/outcomes and exposure to intimate partner violence (IPV) among women in Nigeria. More specifically, the association between IPV and use of contraception; miscarriages,induced abortions, stillbirths, and infant mortality; and having many children, was assessed.

Methods?Data on studied variables were retrieved from the Demographic and Health Surveys of Nigeria 2008, a nationally representative sample of 33,385 women of reproductive age. IPV was defined as exposure to physical, sexual or emotional abuse. The association between contraception use, pregnancy outcomes and infant mortality, and exposure to IPV was assessed using the chi-square test for unadjusted analyses. To control for potential confounding, socio-demographic variables were adjusted for using multiple logistic regression.

Results?Compared with women not exposed to IPV, those who were, exhibited a higher likelihood of using modern forms of contraception; having a history of miscarriages, induced abortions, stillbirths, or infant mortality; and having many children. The aforementioned observations still stood after adjustment for potential confounders (e.g., demographic and socioeconomic factors).

Conclusion?Though causal inference cannot be drawn due to the cross-sectional design, the study has important implications for incorporation of IPV detection and management in initiatives aimed at improving women's reproductive health.     

The relationship between males' attitudes to partner violence and use of contraceptive methods in Turkey

Interventions have been carried out to improve the reproductive health and status of women in Turkey. However, these efforts are limited due to lack of male involvement. Lifestyle risks such as partner violence need to be evaluated in terms of any effects on the use of contraception. Data collected from interviews of married women and their husbands for the 1998 Turkish Demographic and Health Survey and 1971 husbands were included in the study. The percentage of husbands who were against partner violence was 20.4%. However, 22 (0.9%) husbands had an attitude toward the use of violence against their wives. The frequency of contraceptive use was increased from the group of men who had unfavorable attitudes towards violence to the group of men who had favorable attitudes. A similar trend was found in the percentages of condom use for men, with multiple factors influencing contraceptive use. The study suggests that further investigations are needed for couple-related issues to improve the status of women in the community and to empower women for sexual health.     

The relationship between males' attitudes to partner violence and use of contraceptive methods in Turkey.

Interventions have been carried out to improve the reproductive health and status of women in Turkey. However, these efforts are limited due to lack of male involvement. Lifestyle risks such as partner violence need to be evaluated in terms of any effects on the use of contraception. Data collected from interviews of married women and their husbands for the 1998 Turkish Demographic and Health Survey and 1971 husbands were included in the study. The percentage of husbands who were against partner violence was 20.4%. However, 22 (0.9%) husbands had an attitude toward the use of violence against their wives. The frequency of contraceptive use was increased from the group of men who had unfavorable attitudes towards violence to the group of men who had favorable attitudes. A similar trend was found in the percentages of condom use for men, with multiple factors influencing contraceptive use. The study suggests that further investigations are needed for couple-related issues to improve the status of women in the community and to empower women for sexual health.     

High pregnancy rates and reproductive health indicators among female injection-drug users in Vancouver, Canada.

OBJECTIVE: To determine the incidence of pregnancy among active injection-drug users and to identify factors associated with becoming pregnant. METHODS: The Vancouver Injection Drug User Study (VIDUS) is a prospective cohort study that began in 1996. Women who had completed a baseline and at least one follow-up questionnaire between June 1996 and January 2002 were included in the study. Parametric and non-parametric methods were used to compare characteristics of women who reported pregnancy over the study period with those who did not over the same time period. RESULTS: A total of 104 women reported a primary pregnancy over the study period. The incidence of pregnancy over the follow-up period was 6.46 (95% confidence interval (CI) 5.24-7.87) per 100 person-years. The average age of women who reported pregnancy was younger than that of women who did not report pregnancy (27 vs. 32 years, p < 0.001). Women of Aboriginal ethnicity were more likely to report pregnancy (odds ratio 1.6, 95% CI 1.0-2.5). Comparison of drug use showed no significant differences in pregnancy rate with respect to the use of heroin, cocaine or crack (p > 0.05). In examining sexual behavior, women who reported having had a regular partner in the previous 6 months were three times more likely to have reported pregnancy. Despite the fact that 67% of women in this study reported using some form of contraception, the use of reliable birth control was low. Only 5% of women in our study reported the use of hormonal contraceptives. CONCLUSION: There were a high number of pregnancies among high-risk women in this cohort. This corresponded with very low uptake of reliable contraception. Innovative strategies to provide reproductive health services to at-risk women who are injecting drugs is a public health priority.     

Fear of an Intimate Partner and Women’s Health in Early Pregnancy: Findings from the Maternal Health Study

ABSTRACT: Background: Intimate partner violence affects 1 in 4 women at some stage in their lives. Exposure to violence has short‐ and long‐term consequences for women themselves and their children. The objective of this study was to examine associations between fear of an intimate partner and maternal physical and psychological morbidity in early pregnancy. Method: This paper reports baseline measures from a prospective pregnancy cohort study of 1,507 nulliparous women recruited at six public hospitals in Melbourne, Australia. Results: The study showed that 18.7 percent (280/1,497) of women reported being afraid of an intimate partner at some stage in their lives; 3.1 percent (47/1,497) were afraid in early pregnancy and 15.6 percent (233/1,497) had been afraid before but not during the current pregnancy. Compared with women who had never been afraid of an intimate partner, women who reported being afraid of an intimate partner in early pregnancy (≤ 24 wk gestation) were at increased risk of urinary incontinence (adjusted OR = 1.64, 95% CI 0.9–3.1), fecal incontinence (adjusted OR = 3.32, 95% CI 1.2–9.2), vaginal bleeding (adjusted OR = 2.84, 95% CI 1.5–5.5), anxiety (adjusted OR = 10.22, 95% CI 5.0–21.2), and depression (adjusted OR = 4.43, 95% CI 2.1–9.7). Women afraid of an intimate partner before but not during pregnancy experienced a similar pattern of morbidity. Conclusions: Women afraid of an intimate partner both before and during pregnancy have poorer physical and psychological health in early pregnancy. (BIRTH 35:4 December 2008)     

婚前避孕措施使用状况及其影响因素分析

目的 :分析婚前体检的女青年婚前避孕措施的使用状况及其影响因素。方法 :对 1 995年至1 996年到上海市 5所妇幼保健所进行婚前体检的 2 5 80对未婚男女进行问卷调查。结果 :69.3 4%的女青年有过婚前性行为 ,其中 68.75 %使用过避孕措施。首次性行为时使用避孕措施的仅 2 1 .80 %。在有婚前性行为的妇女中 ,3 9.80 %至少怀孕过一次 ,且主要原因为未采用避孕措施 (占 80 .3 4% )。居住在市区、考虑过性行为的后果、知晓人工流产对今后生育的危害、了解避孕药具的价格和来源、认为避孕药具容易获得、父亲管教较严的女性首次性行为时使用避孕措施的比例较高。此外 ,还对婚前避孕药具的来源、婚前停用避孕方法的原因等进行了分析。结论 :加强对避孕知识和人工流产危害性的宣传及提高避孕服务的可及性和可得性 ,有助于增加婚前避孕措施的使用。     

A specification of the types of intimate partner violence experienced by women in the general population

This study analyzes data from a national, general population sample of respondents (National Violence Against Women Survey) to estimate the prevalence of the different forms of intimate partner violence (IPV) that women experience in the United States. The study's purpose, to differentiate types of IPV, follows the Johnson and Ferraro tradition that distinguishes occasional and random acts of abuse from chronic and controlling forms of violence. When examining the specific types of IPV that the survey respondents disclosed, the author finds that the distribution closely resembles Gordon's epidemiological findings. This study analyzed the variance in the number of types of IPV as a function of the childhood abuse the women experienced and their partner's controlling and threatening behaviors. It concludes with a discussion of the multiple responses to IPV that are necessary in contemporary U.S. society.     

Influence of intimate partner violence on mental status in Japanese women during the first trimester of pregnancy

Objective: We examined the relation between intimate partner violence (IVP) and maternal mental status such as depression and anxiety.

Methods: Between April 2016 and October 2016, we asked all Japanese women during the first trimester of pregnancy to answer the three self-administered questionnaires to screen IVP and depressive and anxiety symptoms.

Results: There were 19 women who had a high score in the modified Violence Against Women Screen (VAWS) (4.1%, IPV group) and 408 women who had a score 0 (86.8%, control group). Overall, the rate of the women with depressive, anxiety, and depressive plus anxiety symptoms were 21.3, 31.5, and 16.0%, respectively. The rate of depressive and/or anxiety symptoms in the IPV group were significantly higher than those in the control group (Odds ratio?=?5.02 and 7.40, p?X² test).

Conclusions: The significant adverse effect of IPV on maternal mental status seemed to be observed in Japanese women during the first trimester of pregnancy.