Prevalence and severity of domestic violence among pregnant women, Mexico

OBJECTIVES: To determine whether pregnancy is a risk factor for domestic violence and to compare prevalence and severity of violence reported by women before and during pregnancy. METHODS: There were interviewed 468 women in the third trimester of pregnancy who were seen during prenatal visits at public clinics in the state of Morelos, Mexico. Emotional, physical and sexual violence were investigated. A severity index was built up. Logistic regression analysis was applied in order to identify the main variables associated to domestic violence during pregnancy. RESULTS: The prevalence of domestic violence did not change significantly before and during pregnancy (32%). The prevalence of each type of violence remained the same. About 27% of women who reported violence during pregnancy did not have experience it before, and a comparable proportion had experienced violence before but not during pregnancy. The severity of emotional violence significantly increased during pregnancy (compared to the previous year) whereas the severity of physical violence decreased. Variables most clearly related to violence during pregnancy were: couple's past history of child abuse; women witnessing domestic violence during childhood; and violence in the year before pregnancy. Several risk scenarios were identified, which could be helpful for health care providers. CONCLUSIONS: The results showed that emotional violence is more prevalent than physical and sexual violence, allowing for a better understanding of this phenomenon.     

中国北方城市妇女妊娠前、妊娠期及产后家庭暴力的调查

目的 探讨妊娠前、妊娠期及产后针对妇女的家庭暴力发生的现况以及相关的影响因素。方法 在天津市、河南省、辽宁省以及陕西省，采用分层整群抽样及面对面调查的方法，选择32个区，对有6～18月龄小儿的妇女进行调查，以了解她们妊娠前、妊娠期和产后家庭暴力的情况。采用SPSS软件进行分析。结果 中国北方部分地区妊娠前、妊娠期和产后家庭暴力总的发生率为12．6％，其中性暴力的发生率最高(8．0％)，心理暴力的发生率最低(3．5％)，躯体暴力发生率居中(5．6％)。妊娠前、妊娠期和产后家庭暴力的发生率分别为9．1％、4．3％和8．3％。进一步分析显示妊娠前发生家庭暴力则预示着妊娠期、产后很可能发生家庭暴力。单因素分析发现与家庭暴力相关的因素有：妇女和配偶的受教育程度低、结婚时间长、体力劳动者、个人月收入低、吸烟、饮酒。还发现妇女见到周围有人挨丈夫打的及夫妻关系不好者，发生家庭暴力的可能性大。结论 中国北方城市家庭暴力的发生率较高，应该引起足够的重视。对医务人员进行广泛深入的培训，以增强他们对家庭暴力的认识和反应，以及了解如何进行筛查和管理家庭暴力案例。     

中国母婴健康相关队列研究的文献计量分析

目的 回顾分析母婴健康队列研究的应用趋势,展望未来发展方向.方法 检索中国发表的中文及英文(简称"中英文")母婴队列研究文献,对发表时间、科研单位、研究目标与随访调查等情况进行统计分析.结果 自1991年以来,母婴健康队列研究的文献数量明显增加,中英文核心期刊群均已形成.中英文文献发表数量的年平均增长率分别为12.2％...     

Exposure to Partner,Family, and Community Violence: Gang-Affiliated Latina Women and Risk of Unintended Pregnancy

While teen pregnancy rates appear to be declining in the USA overall, the rate of decline among young Latinas has been less than other ethnic groups. Among the myriad factors associated with elevated pregnancy rates, for Latina girls living in the inner city, exposure to gang and community violence may be a critical context for increased pregnancy risk. This study explores the relationship between gang involvement and reproductive health, and the pathways through which childhood, family, and relationship violence exposure may lead to unintended pregnancy. Interviews of 20 young adult Latinas with known gang involvement in Los Angeles County were audiotaped, transcribed, and coded for key themes related to violence exposure and reproductive health. Limited access to reproductive health care compounded by male partner sexual and pregnancy coercion, as well as physical and sexual violence, emerged in the interviews. Exposures to interparental domestic violence, childhood physical and sexual abuse, and gang violence were prominent and closely associated with unhealthy and abusive intimate relationships. Adverse childhood experiences and exposure to partner, family, and community violence impact the reproductive lives and choices of young Latina women in gangs. These findings may guide targeted pregnancy prevention efforts among urban gang-affiliated Latinas as well as encourage the integration of sexual violence prevention and reproductive health promotion within gang violence intervention programs.     

Safeguarding and Protecting Children in Maternity Services: Implications for Practice

This article debates the issues involved in safeguarding and protecting children in maternity services and offers implications for professional practice. Midwives and other staff who work as members of the maternity team have a safeguarding role to play in the identification of babies and children who have been abused, or are at risk of abuse, and in subsequent intervention and protection services. Assessing domestic violence as a safeguarding issue has been relatively slow in gaining health professional acceptance even though the international evidence suggests that there are irrefutable links between domestic violence and child abuse. Domestic violence increases during pregnancy and the postpartum period, and is significantly related to all three types of child maltreatment up to the child's fifth year, with children under one year being at the highest risk of injury, or death. However, midwives need greater exposure to and familiarity with recommended safeguarding good practice; and must be able to identify and support abused women and children with a joined-up approach that has adequate resources and the support of health service managers. Close inter-agency liaison is required with midwives who are accountable and not afraid to challenge historical working practices, and who are willing to work across traditional boundaries to promote and maintain child safety.     

Voluntary abortion and domestic violence among women attended at a public maternity hospital of Salvador-BA

Quantitative study in order to study domestic violence in women with induced abortion. Interviews were conducted with 147 women hospitalized for induced abortion in a public maternity hospital in Salvador, Bahia. The subjects are characterized by mostly women, black, poorly educated, economically dependent on spouses, experienced psychological abuse, physical and sexual abuse committed by their spouses. Almost half of the women were victims of domestic violence during the current pregnancy, and that was the reason for inducing abortion for 67% of them. The study reveals an association between experience of domestic violence and induced abortion. As mental health consequences, they developed symptoms of post trauma stress disorder. It is necessary that the health professionals consider the cues to identify domestic violence as a health problem associated with induced abortion, which requires a transformation on the training model, including domestic violence as a health issue.     

豫粤两省孕产妇家庭暴力现况比较

目的:在不同地域的较大范围内初步了解我国孕期及产后妇女家庭暴力的发生现况,分析产生家庭暴力的原因及其影响因素。方法:采用整体抽样的方法,于2004年3月~2004年9月在河南省和广东省的部分城镇医院产科门诊和住院部对待产及产后复查的2 835名妇女进行问卷调查。结果:2 835人中孕期曾发生家庭暴力的327人,发生率为11.5%;河南省孕期家庭暴力发生率为16.8%,广东省发生率为6.4%。1 776名产后妇女调查对象中464人遭受家庭暴力,发生率26.1%;河南省发生率为33.7%,广东省发生率为17.4%,两地发生率明显不同(P<0.001,OR=3.0)。孕妇家庭暴力发生的影响因素主要包括:文化程度和职业、家庭收入、家庭生活状况、社会文化背景等。在与非暴力组相比,暴力组孕妇的各种身心健康问题发生率明显增高(P<0.001)。结论;家庭暴力在我国城镇妇女孕期及产后有一定发生,且产后发生率较高,家庭暴力严重影响孕产妇身心健康,应该从多方面进行干预。     

Association Between Domestic Violence and Miscarriage: A Population-Based Cross-Sectional Study Among Women of Childbearing Ages,Sivas, Turkey

Violence against women is a global issue, with ramifications for the reproductive health of women. The current study examined the relation of domestic violence (DV) to miscarriage among women who were victimized during their last pregnancy. The study was conducted in Sivas city center, in Turkey. Associations between self-reported DV and miscarriage were analyzed using multiple regression modeling. Physical and/or sexual DV during the last pregnancy was reported by 10.0% and 6.2% of women, respectively. Women who experienced physical violence were 2.5 times as likely (Odds Ratio (OR) = 2.47, 95% confidence interval [CI]: 1.37–4.84, p = .003) to have experienced a miscarriage than women who did not report physical violence. These findings suggest that victims who experience physical violence during the last pregnancy may be more likely to experience miscarriage. Preventing DV, especially physical violence, may, therefore, be beneficial for avoiding adverse pregnancy outcomes.     

Physical Violence by Partner during Pregnancy and Use of Prenatal Care in Rural India

The role of physical violence during pregnancy on receipt of prenatal care is poorly understood, particularly for South Asian countries that have high levels of both fertility and domestic violence. Data from the 1998/1999 Indian National Family Health Survey and a 2002/2003 follow-up survey that re-interviewed women in four states were analyzed, examining the association between physical violence during pregnancy and the uptake of prenatal care. Women who experienced physical violence during pregnancy were less likely to receive prenatal care, less likely to receive a home-visit from a health worker for a prenatal check-up, less likely to receive at least three prenatal care visits, and less likely to initiate prenatal care early in the pregnancy. This study highlighted the constraining effect that the experience of physical domestic violence during pregnancy had on the uptake of prenatal care for women in rural India. Maternal health services must recognize the unique needs of women experiencing violence from their intimate partners.Key words: Domestic violence, Pregnancy, Prenatal care, India     

Experiences of seeking help from health professionals in a sample of women who experienced domestic violence

The present paper describes a qualitative study of women who suffered domestic violence. The aim was to explore their experiences of seeking help from health professionals and assess their psychological health. Purposive sampling was used to select a subsample from a larger sample of women who were screened for domestic violence as part of a study undertaken at Guy's and St Thomas' Hospitals in London, UK. In-depth, semi-structured interviews were conducted with the subsample of women during the postpartum period (up to 14 months). Interviews were conducted in women's homes and general practitioners' (GPs) surgeries. The sample consisted of 10 women who had experienced domestic violence in the past 12 months (including the current pregnancy), and six women who had experienced domestic violence in the past 12 months but not the current pregnancy. The main outcome measures included: women's experiences of seeking help from health professionals; and assessment for postnatal depression, post-traumatic stress disorder (PTSD) and psychological distress. Women scored highly on measures of postnatal depression and PTSD. With regard to seeking help, there was a tendency for women to regard GPs, and accident and emergency staff as less helpful compared with health visitors in responding to domestic violence. Lack of privacy, continuity of care and time constraints were dominant themes which emerged from women's contacts with health professionals. Very few women voluntarily disclosed domestic violence to a health professional and even fewer were asked directly about domestic violence by one. It is important for health professionals to enquire about domestic violence in a sensitive manner and provide a response that takes into accounts the complexity of women's needs. Domestic violence training is necessary to equip health professionals with the knowledge and skills they need to respond to domestic violence more effectively.     

Narrative Exemplars and the Celebrity Spokesperson in Lebanese Anti-Domestic Violence Public Service Announcements

Domestic violence is a worldwide epidemic. This study examines the effects of narrative exemplars and a celebrity spokesperson in anti-domestic violence ads on Lebanese college students’ attitudes and beliefs towards domestic violence and whether these effects are impacted by personal experience. The practical significance is derived from the high prevalence of domestic violence internationally, making it important to find ways to effectively use media to address this health-related issue that has huge consequences for the individual and society. This study adds to the theoretical understanding of narrative persuasion and media effects. Results indicated that narrative exemplars in anti-domestic violence ads promoting bystander awareness and intervention were more beneficial for people without relevant experience compared to people who know someone affected by domestic violence. Anti-domestic violence ads without narrative exemplars, but that also featured an emotional self-efficacy appeal targeting bystanders, were more effective for participants who know someone who had experienced domestic violence compared to participants without relevant experience. The presence of a celebrity spokesperson elicited more positive attitudes about the ad than a noncelebrity, but failed to directly affect relevant anti-domestic violence attitudes or beliefs. These results highlight the significance of formative audience research in health communication message design.     

Analysis of clinical nurses' publications in national journals

This research study identified clinical nurses' publications. A literature review was carried out in three national periodicals between 2000 and 2007, totalizing 1918 articles. Data demonstrated that clinical nurses' authorship or co-authorship of 162 articles (8.5%); titling was not identified in 75 publications; doctors published the most along with nurses; areas with the highest number of articles were health and nursing education, adult and elderly health. It was concluded that nurses have easier access to publish in research groups; resuming practice, even after post-graduation, they do not keep up scientific production. This entire professional category must double efforts to broaden their participation in periodicals.     

Physical, emotional and sexual violence during pregnancy in Malatya, Turkey

BACKGROUND: In Turkey, violence against women was established as a critical area of concern related to women and various prevention strategies have been developed since 1980. There are limited numbers of studies on violence during pregnancy in the country. This study was performed to determine the prevalence of physical, emotional and sexual violence during pregnancy in Malatya province and the associated factors. METHODS: A cross-sectional interview survey was conducted among pregnant women living in Malatya province between October 2003 and May 2004. Stratified probability-proportional-to-size sampling methodology was used for selecting the study population. A total of 824 pregnant women from 60 clusters were studied. Association between violence prevalences and womens' sociodemographic, fertility and behavioural characteristics were evaluated. RESULTS: During pregnancy 31.7% of women were exposed to any form of violence. Emotional violence was the most frequently reported form (26.7%), followed by sexual (9.7%) and physical violence (8.1%). Regular smoking [odds ratio (OR) 1.6], unwanted pregnancy (OR 1.8), living in urban area (OR 1.5), low education level of husband (OR 1.7), low family income (OR 1.9) and being in second trimester (OR 1.4) were determined to be the main predictors of overall violence during pregnancy. CONCLUSIONS: Violence during pregnancy is a common public health problem in Malatya. Low education level in partners, low family income, husband's unemployment, urban settlement, unwanted pregnancy and smoking should alert health staff towards violence at pregnancy and training of health personnel on the subject is recommended.     

Focusing upon children and men in situations of domestic violence: an analysis of the gendered nature of British health visiting

Despite considerable feminist critiques of British health visiting work which have pointed to its gendered nature, this issue has received very little attention within the professional literature. The emphasis has been upon the 'health' focus, often highlighting the needs of marginalized groups. The recent professional interest in women experiencing domestic violence draws upon a long-standing feminist concern which has established the extent and nature of domestic violence, and the difficulties facing women in seeking help about their situation. The present paper reports some findings from a study of British health visiting practice in relation to women experiencing domestic violence. Drawing upon interview data from 24 health visitors, this paper focuses specifically upon health visitors' accounts of their practice in relation to both children and men when they were aware women were experiencing domestic violence. Their concerns, which include child welfare and personal safety illustrate some of the complexities facing practitioners when faced with domestic violence situations. The analysis also highlights the gendered practices inherent within health visiting work.     

Violence and Reproductive Health: Current Knowledge and Future Research Directions

Objectives: Despite the scope of violence against women and its importance for reproductive health, very few scientific data about the relationship between violence and reproductive health issues are available. Methods: The current knowledge base for several issues specific to violence and reproductive health, including association of violence with pregnancy, pregnancy intention, contraception use, pregnancy terminations, and pregnancy outcomes, are reviewed and suggestions are provided for future research. Results: Despite the limitations of current research and some inconclusive results, the existing research base clearly documents several important points: (1) violence occurs commonly during pregnancy (an estimated 4%–8% of pregnancies); (2) violence is associated with unintended pregnancies and may be related to inconsistent contraceptive use; and (3) the research is inconclusive about the relationship between violence and pregnancy outcomes. Conclusions: Improved knowledge of the risk factors for violence is critical for effective intervention design and implementation. Four areas that need improvement for development of new research studies examining violence and reproductive-related issues include (1) broadening of study populations, (2) refining data collection methodologies, (3) obtaining additional information about violence and other factors, and (4) developing and evaluating screening and intervention programs. The research and health care communities should act collaboratively to improve our understanding of why violence against women occurs, how it specifically affects reproductive health status, and what prevention strategies may be effective.     

Domestic violence: from the visible to the invisible

This study aimed to identify and analyze notifications of domestic violence against children registered at the Regional Health Services in Guarulhos, S?o Paulo, Brazil; the limitations imposed to health professionals' actions and the meaning of domestic violence against children in the health professionals' routine. The notifications registered between 2001 and 2002 were characterized in order to better understand this reality and also to support the collected data through the qualitative approach. There is a predominance of negligence cases 45%, while 26% of the notifications related to physical violence and 14% to suspected sexual violence. Social workers registered the highest number of notifications, 46%. Based on the social agents' discourse, we identified two empirical categories: "interfaces of the violence" and "fear".     

Domestic violence screening, policies, and procedures in Indian health service facilities.

BACKGROUND: Research shows that domestic violence against women in the United States is common, and the prevalence of domestic violence is high among Native American women. Victims of domestic violence can benefit from appropriate office intervention and referral. This study examined the effect of administrative and legal requirements on screening for domestic violence in Indian Health Service (IHS) hospitals and clinics. METHODS: A questionnaire was mailed using the total design method to all IHS hospitals and clinics regarding activities related to domestic violence: screening; policies and procedures; presence of committees; staff training; and state and tribal mandatory reporting requirements. RESULTS: The response rate was 65%. Eighty-eight (62%) of 142 facilities screen for domestic violence. A facility was more likely to screen if it had policies and procedures for domestic violence. Ninety-one (64%) of sites had policies and procedures for domestic violence. Less than one half these sites evaluated the use of these policies and procedures. Hospitals were more likely to have policies and procedures than clinics, as were sites administered by the IHS, rather than those administered by tribal contract. Fifty-eight (40.8%) facilities indicated 18 states have mandatory domestic violence reporting requirements. Thirty-three (23.2%) facilities indicated 31 different tribes mandate reporting of domestic violence. Forty-two (29.6%) facilities reported mandatory staff training in at least one topic related to domestic violence in the past year. CONCLUSIONS: Domestic violence policies and procedures promote screening for this important health care problem.     

Domestic Violence Against Women and Their Mental Health Status in a Colony in Delhi

Background:

Violence against women is a major public health and human rights issue in the world today. This study was conducted to assess the consequences of domestic violence on the mental health of women of reproductive age group.

Materials and Methods:

A community-based, cross-sectional study was conducted in Raj Nagar- I, urban locality in west Delhi near Palam. 350 women of 15-49 years age group residing in the community were selected by stratified random sampling. These women were administered an interview schedule adapted from WHO multi-country study on women’s health and domestic violence. They were assessed for the presence of domestic violence. Mental health status of these women was estimated by using self-reporting questionnaire 20. Data were analyzed using SPSS 12 software. The test applied was chi square test for proportion and binary logistic regression.

Results:

42.8% of the women reported one or the other types of violence. 34.9% of the women reported either physical or sexual violence ever in life. 29.1% of the women reported either physical or sexual violence in past 1 year (current violence). 12% of the women reported mental ill health. Women who had experienced domestic violence were more likely to report mental ill health status and suicidal tendencies as compared to women who had not experienced violence.

Conclusions:

Domestic violence is associated with mental ill health.     

Domestic violence and help-seeking behaviors among rural women: results from a shelter-based study

Research on domestic violence and help-seeking behaviors of women living in rural communities has been limited. This study adds to existing knowledge by examining this type of violence along with mental health characteristics and related help-seeking behaviors of a sample of predominantly Hispanic women seeking shelter at a rural domestic violence shelter. Study participants experienced physical, verbal, emotional, and sexual abuse, harassment, stalking, and abuse with a weapon in their current intimate relationship. Twenty-four percent of study participants of Hispanic backgrounds and 10% of participants from all other racial/ethnic groups reported experiencing all types of abuse listed above. When compared with other study participants, a greater percentage of Hispanic participants indicated that they had thought of and/or attempted suicide. Participants' help-seeking behaviors from formal support systems suggest a mismatch between the types of abuse experienced and the resultant help-seeking behaviors they used. These help-seeking behaviors also indicate the relevance of mental health characteristics (e.g., suicide ideation) in these behaviors. These and findings from other studies may provide the impetus for a systematic documentation of domestic violence and help-seeking behaviors of women living in rural communities.