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Culture, Health & Sexuality: An
International Journal for Research,
Intervention and Care
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http://www.tandfonline.com/loi/tchs20
Women's experiences leaving abusive
relationships: a shelter-based
qualitative study
Masemetse Baholoa, Nicola Christofidesb, Anne Wrighta, Yandisa
Sikweyiyabc & Nwabisa Jama Shaibc
a Department of Family Medicine, Faculty of Health Sciences,
University of the Witwatersrand, Johannesburg, South Africa
b School of Public Health, Faculty of Health Sciences, University
of the Witwatersrand, Johannesburg, South Africa
c Gender and Health Research Unit, South African Medical
Research Council, Pretoria, South Africa
Published online: 03 Dec 2014.
To cite this article: Masemetse Baholo, Nicola Christofides, Anne Wright, Yandisa Sikweyiya &
Nwabisa Jama Shai (2014): Women's experiences leaving abusive relationships: a shelter-based
qualitative study, Culture, Health & Sexuality: An International Journal for Research, Intervention
and Care, DOI: 10.1080/13691058.2014.979881
To link to this article: http://dx.doi.org/10.1080/13691058.2014.979881
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SHORT REPORT
Women’s experiences leaving abusive relationships: a shelter-based
qualitative study
Masemetse Baholo
a
*, Nicola Christofides
b
, Anne Wright
a
, Yandisa Sikweyiya
b,c
and
Nwabisa Jama Shai
b,c
a
Department of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa;
b
School of Public Health, Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, South Africa;
c
Gender and Health Research Unit, South African
Medical Research Council, Pretoria, South Africa
(Received 9 February 2014; Revised 28 September 2014; accepted 17 October 2014)
Intimatepartner violence is a worldwide problem. South Africa has one of the highest rates
of intimate partner violence and therefore requires effective and sustainable approaches to
preventionand response. For abused women, the process of leaving an intimate partner is
difficult and mired in an abundance of complex factors that influence decision making.
This qualitative study explored women’s experiences of leaving abusive homes and
relationships and the critical factors that pushed them to leave. In-depth interviews were
conductedwith 11 adult women who hadexperienced partnerabuse and were residentsof a
shelter in Gauteng Province, South Africa. All interviews were audio-taped with consent,
translatedwhere necessary and transcribed verbatim. Thematic analysis of interviews was
carried out.Two themes emerged as being instrumental to leaving: ‘a phase of change’ and
the ‘process of leaving the abusive relationship’. Leaving an abusive relationship was
found to be a complex processthat did not necessarily imply the end ofthe relationship and
it reflected women’s changing attitudes over time. Awareness of shelters and social
support was found to be critical in facilitating departure from abusive relationships.
Keywords: abuse; intimate partner violence; leaving abusive relationships; shelters;
South Africa
Introduction
Intimate partner violence is an important issue and a persistent problem worldwide that has
existed for many generations (Brown, Transgrud, and Linnemeyer 2009). It transcends
age, sex, race, culture and socioeconomic status (Brown, Transgrud, and Linnemeyer
2009). The World Health Organization defines intimate partner violence as any act of
‘physical, sexual and emotional abuse by a current or former lover, whether cohabiting or
not’ (13) all over the world women are abused emotionally, physically and
psychologically (Garcia-Moreno et al. 2006). In 2006, a population-based survey carried
out across 45 countries by the World Health Organization reported that 10 – 68% of women
were abused by male partners (Garcia-Moreno et al. 2006).
In South Africa, women may be abused in various forms of relationship: marriage,
dating and co-habitating (Jewkes, Levin, and Penn-Kekana 2002). Women who
experience intimate partner violence have increased adverse sexual health problems that
may include sexually transmitted infections (Callands et al. 2013). Due to the power
q2014 Taylor & Francis
*Corresponding author. Email: masbaholo@gmail.com
Culture, Health & Sexuality, 2014
http://dx.doi.org/10.1080/13691058.2014.979881
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imbalance in intimate relationships, women are often at a heightened risk of acquiring HIV
infection (Jewkes, Levin, and Penn-Kekana 2002). In addition, intimate partner violence is
the second highest cause of disease burden in the primary healthcare sector, after HIV
itself, in South Africa (Joyner et al. 2012). South Africa has the highest rate of women
being killed by either an intimate partner or an ex-intimate partner (known as femicide)
(Abrahams et al. 2012). It has been estimated that one woman is a victim of femicide every
eight hours in the country (Abrahams et al. 2012).
Recognising abuse in women and then intervening has gained favour as being critical
in reducing mortality and morbidity associated with intimate partner violence (Coker et al.
2000). It has been noted that the longer the woman is exposed to intimate partner violence,
the higher the greater likelihood of adverse health outcomes (Bonomi et al. 2007). This
includes an increase in medical services utilisation. Although women who have
experienced intimate partner violence are generally supportive of healthcare providers
inquiring about intimate partner violence, these women have also revealed that it is not
always easy to talk about intimate partner violence and they may also not be ready to take
advantage of available resources (Zeitler et al. 2006; Christofides and Jewkes 2010).
The process of leaving an intimate partner can be difficult and is often mired
in complex and entwined factors (Zeitler et al. 2006; Bonomi et al. 2007). For
the purposes of the research reported in this paper, a woman is said to have left
a relationship if she has left the abusive environment to live elsewhere. Leaving an
abusive relationship is often the last option and requires determination and courage
(Coker et al. 2000; Anderson and Saunders 2003). Abused women frequently go through
different stages of adapting to the abuse, acknowledging that they are in an abusive
relationship and finally recognising their need to be free of the abuse (Bonomi et al.
2007). In a study of Nicaraguan women, being submissive to the abuser as a means of
coping with abuse was seen as the first stage of breaking free of the abuse and was
followed by the ‘establishment stage’ that signified a period of recognising that they are
abused and looking for support (Salazaar et al. 2011). Research also found that insight
into the abusive nature of a relationship could arise suddenly but in most cases occurred
gradually over time (Zeitler et al. 2006).
Women’s personal characteristics inform the likelihood of her leaving or staying with
an abusive partner (Jinseok and Gray 2008). Women with high levels of esteem and an
independent source of income, and women who have an internal locus of control were
highly likely to leave an abusive relationship (Anderson and Saunders 2003). Providing
women with social support can assist them to leave their abusive partners and can also
enable them to move more readily to the next stage of change (Burman 2002).
Additionally, social support allows women access to independent living while planning for
the future, and enables them to cope through the changes that could otherwise be
overwhelming (Salazaar et al. 2011). Informal support has been found to be crucial in
alleviating health consequences secondary to intimate partner violence (Snell-Rood 2014).
Against this background, the present study explored the perspectives of abused women
who had left an abusive environment and, in some cases, the relationship, with the view to
understanding the complex set of circumstances that enabled women to free themselves
from abuse.
Methods
This was a qualitative investigation exploring the factors that compelled women to leave
their abusive relationships. The study was undertaken at an abused women’s shelter in a
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large metropolitan area in Gauteng Province, South Africa. This shelter serves the
survivors of domestic violence and sexual offences and is run by the Gauteng Department
of Community Safety. It can accommodate a maximum of 150 women with their children.
Based on individual assessment made at admissions, a woman can be accommodated for a
maximum of nine months. The shelter has a multi-disciplinary team that offers a wide
variety of services that include counselling services for residents, medico-legal services,
court preparation for children and adults, child assessment and specialised counselling for
those children who had been physically and sexually assaulted.
All women over 18 years of age who had experienced abuse by an intimate partner and
were current residents of the shelter at the time of the study were invited to participate in
the study. The abuse experienced could include any of the following: physical, emotional
or sexual abuse by an intimate partner, who could be a husband or boyfriend. Over the
period of the research, the number of residents varied between 35 and 40. Of these
residents, 10 were in the shelter due to reasons other than intimate partner abuse. An initial
information session was held with all the residents. Information leaflets were distributed
and appointments made with those who were willing to participate.
A combination of purposive and convenience sampling was employed. Some shelter
residents refused to participate in the study and the interviewer recruited only those residents
who were happy to do so. Some of those who refused to participate stated that they expected
clinical assessments and medication after the interviews and since the study did not involve a
clinical component, they felt that there was no personal benefit from participating. Other
women who refused to participate cited work constraints. Finally 11 adult women of different
ages, with or without children staying in the shelter, were recruited to participate. Interviews
were conducted in the first half of 2011. Most participants were interviewed once but there
were a couple of participants who were re-interviewed to clarify some parts of their narratives.
All interviews were conducted by the first author, a female medical doctor who was
studying towards a higher degree. She was not involved in any clinical care of the
participants prior to or after the completion of the study. The interviews were guided by an
in-depth interview schedule and were audio-recorded. Demographic data were collected
for each participant and include: age, marital status, number of children, employment
status and ethnicity (White, African, Coloured or Indian).
The scope of study covered the following domains, identified based on existing
literature: (1) how the women came to live at the shelter, (2) the types of abuse
experienced by the women, (3) experiences that led women to leave the abusive
relationship, (4) the preparation and support obtained to facilitate leaving the
relationship. Due to the cultural diversity of the residents of the shelter, the participants
were interviewed in their language of choice (e.g. Zulu, Sotho, English or Tswana). The
researcher is conversant in all of these languages. Interviews lasted between one and one-
and-half hours. They were later transcribed and translated into English. All interviews
took place in the shelter in a private room where auditory privacy was assured.
The transcription of interviews was undertaken mainly by the first author, with a
couple of interviews being transcribed by a professional translator/transcriber. The
interviewer later checked the transcriptions conducted by the other translator/transcriber
against the audio recordings made to ensure quality. Data analysis of each interview was
commenced during the fieldwork so as to inform further data collection.
The transcribed interviews were stored as Word documents and then converted into
Rich Text Format that was then imported into Max QDA 2 software, which was used to
facilitate coding of the interviews. A thematic analysis was then carried out. Initial codes
were compared to those of an independent researcher (one of the co-authors), who coded
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the first few interviews to ensure consistency and clarity. Some codes were derived from
the data itself, while the rest of the codes were sourced from existing literature. Related
codes were grouped together to form core categories. The core categories that emerged
from the participants’ related experiences were combined to build a comprehensive
picture of their collective experiences.
Ethics
The research protocol was reviewed and approved by the University of the Witwatersrand
Human Research Ethics Committee. Pseudonyms were used at all times in order to protect the
participants’ real identities. All the participants were given information leaflets explaining the
purpose of the study, the risks and the benefits and were required to sign consent forms before
the interviews commenced. Participants’ questions about the study were addressed before the
interviews commenced. Onsite social workers were available for participants who
experienced distress during the interviews but this service was not utilised as participants felt
that talking about their experiences had unburdened them of the stress of abuse.
All information gathered from participants was strictly confidential and only the
researchers were privy to it. Additionally, the transcriber was required to uphold the
confidentiality of the data. All transcripts were de-identified prior to commencing coding.
Results
Respondents were of African descent except for one who was of Indian descent. Seven of
the women had been cohabiting with their partners, while four had been married. Five of
the participants’ formal education went as far as high school but they had not completed it,
two of the participants had never finished primary school, three had tertiary education, and
one respondent did not have any formal education. Of the 11 women, 6 were unemployed
and had relied on their partners for financial support before their stay in the shelter. The
other five women had full-time employment.
Narratives provided an account of the changes women underwent over the course of
their relationships that led eventually to them leaving the abusive environment that they
were experiencing. This process comprised two phases: a phase of change (or preparation),
followed by taking action, which culminated in leaving the abusive partner. The phase of
change marked the period where the participants gained a different perspective on their
relationships and was comprised of four elements: progression of violence, realisation that
the partner would not change, the effect of abuse on children and the women’s own
feelings due to abuse. Leaving abusive relationships was facilitated by three elements:
a supportive environment, access to shelter and the opportunity to leave.
Phase of change
Progression of violence
Leaving is not so much an event as a process (Bonomi et al. 2007). Awareness of harm and
abuse on women and their children developed over time. In some ways, the process can be
equated to the contemplation and preparation phases of the stages of change theory
(Prochaska et al. 1994), with women’s needing to change views of themselves and their
relationships.
The abusive nature of the participants’ relationships was often insidious and many first
experienced a change after they had begun cohabiting with their partners. Over time,
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conflict started with arguments that became very heated and later physical abuse ensued.
The women often hid the violence in their relationships from others. They felt embarrassed
and to some degree were also protecting their partners from being judged. However, when
they finally acknowledged the presence of abuse to others, they became open to change
and were ready to accept help.
As the violence escalated, it became difficult for the women to bear. Mpho (aged 23
years, African) felt unable to cope with the violence any longer:
He beat me again and he tried to hit me with a hockey stick but hit the child instead ... I
started to think that there’s nothing for me here. I couldn’t take his beatings so I went to report
him at the police station.
Many women had experienced abuse for many years and felt that there was progression of
abuse from having arguments to being beaten often:
The other years we would only argue. I even cut my hair, he would pull it. If I don’t agree with
him or say I don’t know if he asks me something, he beats me up ... I think he was going to
kill me in the end; I was getting beaten every week. (Anna, aged 42 years, African)
Escalating violence in the participants’ relationships was an indicator that things were
moving from bad to worse. As the abuse became too much to bear, women began to feel
that they had to find a way out of their relationships, irrespective of their financial
dependence on their partners.
Realisation that the partner would not change
Participants indicated that during the course of their relationships, they had initially felt
hopeful that their partners would change. After episodes of physical or emotional abuse,
there would be a period of respite, and the abuser would apologise and the situation would
be harmonious for a while. Then the cycle would start again, and, with time, there would
be an increase in frequency of abusive episodes. At this point, participants felt that a
beating was always imminent and therefore lived in fear of triggering it. However, this
hope that things would change made the participants resilient to abuse in the long term.
On the other hand, there was a commensurate erosion of the participants’ self-esteem
and this made it difficult to gather the strength together to leave their partners, who they had
been with for so long. Mary (aged 25 years, Indian) felt humiliated by the abuse she had
experienced but also held on to the notion that her partner would change in the long run:
I would meet my friend for a short time if I go to the shop and she kept telling me to leave, but
where to? Who do you talk to? ... I was tired, really tired. I could see that he was not going to
change.
Mary’s story is poignant in its demonstration of how tiring it was to maintain the belief
that the abuser might change. In the end, just like the others, she finally accepted that
things would not get better and, hence, that she needed to find a solution.
Concern about the effect of abuse on children
Participants shared their experiences of being abused in front of their children. Women
described how this experience could leave the children traumatised and confused. Mothers
felt helpless against their abusive partners but felt even more powerless to protect their
children from the abuser. Two of the women feared for their lives and thought if they were
killed, their children would be left behind with an abusive father (or father-figure). Others
felt embarrassed by the thought of having to explain to their children in the future about
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why they stayed in abusive relationships. Milly (45 aged years, African) was concerned
about the long-term effects of the abuse on her children:
He thinks you are the worst stupid ever and I think whoever is in the same relationship, they
must quit for the sake of the children because it does not harm us only but it affects the
children: their schoolwork, their emotions, spiritually. They really get hurt. If I tell you about
my kids, they really got scars in their hearts.
Mpho (aged 23 years, African) feared for her child while she was at work:
... he has locked up our two-year-old child in the room so that he can follow me to work to
make sure that I’m not walking with other men. He wanted to make sure that I was really
going to work. I just thought that I can’t live this way, one day I’ll come back from work and
this child would be dead.
Children were not only emotionally or physically abused, but were, at times, subject to
sexual abuse by their fathers. Anna (aged 42 years, African) described one such experience:
She say daddy touch me here. It was like she’s having pains when I’m washing her vagina.
For participants with children, concern for the physical and emotional wellbeing of their
children influenced the decision to leave. They also feared being killed by their partners
and leaving their children behind.
Women’s feelings in response to abuse
During the interviews, participants were emotional and often cried when relating some parts
of their experiences. They struggled to rise above a range of emotions they felt as a result of
the abuse: feeling helpless, fear, sadness, confusion, isolation, anger and self-blame. Their
struggle with these emotions prevented an assertive reaction to their partners’ violence:
I thought that I’m chasing nothing here; I was very angry at him. I was also afraid of him
because of the beatings. (Mpho, aged 23 years, African)
Dineo (aged 20 years, African) also had a range of feelings about her abuser:
I think you know the story of a woman who was murdered by her boyfriend. He told me to
read this story. I read the story .... That’s when I like, started panicking around, I didn’t even
trust him. I was even afraid to go outside because he’s jealous.
Even though these emotions hampered the participants at some point in their
relationships, they were also responsible for the changes in their perception. The thought
of staying in the relationships while the abuse was escalating and living constantly with a
negative self-image became so burdensome that the women found a way to break-free of
these violent relationships.
For one participant, anger at the abuse was so powerful that she developed murderous
feelings towards her partner, and it was the realisation that she had come to the point of
considering murder that pushed her to seek other alternatives, such as leaving.
An important milestone in women’s perception of their relationships was to recognise that
they could not control or prevent the violence. This awareness allowed women to start
thinking beyond simply adopting avoidance strategies to hold off the violent episodes and
to begin to look for a way out of the abuse. Seeking help from friends, family or healthcare
workers signified a major behavioural change in their responses to their partner’s violence.
Leaving the abusive relationship
The time of leaving was different for each participant: some left within a year of being
abused, while others left after many years of abuse. Participants who were married left
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much later than those who were cohabiting with their boyfriends. Despite difficulties
experienced in marriage, married women viewed their marital status as important and
were likely to delay leaving. This reflects the psychological impact that patriarchal
societies have on women’s role within marriage, as it irrevocably impacts upon their status
and identity (Harrison and Montgomery 2001).
The process of leaving an abusive relationship was strongly influenced by the women’s
environment, support from family and friends, and access to shelter. At this stage, women
reported being more relaxed, happier, having an enhanced sense of being in control of their
lives and were more optimistic about the future. However, leaving home to live in the
shelter did not necessarily mean the end of the relationship, but a period of separation that
brought an interim end to the abuse. Ten of the women were still in contact with their
estranged partners: two of the women had their partners coming for supervised visits with
their children, one woman met her partner outside the shelter and the rest communicated
over the phone only.
Supportive environment
All the women had either a family member or a friend providing support in difficult times.
Although some women spoke of challenges confiding in others, they turned to friends and
family during those times when they were desperate for support. With family and friends,
they gained a better perspective of their abusive situation and they also gained information
on alternative places for shelter and counselling support. Sometimes, they planned with
friends how to escape or were able to go to friends’ houses in order to escape the violence.
Naledi (aged 21 years, African) appreciated the support provided by her family:
I got some support from my sister and my cousin. My cousin especially because I talked to
her, she’s the one I told that I’m positive [HIV] because of this one. My sister also like to
defend me, she say that I don’t stay with my boyfriend, I should not let myself be abuse victim
always.
However, women who had jealous partners discussed how they often had few friends
and even those relationships were not deep in nature. It was hard to spend time with friends
because partners suspected that the participants were seeing other men. Although Mary
(aged 45 years, Indian) did not have a supportive family, she did have a supportive friend
who encouraged her to leave:
I didn’t have anyone, like I said my family wasn’t there for me and I don’t expect them to be.
I never asked them for anything. They knew what I was going through but they wouldn’t have
just picked up the phone and said, are you ok? Do you need anything? They said they won’t
help me as long as I’m with this man. They don’t know what I’m going through but they are
giving me options; it’s either my family or them. So I know him for so long, how do I go to my
family and ask for help there? No. That’s why I came here because I don’t wanna be burden
for nobody. ... I would meet my friend for a short time if I go to the shop and she kept telling
me to leave.
Mary described feeling uncertain about what her options were if she were to consider
leaving her relationship. These obstacles were perceived to be overwhelming. Her
narrative highlights that having someone tell her that she needed to leave the relationship
was not enough. She needed practical support to enable her to do so. Participants spoke
about how friends and family sometimes tried to dictate what decisions they should
make. Social support emerged as a critical motivator for women to leave abusive
relationships.
Leaving the abusive partner did not necessarily mean that the women had ended their
relationship, rather they had induced a separation that might cause a change in their
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partners behaviour. That said, once they were in the shelter and could reflect on the effects
of abuse on both themselves and their children, most of the participants resolved to end
their relationships.
Access to shelter
Nine of the participants were not aware of the existence of shelters before they came to live
in this particular shelter. They arrived through referral by the police and social workers.
Only one spoke about how she had heard of the shelter through a friend.
Melinda (aged 28 years, African) was one of the women who had gone to the police for
help, with the result that they brought her to the shelter:
I was beaten by my boyfriend. I went to the police station. He used to do this but I’d never
gone to the police. So the last time he did I went and they asked me if I needed a shelter and I
said yes. So they came here with me.
Milly (aged 45 years, African) had gone to the social worker for counselling and had then
been referred to the shelter:
I was going to the clinic for depression, and the social workers gave me information about the
shelter, and I come to register.
This shelter provided women with a place of safety, an interim period of reflection, and
psychological support. The women found the shelter essential in helping them adhere to
their decision to separate from their violent partners. They found the shelter peaceful and
safe, both for themselves and for their children. Three of the participants reported that had
they known about the existence of shelters they would have left abusive relationships
earlier.
Opportunity to leave
Having the opportunity to escape from a violent husband or boyfriend was crucial in
enabling women to leave. Most women felt trapped and under constant threat, so leaving
the abusive partner was not easy. Many were not bold enough to leave when their partners
were around and also knew that the partners might be incensed by their leaving hence
triggering a violent episode.
Dineo (aged 20 years, African) was terrified of her boyfriend who watched her every
movement, and one day got a chance to escape:
That day he was not at the flat, he went to the tavern and that’s why I ran away and my friend’s
place is in the same block of flats. I sent my friend to check him, and they told her he’s in
another tavern, so I took off.
Family, friends and police played a crucial role in providing a way out. Friends provided a
place to stay, before the women came to the shelter. The police were important as a referral
system as well as for protection and law-enforcement. Therefore, an enabling environment
was an important contextual element in assisting women to free themselves from abuse.
Discussion
This study has identified that the process of breaking free from an abusive relation entailed
two core processes: a phase of change, followed by the process of leaving the abusive
relationship. These themes are reflected in other studies. Campbell and colleagues (1998),
for example, describe a number of turning points, including the ‘his abuse or violence’ and
‘child-related’ factors . Here, ‘his abuse’ relates to the escalation of violence and ‘child-
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related’ details the effect of abuse on children. The turning points that Campbell and
colleagues refer to correlate with the ‘phase of change’ in this study, whereby women’s
change in perceptions of the violence and its effects on their children helped chart a
different course for their relationships.
Realisation that the partner will not change requires an ‘objective’ outside view of the
nature of their relationships. Even though participants had been abused over a long period
of time, they rarely vocalised that their relationship was abusive, but their change in
perception of their relationships gives emphasis to the fact that they realised that the
relationships were not as they should be. This distinction marks an important milestone in
the course of leaving an abusive relationship and has been linked to growing
empowerment through social and family support (Campbell et al. 1998; Enander and
Holmberg 2008). The supportive environment was responsible for the enhanced self-
esteem that transformed women’s responses from powerlessness to being more assertive
and less tolerant to abuse (Salazaar et al. 2011). Although in this study the participants do
not distinctly point out a change within themselves, the change in their perspective on their
situations indicates a deeper transformation. At the time that they left their relationships,
women had come to realise that the abuse was not temporary and that it also defied the
general characteristics of a loving relationship.
The severity of the abuse experienced served to impel women to consider their
situation. As the abuse worsened over time, women felt more degraded and less secure in
their homes. This finding aligns with other research findings suggesting that that
worsening levels and severity of violence made women less tolerant to abuse and caused
them to consider leaving (Campbell et al. 1998; Jinseok and Gray 2008 ).
Through interactions with others, friends or family members, women were exposed to
external sources of support. They came to learn about the availability of shelters and could
envisage a way of changing their situation. The support they found in others also reassured
them that they were not alone and, in turn, gave them strength to change. This is consistent
with the wider literature, which emphasises the importance of social support services as
being integral in assisting women to leave contexts of abuse (Chang et al. 2010; Salazaar
et al. 2011). A recent study in rural India places a special emphasis on the importance of
informal support, which seems to have been crucial in the current study too (Snell-Rood
2014).
In contrast, a few participants viewed family support as negative with respect to their
needs. Social support that came with conditions was found to retard the process of ending
abuse (c.f. Salazaar et al. 2011). However, friends and the availability of shelters can
provide critical support to abused women and may facilitate them leaving the abusive
environment even when their own families are unsupportive.
In this study, violence not only affected the women but also their children. This served
as an enabler to leaving the abusive environment, especially when mothers felt guilty and
were concerned about the future welfare of their children (Campbell et al. 1998; Jinseok
and Gray 2008). Some women were initially determined to tolerate the violence because of
the children, but their perceptions changed as they contemplated the long-term impact of
the abuse.
Limitations
A number of limitations exist with respect to the present study. First, data were collected
from women who were residing in a shelter for abused women, thus their experiences may
differ from those of abused women who seek help from more informal resources such as
Culture, Health & Sexuality 9
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those from within their social networks. Second, it is possible that because the researcher
who conducted the interviews was a medical doctor, participants may have distorted their
responses because of a social desirability effect. However, the threats posed by this
potential limitation were minimised by offering a safe environment for the interview and
building rapport with participants prior to interviewing them.
Conclusion
Intimate partner violence is associated with a range of adverse health and psychological
outcomes, while it is also increases healthcare costs. Supporting women to leave abusive
relationships is integral to a comprehensive response that addresses the needs of women
who experience such violence. Understanding the complexities of the process of leaving is
essential if the response is to be sensitive and effective.
In order to address intimate partner violence effectively, future interventions should
address contextual influences of violence, to develop policies and legal reforms that, in
particular, criminalise intimate partner violence. Tackling societal norms that encourage
accepting attitudes towards intimate partner violence should sensitise communities to be
more intolerant of abusive norms and set the stage for improving women’s social status in
society. Community partnerships with government and non-governmental organisations to
build social support through programmes and shift social norms may also assist abused
women within the communities they live in.
Shelters such as that in the present study have a crucial role in providing safe places for
abused women. In addition, by offering services such as counselling and legal support, and
in some cases job training, women can be provided with much-needed support throughout
the transition period.
Acknowledgements
The authors would like to thank the shelter staff for facilitating the research and for their support and
assistance during the project. We would also like to acknowledge their committed work to assist
abused women. We extend sincere appreciation to the participants in this project who were generous
with their stories, despite their pain. We would like to thank the Rachel Jewkes and colleagues at the
South African Medical Research Council for their generosity and expertise and for providing the
tools with which to conduct interviews.
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Re
´sume
´
La violence entre partenaires intimes est un proble
`me mondial. En Afrique du Sud, ses taux sont
parmi les plus e
´leve
´s au monde et, par conse
´quent, exigent le recours a
`des approches efficaces et
durables pour les pre
´venir et y faire face. Pour les femmes qui subissent ces abus, l’abandon d’un
partenaire intime est un processus difficile, entrave
´par de nombreux facteurs qui influencent leur
prise de de
´cision. Cette e
´tude qualitative a explore
´les expe
´riences d’abandon de foyers violents et de
rupture de relations abusives ve
´cues par ces femmes, ainsi que les principaux facteurs qui les
incitaient a
`partir. Des entretiens en profondeur ont e
´te
´conduits avec 11 femmes adultes ayant subi la
violence de leurs partenaires et he
´berge
´es dans un refuge situe
´dans la Province du Gauteng. Tous les
entretiens ont e
´te
´enregistre
´s avec les consentements des participantes, traduits lorsque cela s’est
ave
´re
´ne
´cessaire et retranscrits verbatim. Une analyse the
´matique a re
´ve
´le
´deux the
`mes
instrumentaux pour les se
´parations: « une phase de changement » et le « processus de rupture
d’une relation abusive ». La rupture d’une relation abusive s’est re
´ve
´le
´e en tant que processus
complexe qui ne signifiait pas ne
´cessairement la fin de cette relation et qui refle
´tait les changements
Culture, Health & Sexuality 11
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d’attitude des femmes dans la dure
´e. L’e
´tude a e
´galement re
´ve
´le
´que la prise de conscience de la
possibilite
´de trouver un refuge et de be
´ne
´ficier d’un soutien social est un e
´le
´ment critique qui rend
plus facile la rupture d’une relation abusive.
Resumen
En todos los paı
´ses, la violencia por parte de la pareja constituye un problema. Suda
´frica registra una
de las mayores tasas de violencia de pareja a nivel mundial; por tanto, allı
´la situacio
´n requiere la
aplicacio
´n de enfoques efectivos y sostenibles destinados a encontrar maneras de prevenirla y de
responder adecuadamente. Para las mujeres vı
´ctimas de abuso, el proceso de dejar a su pareja ı
´ntima
es difı
´cil y se encuentra enredado con muchos factores complejos que influyen en la toma de
decisiones. El presente estudio cualitativo examino
´las vivencias de mujeres que abandonaron
relaciones y hogares abusivos, ası
´como los factores crı
´ticos que operaron de manera determinante
para que e
´stas se fueran. Con este objetivo, se aplicaron entrevistas a profundidad a once mujeres
adultas que habı
´an experimentado abuso por parte de sus parejas y que en ese momento residı
´an en
un albergue de la provincia de Gauteng, Suda
´frica. Con su consentimiento, las entrevistas fueron
grabadas y transcritas textualmente, realiza
´ndose, posteriormente, su ana
´lisis tema
´tico. Dos temas
surgieron como los determinantes de que las mujeres abandonaran su situacio
´n anterior: encontrarse
en “una fase de cambio” y el “proceso de dejar la relacio
´n abusiva”. En este sentido, se determino
´
que el abandono de una relacio
´n abusiva representa un proceso complejo, que no necesariamente
significa el final de la relacio
´n, en el que se ven reflejadas las cambiantes actitudes de las mujeres con
el transcurso del tiempo. Asimismo, se constato
´que el conocimiento sobre la existencia de albergues
y de apoyos sociales resulto
´ser un factor clave que opero
´facilitando el abandono de las relaciones
abusivas.
12 M. Baholo et al.
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