Intimate Partner Violence and the Childbearing Year: Maternal and Infant Health Consequences
School of Nursing, Johns Hopkins University, Baltimore, Maryland, United States Trauma Violence & Abuse
(Impact Factor: 3.27).
05/2007; 8(2):105-16. DOI: 10.1177/1524838007302594
Intimate partner violence (IPV) against women is a significant public health problem with negative physical and mental health consequences. Pregnant women are not immune to IPV, and as many as 4% to 8% of all pregnant women are victims of partner violence. Among pregnant women, IPV has been associated with poor physical health outcomes such as increased sexually transmitted diseases, preterm labor, and low-birth-weight infants. This article focuses on the physical health consequences of IPV for mothers and their infants. The purpose of this review is therefore to examine timely research ranging from 2001 to 2006 on IPV during pregnancy, the morbidity and mortality risks for mothers and their infants, and the association between IPV and perinatal health disparities. It will also identify gaps in the published empirical literature and make recommendations for practice, policy, and research.
- "For women experiencing IPV, negative effects span all aspects of health, from direct mortality to increasing risk factors for poor health outcomes. Mortality can be caused through homicide, or indirectly through suicide (6), maternal causes (7), and as a consequence of HIV infection (8). Morbidity could be due to multiple causes, including physical trauma, psychological trauma, and stress. "
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ABSTRACT: Background: Despite a high burden of disease, in South Africa, intimate partner violence (IPV) is known to be poorly recognised and managed. To address this gap, an innovative intersectoral model for the delivery of comprehensive IPV care was piloted in a rural sub-district. Objective: To evaluate the initiative from the perspectives of women using the service, service providers, and managers. Design: A qualitative evaluation was conducted. Service users were interviewed, focus groups were conducted amongst health care workers (HCW), and a focus group and interviews were conducted with the intersectoral implementation team to explore their experiences of the intervention. A thematic analysis approach was used, triangulating the various sources of data. Results: During the pilot, 75 women received the intervention. Study participants described their experience as overwhelmingly positive, with some experiencing improvements in their home lives. Significant access barriers included unaffordable indirect costs, fear of loss of confidentiality, and fear of children being removed from the home. For HCW, barriers to inquiry about IPV included its normalisation in this community, poor understanding of the complexities of living with violence and frustration in managing a difficult emotional problem. Health system constraints affected continuity of care, privacy, and integration of the intervention into routine functioning, and the process of intersectoral action was hindered by the formation of alliances. Contextual factors, for example, high levels of alcohol misuse and socio-economic disempowerment, highlighted the need for a multifaceted approach to addressing IPV. Conclusions: This evaluation draws attention to the need to take a systems approach and focus on contextual factors when implementing complex interventions. The results will be used to inform decisions about instituting appropriate IPV care in the rest of the province. In addition, there is a pressing need for clear policies and guidelines framing IPV as a health issue.
- "In addition, to being a human rights concern, domestic violence is also been linked to adverse health outcome including termination of pregnancy, sexually transmitted infections, attempted suicide, HIV infection, depression, and anxiety. Violence has also been recorded during pregnancy and is associated with preterm births and low birth weight infants. This study attempted to investigate the effects of domestic violence on maternal and neonatal outcomes during pregnancy and delivery. "
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This study attempted to follow up a cohort of women who presented to a tertiary hospital to investigate the effect of domestic violence on maternal and neonatal outcomes.
Materials and Methods:
Women, between 26-34 weeks of gestation, attending the obstetrics outpatient department, were recruited and followed up until delivery. They were assessed at recruitment and after delivery using the Edinburgh Postnatal Depression Scale, the Abuse Assessment Screen, and a pro forma to assess socio-demographic and clinical characteristics. Bivariate and multivariate statistics were employed to assess statistical significance.
One hundred and fifty women were recruited, 132 delivered in the hospital and were followed up. Domestic violence was associated with antenatal and postnatal depression, spouse's insistence of a boy baby, medical complications during pregnancy, preterm delivery, and lower birth-weight.
Domestic violence has a significant impact on maternal and neonatal outcomes. Screening for domestic violence and interventions should be part of all antenatal programs. India should also employ public health approaches to change its patriarchal culture.
Available from: Zohra S Lassi
- "Maternal stressors such as depression, socioeconomic hardship and intimate partner violence have been linked to preterm birth [67-71]. It has been hypothesized that physical and psychological stress acts through inflammatory pathways involving maternal cortisol to cause premature birth [72,73]. "
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ABSTRACT: Providing care to adolescent girls and women before and between pregnancies improves their own health and wellbeing, as well as pregnancy and newborn outcomes, and can also reduce the rates of preterm birth. This paper has reviewed the evidence-based interventions and services for preventing preterm births, reported the findings from research priority exercise, and prescribed actions for taking this call further. Certain factors in the preconception period have been shown to increase the risk for prematurity and, therefore, preconception care services for all women of reproductive age should address these risk factors through preventing adolescent pregnancy, preventing unintended pregnancies, promoting optimal birth spacing, optimizing pre-pregnancy weight and nutritional status (including a folic acid-containing multivitamin supplement) and ensuring that all adolescent girls have received complete vaccination. Preconception care must also address risk factors that may be applicable to only some women. These include screening for and management of chronic diseases, especially diabetes; sexually-transmitted infections; tobacco and smoke exposure; mental health disorders, notably depression; and intimate partner violence. The approach to research in preconception care to prevent preterm births should include a cycle of development and delivery research that evaluates how best to scale up coverage of existing evidence-based interventions, epidemiologic research that assesses the impact of implementing these interventions and discovery science that better elucidates the complex causal pathway of preterm birth and helps to develop new screening and intervention tools. In addition to research, policy and financial investment is crucial to increasing opportunities to implement preconception care, and rates of prematurity should be included as a tracking indicator in global and national maternal child health assessments.
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