‘It is a hard decision’: a qualitative study of perinatal intimate partner violence disclosure

Abstract

Background Perinatal intimate partner violence is a hidden under reported and difficult to identify problem which has negative effects on mother and child. The present study aimed to explore barriers and facilitators of perinatal intimate partner violence disclosure. Methods This qualitative study was carried out from October 2019 to January 2021 in Mashhad, Iran. Participants included 23 abused women (11 pregnant and 12 after birth) which were selected via purposive sampling. Semi-structured in-depth interviews and focus group discussion were conducted until the data saturation was achieved. The data analysis was performed based on conventional content analysis adopted by Graneheim & Lundman. Results The main themes “barriers to disclosure” and “facilitators of disclosure” were emerged as the result of data analysis. Barriers to disclosure included negative disclosure consequences and protection of family privacy. Facilitators of disclosure included maternal self-efficacy, threats to security, and formal and informal supportive networks. Conclusions Most abused women did not disclose violence despite routine screening for perinatal intimate partner violence in antenatal care. Recognizing the barriers to and facilitators of violence disclosure play an important role in eliminating barriers, strengthening facilitators, providing effective supportive services for abused women, and reducing perinatal violence. Focus on the barriers to and the facilitators of disclosure will be useful to policymakers, health program planners, and health care providers to identify and manage intimate partner violence, appropriately.

“Family and society empowerment”: a content analysis of the needs of Iranian women who experience domestic violence during pregnancy: a qualitative study

“…They should maintain women’s privacy and confidentiality during the perinatal care as well as having enough time to offer to each pregnant woman during prenatal visits. These results are similar to other studies that described these aspects of professional ethics [ 20 , 23 , 48 , 50 ].…”

“…Also, they should be trained in how to address domestic violence in prenatal care and effective screening for violence while this screening requires more than just asking a question. The results are similar to other studies that emphasized the importance of health care professional skill training in the field of domestic violence [ 20 , 47 , 49 , 50 , 52 , 53 ]. According to the results midwives should be trained to strengthen their interpersonal skills to have a good relationship with V/S pregnant women.…”

“…Young pregnant women who are victims of violence need education, economic independence and lack of verification of the gender of the fetus during pregnancy, in addition to the treatment of alcohol-related disorder and the improvement of the spouse’s awareness of pregnancy [ 17 ]. Early identification of women experiencing domestic violence is the first step for screening and intervening to maintain their safety and well-being in many health systems [ 18 – 20 ]. Prenatal care is an opportunity for healthcare professionals to identify V/S pregnant women and consider proper counseling and intervention programs to protect the maternal and child health [ 21 ].…”

“…According to the specific Iranian cultural issue, pregnant women have few options to leave an abusive marital relationship. Therefore, there is a need for effective interventions to maintain maternal safety [ 20 , 29 ]. The results of the study by Nayebi Nia (2019), the reproductive health needs of the victimized women included the need to encourage their self-care, to empower women against domestic violence, to provide a safe sexual life, to improve the capacity of the reproductive health system in support of victimized women, and to train men to be involved in reproductive health issues [ 30 ].…”

Association between the survey-based women’s empowerment index (SWPER) and intimate partner violence in sub-Saharan Africa

“…This association could be that higher decision-making tends to promote open communication, compromise, and problem-solving which reduces the likelihood of conflicts escalating into violence within an intimate partner relationship. It is also possible that women who actively participate in decision-making challenge traditional gender norms and stereotypes that perpetuate unequal power dynamics [32]. This challenges the underlying attitudes that can contribute to abusive behavior.…”