Violence in pregnancy has been associated with maternal death; pregnancy complications including placental abruption, premature rupture of membranes, and pre-term birth; and pregnancy outcomes including spontaneous abortion, miscarriage, and low birth weight. Population Council researchers are involved in a number of initiatives aimed at assessing the extent of the situation and exploring ways to reduce this problem.

Pregnancy and domestic violence: Perspectives of obstetricians and recent mothers
In Pakistan, Population Council researchers conducted a study to assess obstetrician/gynecologists’ awareness of the magnitude of gender-based violence, violence during pregnancy, and the effects of violence on maternal and perinatal health. Providers’ perceptions of potential interventions and barriers to appropriate health sector responses were also explored. The Society of Obstetricians and Gynecologists–Pakistan provided their membership lists and facilitated the interviews. One hundred of their Karachi-based members were interviewed. The majority of obstetricians (n=72) agreed that health care providers’ roles include helping domestic violence victims, although instituting routine screening for domestic violence as part of standard delivery protocols during antenatal care was approved by less than half (n=47) of the providers. The majority of providers expressed interest in dealing with domestic violence and suggested that it would be important to receive pre-service and in-service training to be able to counsel women as part of antenatal care.

To complement the data collected from physicians, interviews were also conducted among 300 women who had recently given birth in a large public maternity hospital. Interviews sought to assess women’s awareness and attitudes towards gender-based violence and violence during pregnancy, their care-seeking behavior for injuries associated with domestic violence, and their attitudes regarding health sector responses. Nearly 25% of the women interviewed reported some form of physical abuse during the index or a previous pregnancy. Among those who sought assistance, the main reason given (73%) was “mediating on her behalf.” A little over half of the women interviewed (55%) thought that an antenatal visit was an appropriate time for health care providers to routinely screen for domestic violence; however, they overwhelmingly (90%) identified doctors as the preferred health care provider to make this type of inquiry.

In a similar Council project in Nepal, women who delivered at home are also being interviewed, in addition to those in maternity hospitals and obstetrician/gynecologists. In addition, focus group discussions will also be conducted among traditional birth attendants. The Society of Obstetricians and Gynecologists–Nepal, and leading social scientists and women’s health advocates in the country are providing guidance to the project.
   

See Also

•  Ebert Program Safe Motherhood Resources

 
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