Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study

Authors: Sally Field, Michael Onah, Thandi van Heyningen, Simone Honikman

Published in: BMC Women's Health | Issue 1/2018

Login to get access

Abstract

Background

Rates of violence against women are reported to be highest in Africa compared to other continents. We aimed to determine associations between mental illness, demographic, psychosocial and economic factors with experience of intimate partner violence (IPV) among pregnant women in a low resource setting in Cape Town and to explore the contextual elements pertaining to domestic violence.

Methods

We recruited adult women attending antenatal services at a primary-level maternity facility. Demographic, socioeconomic and psychosocial data were collected by questionnaire. The Expanded Mini- International Neuropsychiatric Interview (MINI) Version 5.0.0 was used to assess mental health status and the Revised Conflict Tactic Scale (CTS2) used to assess IPV in the six months prior to the study. Non-parametric tests, Wilcoxon sum of rank test, Fisher Exact and two sample T test and multicollinearity tests were performed. Descriptive, bivariate and logistic regression analyses were conducted to identify associations between the outcome of interest and key predictors. A probability value of p ≤ 0.05 was selected. From counselling case notes, a thematic content analysis was conducted to describe contextual factors pertaining to forms of domestic violence (DV).

Results

The prevalence of IPV was 15% of a sample of 376 women. Women who were food insecure, unemployed, in stable but unmarried relationships, had experienced any form of past abuse and were not pleased about the current pregnancy were more likely to experience IPV. MINI-defined mental health problems and a history of mental illness were significantly associated with IPV. Qualitative analysis of 95 counselling case notes revealed that DV within the household was not limited to intimate partners and, DV in this context was often perceived as ‘normal’ behaviour by the participants.

Conclusions

This study contributes towards a greater understanding of the risk profile for IPV amongst pregnant women in low-income settings. Adversity, including food insecurity and mental ill-health are closely associated with IPV during the antenatal period. Advocates against violence against pregnant women are advised to consider that violence in the home may be perpetrated by non-intimate partners and may by enabled by a pervasive belief in the acceptability of the violence.
Literature
1.
World Health Organisation. WHO multi-country study on women“ s health and domestic violence against women: initial results on prevalence, health outcomes and women”s responses. Geneva; 2005.
2.
Abrahams N, Jewkes R, Martin LJ, Mathews S, Vetten L, Lombard C. Mortality of women from intimate partner violence in South Africa: a National Epidemiological Study. Violence Vict. 2009;24:546–56.CrossRefPubMed
3.
Garcio-Moreno C, Jansen HAFM, Elsberg M. Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet. 2006;368:1260–9.CrossRef
4.
Constitutional Court of South Africa. Domestic Violence Act 116 of 1998; 1998. p. 1–14.
5.
6.
Stewart D, MacMillan H, Wathern N. Intimate partner violemce. Can J Psychiatr. 2013;58:1–15.
7.
Roberts AL, McLaughlin K, Conron KJ, Koenen KC. Adulthood stressors, history of childhood adversity, and risk of perpetration of intimate partner violence. Am J Prev Med. 2011;40:128–38.CrossRefPubMedPubMedCentral
8.
Vos T, Astbury J, Piers LS, Magnus A, Heenan M, Stanley L, et al. Measuring the impact of intimate partner violence on the health of women in Victoria , Australia. Bull World Health Organ. 2006;30411
9.
Devries KM, Mak JYM, Bacchus LJ, Child JC, Falder G, Petzold M, et al. Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies. PLoS Med. 2013;10:e1001439.CrossRefPubMedPubMedCentral
10.
Cisler JM, Begle AM, Amstadter AB, Resnick HS, Danielson CK, Saunders BE, et al. Exposure to interpersonal violence and risk for PTSD, depression, delinquency, and binge drinking among adolescents: data from the NSA-R. J Trauma Stress. 2012;25:33–40.CrossRefPubMedPubMedCentral
11.
Dutton MA, Green BL, Kaltman SI, Roesch DM, Zeffiro TA, Krause ED. Intimate partner violence , PTSD , and adverse health outcomes. J. Interpers. Violence. 2006;21:955–68.CrossRefPubMed
12.
Iliyasu Z, Abubakar IS, Galadanci HS, Hayatu Z, Aliyu MH. Prevalence and risk factors for domestic violence among pregnant women in northern Nigeria. J. Interpers. Violence. 2013;28:868–83.CrossRefPubMed
13.
Heise LL, Raikes A, Watts CH, Zwi AB. Violence against women: a neglected public health issue in less developed countries. Soc Sci Med. 1994;39:1165–79.CrossRefPubMed
14.
Hoque ME, Kader MHSB. Prevalence and experience of domestic violence among rural pregnant women in KwaZulu-Natal , South Africa. South African J Epidemiol Infect. 2009;24:34–7.CrossRef
15.
Mbokota M, Moodley J. Domestic abuse--an antenatal survey at king Edward VIII hospital. Durban SAMJ. 2003;93:455–7.PubMed
16.
Martin SL, Macy RJ, Sullivan K, Magee ML. Pregnancy-associated violent deaths the role of intimate partner violence. Trauma, Violence, Abus. 2007;8:135–48.CrossRef
17.
Heaman MI. Relationships between physical abuse during pregnancy and risk factors for preterm birth among women in Manitoba. J Obstet Gynecol Neonatal Nurs. 2005;34:721–31.CrossRefPubMed
18.
Alhusen JL, Frohman N, Purcell G. Intimate partner violence and suicidal ideation in pregnant women. Arch Womens Ment Health. 2015;
19.
Taillieu TL, Brownridge DA. Violence against pregnant women: prevalence, patterns, risk factors, theories, and directions for future research. Aggress Violent Behav Elsevier. 2010;15:14–35.CrossRef
20.
Stewart DE, Cecutti A. Physical abuse in pregnancy. C. Can Med Assoc J Canadian Medical Association. 1993:149–1257.
21.
Shamu S, Abrahams N, Temmerman M, Musekiwa A, Zarowsky C. A systematic review of African studies on intimate partner violence against pregnant women: prevalence and risk factors. PLoS One. 2011;6:e17591.CrossRefPubMedPubMedCentral
22.
Shamu S, Abrahams N, Zarowsky C, Shefer T, Temmerman M. Intimate partner violence during pregnancy in Zimbabwe: a cross-sectional study of prevalence, predictors and associations with HIV. Trop Med Int Heal. 2013;18:696–711.CrossRef
23.
Seedat M, Van NA, Jewkes R, Suffl S, Ratele K. Violence and injuries in South Africa: prioritising an agenda for prevention. Lancet. 2009;374:1011–22.CrossRefPubMed
24.
Pronyk P, Hargreaves J, Kim J, Morison L, Phetla G, Watts C, et al. Effect of a structural intervention for the prevention of intimate-partner violence and HIV in rural South Africa: a cluster randomised trial. Lancet. 2006;
25.
26.
Western Cape Government. Report on the identification of policing needs and priorities in the Western Cape. 2013.
27.
Strategic Development Information and GIS Department. City of cape town – 2011 census – Ward 047. Stat South Africa. 2013;
28.
29.
Brewer K. A model of systematic sampling with unequal probabilities. Aust J Stat. 1963;5
30.
Reichenheim ME, Moraes CL. Comparison between the abuse assessment screen and the revised conflict tactics scales for measuring physical violence during pregnancy. J Epidemiol Community Health. 2004;58:523–7.CrossRefPubMedPubMedCentral
31.
Straus M. Cross-cultural reliability and validity of the revised conflict tactics scales: a study of university student dating couples in 17 nations. Cross-Cultural Res. 2004;38:407–32.CrossRef
32.
Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52:30–41.CrossRef
33.
Myer L, Stein DJ, Grimsrud A, Seedat S, Williams DR. Social determinants of psychological distress in a nationally-representative sample of south African adults. Soc Sci Med. 2008;66:1828–40.CrossRefPubMedPubMedCentral
34.
Bruwer B, Emsley R, Kidd M, Lochner C, Seedat S. Psychometric properties of the multidimensional scale of perceived social support in youth. Compr Psychiatry. 2008;49:195–201.CrossRefPubMed
35.
Honikman S, van Heyningen T, Field S, Baron E, Tomlinson M. Stepped care for maternal mental health: a case study of the perinatal mental health project in South Africa. PLoS Med. 2012;9:e1001222.CrossRefPubMedPubMedCentral
36.
Josefsson A, Angelsiöö L, Berg G, Ekström C-M, Gunnervik C, Nordin C, et al. Obstetric, somatic, and demographic risk factors for postpartum depressive symptoms. Obstet Gynecol LWW. 2002;99:223–8.
37.
Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26:289–95.CrossRefPubMed
38.
39.
40.
Blumberg SJ, Bialostosky K, Hamilton WL, Briefel RR. The effectiveness of a short form of the household food security scale. Am J Public Health Am Public Health Assoc. 1999;89:1231–4.CrossRef
41.
Swindale A, Bilinsky P. Development of a universally applicable household food insecurity measurement tool: process, current status, and outstanding issues. J Nutr. 2006;136:1449S–52S.CrossRefPubMed
42.
Sheehan V, Lecrubier Y, Sheehan K, Amorim P, Janavs J, Weiller E, et al. The MINI-international neuropsychiatric interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;Jan 59:22–33.
43.
Kaminer D. The truth and reconciliation Commission in South Africa: relation to psychiatric status and forgiveness among survivors of human rights abuses. Br J Psychiatry. 2001;178:373–7.CrossRefPubMed
44.
Spies G, Stein DJ, Roos A, Faure SC, Mostert J, Seedat S, et al. Validity of the Kessler 10 (K-10) in detecting DSM-IV defined mood and anxiety disorders among pregnant women. Arch. Womens. Ment. Health. 2009;12:69–74.CrossRefPubMed
45.
Lecrubier Y, Sheehan D V, Weiller E, Amorim P, Bonora I, Sheehan KH, et al. The Mini International Neuropsychiatric Interview (MINI ). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur. Psychiatry [Internet]. Éditions scientifiques et médicales Elsevier, Paris; 1997;12:224–231. Available from: https://​doi.​org/​10.​1016/​S0924-9338(97)83296-8
46.
Statscorp. Stata Statistical Software: Release 13. College Station: TX: Statscorp LP; 2013.
47.
Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21:459–68.CrossRefPubMed
48.
Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika Springer. 1951;16:297–334.CrossRef
49.
Chen X, Ender P, Mitchell M, Wells C. Regression with STATA. UCLA Acad. Technol. Serv. 2003;
50.
Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, editors. Anal. Qual. Data. London: Routledge; 1994. p. 173–94.CrossRef
51.
Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol BMC Med Res Methodol. 2013;13:117.CrossRefPubMed
52.
53.
O’Doherty L, Hegarty K, Ramsay J, Davidson L, Feder G, Taft A. Screening women for intimate partner violence in healthcare settings. Cochrane Database Syst Rev. 2015;
54.
Tsai AC, Tomlinson M, Comulada WS, Rotheram- MJ. Intimate partner violence and depression symptom severity among south African women during pregnancy and Postpartum : population-based prospective cohort study. PLoS Med. 2016;
55.
56.
Machisa MT, Christofides N, Jewkes R. Mental ill health in structural pathways to women’s experiences of intimate partner violence. PLoS Med. 2017:1–19.
57.
Bacchus L, Mezey G, Bewley S. Women’ s perceptions and experiences of routine enquiry for domestic violence in a maternity service. BJOG. 2002;109:9–16.CrossRef
58.
59.
Postmus JL, Plummer S, Mcmahon S, Murshid NS. Understanding economic abuse in the lives of survivors. J. Interpers. Violence. 2012;27:411–30.CrossRefPubMed
60.
Scribano PV, Stevens J, Kaizar E. The effects of intimate partner violence before, during, and after pregnancy in nurse visited first time mothers. Matern Child Health J. 2013;17:307–18.CrossRefPubMed
61.
Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012;90:139G–49G.CrossRefPubMed
62.
Roberts GL, Lawrence JM, Williams GM, Raphael B. The impact of domestic violence on women’s mental health. Aust N Z J Public Health. 1998;22:796–801.CrossRefPubMed
63.
Howard LM, Oram S, Galley H, Trevillion K, Feder G. Domestic violence and perinatal mental disorders: a systematic review and meta-analysis. PLoS Med. 2013;10
64.
Chen LP, Murad MH, Paras ML, Colbenson KM, Sattler AL, Goranson EN, et al. Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis. Mayo Clin Proc. 2010;85:618–29.CrossRefPubMedPubMedCentral
65.
Rotheram-Borus MJ, Tomlinson M, Le RI. Stein J. Alcohol use, partner violence, and depression: a cluster randomized controlled trial among urban south African mothers over 3 years. Am J Prev Med. 2015:1–11.
66.
Charles P, Perreira K. Intimate partner violence during pregnancy and 1-year post-partum. J Fam Violence. 2007;22:609–19.CrossRef
67.
68.
69.
Stewart DE, Gucciardi E, Grace SL. Depression. BMC Womens Health. 2004;8:1–8.
70.
71.
Doblyte S, Jiménez-mejías E. Understanding help-seeking behavior in depression: A Qualitative Synthesis of Patients ’ Experiences. 2017;
72.
Matthews T, Danese A, Wertz J, Odgers CL, Ambler A, Moffitt TE, et al. Social isolation , loneliness and depression in young adulthood: a behavioural genetic analysis. Soc Psychiatry Psychiatr Epidemiol Springer Berlin Heidelberg. 2016;51:339–48.CrossRef
73.
Eugenio Zacarias A, Macassa G, Soares JJF. Women as perpetrators of IPV: the experience of Mozambique. J Aggress Confl Peace Res. 2012;4:5–27.CrossRef
74.
Islam TM, Tareque I, Tiedt A, Hoque N. The intergenerational transmission of intimate partner violence in Bangladesh. Glob Health Action. 2014;(1):1–11.
75.
Speizer IS. Intimate partner violence attitudes and experience among women and men in Uganda. J Interpers Violence. 2010;25:1224–41.CrossRefPubMed
76.
Aslam S, Zaheer S, Shafique K. Is spousal violence being “vertically transmitted” through victims? Findings from the Pakistan demographic and health survey 2012-13. PLoS One. 2015;10:e0129790.CrossRef
77.
Rada C. Violence against women by male partners and against children within the family: prevalence, associated factors, and intergenerational transmission in Romania, a cross-sectional study. BMC Public Health BMC Public Health. 2014;14:129.CrossRefPubMed
78.
Krug EG, Mercy JA, Dahlberg LL, Zwi AB. The world report on violence and health. Lancet. 2002;360:1083–8.CrossRefPubMed
79.
Benjamin A. Community Counsellors’ experience of trauma and resilience in a low income community. Stellenbosch; 2014.
80.
Benjamin L, Crawford-Browne S. The Systemic Impact of Continuous Trauma. In: Benjamin L, editor. Not just a drop in the Ocean: Breaking the Cycle of Violence, A Reflection on the theory and practice of Community Action towards a Safer Environment. Cape Town; 2011.
81.
Shisana O, Simbayi LC, Rehle T, Zungu NP, Zuma K, Ngogo N, Jooste S P-, Van Wyk V, Parker W, Pezi S, Davids A, Nwanyanwu O, Dinh TH, SABSSM III Implementation Team (2010). South African National HIV Prevalence, Incidence, Behaviour and Communication Survey. Cape Town: The health of our children. HSRC; 2008.
82.
Microfinance Participation MN. Control over resources, and justification of IPV results from a nationally representative sample of women. J. Interpers. Violence. 2016;
Metadata
Title
Domestic and intimate partner violence among pregnant women in a low resource setting in South Africa: a facility-based, mixed methods study
Authors
Sally Field
Michael Onah
Thandi van Heyningen
Simone Honikman
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0612-2

Other articles of this Issue 1/2018

BMC Women's Health 1/2018 Go to the issue

Research article

Hyaluronan–binding protein 2 (HABP2) gene variation in women with recurrent miscarriage

Research article

Impact of the Urban Reproductive Health Initiative on family planning uptake at facilities in Kenya, Nigeria, and Senegal

Research article

Intimate partner sexual violence and risk for femicide, suicidality and substance use among women in antenatal care and general out-patients in Thailand

Research article

Ghanaian media coverage of violence against women and girls: implications for health promotion

Research article

Sexual compulsivity and its relationship with condomless sex among unmarried female migrant workers in Shanghai, China: a cross-sectional study

Research article

Patterns of missing data in the use of the endometriosis symptom diary