A violência por parceiro íntimo (VPI), durante a fase gravídico-puerperal da mulher, pode ter consequências sérias e desastrosas tanto para a saúde das mulheres como para seus conceptos/neonatos. Algumas dificuldades das mães, durante o aleitamento materno, podem estar relacionadas, direta ou indiretamente, à atitude de agressão por parte do parceiro, independente de ocorrer antes, durante e/ou depois da gestação. Este estudo teve como objetivo analisar a prática da amamentação entre mulheres em situação de VPI, durante a gestação atual, usuárias de um serviço de pré-natal da rede pública quanto à duração do aleitamento materno exclusivo (AME), ao nível de autoeficácia materna para amamentar e aos fatores relacionados ao início, estabelecimento da amamentação e desmame precoce. Trata-se de um estudo quantitativo e descritivo-exploratório, desenvolvido no CRSM-MATER, situado em Ribeirão Preto - SP, com aprovação da Comissão de Ética em Pesquisa com Seres Humanos, nº 1421/2011. Os dados foram coletados no período de maio de 2012 a maio de 2013. As mulheres participantes do estudo foram recrutadas a partir de um inquérito sobre prevalência de VPI na gestação, aplicado no pré-natal para 358 gestantes, além de dados sociodemográficos e ginecológicos. Na internação, as informações sobre variáveis obstétricas, neonatais e de amamentação foram coletadas no prontuário. Com 30 dias de pós-parto, as mulheres foram acompanhadas no domicílio, quando foi aplicado o Instrumento Breastfeeding Self-Efficacy Scale (BSES), e com 70 dias após o parto, por contato telefônico, para obter informações sobre a amamentação. Os dados foram analisados pelo programa estatístico SAS ® 9.0, com análise fundamentada na estatística descritiva, utilizando-se o Teste Exato de Fisher, t-Student e Análise de Variância. Verificamos que 17,59% das participantes relataram algum tipo de VPI, durante a gestação atual, sendo 94% por violência psicológica, 42%, física e 2%, sexual. A média de idade foi de 24,5 anos e de estudo, 8,94 anos, renda familiar média de 2,61 salários-mínimos. Na alta hospitalar, 88% dos bebês estavam em AME, reduzindo para 55,32% e 40% com 30 e 70 dias após o parto, respectivamente. A média de duração do AME foi de 19,08 dias. E 54% das mulheres apresentaram alta autoeficácia na amamentação. Não houve associação do nível de autoeficácia na amamentação e da duração do AME com o tipo de VPI, na gestação atual. Verificamos associação da duração do AME com o nível de autoeficácia na amamentação com 30 e 70 dias, após o parto. Dentre os fatores relacionados ao início, estabelecimento da amamentação e desmame precoce, observamos associação estatisticamente significativa do nível de autoeficácia na amamentação com o Apgar de 1º minuto, a presença de intercorrências com o recém-nascido (RN) e a separação da mãe durante a internação. Concluímos que a análise da autoeficácia na amamentação entre mulheres em situação de VPI, na gestação atual, possibilitou identificar fatores relacionados à amamentação que podem ter influências negativas e positivas sobre o início e estabelecimento da amamentação, bem como para o desmame precoce. A BSES é um instrumento que pode ser usado tanto em pesquisas como no planejamento de uma assistência mais efetiva / Intimate Partner Violence (IPV) during the pregnancy-puerperal phase can have serious and disastrous consequences for women and their neonates. Some difficulties for mothers during breastfeeding, may be related directly or indirectly to the act of aggression by the partner before, during or after gestation. This study\'s objective is to analyze breastfeeding in the IPV situation during current gestation among users of a prenatal service from the public health care in relation to the duration of the exclusive breastfeeding (EBF), the level of maternal self-efficacy to breastfeed, and breastfeeding factors related to its initiation, establishment, and early weaning. The present study is quantitative and descriptive-exploratory, developed at CRSM-MATER, situated in Ribeirão Preto, Sao Paulo, with the approval of the Ethics Committee on Human Research, no. 1421/2011. The data were collected from May 2012 to May 2013. The participating women (n=358) were recruited from an inquiry about the prevalence of IPV during their gestation, applied in pre-natal. Socio-demographic and gynecological data were also considered. At admission, information about obstetric variations, neonatal and breast-feeding were collected. In the 30th day from postpartum, the Breastfeeding Self- Efficacy Scale (BSES) instrument was applied in person in the home. Within 70 days postpartum, information about breast-feeding was obtained via telephone. The data were analyzed in using SAS® version 9.0 statistical software, with an analysis grounded in descriptive statisticz, utilizing the Fisher\'s exact test, Student\'s t-test and Variance Analysis. The average age was 24.5 years and 8.94 studying years, average family income was 2.61 minimum wage. It was verified that 17.59% of the participants reported some kind of IPV during gestation, with 94% of these cases reporting psychological, 42% physical and 2% sexual violence. At hospital discharge, 88% of neonates were in EBF, reduced to 55.32% and 40% at 30 and 70 days postpartum, respectively. The average duration of EBF was 19.08 days. 54% of the women presented high self-efficacy in breast-feeding. There was no association between the kind of IPV in the current gestation with the level of self-efficacy in breast-feeding or with the duration of EBF. There was however, an association between the duration of the EBF and the level of self-efficacy in breast-feeding at 30 and 70 days postpartum. Among breast-feeding characteristics, there were significant associations between the level of self-efficacy in breast-feeding with the Apgar of 1st minute, neonatal complications and maternal separation during hospitalization. We conclude that self-efficacy in breastfeeding among women in situations of IPV during gestation can influence breastfeeding beginning, breastfeeding establishment and early weaning. The present study establishes the utility of the BSES as a research instrument in this context, which may help guide the development of strategies for more effective assistance

A violência doméstica contra a mulher é um evento complexo e muito prevalente no Brasil, sendo os serviços de saúde frequentemente procurados por essas mulheres, o que coloca serviços e profissionais de saúde em lugar de destaque no manejo desses casos. Considerando o papel do enfermeiro dentro do sistema de saúde, o objetivo do estudo foi compreender a percepção destes profissionais sobre a problemática. Para tal utilizou-se uma abordagem qualitativa, em que foram entrevistados 11 enfermeiras que trabalham nas Unidades Distritais de Saúde do município de Ribeirão Preto, utilizando um roteiro semi estruturado. Os dados foram processados, lidos atentamente e organizados nas seguintes unidades temáticas: 1-A visão das enfermeiras sobre a questão de gênero; 2-A visão das enfermeiras sobre a violência contra a mulher; 3-Atendimento: Rezo para não chegar nada no meu plantão[...] Quando chega é um problema!; 4-Aspectos Jurídicos: Está tudo no caderninho! e 5-Formação: Olha se foi, foi uma aula bem superficial. As enfermeiras entrevistadas percebem que houve uma mudança no papel da mulher na sociedade moderna, porém, mantêm uma visão tradicionalista de gênero; assim, identificam um momento de transição em que a \"mulher moderna\" vive entre o paradoxo de ser um sujeito social ativo e ser a \"rainha do lar\". Neste sentido, as enfermeiras entrevistadas percebem que a mulher de hoje apenas multiplicou funções, mas ainda não dividiu responsabilidades. Elas percebem ainda a liberdade sexual feminina como libertinagem; neste sentido prevalece discursos em que às mulheres é vedado o direito de exercerem sua sexualidade de forma livre, sendo este assunto tratado com denotações negativas. Associam a violência contra a mulher a aspectos relacionados à individualidade dos casais; aspectos externos relacionados ao estilo de vida imposto pela sociedade moderna e ao uso de álcool e drogas; atribuem a continuidade das relações violentas pelo medo, pela vergonha e por dependência financeira e moral de seus companheiros e pela falta de apoio social; assim, essas mulheres permanecem nas relações por não verem outra possibilidade de vida. Implícita na temática da violência contra as mulheres, está sempre presente nos discursos o fato das mulheres se manterem em relações assimétricas com seus parceiros, o que as tornam submissas e contribui para a manutenção do ciclo da violência. Quanto ao atendimento, sentemse os profissionais de saúde despreparados para lidar com a situação; reconhecem eles principalmente a violência física e focam sua assistência ao atendimento das lesões, e percebemos então a invisibilidade da violência contra a mulher pelos profissionais de saúde, que possivelmente se distanciam para evitar frustrações frente ao problema com o qual não se sentem preparados para lidar. Não possuem conhecimentos adequados quanto às questões jurídicas; e, assim, ao atender casos de violência, não se prendem aos fatores legais, mas sim a fatores de ordem pessoal, às especificidades do caso atendido e à própria estrutura dos serviços. Por fim, são unânimes em reconhecer a necessidade de treinamento para que possam melhor abordar o tema. / Domestic violence against women is a complex event and very prevalent in Brazil. These women frequently seek for health services, which require them and their health professionals to manage these cases. Considering the role of nurses in the health system, this study aimed to understand the perception of these professionals about the problem. A qualitative method was used and 11 nurses working in the District Health Units in the city of Ribeirão Preto, SP, Brazil were interviewed through a semi-structured questionnaire. Data were processed, carefully read and organized into the following thematic units: 1- gender\'s conception; 2- understanding of nurses about violence; 3- care delivery: I pray for nobody to arrive during my shift [...] It\'s a problem when someone arrives!; 4- Law aspects; 5- Education- Well, If I had it, it was a very superficial class. Interviewed nurses perceive that women\'s role has changed in modern society; however, there is a traditional view of genders. Therefore, they identify a moment of transition in which the \"modern woman\" lives the paradox of being an active social subject and \"the lady of the house\". In this perspective, the nurses perceive that today\'s women have multiplied their functions but have not shared their responsibilities. They also perceive that women\'s sexual freedom is seen as debauchery in which discourses about women being forbidden to freely exercise their sexuality prevail and is an issue addressed with negative connotation. They associate violence against women with aspects related to the individuality of couples, external aspects related to the life style that is imposed by modern society and the use of alcohol and drugs, attribute the persistence of violent relationships to fear, shame, financial and moral dependency on partners, and lack of social support. Thus, these women remain in these relationships because they do not see other options for their lives. The fact that women keep asymmetric relationships with their partners is implicit in the violence subject. This asymmetry makes them submissive and favors the maintenance of the violence cycle. Professionals feel unprepared to deal with the situation, especially acknowledge physical violence and focus care delivery on lesions. We perceive that violence against women is invisible to the eyes of health professionals, who possibly distance themselves so to avoid frustration in relation to a problem they do not feel prepared to deal with. They do not have appropriate knowledge related to law and therefore, when they attend cases of violence, do not pay attention to legal issues but on factors related to the individual, to the specificities of each case and structure of the services themselves. Finally, they all agree on the need of education so as to better address the subject.

Bakgrund : Studier visar att en av tre kvinnor världen över har blivit utsatta för våld. Undersökningen Slagen dam visar att cirka hälften av Sveriges kvinnor har blivit utsatta för sexuella-och fysiska hot någon gång efter de fyllt 15 år. Våld mot kvinnor finns i alla samhällsklasser och är ett av världshälsoproblemen. Kvinnor som har blivit utsatta för våld söker sig ofta till vården. Därför har hälso-sjukvården en nyckelroll till att upptäcka och stödja våldsutsatta kvinnor. Syfte: Syftet med litteraturöversikten var att sammanställa kunskap om vilken beredskap som finns för sjuksköterskor att bemöta våldsutsatta kvinnor. Metod : Designen är en litteraturöversikt. Datainsamlingen har skett i databaserna Cinahl, Pubmed och Web OF Science. Resultat : Resultatet är baserat på 15 vetenskapliga artiklar och visar tre huvudområden: Vikten av utbildning, Sjuksköterskans beredskap i mötet med den våldsutsatta kvinnan och organisatoriska faktorer. Resultatet visade att vårdpersonal har brist på utbildning och beredskap för att kunna möta kvinnor som har blivit utsatta för våld. Förutom att det finns brist på beredskap finns det också tidsbrist samt kommunikationsbrist mellan myndigheterna något som ytterligare motverkade chansen till att stödja våldsutsatta kvinnor. Slutsats : Utifrån föreliggande litteraturöversikt kan slutsatsen dras att tydliga riktlinjer, utbildning, övning, beredskap behövs och program/ rutiner för att kunna stödja den våldsutsatta kvinnan. Det är vidare avgörande att få stöd från organisatorisk ledare för att kunna uppnå förändring. / Background: Studies show that one of three women worldwide is expose to partner violence. The study slagen dam shows that almost half of the women in Sweden have been exposed to sexual and physical threats sometime after they reach the age of 15. Violence upon women is major public health problem that you can find in every social group in society. Women who are expose to partner violence are more likely to seek hospital help. Purpose: The aim of the literature review was to collocate knowledge and preparedness of nurses when they are encountering women who are exposed to violence. Method: The method is a literature review. Data collection has taken place in databases Cinahl and PubMed and Web of science. Results: The finding is based on 15 scientific articles and 3 key areas: The importance of education, nurse’s preparation for meetings regarding abused women, and organization elements. The result articles illustrate that health-care professional has limited knowledge and preparedness to help and counting women who were victims of abuse. Lack of time and lack of communication between different authorities created a barrier to identify women who were exposed to violence. Conclusions: From this study, the clue can drown that guidelines, knowledge, and training are need, in order to help women who are living with partner violence.

Ao se realizar uma interface entre a violência por parceiro íntimo (VPI) e suas relações para com a saúde da mulher, nota-se que as situações de violência tanto física como a sexual e psicológica afetam claramente a saúde sexual e reprodutiva, com impactos importantes. O presente estudo tem por objetivos: analisar aspectos da saúde reprodutiva das gestantes que estão associados à situação de VPI, durante a presente gestação; e identificar a prevalência de casos de VPI e classificar quanto ao tipo e momento da ocorrência. Trata-se de um estudo descritivo, do tipo transversal, desenvolvido com gestantes em acompanhamento de pré-natal no CRSM-MATER, uma maternidade de baixo risco na cidade de Ribeirão Preto-SP. A coleta de dados foi realizada através da aplicação de dois instrumentos, um para investigação da ocorrência da violência e outro para identificação de dados sociodemográficos e de saúde reprodutiva. Para verificar a associação entre as variáveis qualitativas, os dados foram submetidos ao Teste Exato de Fisher. Além disso, a quantificação desta associação foi mensurada por meio de modelos de regressão logística onde se calculou o Odds Ratio bruto (ORb) com seus respectivos intervalos de confiança de 95%. Todas as análises estatísticas foram realizadas com a utilização do software estatístico SAS® 9.0. A amostra constitui-se por 233 gestantes que passaram por consulta de pré-natal, no período de maio a dezembro de 2012. A ocorrência de VPI alguma vez na vida foi relatada por 55,36% das mulheres, enquanto, no período gestacional, verificou-se uma prevalência de 15,45% de violência geral, sendo 5,15% de violência física, 14,59% de violência psicológica e 0,43% de violência sexual. Observou-se associação entre a VPI e as mulheres que se autorreferiram de cor preta ou parda (p= 0,0052; ORb=3,344; IC 95%: 1,399; 7,997) e que não estavam em um relacionamento com seus companheiros, no período da entrevista (p= 0,0348; ORb =3,840; IC 95%:1,376; 10, 717). Nota-se uma tendência à VPI entre as mulheres em idade mais jovem, com baixa escolaridade e que não exercem atividade remunerada. As características de saúde reprodutiva apontam associação entre a VPI e as mulheres que não desejaram a atual gestação (p= 0,0020; ORb = 4,351; IC 95%: 1,786; 10,602), que raramente frequentam a consulta ginecológica (p= 0,0129; ORb = 2,971; IC 95%: 1,116; 7,911) e que, ao longo da vida, fizeram uso de método contraceptivo do tipo comportamental (p = 0,0572; ORb = 2,372; IC 95%: 1,023; 5,496). O estudo é precursor no Brasil e revelou algumas relações da VPI e suas implicações na saúde reprodutiva. Assim, outros estudos se fazem necessários para se compreender mais amplamente esta relação, além de se direcionar o olhar para a identificação das mulheres em situação de violência, a fim de melhorar as condições de saúde das mesmas, em especial da saúde reprodutiva, repensando as ações interventivas, relacionando-as não somente aos serviços de saúde mas também a uma conjuntura intersetorial / On establishing an interface between intimate partner violence (IPV) and its connection with the woman\'s health, we see that situations of violence, whether physical, sexual or psychological, have a clear effect on sexual and reproductive health, with important types of impact. The present study has two main purposes: first, to analyse those aspects of the reproductive health of pregnant women that are linked to situations of IPV during the pregnancy; and secondly, identification of the prevalence of cases of IPV and classify them according to the type and the moment of the occurrence. This is a descriptive study of the transversal variety, applied to pregnant women who are having antenatal care at CRSM- MATER, a low-risk maternity unit in the city of Ribeirão Preto, State of São Paulo, Brazil. The collection of data was made by applying two different instruments, one for the investigation of the occurrence of violence and the other to identify the social and demographic data and also the data regarding reproductive health. To check the association between qualitative variables, the data were subjected to the Exact Fisher Test. In addition, the quantification of this association was measured using models of logistic regression with the calculation of the raw odds ratio (rOR) with their respective confidence intervals of 95%. All the statistical analyses were carried out with the use of the statistical software SAS® 9.0. The sample consisted of 233 pregnant women who had antenatal care between May and December 2012. The occurrence of IPV at least once in life was reported by 55.36% of the women considered, while during the pregnancy the general violence rate of 15.45%, with 5.15% of physical violence, 14.59% of psychological violence and 0.43% sexual violence. There was a connection between IPV and women who declared themselves as black or partially skin-melaninated (p=0.0052; rOR = 3.840; IC=05%: 1.399; 7.997) and those who were not in a relationship with their partners at the time of the interview (p=0.0348; rOR=3.840; IC 95%: 1.376; 10.717). We also see a greater trend towards the presence of IPV among women who are younger, with lower levels of schooling, and who were not in paid work. The characteristics of reproductive health show an association between IPV and women who did not want the current pregnancy (p=0.0020; rOR=4.351; IC 95%: 1.786; 10.602), who rarely attend appointments with the gynaecologist (p=0.0129; rOR=2.971; IC = 95%: 1.023; 5,496). The study is the first of its kind in Brazil and has shown some relations between IPV and its implications related to reproductive health; other studies are therefore necessary so we may understand this relationship from a wider perspective, and also so we may direct our studies to the identification of those women in a situation of violence, with a rethink of intervention actions, relating them not only to health services but also to an intersectorial underlying situation

This thesis examines the ways in which my artistic practice is creating a space for victims and survivors of domestic violence and sexual assault to share, gain catharsis, and spark discussions. As a survivor of domestic violence and sexual assault, I have often felt there was no space for me to voice the many emotions that come with my experience. After creating and sharing autobiographical work about my story, many women have shared their stories of survival with me. Through these many conversations, I knew that we needed to create a space to share these stories. I have created this space through the To(get)her project. To(get)her is a collaborative performance and installation in which women from a variety of backgrounds destroy and transform wax guns with kitchen and cosmetic tools such as waffle irons, hair dryers, high-heeled shoes, curling irons, and meat tenderizers. These wax guns act as a metaphor for the violence that happens to many women on a daily basis. One in three women will encounter domestic violence and one in five women will be raped in their lifetimes in the United States. Not only are many of our bodies attacked mentally, physically and sexually, but the government also stakes claims on our bodies. With 138 representatives and 22 senators voting against the Violence Against Women Act (VAWA) and many of those same politicians also voting against stricter gun regulations it is apparent that these politicians do not see it as problematic that women’s bodies are so often targets. Further, in the current political climate it is imperative that people in the United States understand the importance of VAWA, and that it is a necessary bill that will be up for reauthorization in 2018. There have been six iterations of the To(get)her project. Through these performances, over 75 self-identifying women have been a part of the project, sharing their stories and igniting discussion about violence against women. When women come together, their connections are empowering, fierce, sometimes gentle and always meaningful.

<p>Although gender-based violence has been identified as highly problematic in South Africa, it has not been given much scholarly attention in relation to refugee women. This study focuses on the experience of some of these women who have resettled in Cape Town. The main focus is on gender-based violence and the linkages between conflicts at home, fleeing from it, as well as the problems faced by women when they reach the &lsquo / new&rsquo / country where they are suppose to be safe, but yet continue to experience gender violence. By referring to my own empirical research I try to tease out the many instances of violence and abuse such women face, how they understand and try to make sense of it and how they try to take up their lives in Cape Town. I utilized the much used ecological framework to analyze gender-based violence and argue that, while this &lsquo / model&rsquo / is dynamic and allows one to make analytical linkages across different &lsquo / levels&rsquo / of violence, it nevertheless does not adequately provide for understanding the relationship between larger global and international processes, the connection that women may still have with their countries of origin and the impact of being a refugee or unwanted &lsquo / immigrant&rsquo / in South Africa</p>

The objective of this thesis is to identify ways that international actors can be most effective in influencing policy change pertaining to women’s safety and security in India. Since the 1970s, domestic groups within India and international organizations have focused on promoting gender equality and combatting problematic social norms that beget discrimination and violence against women. This thesis examines some of the programs and campaigns that Indian governments and civil society actors – domestic and international – have implemented to promote the rights and protections of women. This thesis considers examples of finance, social networking, training, education, and information propagation, which are key ways that international actors can participate in efforts to combat prevailing attitudes that undermine the human dignity of girls and women in India. Because violence against women is systemic in nature, and because it is a social malaise that transcends culture, development professionals should frame issues of gender violence in terms of basic human rights. Fundamentally, international organizations are most effective in enhancing the status of women in India by providing grassroots organizations with critical resources to which they would not otherwise have access.

The patriarchal systems, stories, and powers that govern our world have made women extremely vulnerable to the threat of physical, emotional, spiritual, and intellectual violence. Despite efforts of millions of people working to end this attack, personal violation is a daily reality for many women and one that I believe will not change until efforts to end violence against women begin to address the very roots of dominant culture. This research will explore the personal experiences of five women’s rights activists in Swaziland who are engaged in a transformative practice to end violence against women. Through in depth open-ended interviews, I look at the ways each activist’s life journey reflects her changing understanding of formative values. Following this, I consider ways in which this personal development has led each woman to a deeply transformative, rather than simply a reactive, response to violence against women.

The patriarchal systems, stories, and powers that govern our world have made women extremely vulnerable to the threat of physical, emotional, spiritual, and intellectual violence. Despite efforts of millions of people working to end this attack, personal violation is a daily reality for many women and one that I believe will not change until efforts to end violence against women begin to address the very roots of dominant culture. This research will explore the personal experiences of five women’s rights activists in Swaziland who are engaged in a transformative practice to end violence against women. Through in depth open-ended interviews, I look at the ways each activist’s life journey reflects her changing understanding of formative values. Following this, I consider ways in which this personal development has led each woman to a deeply transformative, rather than simply a reactive, response to violence against women.

This thesis will uncover how law and policy, as well as how social workers speak to their practice, shape how the Manitoba child welfare system intervenes in cases of violence against mothers. By searching for the dominant themes of "invisible fathers" and "mothers failing to protect", this project substantiates how these themes contribute to the failure of the current system to hold the perpetrator accountable for his violence. I set out to confirm the argument that men need to be included as both risks and assets in the frame of our child welfare lens when assessing risk for children, in order to realize a feminist perspective in our work with families. Discourse analysis methods from a number of sources were drawn on to reveal and analyze how the discourse of "mothers failing to protect" has emerged, and how it informs child welfare practice and policy in ways that harm mothers and children. / May 2009