Background: Intimate partner violence (IPV) is not only considered a serious public health issue and a cause of human suffering (National Center for Injury Prevention of the Centers for Disease Control and Prevention, 2015), IPV can be a barrier to utilization of care in vital life phases (Bonomi et al, 2009; Snow Jones, Dienemann, & Schollenberger, 2006), and a determinant of many serious negative health outcomes for affected individuals and their families (Silverman et al, 2020). As a significant contributor to health, social, and economic disparities, violence jeopardizes the fabric of families and transcends all levels of socioeconomic status (Rhodes, 2012). Among those who suffer serious to fatal consequences as a direct result of IPV, the perinatal period has only recently received special attention in research and is extremely scarce (WHO, 2011). This is particularly the case as the exposure/context of IPV may be further complicated by societal crises such as natural disasters and pandemics, where the threat of violence and its health consequences may be heightened (Yehuda et al, 2008). Objectives: The objectives of this dissertation were to address the knowledge gaps pertaining to perinatal IPV and violence experiences during the COVID-19 pandemic. It had three specialist articles, two of which were reviews of the literature, and one was a population-based empirical study. The objectives of the dissertation were as follows: 1) To explore uni- and bi-directional IPV prevalence estimates and associated factors during the perinatal period (Paper I) (Mojahed et al, 2021a); 2) To investigate a broader range of pre- pandemic contexts of social and geographical isolation and their associations with IPV, as well as to provide reliable, preliminary knowledge of their potential impact during the COVID- 19 pandemic (Paper II) (Mojahed et al, 2021b; 3) To explore the 12-month prevalence of psychological, physical, and sexual IPV within an existing cohort, which consists of women and men, as well as to detect any possible changes during the COVID-19 pandemic in the experienced IPV behaviors as opposed to pre-pandemic times (Paper III) (Mojahed et al, 2023); 4) To explore factors that could prospectively predict IPV victimization (Paper III). Materials and Methods: Paper I involved a qualitative synthesis of the literature. Due to the heterogeneity of prevalence studies and varying violence definitions, quantitative analyses were not feasible for this review. The paper investigated prevalence estimates of perinatal IPV among intimate partners and explored associated factors. Information such as author, year of publication, recruitment setting, study design, sample size, directionality of IPV, prevalence estimates, and types of violence were extracted and tabulated. The integrative ecological model was used to consider population characteristics and (gender-based) associated factors relevant to IPV prevalence. Paper II was a rapid review conducted following Cochrane guidelines to address the urgency of studying IPV in the context of the COVID-19 pandemic. The review focused on the correlation between social and geographical isolation and IPV. Paper III utilized data from the population-based longitudinal study DREAMCORONA. Descriptive analyses were performed to determine the prevalence of IPV victimization among women and men, examining changes during the pandemic. Pearson correlation analyses and multiple logistic regression analysis were conducted to identify associations and potential predictors of IPV. The results were presented as odds ratios with confidence intervals. Results: In Paper I, several key findings were reported. Psychological uni-directional IPV against female partners was most prevalent during pregnancy. Studies comparing IPV prevalence before and after childbirth showed mixed results, with some reporting a decrease and others reporting an increase in IPV after birth. Risk factors at the individual, family, community, and societal levels were identified, including socioeconomic status, substance use, insufficient prenatal care utilization, low self-esteem, unplanned pregnancy, lack of support, and certain social and ethnic identities. Paper II found that lack of social support increased the risk of IPV victimization, and the compounding effect of social and geographical isolation heightened this risk. It also revealed that social isolation correlated with physical and sexual IPV among female drug users and predicted various forms of IPV among immigrant women. In Paper III, it was found that around 50% of women and 40% of men experienced some form of IPV in the last 12 months. Psychological aggression was the most prevalent form of violence reported. The majority of women and men reported no change in victimization by psychological and physical violence during the pandemic. On the other hand, about a quarter of (expectant) mothers (27%) and fathers (22-24%) reported an increase in psychological and physical IPV. With regard to sexual violence, neither mothers nor fathers reported any changes during the pandemic. Higher partnership satisfaction reduced the likelihood of IPV victimization, while symptoms of anger-hostility increased this probability. Conclusions: Considering the burden of perinatal IPV and the impact of the COVID-19 pandemic on IPV, this dissertation highlights the urgent need for effective preventive interventions. The findings suggest the importance of initiating antenatal care and delivering in clinical settings, as these factors were associated with a lower risk of perinatal IPV. Routine screening for IPV in obstetric care is crucial, and healthcare providers should be aware of the elevated risk for mental health distress among perinatal partners exposed to IPV. As experiences of IPV remained largely unchanged during the pandemic, there is a strong recommendation to strengthen and improve access to support services. Alternative support measures such as messenger services and telemedicine should be accessible and reliable for victims of severe IPV who may face increased isolation. Raising awareness about IPV is essential for individuals in informal and formal sectors, as well as family and friends within the immediate social network of those at risk. The findings also support the use of programs targeting adverse interaction patterns, particularly psychological aggression. Future research should focus on associated factors of IPV during the peripartum period and other critical life phases or societal events. It is crucial to adopt ecological and intersectional perspectives to gain a comprehensive understanding of IPV. Furthermore, including the perspective of the other partner in IPV research can provide valuable context for better prevention and intervention strategies.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:91857 |
| Date | 04 June 2024 |
| Creators | Mojahed, Amera Abdulqadir A. |
| Contributors | Garthus-Niegel, Susan, Croy, Ilona, Technische Universität Dresden |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
Page generated in 0.0436 seconds