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Questions about IPV should be part of contraceptive counseling: findings from a community-based longitudinal study in Nicaragua
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
(English)Article in journal (Refereed) Submitted
Identifiers
URN: urn:nbn:se:umu:diva-43387OAI: oai:DiVA.org:umu-43387DiVA: diva2:413311
Available from: 2011-04-28 Created: 2011-04-28 Last updated: 2013-02-05Bibliographically approved
In thesis
1. Intimate partner violence in Nicaragua: studies on ending abuse, child growth, and contraception
Open this publication in new window or tab >>Intimate partner violence in Nicaragua: studies on ending abuse, child growth, and contraception
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Intimate partner violence (IPV) is a pervasive, worldwide public health problem and one of the most common violations of human rights. The aim of this thesis were twofold: (i) to study the process and factors related to ending of IPV of Nicaraguan women and (ii) to examine to what extent IPV exposure is associated with the child linear growth and women’s contraceptive use after pregnancy.

Methods: Data were collected from a panel study which followed 398 women who were inquired about their IPV exposure during pregnancy and at follow-up a median of 43 months after delivery. Three hundred seventy five of their children were available for anthropometric assessment. Thirteen in-depth interviews were conducted with women exposed to physical/sexual IPV during pregnancy but not at follow-up. For analysis both quantitative and qualitative methodologies were used.

Results: Women experienced four patterns of abuse: never abused, ending abuse, continued abuse, and new abuse. Of the women who experienced any IPV before or during pregnancy, 59% (95% CI 52-65%) reported no abuse at follow-up (135/229).  Women exposed to a continued abuse pattern and those exposed to any IPV, emotional or physical IPV at follow-up had higher odds of reversible contraceptive use. Further, exposure to any IPV and controlling behavior by a partner during pregnancy impaired the index child linear growth. Girls whose mothers had low social resources during pregnancy were the most affected. Women felt that being inquired about IPV while pregnant contributed to process of ending the abuse.

Ending IPV was experienced as a process with three phases: “I came to a turning point,” “I changed,” and the “Relationship ended or changed.” Successful strategies to ending abuse mainly involved utilizing informal networks. Ending IPV did not always mean ending the relationship. IPV awareness, severity of the abuse, and economic independence were individual factors associated with ending of abuse. At the relationship level, diminishing or no exposure to controlling behavior by their partner was a key element. At the community level, a supportive and less tolerant to IPV environment as well as exposure to IPV inquiry during pregnancy facilitated the process of ending abuse.

Conclusion: The study found that IPV exposure is associated with the children’s linear growth and women’s reversible contraceptive use. In addition, it is clear that gender norms regarding IPV are not static and that they play an important role in facilitating the process ending the abuse by increasing abused women’s access to emotional and material support. Our results emphasize the relevance of improving public services response to IPV.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 43 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1411
Keyword
Intimate partner violence, IPV, child growth, contraception, pregnancy, Nicaragua, ending abuse
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-43390 (URN)978-91-7459-169-9 (ISBN)
Public defence
2011-05-20, Sal 135, Allmänmedicin, by 9A, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2011-04-29 Created: 2011-04-28 Last updated: 2013-02-05Bibliographically approved

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Salazar, MarianoHögberg, Ulf

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CiteExportLink to record
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