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Domestic violence and pregnancy

14 April 2011 Expertsvar

Does experience of violence affect a woman’s labour during delivery? And how do midwives in maternity care deal with the issue of violence against pregnant women? These are questions that Hafrún Finnbogadóttir, a researcher at Malmö University in Sweden, has studied. She is now presenting her findings in a licentiate thesis.

Domestic violence, especially violence against pregnant women, is still a shameful subject. This is despite the fact that it is a severe public health issue which threatens both the mother-to-be and the unborn child's health outcomes.

Few Swedish studies have examined how common physical violence against pregnant women is, and those studies available show that the prevalence is widespread namely between 1.3 to 11.0 percent of pregnant women in Sweden

Hafrún Finnbogadóttir, a researcher at the Faculty of Health and Society at Malmö University in Sweden, and with long clinical experience as a midwife, became aware, about twelve years ago, of the major health problems caused by problems such as violence against pregnant women.

“I realised that as a midwife I must have encountered many of these women in my work and that I neither had the knowledge nor the readiness to deal with them,” she says.

This is one of the reasons Finnbogadóttir chose to focus her research on violence – both physical and mental – against pregnant women.

Slow or difficult labour i.e. labour dystocia has a major negative impact on birth outcomes and include the reason behind half of all unplanned cesarean. Finnbogadóttir has investigated to what extent experience of violence affects a woman’s labour. The study, in which 2,652 first-time mothers were included, showed that those women who had experienced violence and consumed alcohol during late pregnancy had higher risk of having the diagnosis, labour dystocia. However, Finnbogadóttir found no connection between the experience of violence and labour dystocia at full term. To quote Finnbogadóttir “We need more studies in this field”. Recently, a study from Iran showed an association between experienced abuse from their partner / spouse and labour dystocia.

Finnbogadóttir has also conducted a study among 16 midwives in which every fourth midwife declared that she had never disclosed that a patient had been exposed to violence.

“Midwives need both updated knowledge and tools with regard to abused pregnant women who are victims of domestic violence. Midwives feel that they lack support and feel that they are betraying both the women and the unborn child,” says Finnbogadóttir.

She now hopes that her research will bring attention to the problem and will motivate the maternity care in southern Sweden to create procedures to identify domestic violence. There is a need for guidelines, a plan of action and a care plan. And further continuous training and support in the area for the midwives  

Finnbogadóttir intends to continue her research in this area.

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