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Violence against women during pregnancy and postpartum period: a mixed methods study protocol.

ABSTRACT: INTRODUCTION:Violence against women is a public health problem that poses serious consequences for victims and their environments. The healthcare system struggles to assess this phenomenon during prenatal and postpartum care because of pregnant and postpartum women's potential vulnerabilities. The research protocol presents the aims to evaluate the prevalence of violence, the period(s) in which it occurs, aggressors and forms it takes as well as to explore how violence against women is perceived among pregnant and postpartum women. METHODS AND ANALYSIS:This mixed methods study protocol uses an explanatory sequential design and is based on the establishment of meta-inferences that result from the combination of quantitative and qualitative approaches. Probabilistic sampling will be used to select the study participants: 584 women attending prenatal and/or postpartum care outpatient services at the University of Campinas Women's Hospital, Brazil. The quantitative approach will consist of four validated questionnaires, and the qualitative approach will use focus groups that serve to deepen the understanding of participants' views about the study topic. To create the focus groups, 72 study participants will be invited and divided into 6 groups (3 adolescents and 3 adults) based on age and pregnancy/postpartum condition. Descriptive analysis of sociodemographic characteristics and questionnaire results will be used to identify the prevalence and forms of violence experienced by women during the pregnancy-puerperal cycle, the relationships between women and their aggressors, and the existence of a history of violence. A bivariate and multivariate analysis will be performed to identify the association between sociodemographic factors and violence as an outcome. Qualitative data will be analysed through Grounded Theory to understand women's perceptions of the phenomenon studied. ETHICS AND DISSEMINATION:The research protocol was approved by the Research Ethics Committee of the University of Campinas, Brazil number CAAE: 13426819.1.0000.5404. The results will be disseminated to the health science community.

SUBMITTER: Sanchez ODR

PROVIDER: S-EPMC7580047 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Violence against women during pregnancy and postpartum period: a mixed methods study protocol.

Sánchez Odette Del Risco ODR Bonás Mariana Kerche MK Grieger Isabella I Baquete Aline Geovanna Lima AGL Nogueira Vieira Daniella Aparecida DA Contieri Bozzo Campos Bianca B Guerazzi Pousa Pereira Carla Grazielle CG Surita Fernanda G FG

BMJ open 20201021 10

<h4>Introduction</h4>Violence against women is a public health problem that poses serious consequences for victims and their environments. The healthcare system struggles to assess this phenomenon during prenatal and postpartum care because of pregnant and postpartum women's potential vulnerabilities. The research protocol presents the aims to evaluate the prevalence of violence, the period(s) in which it occurs, aggressors and forms it takes as well as to explore how violence against women is p ...[more]

PMID: 33087371

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Project description:BackgroundDigital health is increasingly used to meet the needs of perinatal people, with estimates of pregnancy-related internet use ranging from 90% to 97% of pregnant people. As digital health takes on greater importance during the perinatal period, it is essential that providers and developers of digital health content understand why perinatal people use these resources and the features that enhance their experience. However, gaps remain in understanding the content that is most helpful and how the platforms are navigated. Learning directly from perinatal people about their needs will help ensure alignment between perinatal needs and available content.ObjectiveThis formative study aims to identify the reasons why perinatal people use digital health resources; the features of the digital health platforms that are of greatest importance to them; and how these differ by perinatal stage (pregnancy vs post partum), mental health conditions, parity, and demographics (race and ethnicity).MethodsThis mixed methods study used interviews; surveys; and secondary data on demographic, health, and pregnancy characteristics to identify the digital health needs and preferences of pregnant and postpartum people who used the Maven digital health platform in the United States during their pregnancy or postpartum period. The interviews informed the content of the surveys and provided additional insights and examples for interpreting the survey results. The surveys were used to collect data from a sample of Maven users, and the results were linked to the secondary data set. The interviews were thematically analyzed, and survey data were analyzed using descriptive statistics and stratified by parity, race, and mental health status.ResultsOverall, 13 people were interviewed (including n=4, 31% pilot interviews), and 147 pregnancy and 110 postpartum survey respondents completed the surveys and had linkable secondary data. Top reasons for using digital health resources during pregnancy were to (1) know what is normal or typical during pregnancy, (2) have access to a health care provider when needed, and (3) know how the baby is developing. Top reasons for postpartum use were to (1) help with breastfeeding, (2) know what normal baby development is, and (3) help with the baby's health issues. Top platform features during pregnancy and the postpartum period were (1) credible and trustworthy information and providers, (2) nonjudgmental information and support, and (3) no cost to the user. In general, more reasons for using digital resources were identified as extremely important during pregnancy compared with post partum. The results showed minor variations across strata.ConclusionsThis formative research found minor differences in digital resource needs and preferences across user characteristics among perinatal people in the United States. Future work should examine whether there are variations in interests within topics by user characteristics, which may provide additional opportunities to better meet user needs.

Project description:BackgroundIntimate partner violence is a devastating human rights violation and public health problem with high prevalence rates globally. Intimate partner violence during pregnancy is associated with devastating maternal, perinatal, and neonatal health effects. We present the protocol for a systematic review and meta-analysis to estimate the global lifetime prevalence of intimate partner violence during pregnancy.MethodsThis review aims to systematically synthesize the evidence on the global prevalence of violence against women by intimate partners during pregnancy using available population-based data. A comprehensive search of MEDLINE, EMBASE, Global Health, PsychInfo, and Web of Science databases will be conducted to identify all relevant articles. Manual searches will be conducted in Demographic and Health Survey (DHS) data reports and websites of national statistics and/or other offices. DHS data analysis will also be conducted. Based on inclusion and exclusion criteria, titles and abstracts will be screened for eligibility. Then, full-text articles will be assessed for eligibility. The following data will be extracted from included articles: study characteristics, population characteristics (e.g., ever-partnered, currently partnered, or any women, and age range), violence characteristics (e.g., type of violence, and perpetrator), estimate type (e.g., intimate partner violence during any pregnancy or during last pregnancy), subpopulation type (e.g., by age, marital status, urban/rural), prevalence estimate, and key quality indicators. A hierarchical Bayesian meta-regression framework will be used. This multilevel modelling approach will use survey-specific, country-specific, and region-specific random effects to pool observations. This modelling technique will be used to estimate global and regional prevalence.DiscussionThis systematic review and meta-analysis will provide estimates on the global and regional prevalence of intimate partner violence during pregnancy and contribute to monitoring progress towards Sustainable Development Goal (SDG) Target 5.2 on eliminating violence against women and to SDG Targets 3.1 and 3.2 on reducing maternal mortality and neonatal mortality. Given the significant health impacts of intimate partner violence during pregnancy, potential for intervention, and urgency to address violence and improve health, this review will provide critical evidence to governments, non-governmental organizations, and policymakers on the magnitude of violence during pregnancy. It will also inform effective policies and programs to prevent and respond to intimate partner violence during pregnancy.Systematic review registrationPROSPERO ID CRD42022332592.

Project description:Background and objectivesAssess the incidence and factors associated with major depressive episodes (MDEs) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared with healthy pregnant women (HPW) and nonpregnant women with epilepsy (NPWWE) in comparable timeframes. Previous studies have reported higher rates of postpartum depression in women with epilepsy compared with women without epilepsy. However, the incidence of MDE using a structured interview during pregnancy and postpartum has not been directly compared with control groups, and the comparison of depression and anxiety symptoms and the role of associated factors remain ambiguous.MethodsThe Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational parallel group cohort study of PWWE and their children. This report examines mood disorders. Unlike previous epilepsy pregnancy studies, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory [BDI] and Edinburg Postnatal Depression Scale [EPDS]) and anxiety (Beck Anxiety Inventory [BAI]) were also assessed along with multiple clinical factors.ResultsThis study included PWWE (n = 331) and HPW (n = 102) during pregnancy and postpartum and NPWWE (n = 102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms.DiscussionAlthough SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed and symptomatic patients should be offered treatment.Trial registration informationThis study is registered at ClinicalTrials.gov as NCT01730170.

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Violence against women during pregnancy and postpartum period: a mixed methods study protocol.

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Violence against women during pregnancy and postpartum period: a mixed methods study protocol.

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