What do pregnant women experiencing intimate partner violence expect of their health providers and hospital systems?

Abstract

Background: Intimate partner violence is a pervasive public health and human rights problem with multidimensional effects on women’s physical, mental and reproductive well-being. The World Health Organization has recommended a first-line response to disclosures of intimate partner violence. However, a strong evidence base of which interventions work best is lacking and there is a greater need to listen to the voices of survivors to tailor responses. The primary purpose of this paper was to explore what pregnant women experiencing IPV wish for from their health providers and hospital systems.

Methods: This paper is part of a broader study which included a survey of 1,067 pregnancy care patients at a large tertiary hospital in Melbourne. For this paper, we analysed an open-ended question related to victim/survivor women’s needs and what they wish for from health practitioners and the healthcare system. Overall, while 571 women responded to the open-ended questions, only those relating to women who screened positive on the composite abuse scale or responded ‘Yes’ to screening questions (n = 142) or had been afraid of their partner in the previous 12 months (n = 13) or had experienced reproductive coercion in the last 12 months (n = 6) were analysed for this paper, making a total of 161 respondents.

Results: Four main themes emerged from the women in this study: 1) woman-centred care; 2) relationship and domestic violence-specific concerns; 3) male partner involvement and education; and 4) hospital system reform.

Conclusions: This study shows that women experiencing intimate partner violence value care that is supportive of them, provides tailored health information, and involves their partner, as well as a health system that is well-organized, accessible and provides continuity of care. It is important to align maternal health services with attributes of care valued by women to meet the complex health needs of pregnant women experiencing intimate partner violence.