Pregnant women and health workers’ perspectives on perinatal mental health and intimate partner violence in rural Ethiopia: a qualitative interview study

BMC Pregnancy and Childbirth

Research

Adiyam Mulushoa¹  Tesera Bitew¹  Charlotte Hanlon²  Louise M. Howard³  Roxanne C. Keynejad³ 

[1] Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Centre for Global Mental Health, Health Service and Population Research Department, PO31 David Goldberg Building, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Denmark Hill, SE5 8AF, London, UK;Section of Women’s Mental Health, Health Service and Population Research Department, PO31 David Goldberg Building, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, Denmark Hill, SE5 8AF, London, UK;

关键词: Pregnancy;    Perinatal mental health;    Perinatal depression;    Antenatal care;    Intimate partner violence;    Domestic violence;    Ethiopia;    Qualitative;    Interviews;   

DOI  :  10.1186/s12884-023-05352-8

 received in 2022-05-13, accepted in 2023-01-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMental health conditions are common during the perinatal period and associated with maternal, foetal, and neonatal morbidity and mortality. There is an established bidirectional relationship between mental health conditions and intimate partner violence (IPV), including during and after pregnancy. Mean lifetime prevalence of physical, sexual or emotional IPV exposure among women in rural Ethiopia is estimated to be 61% and may be even higher during the perinatal period. We aimed to explore the perspectives of women and antenatal care (ANC) health workers on the relationship between all types of IPV and perinatal mental health, to inform the adaptation of a psychological intervention for pregnant women experiencing IPV in rural Ethiopia.MethodsWe conducted in-depth qualitative interviews with 16 pregnant women and 12 health workers in the Gurage zone of the Southern Nations, Nationalities and People’s Region of Ethiopia, between December 2018 and December 2019. We conducted thematic analysis of English-translated transcripts of audio-recorded Amharic-language interviews.ResultsParticipants contextualised IPV as the primary form of abusive treatment women experienced, connected by multiple pathways to emotional and bodily distress. Patriarchal norms explained how the actions of neighbours, family, community leaders, law enforcement, and government agents in response to IPV often reinforced women’s experiences of abuse. This created a sense of powerlessness, exacerbated by the tension between high cultural expectations of reciprocal generosity and severe deprivation. Women and health workers advocated a psychological intervention to address women’s powerlessness over the range of difficulties they faced in their daily lives.ConclusionsWomen and health workers in rural Ethiopia perceive multiple, interconnected pathways between IPV and perinatal emotional difficulties. Contrary to expectations of sensitivity, women and health workers were comfortable discussing the impact of IPV on perinatal mental health, and supported the need for brief mental health interventions integrated into ANC.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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