Child sexual abuse and subsequent maternal parenting: a qualitative meta-synthesis

Abstract

BackgroundChild sexual abuse (CSA) is a major global problem, resulting in adverse outcomes, including parenting outcomes, for those who have experienced it. To better understand how to intervene with mothers who may be facing adverse parenting outcomes, a comprehensive systematic review on women's views of the association between their experiences of CSA and their subsequent parenting is needed. We aimed to synthesise relevant published literature and to elucidate the mechanisms explaining this association. MethodsSeven databases (Embase, ProQuest Dissertations & Theses Global, PsycINFO, PubMed, Scopus, Sociological Abstracts, and Web of Science) and grey literature were searched from March 28 to March 29, 2017. Additionally, articles that cited included articles and the reference lists of included articles were searched from April 23, 2018, to May 18, 2018. We selected articles that were qualitative, available in full text and in English, had CSA as the main risk factor, and had the parenting of mothers as the main outcome. Two reviewers completed the initial screening and full text review of studies, and two reviewers extracted data and determined quality. A meta-synthesis of extracted qualitative data was completed using grounded theory. This review adhered to PRISMA guidelines. FindingsData from 105 articles were analysed; results showed that maternal history of CSA affected several parenting domains. Most prominently, mothers expressed a desire to protect their children from abuse and developed strategies to do so. Although mothers sought to protect their children, some had children who were abused by themselves or others. Maternal personal experiences of CSA influenced their reactions to their child's disclosure of abuse by others. Additionally, child-rearing and breastfeeding practices, and mother–child relationships, were often affected by mothers' experiences of CSA, though motherhood helped some women cope with these experiences. InterpretationOur review found that CSA was associated with maternal parenting practices. Limitations include lack of rigour in some studies and that the parenting experiences of mothers with undisclosed CSA histories were unknown. However, this review is the first attempt, to our knowledge, to comprehensively synthesise the qualitative literature on this topic. Given the lack of interventions to address these issues, our results can be used to develop intervention components targeted at specific areas of parenting concern. FundingNone.