‘They just walk away’ – women’s perception of being silenced by antenatal health workers: a qualitative study on women survivors of domestic violence in Nepal

Poonam Rishal,Sunil Kumar Joshi,Mirjam Lukasse,Berit Schei,Katarina Swahnberg

doi:10.3402/gha.v9.31838

Abstract

BackgroundDomestic violence during pregnancy has detrimental effects on the health of the mother and the newborn. Antenatal care provides a ‘window of opportunity’ to identify and assist victims of domestic violence during pregnancy. Little is known about the experience, needs, and expectations from the women's perspective in relation to domestic violence in Nepal.ObjectiveOur study aims to explore how women who have experienced domestic violence evaluate their antenatal care and their expectations and needs from health centers.DesignTwelve in-depth interviews were conducted among women who had experienced domestic violence during pregnancy and utilized antenatal care. The women were recruited from two different organizations in Nepal.ResultsWomen in our study concealed their experience of domestic violence due to fear of being insulted, discriminated, and negative attitudes of the health care providers. The women wished that the health care providers were compassionate and asked them about their experience, ensured confidentiality and privacy, and referred them to services that is free of cost.ConclusionsFindings from our study may help the health care providers to change their attitudes toward women survivors of domestic violence. Identifying and assisting these women through antenatal care could result in improved services for them and their newborns.

Highlights

The United Nation’s (UN) Declaration on the Elimination of Violence against Women has defined domestic violence (DV) as physical, psychological, and sexual violence that occurs within a private sphere, generally between individuals who are related through blood or intimacy [1]
Recommendations to help improve the quality of care for women who have experienced domestic violence during pregnancy and who come for antenatal care all the authors, challenging each other’s understanding based on personal and professional backgrounds
The women were given the opportunity to decline or reschedule the interview or Results Three main categories emerged from the in-depth interviews and are discussed as follows: 1) enduring domestic violence Á a hidden burden, 2) all we need is an opportunity, and 3) made a bad thing worse (Table 5)

Summary

Introduction

The United Nation’s (UN) Declaration on the Elimination of Violence against Women has defined domestic violence (DV) as physical, psychological, and sexual violence that occurs within a private sphere, generally between individuals who are related through blood or intimacy [1]. The Nepal Demographic Health Survey (NDHS) of 2011 reported that one in five (22%) women aged between 15 and 49 years has experienced physical violence at least once in their lifetime, and 12% have experienced sexual violence perpetrated by their husband. Objective: Our study aims to explore how women who have experienced domestic violence evaluate their antenatal care and their expectations and needs from health centers. Results: Women in our study concealed their experience of domestic violence due to fear of being insulted, discriminated, and negative attitudes of the health care providers. Conclusions: Findings from our study may help the health care providers to change their attitudes toward women survivors of domestic violence. Identifying and assisting these women through antenatal care could result in improved services for them and their newborns

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Methods

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Discussion

Conclusion