Papers by Eva Marie Engebakken Flaathen
European Journal of Midwifery
INTRODUCTION Antenatal depression and intimate partner violence (IPV) are independently associate... more INTRODUCTION Antenatal depression and intimate partner violence (IPV) are independently associated with adverse short-and long-term health effects for women and their children. The main aim of the study was to investigate the prevalence of antenatal depression and the association between symptoms of antenatal depression and physical, emotional and sexual abuse in a culturally diverse population attending antenatal care. METHODS A cross-sectional study was conducted with 1812 culturally diverse pregnant women from Safe Pregnancy, a randomized controlled trial to test the effect of an intimate partner violence intervention for abused women in southeastern Norway. RESULTS More than one in ten women (14%) reported symptoms of antenatal depression. Women with symptoms of antenatal depression were significantly younger and single, had lower educational level, more limited economic resources and were more likely to use tobacco and to report negative experiences regarding alcohol consumption, including that of her partner, compared to women with no symptoms of depression. A total of 15.4% of the women reported experiences of some form of IPV during their lifetime. Most women reported previous experiences of IPV rather than recent experiences. Women with a history of IPV were significantly more likely to report symptoms of antenatal depression, after adjusting for confounding factors (AOR=1.96; 95% CI: 1.35-2.83). CONCLUSIONS Women who reported symptoms of antenatal depression were significantly more likely to have experienced physical, emotional and sexual IPV than women with no history of IPV. It is important to identify women at risk of antenatal depression in order to offer appropriate services during pregnancy.
Trauma, Violence, & Abuse
Intimate partner violence (IPV) around the time of pregnancy is a recognized global health proble... more Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem. Ethnic minorities and immigrant pregnant women experiencing IPV require culturally responsive health services. The aim of this scoping review was to identify aspects of cultural sensitivity in interventions to prevent or reduce IPV among ethnic minorities and immigrant pregnant women in high-income countries. Eight databases were searched in November 2019. Any type of scientific research, quantitative, qualitative, or mixed methods studies regarding interventions against IPV among pregnant women were considered for inclusion. Resnicow et al.’s definition of cultural sensitivity was used to identify aspects of cultural sensitivity. Ten papers relating to nine interventions/studies met our inclusion criteria. These studies, which included randomized controlled trials, a mixed methods study, a program evaluation, and a longitudinal study, were conducted in Australia, Belgium, Norway, and...
BMC Pregnancy and Childbirth
Background Intimate partner violence (IPV) during pregnancy is a global health problem with adver... more Background Intimate partner violence (IPV) during pregnancy is a global health problem with adverse consequences for mothers, infants and families. We hypothesise that information about IPV and safety behaviours during pregnancy has the potential to increase quality of life and the use of safety behaviours and prevent IPV. Methods A multicentre randomised controlled trial among culturally diverse pregnant women in Norway, to test the effect of a tablet-based video intervention about IPV and safety behaviours. Women attending routine antenatal check-ups alone (baseline) were screened for violence (Abuse Assessment Screen) by responding to questions on a tablet, and randomised (1:1) by computer to receive an intervention or a control video. The intervention video presented information about IPV and safety behaviours. The controls viewed a video promoting healthy pregnancy in general. Outcome measures were assessed three months post-partum: The World Health Organization Quality of Life...
Sexual & Reproductive Healthcare, 2021
OBJECTIVES Unintended pregnancy in the context of intimate partner violence (IPV) is a public hea... more OBJECTIVES Unintended pregnancy in the context of intimate partner violence (IPV) is a public health issue. It is associated with increased health risks for women and their children. Our objective was to investigate the association between unintended pregnancy and emotional, physical and sexual IPV in a multi-cultural population attending routine antenatal care. STUDY DESIGN A prospective cross-sectional study of 1788 pregnant women who filled out a questionnaire during pregnancy as part of a randomized controlled trial conducted in southeastern Norway. MAIN OUTCOME MEASURES Pregnancy intendedness was measured by asking women if their pregnancy was planned or not. The Abuse Assessment Screen and the Composite Abuse Scale R-SF, consisting of descriptive questions, were used to measure IPV. Chi-square tests, a Mann-Whitney U test, and binary logistic regression analysis were used. RESULTS Almost one in five women (17.4%) reported that their current pregnancy was unintended. Women with unintended pregnancy were significantly younger, had lower educational backgrounds, more limited economic resources and were more likely to be non-native Norwegian speakers. A total of 15.3% of the women reported some experience of IPV in their lifetime. These women were significantly more likely to experience an unintended pregnancy than women who had not experienced IPV, after adjusting for confounding factors: AOR = 1.74 (95% CI [1.23-2.47]). CONCLUSIONS Women who had experienced IPV were significantly more likely to have an unintended pregnancy than women who had not experienced IPV. It is of major importance to identify those women and offer appropriate services during pregnancy.
BACKGROUND Violence against women is considered a global health problem, and intimate partner vio... more BACKGROUND Violence against women is considered a global health problem, and intimate partner violence (IPV) around the time of childbirth can have severe consequences for mother and child. Prenatal care is considered a window of opportunity to address IPV and ask women about violence exposure since women are in regular contact with healthcare providers. Mobile Health (mHealth) might overcome barriers to talk about IPV face-to-face. OBJECTIVE Our objective was to explore midwives’ attitudes toward a tablet intervention with information about IPV, safety behaviors, and their experiences to include pregnant women of different ethnic backgrounds in a randomized controlled trial (RCT). METHODS Individual interviews were conducted with nine midwives participating in an RCT to test a video on a tablet to promote safety behaviors in prenatal care. Analysis was guided by thematic analysis, according to Brown and Clark. RESULTS Midwives perceived a tablet intervention as an appropriate suppl...
BMC Public Health, 2019
Background: Intimate partner violence (IPV) around the time of pregnancy is a recognized global h... more Background: Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem with damaging consequences. However, little is known about the effect of violence assessment and intervention during pregnancy. We hypothesise that routine enquiry about IPV during pregnancy, in combination with information about IPV and safety behaviours, has the potential to increase the use of these behaviours and prevent and reduce IPV. Methods: The Safe Pregnancy study is a randomised controlled trial (RCT) to test the effectiveness of a tablet-based intervention to promote safety behaviours among pregnant women. Midwives include women who attend routine antenatal care. The intervention consists of a screening questionnaire for violence and information about violence and safety behaviours through a short video shown on a tablet. The materials are available in different languages to ensure participation of Norwegian, Urdu, Somali and English-speaking women. Eligible women answer baseline questions on the tablet including the Abuse Assessment Scale (AAS). Women who screen positive on the AAS will be randomized to an intervention video that contains information about violence and safety behaviours and women in the control group to a video with general information about a healthy and a safe pregnancy. All women receive information about referral resources. Follow up will be at three months post-partum, when the woman attends the maternal and child health centre (MCHC) for the baby's checkup. Outcome measures are: Use of safety behaviours and quality of life (primary outcomes), prevalence of violence, mental health measures and birth outcomes (secondary outcomes). Intention to treat analysis will be performed. Discussion: The project will provide evidence on whether enquiry about violence and a short video intervention on a tablet is effective and feasible to prevent or reduce harm from IPV among women who attend antenatal care. Trial registration: This study is registered in ClinicalTrials.gov. Identifier: NCT03397277 (Registered 11th January 2018).
Violence Against Women, 2020
Intimate partner violence (IPV) during pregnancy has negative health impacts on the woman and the... more Intimate partner violence (IPV) during pregnancy has negative health impacts on the woman and the fetus. There is a lack of evidence supporting effective interventions to prevent IPV during pregnancy. This user-involvement study was conducted to get feedback on a culturally sensitive, tablet intervention containing questions about violence and safety-behaviors and a video promoting safety behaviors. This resulted in important feedback on the intervention content. Our findings show that women are in favor of disclosing IPV via a tablet. They suggested ways to address barriers for disclosure, such as safeguarding anonymity and creating a trustful relationship with the midwife.
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Papers by Eva Marie Engebakken Flaathen