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Violence against women and reproductive health: prevention, protection and action

Date: Wednesday 31 October 10.45–12.15
Source: Forum 11
Authors: Iatamze Verulashvili, Head, Health Division, Women's Center, Georgia

Abstract

The purpose of this study was to examine physicians' screening practices for female partner abuse during prenatal visits and epidemiological observation of pregnant women to reveal the impact of violence on health.

A self-administered questionnaire was developed to collect data on physicians' screening practices. The survey contacted obstetricians/gynaecologists practicing in Georgia. The response rate was 79.2% (420/530). Routine screening was carried out among 297 pregnant women.

More than half of respondents estimated that 23% or more of their patients had experienced abuse. Only 2% of respondents had recent training on partner abuse. Only 17% of respondents routinely screened for partner abuse at the first prenatal visit and 5% at follow-up visits. Screening revealed violencein 134 cases (45%). Of these, sexual violence was experienced in 25% of cases, and domestic violence in 75%. Among women who experienced abuse there was a higher relative risk of: impending abortion (27%), hypertensive syndrome (44%), urinary tract infection (60%), and intrauterine growth retardation (16%). Newborns were of lower weight (38%), and size (35%), and four cases of stillbirths and one case of mother-to-child transmission of HIV were recorded.

Violence is associated with hypertension during pregnancy and intrauterine growth retardation. Most physicians do not routinely screen for abuse during prenatal visits.

The Women's Center has used research results to influence public health policies, laws and interventions, develop advocacy materials and publish the books Medical Aspects of Domestic Violence and Reproductive Rights and Health. The centre has also created and implemented a certificate programme for postgraduate training doctors: `Impact of Violence on Reproductive Health', which supports the creation of policies for improved identification, documentation, surveillance, professional education and forensic examination. The centre has implemented violence indicators, raised awareness at community level (training 560 women and creating a network of 56 volunteers at regional level in 12 regions), and trained 340 law enforcement officers and doctors. Nine hundred and twenty-one pregnant women have had routine HIV testing and 123 face-to-face consultations. We have also lobbied the government for health-care subsidies for women who are victims of violence and other forms of abuse.