الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 57 |  |  |
| | | from | 57 | | |
Abstract
Although the research literature is growing every day, it is often difficult to determine the exact nature of pregnancy-related violence. This has posed difficulties for both researchers and practitioners, who need a clear understanding of the relationship between intimate partner violence (IPV) and pregnancy to develop and implement effective prevention and intervention programs. What adds to the complexity of the problem is the nature of the community, habits, traditions, and beliefs in the eastern countries generally and the Gulf countries specially. Also no available literature, in Kuwait, could be found dealing with pregnancy violence. Thus, the current research was carried out. The purpose of this research is to estimate the prevalence of different forms of domestic violence against pregnant women in Kuwait, identify epidemiological characteristics of women, particularly vulnerable to domestic violence, and reveal the determinants of domestic violence against women including risk and protective factors.
To achieve these aims, 200 pregnant women were randomly selected from a primary health care clinic randomly selected. A specially designed questionnaire was prepared for this study. All the selected women were directly interviewed after getting their consent to share in the study. The collected data included: socio-demographic characteristics of both the interviewed woman and her husband, risky behavior that may contribute to violence, pattern and frequency of violence as well as the response of women to violence. The health impacts of violence either on the general or reproductive health of the woman was also inquired about. The questionnaire was pre-coded to facilitate data entry to the statistical analysis program.
The results of the current study can be summarized in the following:
The mean age of the studied groups did not differ significantly (P = 0.396) with an average of 33.10 + 6.319, 32.46 + 4.427 and 31.25 + 3.890 years for the non violence, violence, and pregnancy violence groups respectively. Group 3 tended to have a significantly older age at marriage (26.50 + 1.155 years) compared with group 1 (22.26 + 3.709 years) and group 2 (23.01 + 2.452 years), P < 0.001. Group 1 tended to significantly have a higher degree of education, where 59.8% of them had higher than secondary educational certificate compared with 37.9% of group 2 and only 12.5% of group 3 (P < 0.001). Also, a significantly lower proportion of the last group (31.3%) were currently working compared with 37.9% of group 2 and 54.7% of group 1, P = 0.037.
Educational level did not differ significantly among the studied three groups with 50% of group 3 husbands holding higher than secondary educational certificate compared with 64.4% of groups 2 and 59.8% of group 1, P = 0.525. A higher proportion of husbands of women exposed to violence during pregnancy (50.0%) tended to have their own business compared with 29.9% of group 2 and 27.8% of group 1, P = 0.008.
Women suffering from violence during their last pregnancy (group 3) had a significantly shorter duration of marriage (4.75 + 1.769 years) than the other groups (10.65 + 6.627 years and 9.44 + 4.065 years, respectively), P < 0.001.
All women suffering from violence during pregnancy had a nuclear family type compared with 80.4% of non violent group and 72.4% of violence group, P = 0.039. The highest mean crowding index (1.68 + 0.384 individual/room) was that of violence group followed by pregnancy violence group (1.37 + 0.453 individual/room), while women not suffering from any violence had a mean crowding index of 1.26 + 0.536 individual/room. These differences are statistically significant, P < 0.001. The house of women suffering from violence during pregnancy is mainly of the rented type (75%) compared with 21.3% and 33.3% of the other two groups, P < 0.001, with lesser number of rooms (3.31 + 0.873 compared with 6.32 + 3.610 and 4.66 + 3.117 rooms, P < 0.001), and lesser number of bed rooms (.12 + 0.719 compared with 4.01+ 2.539 and 3.48 + 2.877 bed rooms, P < 0.001)
The non violence and pregnancy violence groups were nearly drinking the same amount of coffee cups while the violent group tended to drink more cups where 32.2% consumed 4-6 cups per day compared with 18.6% of non violent group and 18.8% of pregnancy violence group, P = 0.026. All the studied women were neither smoking nor addicting any alcoholic or other drugs.
The highest rates of coffee consumption are noticed among husbands of pregnancy violence group followed by violence group and the non violence one. The majority of husbands of group 3 (81.2%) consumed 4-7 coffee cups daily compared with 38.1% of group 1 and 74.8% of group 2, P < 0.001. Although smoking was more common among husbands of groups 3 (50.0%) than the other groups (39.2% and 43.7%) yet, these differences are not statistically significant, P = 0.657. Also husbands of group 1 significantly tended to be more addicts (25.0% compared with 0.0% and 4.6% respectively, P < 0.001), using tonics (50.0% compared with 13.4% and 13.8% respectively, P = 0.001), and play violent video games (93.2% compared with 36.1% and 40.2% respectively, P < 0.001).
A significantly lower proportion of women who did not suffer from violence (25.8%) suffered from physical violence compared with 78.2% of the violence groups and 68.7% of the pregnancy violence group, P < 0.001. Also, a smaller proportion of group 1 witnessed violence against their mothers during childhood (21.6%) compared with 28.7% of group 2 and 68.7% of group 3, P = 0.001. Women exposed to violence were more likely to suffer from gender discrimination (73.6%) compared to those suffering from violence during pregnancy (31.3%) or those who did not (28.9%). The most common form of discrimination was charging her with housework, followed by lower rates of medical care, hitting, and not allowing her to continue education.
Women exposed to violence during pregnancy tended to suffer from more severe forms of violence than the violence group. The majority of the violence group (72.4%) suffered from verbal abuse, while 50% of pregnancy violence groups suffered from kicking / hand fist compared with none of violence group 1, P < 0.001. Also, the majority of the pregnancy violence group (75%) was exposed to sexual assault compared to only 18.4% of the violence group, P < 0.001. They were also more frequently suffering from violence either during the last month (p = 0.001) or the last year (P < 0.001). The majority of both groups were exposed to more hitting by their husbands if they refused sexual assault (75.0% and 83.7%, P – 0.673). A higher proportion of husbands of pregnancy violence group did not allow them to receive medical care (37.5% compared with 4.6%, P = 0.001).
The pregnancy violence groups were more likely to suffer from isolation from relatives (75.0% compared with 23.0%, P < 0.001), feel unsafe (81.3% compared with 32.2%, P < 0.001), and to be exposed to violence in the presence of family member (81.3% compared with 27.6%, P < 0.001).
A quarter of pregnancy violence groups abandoned their houses compared to none of the violence groups, while 75% complained to family members compared with 55.2%, P <0.001. Less than half (44.8%) of the violence group did not take any reactive measure against violence towards them. The most common cause of non reacting was religious aspect (43.6%) followed by sake of children (15.4%). Avoiding remarriage of the husband was only stated by 2.6% while equal proportions (10.2%) stated “no place to go”, “fear of scandal”, and “hoping for change”.
The relation with others of the majority of women suffering from violence during pregnancy was affected when compared with those suffering from violence (87.5% compared with 23.8%, P < 0.001). They were also more likely to suffer from suicidal attempt than the other group (50.0% compared with 9.2%, P < 0.001).
The most common medical disorders suffered by battered women are anorexia (51.7% compared with 56.3%, P =0.578), difficulties in the gastrointestinal tract (42.5% compared with 31.3%, P = 1.00), and difficulties in sleeping (37.9% compared with 50.0%, P 0.571). The least suffered complaint is difficulties in urination (4.6% compared with 50.0%, P = 0.013). All women suffering from violence during pregnancy were suffering from at least one disorder compared with 93.1% of the violence group.
Exactly three quarter of the pregnancy violence group suffered from complications during pregnancy compared with 42.5% of violence group. Hypertension was stated by 43.8% of pregnancy violence groups and 28.7% of the violence group while premature labour was suffered by 13.8% of this group and 25% of the previous group. None of the women of violence group suffered from abortion due to violence against them while only 6.2% of pregnancy violence group suffered such outcome. These differences are statistically significant, P = 0.017.
The desire to become pregnant was not affected by exactly half the group (50.0%). All those of the pregnancy violence group who did not accept pregnancy used contraceptive secretly.
Out of the woman characteristics, level of education and frequency of coffee consumption proved to be significant predictor of violence against women. Also, exposure to violence during childhood and non witnessing violence directed toward her mother proved also to be a significant predictor. Nuclear family type and living in a rented house played a significant role to predict violence. The only significant character related to the husband was coffee consumption.
Due to the small number of cases of the pregnancy violence group; two sets were used for logistic regression, one dealing with woman characteristics and the other one dealt with husband characteristics. Older age at marriage and short duration of marriage in addition to violence against mothers proved to be significant predictors of violence against pregnant women. Frequent consumption of coffee, consuming tonics and playing violent video games proved to be significant predictors of the assaultive behavior of husbands during their wives during pregnancy.
The following can be recommended: Strengthening national commitment and action, establish, and monitor multi-sectoral action plans to address violence against women, promoting primary prevention through development, implementation and evaluation of programmes, integrate responses to violence against women into existing programmes, make physical, social, and psychological environments safer for women whether inside home or in the community at large, strengthening the health sector response, and support research on the causes, consequences, and costs of violence against women and on effective prevention measures.