Prevalence of experienced abuse in healthcare and associated obstetric characteristics in six European countries

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Objectives: To assess the prevalence and current suffering of experienced abuse in healthcare, to present the socio-demographic background for women with a history of abuse in healthcare and to assess the association between abuse in healthcare and selected obstetric characteristics. Design: Cross-sectional study. Setting: Routine antenatal care in six European countries. Population: In total 6923 pregnant women. Methods: Cross-tabulation and Pearson's chi-square was used to study prevalence and characteristics for women reporting abuse in healthcare. Associations with selected obstetric factors were estimated using multiple logistic regression analysis. Main outcome measures: Abuse in healthcare, fear of childbirth and preference for birth by cesarean section. Results: One in five pregnant women attending routine antenatal care reported some lifetime abuse in healthcare. Prevalence varied significantly between the countries. Characteristics for women reporting abuse in healthcare included a significantly higher prevalence of other forms of abuse, economic hardship and negative life events as well as a lack of social support, symptoms of post-traumatic stress and depression. Among nulliparous women, abuse in healthcare was associated with fear of childbirth, adjusted odds ratio 2.25 (95% CI 1.23-4.12) for severe abuse in healthcare. For multiparous women only severe current suffering from abuse in healthcare was significantly associated with fear of childbirth, adjusted odds ratio 4.04 (95% CI 2.08-7.83). Current severe suffering from abuse in healthcare was significantly associated with the wish for cesarean section, and counselling for fear of childbirth for both nulli- and multiparous women. Conclusion: Abuse in healthcare among women attending routine antenatal care is common and for women with severe current suffering from abuse in healthcare, this is associated with fear of childbirth and a wish for cesarean section.

 

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Authors & affiliation: 
Lukasse M, Schroll AM, Karro H, Schei B, Steingrimsdottir T, Van Parys AS, Ryding EL, Tabor A; Bidens Study Group. 1 Department of Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway, 2 Center of Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark, 3 Department of Obstetrics and Gynecology, University of Tartu, Tartu, Estonia, 4 Department of Public Health and General Practice at the Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway, 5 Department of Obstetrics and Gynecology, St. Olav’s University Hospital, Trondheim, Norway, 6 Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland, 7 Universiteit Gent, ICRH/Vrouwenkliniek, Ghent, Belgium, 8 Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institute, Solna, Sweden, and 9 Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
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Published In: 
Acta Obstet Gynecol Scand. (2015) 94(5): 508-17
Publication date: 
Sunday, January 18, 2015