What does violent and premature death mean?
Violence against pregnant women by their partners is a major public health issue. It can cause physical and emotional harm to women, cause complications during pregnancy and harm the health of the child. It is unclear what type of intervention is best suited to protect women and their children during pregnancy and after childbirth. Interventions that can work include counseling and psychotherapy to increase women's confidence and encourage them to develop strategies to avoid abuse. Referring to social workers, mother-and-child centers or other community-based services could also help. Violent partners can be included in specialized therapy programs.
The usual antenatal services offer health workers the opportunity to identify women who are at risk for abuse. In this review, we looked at 10 randomized trials involving a total of 3417 women. Seven of these studies involved pregnant women at high risk of intimate partner violence. The interventions examined in the studies included a one-off brief individual consultation, case management and referral to social workers, as well as several therapy sessions during pregnancy and after the birth. Due to a lack of data and the fact that the impact of the interventions was recorded differently, we were unable to identify interventions that were better suited than others. The studies focused on different effects and we were unable to summarize the information in a way that would allow us to draw any conclusions about the overall effectiveness of the interventions. Most of the studies did not provide any information on whether or not the violence episodes had decreased. A single study found that the total number of women who reported intimate partner violence during pregnancy and after childbirth decreased when they received psychotherapy. Several studies looked at whether the treated women were less depressed after giving birth to the child. However, the evidence was inconclusive. Other outcomes for the baby, such as lower birth weight and premature birth, were reported in only one study. The intervention did not reduce the risk of premature birth (<2500 g). None of the studies reported results regarding serious consequences such as stillbirth, neonatal death, miscarriage, maternal death during or after pregnancy, prenatal bleeding, and premature placental detachment. More data from well-conducted studies are needed before any particular intervention approach can be recommended.
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