Postnatal depression is strongly linked to psychological abuse by an intimate partner during pregnancy, independent of any physical or sexual violence, according to the research of Dr. Ana Bernarda Ludermir of the Universidade Federal de Pernambuco in Recife, Brazil and colleagues at the School of Social and Community Medicine at the University of Bristol.
These findings are significant as most social policies currently focus on prevention and treatment of physical violence only.
A total of 1,045 women between the ages of 18 and 49 years were included in the study and interviewed during pregnancy and after delivery. The women, who were receiving care at primary health care clinics during their third trimesters, were given a questionnaire that assessed partner violence.
The findings showed that 270 (26 percent) of these women suffered from postnatal depression, and the most common form of abuse was psychological (28 percent).
Frequency of psychological abuse during pregnancy was strongly linked to the rate of postnatal depression, and even though this association was reduced after adjustment, women who reported the highest occurrences of psychological abuse were still more than twice as likely to develop postnatal depression than those who had not experienced this type of violence.
“We recorded a clear positive association between the frequency of psychological violence during pregnancy and the occurrence of postnatal depression, even after adjustments,” said Ludermir.
“As in previous studies, psychological violence was much more common than was physical or sexual violence. About 10 percent of the burden of postnatal depression could be attributed to partner violence during pregnancy, with most attributable to psychological violence, which was the most common form of violence in our study.”
She added, “Partner violence is increasingly becoming recognized as an important public health problem worldwide. However, psychological violence is often not identified because of the emphasis placed on the detection of physical and sexual violence.”
The study shows the importance of recognizing psychological abuse as well as physical abuse, especially as it relates to pregnancy and depression. Screening expectant women for psychological abuse is a future possibility in diagnosing and treating women with mental health concerns.
“Prenatal care could provide an opportunity for improved detection by health care professionals, but the precise role of health providers in identification of partner violence against women needs further elucidation. Interventions that might prevent psychological violence, or help to treat the consequences of such violence, should reduce the substantial burden of postnatal depression that affects mothers, children, and the health system as a whole,” said Ludermir.
Dr. Rachel Jewkes of the Gender and Health Research Unit, Medical Research Council, Pretoria, South Africa, was quoted as saying, “Emotional abuse has not been part of many screening recommendations to identify women who experience abuse during prenatal care, such as those from the American Congress of Obstetricians and Gynecologists.
“However, there is mounting evidence that guidelines should include questions about emotional abuse, as well as physical and sexual abuse. Prevention of all forms of intimate partner violence is very important for improving women’s health, particularly their mental health,” added Jewkes.
Source: University of Bristol