Stigma and Parenting Children Conceived From Sexual Violence

Rouhani, Shada A.; Scott, Jennifer; Greiner, Ashley; Albutt, Katherine; Hacker, Michele R.; Kuwert, Philipp; VanRooyen, Michael J.; Bartels, Susan A.

doi:10.1542/peds.2014-3373

Cited by 20 publications

(21 citation statements)

References 36 publications

(45 reference statements)

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“…Similarly, including wider community members within treatment and improving economic opportunities for clients, as well as using this as a platform for anti-stigma work were deemed highly relevant treatment components. This understanding is corroborated within existing literature, that women with CBSV face rejection and abandonment from their family and community, including access to their livelihoods, and social network (Rouhani et al 2015;Albutt et al 2016;Verelst et al 2014, Kelly et al 2017. However, experts in this study were less optimistic about the feasibility of implementation.…”

Section: Discussionsupporting

confidence: 81%

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

Anderson

2018

Health Care for Women International

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Section: Discussionsupporting

confidence: 81%

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

Anderson

2018

Health Care for Women International

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“…A total of 852 participants (764 in the parenting group, 83 in the termination group, and 3 who met criteria for both study groups) completed quantitative interviews. Quantitative data from the parenting and the termination group have been published elsewhere [20–22]. …”

Section: Methodsmentioning

confidence: 99%

Sexual violence-related pregnancies in eastern Democratic Republic of Congo: a qualitative analysis of access to pregnancy termination services

et al. 2016

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BackgroundSexual violence has been prevalent throughout the armed conflict in eastern Democratic Republic of Congo (DRC). Research on sexual violence-related pregnancies (SVRPs) and pregnancy termination in eastern DRC, a context with high prevalence of sexual violence, high maternal mortality, and restrictive abortion laws, is scant but crucial to improving the overall health of women in the DRC. Understanding women’s perceptions and experiences related to an SVRP, and in particular to pregnancy termination in this context, is critical for developing effective, targeted programming.MethodsRespondent-driven sampling (RDS) was used to recruit two subgroups of women reporting SVRPs, 1) women raising a child from an SVRP (parenting group) and 2) women who had terminated an SVRP (termination group), in Bukavu, DRC in 2012. Semi-structured qualitative interviews on pregnancy history and outcomes were conducted with a systematically selected sub-group of women recruited through RDS methodology. Interview responses were translated, transcribed and uploaded to the qualitative data analysis software Dedoose. Thematic content analysis, complemented by the constant comparative technique from grounded theory, was subsequently used as the analytic approach for data analysis.ResultsFifty-five qualitative interviews (38 parenting group and 17 termination group) were completed. The majority of women in the termination group reported using traditional herbs to terminate the SVRP, which they often obtained on their own or through family, friends and traditional healers; whereas women in the parenting group reported ongoing pregnancies after attempting pregnancy termination with herbal medications. Three women in the termination group reported accessing services in a health center. Almost half of the women in the parenting group cited fear of death from termination as a reason for continuing the pregnancy. Other women in the parenting group contemplated pregnancy termination, but did not know where to access services. Potential legal ramifications and religious beliefs also influenced access to services.ConclusionsWomen in this study had limited access to evidence-based safe abortion care and faced potential consequences from unsafe abortion, including increased morbidity and mortality. Increased access to reproductive health services, particularly safe, evidence-based abortion services, is paramount for women with SVRPs in eastern DRC and other conflict-affected regions.

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“…Although respondent-driven sampling (RDS) was used to recruit participants, the qualitative data represent a convenience sample due to smaller sample sizes. Quantitative data [ 26 , 30 , 16 ] and complete study methods, including respondent-driven sampling (RDS) methodology [ 30 ], have been published previously. Qualitative data on disclosure of SVRPs among both the parenting and termination groups are presented here.…”

Section: Methodsmentioning

confidence: 99%

“…[ 11 , 13 ] Stigma following sexual violence has previously been documented in eastern DRC,[ 14 – 15 ] and may impact disclosure of a sexual violence-related pregnancy (SVRP) in several important ways. Stigma may prevent survivors from disclosing that the pregnancy was conceived from sexual violence and influence who is informed of the pregnancy, resulting in delayed disclosure and/or failure to seek pregnancy-related care, and may influence women’s decisions to continue or to terminate the pregnancy [ 16 ]. Termination of pregnancy in DRC is highly restricted, permissible only to save the life of a woman,[ 17 , 18 ] and access to skilled providers for termination services is limited [ 19 ], which may further impact disclosure of SVRPs, especially among survivors considering pregnancy termination.…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Analysis of Disclosure Patterns among Women with Sexual Violence-Related Pregnancies in Eastern Democratic Republic of Congo

et al. 2016

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The Democratic Republic of the Congo (DRC) has experienced nearly two decades of civil conflict in the Eastern regions of North and South Kivu. This conflict has been notorious for the use of sexual violence as a weapon of war, leading in many cases to pregnancy after rape. The objectives of this analysis were: 1) to describe patterns of sexual violence-related pregnancy (SVRP) disclosure; 2) to consider why survivors chose to disclose to particular individuals; and 3) to examine the dialogue around SVRPs between women with SVRPs and their confidants. In South Kivu Province, Democratic Republic of Congo, two sub-groups of sexual violence survivors completed qualitative interviews, those currently raising a child from an SVRP (parenting group, N = 38) and those who had terminated an SVRP (termination group, N = 17). The findings show that a majority of SVRPs were conceived when participants were held in sexual captivity for prolonged periods of time. The SVRPs were disclosed to friends, family members, other sexual violence survivors, community members, spouses, health care providers, or perpetrators. The confidants were most often chosen because they were perceived by the participants as being discreet, trusted, and supportive. The confidants often provided advice about continuing or terminating the SVRP. Trust and discretion are the most important factors determining to whom women with SVRPs disclose their pregnancies. The vital role of confidants in giving support after disclosure cannot be overlooked. Providing opportunities for survivors to safely disclose their SVRPs, including to health care providers, is a necessary first step in allowing them to access safe and comprehensive post-assault care and services.

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Stigma and Parenting Children Conceived From Sexual Violence

Cited by 20 publications

References 36 publications

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

Mothers with children born of sexual violence: Perceptions of global experts regarding support in social care settings

Sexual violence-related pregnancies in eastern Democratic Republic of Congo: a qualitative analysis of access to pregnancy termination services

A Qualitative Analysis of Disclosure Patterns among Women with Sexual Violence-Related Pregnancies in Eastern Democratic Republic of Congo

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