The cyclical and intergenerational effects of perinatal domestic abuse and mental health
Domestic abuse and mental health disorders are particularly dangerous during the perinatal period, due to their effects on both the mother and the developing fetus. Furthermore, domestic violence and mental health appear to be linked, which can result in these issues being passed down through generations. In order for health professionals to respond efficaciously, pre-registration and ongoing training is needed on how to ask, respond, provide support and refer women on to appropriate supportive agencies. High-quality research is also needed to improve outcomes.
Perinatal mental health disorders, such as depression, anxiety, and psychosis, can be present during pregnancy and/or up to 1 year postnatally (O'Hara and Wisner, 2014). Their presence during this period has a considerable impact on the mother, her developing fetus, and the growing child, with significant short- and long-term consequences. Approximately 15-20% of women suffer from perinatal mental disorders, with depression and anxiety being the most prevalent, affecting 12–13% of women respectively (National Institute for Health and Care Excellence (NICE), 2014).
The strongest risk factors for developing perinatal mental illness have repeatedly been found to include a history of psychiatric illness, domestic abuse, low socioeconomic status and unsatisfactory social support (Howard et al, 2014; Waters et al, 2014; Biaggi et al, 2016). Howard et al (2013) found that all types of perinatal mental disorder were associated with experiences of domestic abuse. Women with probable antenatal depression were three times more likely to have experienced domestic abuse in their lifetime, and five times more likely to have experienced domestic abuse during pregnancy. As the data used were cross-sectional, causality could not be established, but the authors suggested that domestic abuse might contribute to the burden associated with perinatal mental health. In a study carried out in Brazil, Ferraro et al (2017) found domestic abuse and perinatal mental illness to be highly correlated, with 62.9% of women with perinatal mental health problems having experienced domestic abuse in the previous 12 months. This underscores the importance of identifying and providing support for women who have experienced or are experiencing domestic abuse in order to prevent morbidity and mortality associated with poor perinatal mental health.
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