Perspectives on supporting fathers affected by postnatal depression and a history of violence (original) (raw)
Related papers
International Journal of Qualitative Studies on Health and Well-Being, 2016
Objective: Intimate partner violence (IPV) is a large public health problem with far-reaching consequences for those involved. The aim of this study was to explore fathers' experiences of change during pregnancy and early parenthood in the context of IPV. Methods: The methodological approach in this interview study was hermeneutics, based on a lifeworld perspective. Ten men, who had subjected their partners to violence during the childbearing period, and had become fathers within the previous 6 years, participated. Results: The analysis revealed four themes: beginning to acknowledge that you are inflicting violence, receiving confirmation that you are more than just a perpetrator of violence, becoming aware of the child, and the desire to receive support in the process of learning how to become a father. Levinas' concept ''the face of the other'' is used to interpret the findings. Conclusion: This study contributes to a more nuanced and expanded picture of IPV. It shows that men who inflict violence want to be and learn how to be fathers. We need more knowledge about how to stop violent acts and support these men in the process of fatherhood.
Journal of Affective Disorders, 2019
Background: We aimed to assess the relationship between intimate partner violence (IPV) and maternal mental health ten years after a first birth Methods: 1507 first-time mothers completed questionnaires at 3, 6, 12 and 18 months postpartum and 4 and ten years post the index birth. Exposure to IPV was assessed using the Composite Abuse Scale at 1, 4 and ten years. Standardised measures of depressive (CES-D), anxiety (BAI) and post-traumatic stress symptoms (PCL-C) were completed at ten-year follow-up. Results: One in three (34%) women experienced IPV between the birth of their first child and their child turning 10. For the one in six women (18.6%) who experienced IPV in the year prior to ten-year follow-up, the prevalence of depressive symptoms was 38.9% compared with 14.2% for women who never reported IPV (adjusted odds ratio [AdjOR] 2.9, 95% confidence interval [CI] 1.9-4.5). Prevalence of anxiety symptoms was 28.1% compared with 8.5% (AdjOR 3.4, 95% CI 2.0-5.9); and prevalence of post-traumatic stress symptoms was 41.9% compared with 11.3% (AdjOR 4.9, 95% CI 3.0-7.9). Limitations: Mental health symptoms and exposure to IPV were assessed by self-report and may be subject to misclassification bias as a result of non-disclosure. Conclusions: The high prevalence of mental health symptoms among women exposed to IPV in the ten years after giving birth coupled with the extent of post-traumatic stress symptoms and co-morbid mental health symptoms reinforce the need to provide appropriate care and referral pathways to women in the decade after having a baby. Recognition of the context of IPV and nature of mental health concerns is needed in tailoring responses.
Working with Fathers around Domestic Violence: Contemporary Debates
Child Abuse Review, 2012
This article discusses the issues that emerged from a small consultation exercise with academics and practitioners in the field of domestic violence on their perceptions of practice interventions with fathers who were domestically violent. The exercise suggests that there has been a growth in such interventions especially in the UK over the last decade as a result of the recognition of domestic violence as a child protection issue. There are tensions, however, and these mapped onto tensions between interventions located in working with perpetrators and more recent interventions that have a focus on fathers. More importantly, tensions about what kinds of practice interventions were most desirable were linked to wider debates within practice about the merits of set programmes versus more individualised responses. Respondents expressed concern about the lack of evidence on effectiveness on programmes.
Journal of Women's Health
Background: Intimate partner violence (IPV) negatively impacts maternal and infant health, yet few studies assess violence at multiple time points during the childbearing year. Methods: Using data on 2018 women from the multisite Community Child Health Network (CCHN), this study assesses the relationship between past-year IPV (reported at 1 and 12 months postpartum) and maternal depression and perceived stress measured 1 year postpartum. Past-year IPV was measured using a modified version of the HITS (Hurts, Insults, Threatens, and Screams) assessment; depression was assessed using the Edinburgh Postnatal Depression Scale; perceived stress was assessed by the Perceived Stress Scale. Multivariable logistic regression models estimated risk for depression and estimated stress scores among women reporting exposure to IPV at one or both time points compared to those unexposed to IPV, adjusting for maternal age and household income. Results: At 1 month postpartum, 36% of participants reported past-year IPV. At 12 months postpartum, 48% of participants reported IPV at either or both interviews. Compared to women reporting no IPV at either time point, violence reported at both time points was associated with symptoms of postpartum depression (considered a score of ‡13) (odds ratio [OR] = 2.06, confidence intervals [CI] = 1.21-3.53) and increased levels of perceived stress (b = 1.64, CI = 0.86-2.41) at 12 months postpartum after adjusting for baseline depression and perceived stress, respectively. Conclusions: These findings expand on previous research by showing that IPV, particularly when recurrent, is associated with increased risk of depression and perceived stress 1 year postpartum. Routine IPV screening paired with linkage to support services throughout prenatal and postpartum care is one strategy to address this important problem.
Family violence: Fathers assessing and managing their risk to children and women
Children and Youth Services Review, 2013
Domestic violence Child maltreatment Fatherhood Risk assessment Risk management Qualitative comparative analysis All too often, child protective workers fail to identify domestic violence, thus, endangering both child and adult family members. A potential solution is engaging men who abuse in assessing and managing their own risk to family members. This was the aim of a psycho-educational fathering program developed and tested in the southeastern United States. Over the course of the group, the men set goals on how to relate to their children and to their current or former partners, and they reflected on their achievement of these goals. The men's self-appraisals were supported by their caseworkers' assessments. A comparison of child protection data before and after entry in the group showed an extensive decrease in the families assessed with child protection findings and with household domestic violence. The evaluation used a qualitative comparative analysis (QCA) that identified configurations of conditions overlapping with child protection outcomes. Some of the men's characteristics included in these configurations ran counter to predictors usually associated with child maltreatment and domestic violence. The evaluation results point to the unique contributions that QCA can make to risk assessment.
BJOG: An International Journal of Obstetrics & Gynaecology, 2012
Objective To examine maternal depressive symptoms during and after pregnancy and explore their relationship with intimate partner violence in the 12 months after birth. Design Prospective pregnancy cohort study of nulliparous women. Setting Melbourne, Australia. Population In all, 1507 eligible women completed baseline data (mean gestation 15 weeks). Analyses are presented for 1305 women who completed all follow-up questionnaires. Methods Women were recruited from six public hospitals at between 6 and 24 weeks of gestation. Written questionnaires were completed at recruitment and at 3, 6 and 12 months postpartum. Main outcome measures Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Intimate partner violence was assessed using the short version of the Composite Abuse Scale. Results Sixteen per cent of women reported depressive symptoms (EPDS ‡ 13) in the 12 months postpartum, with most women first reporting depressive symptoms in the second 6 months after birth. Around 40% of women reporting depressive symptoms at each follow up also reported intimate partner violence. Factors associated with postpartum depressive symptoms in multivariable models were: emotional abuse alone (adjusted odds ratio [OR] 2.72, 95% CI 1.72-4.13), physical abuse (adjusted OR 3.94, 95% CI 2.44-6.36), depression in pregnancy (adjusted OR 2.89, 95% CI 1.75-4.77) and unemployment in early pregnancy (adjusted OR 1.60, 95% CI 1.03-2.48). Conclusions Screening for maternal depression at 3 months postpartum or earlier may miss over half the women with depression in the first 12 months after birth. Intimate partner violence is common among women reporting postnatal depressive symptoms and may be an important factor for health professionals to consider in their management.
PLOS ONE
Objectives Few studies have investigated health service use of mothers experiencing mental health problems or intimate partner violence (IPV). The aim of this study was to investigate health service utilisation of mothers experiencing mental health problems and intimate partner violence ten years after having a first baby. Methods Prospective cohort of 1507 first-time mothers recruited in Melbourne, Australia. Follow-up at ten years incorporated: Center for Epidemiologic Studies Depression Scale, Beck Anxiety Inventory, Posttraumatic Stress Disorder Checklist, Composite Abuse Scale. Results At ten years postpartum, one in four mothers (26.1%) reported depressive, anxiety or posttraumatic stress symptoms, and almost one in five (19.4%) reported recent IPV. Two-fifths of mothers reporting clinically significant mental health symptoms had experienced recent IPV (Odds Ratio = 5.6, 95% CI 3.9–8.1). Less than half of mothers experiencing mental health problems at ten-year follow-up had di...
A history of personal violence and postpartum depression: is there a link?
Archives of Women's Mental Health
Background: A link between violence and depression has been shown, but not a link between violence and postpartum depression. This study sought to determine if there is an association between a history of abuse (physical, sexual, emotional as a child or adult) and postpartum depression (PPD). Method: 200 postpartum women were recruited from 6 hospitals. At 8-10 weeks postpartum, a telephone interviewer asked women about physical, emotional or sexual abuse as an adult or child and sociodemographic, obstetrical and personal medical history. PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS, score of Ն12). Abuse was determined by the Conflict Tactics Scale or the Abuse Assessment Screen. Chi-square and logistic regression were used to determine the relationship between violence and PPD. Results: 11% of women had EPDS scores of Ն12. Rates of childhood (6.5%), or adult (6.5%) physical abuse; and childhood (13%) or adult (14%) sexual abuse were reported by respondents. Emotional abuse in the current relationship (29.6%) exceeded that of childhood abuse (3.5%). Overall 43.2% of respondents had at least one form of abuse. Having a history of depression (OR ϭ 3.3 (95% CI, 1.3-8.7)), panic attack during pregnancy (OR ϭ 5.4 (1.6-19.0)), maternal complications (OR ϭ 5.0 (1.7-15.1)), low social support (OR ϭ 3.3 (1.3-8.7)) and emotional abuse (OR ϭ 2.8 (1.1-7.4) were associated with PPD. Conclusion: Emotional abuse but not physical or sexual abuse was found to be associated with PPD. A possible explanation for this relationship may be that being in an abusive situation puts one at risk for depression and in turn, postpartum depression.
More present than absent: Men who use domestic violence and their fathering
Child & Family Social Work
An earlier article referred to the "absent presence" of the perpetrator in the lives of children and their mothers who have lived with domestic violence. It identified the ways in which the shadow of the perpetrator continued and was evidenced in the "symptoms of abuse" that both women and children experienced in spite of his absence. The current article argues that fathers who use violence are actually more present than absent in the lives of children (and women), even following separation. A mixed method approach surveyed men in Men's Behaviour Change Programs (N = 101), and interviewed women who had experienced violence (N = 50). The studies reported that the majority of men in both the quantitative men's study (80%) and the qualitative women's study (77%) had substantial contact with children. The women's interviews highlight the problematic fathering that many of their children experienced, both before and after separation. They reported very high levels of child abuse and poor attitudes to both women and children. The article concludes that the family violence and child welfare systems are poorly configured to address fathers who use violence and continue to hold substantial parenting roles, including following separation.
BMC Pregnancy and Childbirth, 2012
Background: Research has shown that exposure to interpersonal violence is associated with poorer mental health outcomes. Understanding the impact of interpersonal violence on mental health in the early postpartum period has important implications for parenting, child development, and delivery of health services. The objective of the present study was to determine the impact of interpersonal violence on depression, anxiety, stress, and parenting morale in the early postpartum. Methods: Women participating in a community-based prospective cohort study (n = 1319) completed questionnaires prior to 25 weeks gestation, between 34-36 weeks gestation, and at 4 months postpartum. Women were asked about current and past abuse at the late pregnancy data collection time point. Postpartum depression, anxiety, stress, and parenting morale were assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale, the Spielberger State Anxiety Index, the Cohen Perceived Stress Scale, and the Parenting Morale Index, respectively. The relationship between interpersonal violence and postpartum psychosocial health status was examined using Chi-square analysis (p < 0.05) and multivariable logistic regression.