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Bang, zoom, one day to the moon, Alice

You may wish to check out the recent study, "Intimate partner abuse before and during pregnancy as risk factors for postpartum mental health problems, published April 7, 2014 in the journal BMC Pregnancy and Childbirth. Did your husband ever threaten you while you were pregnant? Typical male verbal abuse of a pregnant spouse might start with something, "I feel like punching my fist right through your navel for spending so much money on food." This may happen a day or two before the mother goes to the hospital to have the baby. What's on the mother's mind during labor is the husband's abusive words threatening to "punch his fist right through her navel" when she's a few days from delivery of the baby. What's diminished on the new mother's mind the day after the labor is over is the joy of the new baby or the image of a smiling, proud spouse who feels protective of his wife instead of angry at the reality of having an additional mouth to feed, if the male is the only one earning an income at the time.

Bang, zoom, one day to the moon, Alice: Intimate partner violence of a pregnant mom can lead to PTSD.
Anne Hart, photography and book.

After the birth, there may be a honeymoon period emotionally with kinder words, but the verbal, emotional, psychological, and finally physical abuse often escalates. In the meantime the women are left with not only post-partum depression but also chronic anxiety and sometimes from the hormonal changes, becoming housebound with agoraphobia. It has happened so often, and frequently in households where the husband verbally threatens or otherwise abuses the wife either physically or emotionally or both. Often the psychological abuse escalates into physical abuse, especially if the spouse sees the new mother as a burden keeping him from his freedom of travel or meeting other women.

As far as the new study, the results of that research provide further evidence that intimate partner abuse is a risk factor for postpartum mental health problems, explains the study's abstract. The researchers also underscore the complex risks and needs associated with intimate partner abuse among postpartum women and support the use of integrated approaches to treating postpartum mental health problems.

Future efforts should focus on the extent to which strategies designed to reduce intimate partner abuse also improve postpartum mental health and vice versus

Ashley Pritchard, a Simon Fraser University doctoral student, is among four authors of a new research paper calling for closer monitoring of new mothers for mental health problems in light of their findings. The four have advanced previous research that links intimate partner abuse to postpartum mental health problems.

They discovered that 61 percent of all women who participated in the study, "Intimate partner abuse before and during pregnancy as risk factors for postpartum mental health problems," experienced mental health symptoms, according to an April 28, 2014 news release, "Abuse jeopardizes new mothers' mental health." The open-access journal BMC Pregnancy and Childbirth has published online the researchers’ study.

The study examined associations of psychological, physical and sexual abuse experienced by 100 English-speaking mothers in British Columbia, aged 18 years and older, in the first three months of their postpartum period

Even though the abuse was typically minor in nature, such as name-calling, any type of intimate partner abuse—before or during pregnancy—was linked to higher than normal levels of postpartum mental health problems. Forty-seven per cent of all women who participated in the study experienced at least moderate mental health symptoms.

The participants were largely from high socioeconomic backgrounds and were not considered at high risk of postpartum mental health problems. “I think when people hear the word abuse they automatically think about physical abuse,” says Pritchard, according to the news release. Pritchard is a Simon Fraser University (SFU) psychology student who interviewed the study’s participants and helped recruit them. “This research shows that different types of abuse have negative consequences and should be part of routine health checks for new mothers.”

In addition to questions about their general health and wellbeing, participants answered questions about their experiences of intimate partner abuse and about their mental health during their postpartum period

Their symptoms, which included depression, stress, anxiety, obsessive-compulsive disorder (OCD) and Post Traumatic Stress Disorder (PTSD), were above normal levels and were triggered by specific types of abuse. For example, psychological abuse—verbal and emotional—was associated with stress and PTSD. Physical abuse was associated with depression, OCD and PTSD. Sexual abuse was associated with OCD.

Multivariate modeling also showed that as the number of types of intimate partner abuse experienced increased—especially during pregnancy—so did the number of different types of postpartum mental health problems, and their severity. The authors say their findings underscore the complex risks and needs associated with intimate partner abuse among postpartum women, regardless of socioeconomic background.

Recognizing that it would be challenging to achieve, the authors recommend that healthcare providers screen new mothers more intensely for intimate partner abuse

“Educating both the public and health care professionals about the prevalence and effects of intimate partner abuse would help to diminish the stigma surrounding the issue,” says Pritchard, according to the news release.

“In addition to education, the development of strong rapport and trust between mothers-to-be and their healthcare providers would likely make it easier to discuss topics such as partner abuse openly.” The authors advocate that further studies investigate intervention and prevention strategies.

Pritchard’s collaborators on this study were SFU alumna Sarah Desmarais, an assistant professor of psychology at North Carolina State (NC State) University and the lead author, Evan Lowder, an NC State graduate student and Patricia Janssen, a University of British Columbia professor in the School of Population and Public Health. Desmarais graduated from SFU in 2008 with a doctorate in psychology.

The British Columbia Mental Health and Addictions Research Network, the Social Sciences and Humanities Research Council of Canada and the Michael Smith Foundation for Health Research funded this research.

Simon Fraser University is consistently ranked among Canada's top comprehensive universities and is one of the top 50 universities in the world under 50 years old. With campuses in Vancouver, Burnaby and Surrey, B.C., SFU engages actively with the community in its research and teaching, delivers almost 150 programs to more than 30,000 students, and has more than 125,000 alumni in 130 countries.

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