Decrease in Domestic Violence During Pregnancy

Abstract

Our aim is to evaluate the prevalence of domestic violence (DV) among pregnant women and find out whether several factors were associated with DV or not. A total of 317 pregnant women applied at Sanliurfa Obstetrics Hospital and Harran University obstetrics and gynecology department outpatient clinic were interviewed using the modified form of Abuse Assessment Screen questionnaire. Several clinical and sociodemographic data were also obtained from the participants. Mean pregnancy number per woman (gravida) was 3.62 ± 0.13. 47.3% of women had experienced DV before pregnancy. However, the rate of DV exposure significantly decreased to 10.3% during pregnancy (p < .001). Participants with positive family history of DV (mother’s exposure) had significantly higher DV rates (p < .001). Those who were exposed to DV, visited their parents less (p = .002). The mean body mass index of DV exposed women was significantly lower (p = .011) than non-DV exposed women. DV exposed women had fewer social interactions and their weight gain may affected by violence. Pregnancy appears to decrease DV in Sanliurfa.

Keywords

pregnancy domestic violence Turkey

Introduction

Many researchers have focused on domestic violence (DV) during pregnancy and have tried to determine its prevalence and associated risk factors. DV during pregnancy not only harms victims’ physical health but may also impact mental health as well. The prevalence of DV during pregnancy has been found to be in 14% in India (Varma, Chandra, Thomas, & Carey, 2007), 4.3% in China (Leung, Leung, Lam, & Ho, 1999), 6.6% in Canada (Stewart & Cecutti, 1993), and so on. Studies have shown that DV may cause long-term psychological problems (Stewart & Cecutti, 1993; Zhang, Zou, Cao, & Zhang, 2012). It is known that alcohol abuse, depression, suicide attempts, and posttraumatic stress disorder are positively associated with abuse during the prenatal period (Asad et al., 2010; Mahapatro, Gupta, Gupta, & Kundu, 2011; Thompson et al., 2000).

Although DV during pregnancy has been studied in Turkey, no statistical information or research studies are available on DV during pregnancy in southeastern of Anatolia (SEA; a region in the south east of Turkey), which is different from other regions of Turkey by sociocultural means. Ethnic diversity is greater in this part and SEA has the highest poverty rate among the regions of Turkey. The fertility rate of the region is higher than the other regions of Turkey and almost two thirds of the population is under the age of 30. There is intensive migration from rural area to urban centers. Urban women with rural background cannot take part in economic activities due to lack of education-training (Fazlioglu, 2002). Local women suffer from gender inequality, and they do not have economic opportunities (Saatci & Akpinar, 2007; Unver, 1997). The age of marriage is low. Girls at the age of 16 to 17 years get married by the demand of their families (İçli, Şevket, & Boyacıoğlu, 2012). Women’s participation in decision making is extremely limited. For example, only 12.4% of all married women chose their spouses with their own free will (Fazlioglu, 2002). There is general reluctance for the education of girls based on traditional factors (Yildiz, 2010). The tradition of bride price, generally paid to the father of a girl for marriage, is very widespread in the region (Ilkkaracan, 1998). Polygamy marriages that are practiced in the region generally consist of only two wives and are especially common among tribal leaders (İçli et al., 2012). In this region, the frequency of suicides is higher than the other regions and suicides and suicides attempts of women are particularly higher than men (Delice & Teymur, 2012). Agriculture is the dominant production sector in the region (Unver, 1997). The landowners consist of two major groups, the small landholders and large tribal families. The members of the tribal families are both landlords and decision makers in the communities (Ayguney, 2002). Of these households, 60% are nuclear families, but a quarter of all households are extended, a significantly higher number than in other parts of Turkey (Hill, 2006).

Children are regarded as necessary for a happy marriage (Isikoglu et al., 2006) and childless couples are often excluded from taking leading roles in important family functions (Rutstein & Shah, 2004). As it is common in underdeveloped regions, in the eastern part of Turkey, sons are also valued more than daughters due to the beliefs that boys will be in command of family property in the future, as well as providing security for their elderly parents and leaving as large a posterity is possible by sons (Kagitcibasi & Ataca, 2005; Okten, 2009).

In the studies carried out in Turkey, risk factors for DV were women who marry at a young age, undereducation, unemployment, lower level of income, more than two children, partners having a lower level of education and partners having a habit of gambling and drinking (Akar, Aksakal, Demirel, Durukan, & Ozkan, 2010; Tokuc, Ekuklu, & Avcioglu, 2010). In this study, we aim to extend the present knowledge regarding the relationship between DV and pregnancy. The objective of our study is to evaluate the prevalence of DV against pregnant women and find out whether several factors were associated with DV or not in a southeastern part of Turkey.

Material and Method

This study was conducted in Sanliurfa, a southeastern city of Turkey. The population of Sanliurfa is about 1.5 million, which makes up more than 20% of the regional population. It is a city with a mixed Turkish, Kurdish, and Arabic population. A total of 317 pregnant women who attended at Sanliurfa Obstetrics Hospital and Sanliurfa Harran University Obstetrics and Gynecology Outpatient Clinic, Turkey, aged between 18 and 50 years were enrolled. The participants consisted of consecutive patients who applied for routine obstetrical examinations at the either one of the settings. Two of them refused to participate in the study. All of the participants gave informed consent after explanation of the study design by the obstetrician who was also in the research team (V.M. and A.M.). Although all of the participants arrived at the clinics with a family member, the women were interviewed alone using the modified of Abuse Assessment Screen (AAS) questionnaire by the obstetrician. The participants were reassured that the gathered information would be confidential and nobody’s identity would be uncovered. Women with past or current history of severe mental illness (mental retardation, schizophrenia or psychotic disorders) were excluded from the study by a medical database search from the online information system during the evaluation. The interview was conducted in Turkish or Kurdish by the obstetrician. In case of Arabic participants who could not speak either Turkish or Kurdish a native Arabic speaker nurse was involved in translation. Because of the risk of disclosure of the identities referral to social workers and emergency lines was made rather than explicit support. The study was approved by the Local Ethics Committee. The questionnaire consisted of two sections. The first part consisted of sociodemographic characteristics, lifestyle factors, reproductive and medical history, sexual experience, and information about DV in past and during pregnancy. In the second part, a modified version of the AAS questionnaire was introduced. We used a structured questionnaire modified from the AAS questionnaire to determine violence among pregnant women. The AAS gives a measure of current and past-year abuse and of lifetime abuse. Any positive response to current, past-year, or lifetime abuse was regarded as abuse. This questionnaire has been used in Turkish clinical settings before (Yildizhan et al., 2009). By using this form, DV during pregnancy and before pregnancy were recorded. Screening questions were as follows: (a) Before your pregnancy, have you been hit, slapped, kicked or otherwise physically hurt by someone? (b) Since your pregnancy began, have you been hit, slapped, kicked, or otherwise physically hurt by someone? (c) Have you ever been humiliated or shouted during pregnancy by someone? (d) Have you ever experienced financial abuse during your current pregnancy? (e) Has anyone forced you to have sexual activities without consent during pregnancy? (f) Are you hesitant or afraid of your partner during pregnancy? (g) In case of violence, is there anybody who knows that you had experienced violence? Women who reported a past and/or recent history of DV formed the “abused” group, and women who had not reported DV formed the “non-abused” group.

Definitions

According to Turkish Republic Prime Minister Directorate General on Status of Women (2009), types of DV were classified into four categories as follows:

Verbal violence: insulting or swearing/humiliating or blaming in front of others/scared her or threatening to harm her or her relatives

Physical violence: slapped her or throwing something at her/pushed or shoved her or pulled her/hit her with his fist/kicked her, dragged her or beat her up/choked or burnt her on purpose/threatened to use or used a gun, knife

Sexual violence: use of physical force to compel her to engage in sex against her will/had sexual intercourse when she did not want to because she was afraid/forced her to do something sexual that she found degrading or humiliating

Economic violence: not letting women work/limiting the amount of resources to use by the partner/not giving money for household expenses.

To provide the consistency of the terms and establish a common language, the participants were informed of these definitions of DV.

Statistical analysis

Statistical analysis was performed using SPSS 15.0 for Windows (SPSS, Chicago, IL, USA). Descriptive statistics were tabulated. The t test and χ² test were used, where appropriate, for comparing the nonabused group with the abused group. p < .05 was accepted as significant.

Results

Mean age of the women was 27.4 ± 5.9. A total of 151 participants (47.6%) had a history of abuse. Only 33 of the 151 (21.9%) women reported that DV continued during current pregnancy. All the women who have faced DV during pregnancy reported to have had been slapped/pushed at by their husband. Fourteen of them reported to have been humiliated/shouted verbally by their partner. Twenty-one women had been financially abused during current pregnancy. Sexual abuse during the current pregnancy was reported by 16 females. Eighteen of those women who had been abused during pregnancy said that they were afraid of their partner. The statistical information about the sample profile is given in Table 1. The association of abuse with their sociodemographic characteristics is shown in Table 2. Our data indicate no significant difference in economic situation, ethnicity, type of family, sexual satisfaction, median sexual intercourse (monthly), dyspareunia, smoking status, gravidity, parity, gestational week at delivery, Apgar 1 score, Apgar 5 score between the abused and nonabused groups. However, the rate of DV exposure significantly decreased to 10.3% during pregnancy (p < .001). We also asked women, “Did you experience domestic violence after you and your partner found out the sex of your baby in any of your previous pregnancies?” A total of 265 women answered “no,” and 26 women answered “yes” to the question. Only 10 of them had a boy and 16 of them had a girl. Participants with a positive family history of DV (mother’s exposure) had significantly higher DV rates (p < .001) than women not reporting a family history of DV. Those who were exposed to DV, visited their parents less (p = .002). The mean body mass index (BMI) of DV-exposed women was significantly lower (p = .011) than non-DV exposed women.

Table 1.

Sample Sociodemographic Characteristics (n = 317).

	n	%
Age (M ± SD)	27.4 ± 5.9
Race-ethnicity
Turkish	32	10.1
Arabian	136	42.9
Kurdish	146	46.1
Other	3	3
Place of residence
Rural	152	47.9
Urban	165	52.1
Type of family
Nuclear	227	70.3
Extended	90	29.7
Type of union
Office wedding	297	93.1
Islamic marriage	19	4.1
Outside marriage	2	2.8
Marriage style
Arranged marriage	255	79.9
Dating	57	17.9
Other	5	2.2
Education levels
Illiterate	93	29.2
Primary	195	61.1
Secondary	28	8.8
University	1	0.9

Table 2.

Sociodemographic Data and Risk Factor for Abused and Nonabused Women.

Variables	Abused women (n = 151)	Non-abused women (n = 166)	p value
Mean wage Turkish Liras/monthly ($1 :1.8 TL)	550.00	609.52	.152
Median sexual intercourse (monthly)	6.76	7.16	.924
Sexual satisfaction
Not satisfied	21 (13.9%)	12 (7.2%)	.145
Satisfied	130 (86.0%)	154 (92.7%)	.145
Dyspareunia
No	115 (76.1%)	129 (77.7%)	.825
Yes	36 (23.8%)	37 (22.2%)	.825
Smoking status
Smoker	10 (6.6%)	18 (10.8%)	.186
Nonsmoker	141 (93.3%)	148 (89.1%)	.186
Her mother’s exposure to violence
Yes	51 (33.7%)	7 (4.2%)	<.001
No	100 (66.2%)	159 (95.7%)	<.001
Body mass index (BMI)	24.12	24.92	*.011
Visiting parents (times in a month) M ± SD	3.07 ± 0.29	5.86 ± 0.63	*.002
Gravidity (M ± SD)	3.74 ± 0.20	3.50 ± 0.17	.497
Parity (M ± SD)	2.25 ± 0.17	2.19 ± 0.15	.974
Gestational week at delivery	36.91	36.83	.727
Fetal or newborn’s weight (kg)	3.23	3.19	.544
Apgar 1 score	7.58	7.54	.420
Apgar 5 score	9.56	9.45	.304

p < .05.

Discussion

The present study assessed the prevalence of DV during pregnancy and the relationship between abused women and their sociodemographic characteristics in southeastern region of Turkey. In all, 317 women interviewed agreed to participate in the present study; 151 (47.6%) women reported having experienced abuse. The rate of DV exposure decreased to 10.3% during pregnancy.

Our first finding is the DV rate among pregnant women. The prevalence of physical DV during pregnancy is 10.3%. In studies conducted in Turkey, the prevalence of DV during pregnancy range from 4.6% to 25.7% (Deveci, Acik, Gulbayrak, Tokdemir, & Ayar, 2007; Ergonen et al., 2009; Yanikkerem, Karadas, Adiguzel, & Sevil, 2006). In Turkey, differences in prevalence rates may be due to several reasons. First, sociodemographic variables such as socioeconomic status, illiteracy rates and so on may have an effect on DV. Higher socioeconomic status is expected to be inversely related with DV. Turkey is large country with different sociocultural structure. The National Research on DV against Women in Turkey (Turkish Republic Prime Minister Directorate General on Status of Women, 2009) has been carried out with a very large simple size was found that the rate prevalence of DV was higher in eastern than in western provinces of Turkey because in the eastern regions of the country, the socioeconomic status of women in worse than in the western regions. Second, the AAS used in studies of DV can be considered theoretically appropriate for measuring DV but it is based on subjective evaluation. The questionnaire is based on structured interview. Because the women may not be willing to tell their intimate life for the first time, there may have been interview bias. The prevalence rate of DV during pregnancy in our study is almost same with results obtained in a study conducted in Jordan (Oweis, Gharaibeh, & Alhourani, 2010). Both Jordan and southeastern Anatolia communities share a common social and cultural background, including having multiple children, family living in poverty, larger family size, male dominated and tribal structure, which may explain the similar rates of DV during pregnancy in these areas. A total of 151 (47.6%) women reported DV before their pregnancy. Of these women, 33 (21.9%) stated that DV continued during their current pregnancy.

The second finding of our study is the decrease of DV during pregnancy compared with the prepregnancy period. It may be explained in a cultural and traditional basis. The region is dominated by tribal structures which have the characteristics of clan. Two basic internal dynamic of the tribal organization are very strong feeling of “we” and of “solidarity” (Ilkkaracan, 1998). These values of tribal society originate intention and desire of having children. Thus, when a woman gives birth, her status changes in the tribe and she receives increasing respect (İçli et al., 2012). One study conducted in Kars province in eastern of Turkey found that 24.1% of the women who experienced violence before pregnancy, only 11.1% of women suffered from violence during pregnancy (Arslantas et al., 2012). The results of this study show that the rate of DV fell by almost half, whereas in our study, the rate of DV decreased from 47.6% to 10.3%. The differences in the findings concerning the decline rate of DV may be attributable to geographical and sociocultural differences. Kars’s cultural structure is similar to Western culture due to high immigration rates from Northern Caucasia to Kars (Arslantas et al., 2012). However, our study and Arslantas et al.’s study confirm that in Turkey, pregnancy has significant impact in reducing DV. In contrast, studies from Western society show that pregnancy may increase the risk of DV as a result of an unintended or unwanted pregnancy (Helton & Snodgrass, 1987; Stewart & Cecutti, 1993; Webster, Sweet, & Stolz, 1994). This may be explained by obvious cultural differences. Turkish families greatly value children and desire to have children. SEA has also the highest fertility rate in Turkey (3.46 children per women; Hacettepe University Institute of Population Studies, 2009). Hilberman and Munson (1978) suggested that abused women may try to protect themselves by repeatedly getting pregnant. According to our findings, there was no statistically significant difference in gravidity and parity between the abused group and the nonabused group. Thus, our results suggest that women would not appear to get pregnant to intentionally to prevent violence.

In Sanliurfa society, when giving birth to a son, women’s status increases in their family and in their community. In our study, we asked women, “Did you experience domestic violence after you and your partner found out the sex of their baby in previous pregnancies?” A total of 265 women answered “no,” and 26 women answered “yes” to the question. Of the women responding yes to the question, only 10 had a boy and 16 had a girl. Significant differences were not found with a regard to the sex of baby. Therefore, it seems that getting pregnant with a baby girl is not a risk factor for DV in Sanliurfa.

Our third finding is that physical violence was the most common form of DV during pregnancy, followed by verbal abuse (5.3% and 4.4%, respectively). In all, 5% of the participants reported sexual abuse, 6.6% reported financial abuse that had occurred during pregnancy. These results show that there is very little difference in rates of specific forms of violence. Thus, it is likely that some or many forms of violence can be present at the same time. Previous studies reported that several types of DV may occur together (Busch-Armendariz, Dinitto, Bell, & Bohman, 2010; Saltzman, Fanslow, Mc Mahon, & Shelley, 2002).

Most studies (Jewkes, Levin, & Penn-Kekana, 2002; Leung et al., 1999; Sambisa, Angeles, Lance, Naved, & Thomton, 2011; Usta, Farver, & Pashayan, 2007) have reported a relationship between sociodemographic variables and DV Our data indicate that no significant difference in ethnicity, place of residence, marital status, education levels, type of family, smoking, medical illness, gravidity between abused groups and nonabused groups. Thus, our finding suggests that DV in the Sanliurfa population can affect all segments of society regardless of age, education level, and ethnicity.

Our fourth finding is that participants with a positive family history of DV (mother’s exposure) had significantly higher DV rates (p < .001) than women without a positive family history of DV. The results from the current study point to an association between women’s witnessing marital violence in their family of origin and later being subjected to DV by their husbands or partners. The World Health Organization (WHO) states that a history of violence in the family is an individual risk factor for DV. Our finding is consistent with previous reports (WHO, 2005). The correlation between mother’s violence history and DV may be useful for screening people in medical settings such as emergency wards and outpatient clinics who are prone to DV. In the case where risk factors are deemed to be present, the patients can be referred to social workers in the hospital for legal and social interventions.

Another result and fifth finding of this study was that those who were exposed to DV visited their parents less (p = .002). Less frequent visits may be an indicator that the abusive partner is isolating the pregnant women from her family/social support system. Further research is needed to investigate less frequent family visits in abused females.

The sixth and the last finding is that the mean BMI of DV-exposed women (24.12 kg/m²) was significantly lower than nonabused women (p = .011). Women who had a history of DV tend to have higher levels of psychological problems (Avdibegovic & Sinanovic, 2006). Lower weight might also be associated with emotional dysfunction and psychosocial stress. However, it is difficult to draw the conclusion that the negative emotional impact of DV is the only factor leading to low weight. Other factors also may also contribute to this. Yount and Li (2011) reported that various forms of violence against women also are associated with poor eating practices and digestive problems, including a loss of appetite, abdominal pain, diarrhea or constipation, disordered eating and weight-control practices, and poorer treatment outcomes for eating.

There are several limitations to the present study. First, the sample size was small, highly selective, and consisted of women attending obstetrics and gynecology outpatient clinic. Thus, results may not be generalized to the entire Sanliurfa population. Second, our study is a cross-sectional study, which does not allow the exact determination of effect of sociodemographic factors on DV. However, our study reflects the perceptions of DV and pregnancy in a different cultural setting other than western or southeastern societies.

Conclusion

In southeastern Turkey, 47.6% of women have a history of exposure to violence and 10.3% of women were exposed to DV during pregnancy. The decrease in the rate of DV during pregnancy may be related to the social and cultural structure of the region. A positive family history of violence, less frequent visits to parents, and a low BMI may be associated with present abuse.

In summary, customary practices and traditional belief may have a negative influence on the status of women in the region and need to be addressed to change the behaviors and attitudes of the perpetrators. Future research will expand our knowledge about association between traditional culture and violence.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

Erman Bağcıoğlu is an assistant professor in the Department of Psychiatry, Afyon Kocatepe University. He made his compulsory service in the eastern part of the Turkey.

Mehmet Vural is an associate professor in the Department of Obstetrics and Gynecology, Harran University. He has worked long years in the eastern part of Turkey.

İbrahim Fatih Karababa is an assistant professor in the Department of Psychiatry, Harran University. He is also the director of the department.

Mahmut Akşin is an obstetrics and gynecology specialist who worked in rural areas of Sanliurfa.

Salih Selek is an associate professor in the Department of Psychiatry, Istanbul Medeniyet University. He has worked 10 years in the eastern part of the Turkey.

References

Akar

Aksakal

F. N.

Demirel

Durukan

Ozkan

(2010). The prevalence of domestic violence against women among a group woman: Ankara, Turkey. Journal of Family Violence, 25, 449-460.

Arslantas

Adana

Ergin

Gey

Bicer

Kiransal

(2012). Domestic violence during pregnancy in an eastern city of Turkey: A field study. Journal of Interpersonal Violence, 27, 1293-3313.

Asad

Karmaliani

Sullaiman

Bann

C. M.

McClure

E. M.

Pasha

. . .Goldenberg

R. L.

(2010). Prevalence of suicidal thoughts and attempts among pregnant Pakistani women. Acta Obstetricia Gynecologica Scandinavica, 89, 1545-1551.

Avdibegovic

Sinanovic

(2006). Consequences of domestic violence on women’s mental health in Bosnia and Herzegovina. Croatian Medical Journal, 47, 730-741.

Ayguney

(2002). Burden of development in Southeastern Turkey: Salinization and sociocultural disruption (Master’s thesis). Lund University International Master’s Programme in Environmental Science, Ankara, Turkey.

Busch-Armendariz

N. B.

Dinitto

D. M.

Bell

Bohman

(2010). Sexual assault perpetrators alcohol and drug use: The likelihood of concurrent violence and post-sexual assault outcomes for women victims. Journal Psychoactive Drug, 42, 393-399.

Delice

Teymur

(2012). The investigation of suicides in South Eastern Anatolia: The Batman city example. Ataturk Universitesi Sosyal Bilimler Enstitusu Dergisi, 16, 57-80.

Deveci

S. E.

Acik

Gulbayrak

Tokdemir

Ayar

(2007). Prevalence of domestic violence during pregnancy in a Turkish community. The Southeast Asian Journal of Tropical Medicine and Public Health, 38, 754-760.

Ergonen

A. T.

Ozdemir

M. H.

Can

I. O.

Sonmez

Salaçin

Berberoğlu

Demir

(2009). Domestic violence on pregnant women in Turkey. Journal of Forensic and Legal Medicine, 16, 125-129.

10.

Fazlioglu

(2002). CATOM: A model for empowering women in Southeastern Anatolia (multi-purpose community centers) kadın/women 2000. Journal for Women Studies, 3, 43-63.

11.

Hacettepe University Institute of Population Studies. (2009, March). Turkey demographic and health survey: Preliminary report. Ankara, Turkey: Author.

12.

Helton

A. S.

Snodgrass

F. G.

(1987). Battering during pregnancy: Intervention strategies. Birth, 14, 142-147.

13.

Hilberman

Munson

(1978). Sixty battered women. Victimology, 2, 460-470.

14.

Hill

(2006). The GAP and human rights: Turkey’s successes and conflicts with sustainable development in the Kurdish region of Southeast Anatolia (Master’s thesis). A thesis, presented to the department of international studies and the Honors College of the University of Oregon in partial fulfillment of the requirements for the degree of Bachelor of Arts, Eugen, OR.

15.

İçli

T. G.

Şevket

Ö.

Boyacıoğlu

A. Ö

. (2012). A study on hierarchical/normative order, marriage and family patterns in Bin Yousuf Tribe of Southeastern Turkey. Advances in Applied Sociology, 2, 19-29.

16.

Ilkkaracan

(1998). Exploring the context of women’s sexuality in eastern Turkey. Reproductive Health Matters, 6(12), 66-75.

17.

Isikoglu

Senol

Berkkanoglu

Ozgur

Donmez

Stones-Abbasi

(2006). Public opinion regarding oocyte donation in Turkey: First data from a secular population among the Islamic world. Human Reproduction, 21, 318-323.

18.

Jewkes

Levin

Penn-Kekana

(2002). Risk factors for domestic violence: Finding a South African cross-sectional study. Social Science Medicine, 55, 1603-1617.

19.

Kagitcibasi

Ataca

(2005). Value of children and family change: A three-decade portrait from Turkey. Applied Psychology, 54, 317-337.

20.

Leung

W. C.

Leung

T. W.

Lam

Y. Y.

P. C.

(1999). The prevalence of domestic violence against pregnant women in a Chinese community. International Journal of Gynecology & Obstetrics, 66, 23-30.

21.

Mahapatro

Gupta

R. N.

Gupta

Kundu

A. S.

(2011). Domestic violence during pregnancy in India. Journal of Interpersonal Violence, 26, 2973-2990.

22.

Okten

(2009). Gender and power: The system of gender in Southeastern Anatolia. The Journal of International Social Research, 2, 302-312.

23.

Oweis

Gharaibeh

Alhourani

(2010). Prevalence of violence during pregnancy: Findings from a Jordanian survey. Maternal and Child Health Journal, 14, 437-445.

24.

Rutstein

S. O.

Shah

I. H.

(2004). Infecundity, infertility, and childness in developing countries (DHS Comparative Reports No. 9). Claverton, MD: ORC Marche and the World Health Organization. Available from http://www.measuredhs.com

25.

Saatci

Akpinar

(2007). Assessing poverty and related factors in Turkey. Croation Medical Journal, 48, 628-635.

26.

Saltzman

L. E.

Fanslow

J. L.

Mc Mahon

P. M.

Shelley

G. A.

(2002). Intimate partner violence surveillance: Uniform definitions and recommended data elements, version 1.0. Atlanta, GA: Centre for Disease Control and Prevention, National Centre for Injury Prevention and Control.

27.

Sambisa

Angeles

Lance

P. M.

Naved

R. T.

Thomton

(2011). Prevalence and correlates of physical spousal violence against women in slum and nonslum areas of urban Bangladesh. Journal Interpersonal Violence, 26, 2592-2618.

28.

Stewart

D. E.

Cecutti

(1993). Physical abused in pregnancy. Canadian Medical Association Journal, 149, 1257-1263.

29.

Thompson

Canterino

J. C.

Feld

S. M.

Stumpf

P. G.

Kuo

Harrigan

J. T.

(2000). Risk factor for domestic violence in pregnant women. Prim Care Update OB/GYNS, 7, 138-141.

30.

Tokuc

Ekuklu

Avcioglu

(2010). Domestic violence against married women in Edirne. Journal Interpersonal Violence, 25, 832-847.

31.

Turkish Republic Prime Minister Directorate General on Status of Women. (2009). Nation research on domestic violence against women in Turkey. Ankara, Turkey: Icon Institute.

32.

Unver

I. H. O.

(1997). Southeastern Anatolia Project (GAP). International Journal of Water Resource Development, 13, 453-483.

33.

Usta

Farver

J. A.

Pashayan

(2007). Domestic violence: The Lebanese experience. Public Health, 121, 208-219.

34.

Varma

Chandra

P. S.

Thomas

Carey

M. P.

(2007).Intimate partner violence and sexual coercion among pregnant women in India: Relationship with depression and post-traumatic stress disorder. Journal of Affective Disorders, 102, 227-235.

35.

Webster

Sweet

Stolz

T. A.

(1994). Domestic violence in pregnancy: A prevalence study. Medical Journal of Australia, 161, 466-470.

36.

WHO. (2005). WHO multi-country study on women’s health and domestic violence against women: Summary report of initial results on prevalence, health outcomes and women’s responses. Geneva, Switzerland: WHO Press.

37.

Yanikkerem

Karadas

Adiguzel

Sevil

(2006). Domestic violence pregnancy in Turkey and responsibility of prenatal healthcare providers. American Journal of Perinatology, 23, 93-103.

38.

Yildizhan

Adali

Kolusari

Kurdoglu

Yildizhan

Sahin

(2009). Domestic violence against infertile women in a Turkish setting. International Journal of Gynecology & Obstetrics, 104, 110-112.

39.

Yildiz

(2010). Violence against women in Turkey: Beliefs and traditions. Journal of Critical Studies in Business and Society, 1, 120.

40.

Yount

K. M.

(2011). Domestic violence and obesity in Egyptian women. Journal Biosocial Science, 43, 85-99.

41.

Zhang

Zou

Cao

Zhang

(2012). Relationship between domestic violence and postnatal depression among pregnant Chinese women. International Journal of Gynecology & Obstetrics, 116, 26-30.