• Open Access

The impact of psychological abuse by an intimate partner on the mental health of pregnant women

Authors

  • A Tiwari,

    Corresponding author
    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • a KL Chan,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • b D Fong,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • a WC Leung,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • c DA Brownridge,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • d H Lam,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • c B Wong,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • e CM Lam,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • f F Chau,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • g A Chan,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • h KB Cheung,

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author
  • and i PC Ho j

    1. a Department of Nursing Studies, LKS Faculty of Medicine and b Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Chinac Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, Chinad Department of Family Social Sciences, Arthur V. Mauro Centre for Peace and Justice, University of Manitoba, Winnipeg, Canadae Department of Obstetrics and Gynaecology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Chinaf Department of Obstetrics and Gynaecology, Princess Margaret Hospital, Hong Kong, Chinag Department of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Hong Kong, Chinah Department of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong, Chinai Department of Obstetrics and Gynaecology, Tuen Mun Hospital, Hong Kong, Chinaj Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
    Search for more papers by this author

  • Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.

Dr A Tiwari, Department of Nursing Studies, LKS Faculty of Medicine, 4/F, William MW Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong, China. Email afytiwar@hkucc.hku.hk

Abstract

Objective  The objective of this first population-based study in Hong Kong was to assess the impact of psychological abuse by an intimate partner on the mental health of pregnant women.

Design  Survey.

Setting  Antenatal clinics in seven public hospitals in Hong Kong.

Population  Three thousand two hundred and forty-five pregnant women.

Methods  The Abuse Assessment Screen (AAS) and demographic questionnaires were administered face-to-face at 32–36 weeks of gestation. At 1 week postpartum, the AAS, Edinburgh Postnatal Depression Scale and SF-12 Health Survey were administered by telephone.

Main outcome measures  Intimate partner violence, postnatal depression and health-related quality of life.

Results  Two hundred and ninety six (9.1%) of the participants reported abuse by an intimate partner in the past year. Of those abused, 216 (73%) reported psychological abuse only and 80 (27%) reported physical and/or sexual abuse. Forty six (57.5%) in the physical and/or sexual abuse group also reported psychological abuse. Women in the psychological abuse only group had a higher risk of postnatal depression compared with nonabused women (adjusted OR: 1.84, 95% CI: 1.12–3.02). They were also at a higher risk of thinking about harming themselves (adjusted OR: 3.50, 95% CI: 1.49–8.20) and had significantly poorer mental health-related quality of life (P < 0.001). The higher risks of postnatal depression and thinking of harming themselves were not observed in the physical and/or sexual abuse group although significantly poorer mental health-related quality of life (P < 0.001) was observed.

Conclusions  Psychological abuse by an intimate partner against pregnant women has a negative impact on their mental health postdelivery. Furthermore, psychological abuse in the absence of physical and/or sexual abuse can have a detrimental effect on the mental health of abused women. The findings underscore the importance of screening pregnant women for abuse by an intimate partner and the need for developing, implementing and evaluating interventions to address psychological abuse.

Ancillary