Lifetime sexual violence and childbirth expectations - A Norwegian population based cohort study.
OBJECTIVE
this study aimed to explore the association between lifetime sexual violence and expectations about childbirth.


METHODS
Norwegian population-based cohort study.


METHODS
women presenting for routine ultrasound examinations were recruited to the Norwegian Mother and Child Cohort Study between 1999 and 2008.


METHODS
78,660 pregnant women.


METHODS
sexual violence and expectations about childbirth were self-reported during pregnancy using postal questionnaires. Risk estimations were performed using multivariable logistic regression analysis and stratified by parity.


METHODS
fear of childbirth, the thoughts about pain relief, worries about the infant's health and looking forward to the arrival of the infant.


RESULTS
of 78,660 women, 18.4% reported a history of sexual violence and 0.9% were exposed to sexual violence within the last 12 months, including during the current pregnancy. We found that nulliparous women who reported previous or recent sexual violence had a decrease in the odds of looking forward to the arrival of the infant with an AOR of 0.8 (95% CI 0.7-0.9) and 0.4 (95% CI 0.3-0.6), respectively, compared to non-abused women. The same pattern was observed among multiparous women and they were more likely to report worries about the infant's health. Severe sexual violence (rape) was associated with concerns about childbirth, especially for nulliparous women that were more likely to express fear of birth, a hope for a pain-free birth, a desire for caesarean section and worries about the infant's health than non-exposed women.


CONCLUSIONS
women with a lifetime exposure to sexual violence, both past experiences and within the last 12 months, were less likely to look forward to the arrival of the infant than non-exposed women, and they were more likely to worry about the infant's health. Women with experiences of severe sexual violence (rape) had more concerns about childbirth than women without this experience. This finding shows that exploring women's attitudes toward childbirth may work as an approach when examining exposure to violence.
Section of Obstetrics at the Department for Women's and Children's Health, Oslo University Hospital, Postboks 4950 Nydalen, N-0424 Oslo, Norway. Electronic address: UXHELZ@ous-hf.no.
Lena
L
Henriksen
Department of Public Health and General Practice at the Faculty of Medicine, The Norwegian University of Science and Technology (NTNU), Håkon Jarls gate 11, N-7489 Trondheim, Norway; Department of Gynecology at the Women's Clinic, St.Olavs Hospital, Trondheim University Hospital, Postbox 3250 Sluppen, N-7006 Trondheim, Norway. Electronic address: Berit.Schei@ntnu.no.
Berit
B
Schei
Department of Health, Nutrition and Management, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Postboks 364 Alnabru, N-0614 Oslo, Norway. Electronic address: mirjam.lukasse@gmail.com.
Mirjam
M
Lukasse
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D015331:Cohort Studies; D005239:Fear; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D009664:Norway; D036801:Parturition / Q000523:psychology*; D010465:Perception; D011247:Pregnancy; D012742:Sex Offenses / Q000523:psychology*; D012923:Social Class; D011795:Surveys and Questionnaires
Expectations; Fear of childbirth; MoBa; Pregnancy; Sexual violence