title: A Qualitative Analysis of Disclosure Patterns among Women with Sexual Violence-Related Pregnancies in Eastern Democratic Republic of Congo.
abstract: The Democratic Republic of the Congo (DRC) has experienced nearly two decades of civil conflict in the Eastern regions of North and South Kivu. This conflict has been notorious for the use of sexual violence as a weapon of war, leading in many cases to pregnancy after rape. The objectives of this analysis were: 1) to describe patterns of sexual violence-related pregnancy (SVRP) disclosure; 2) to consider why survivors chose to disclose to particular individuals; and 3) to examine the dialogue around SVRPs between women with SVRPs and their confidants. In South Kivu Province, Democratic Republic of Congo, two sub-groups of sexual violence survivors completed qualitative interviews, those currently raising a child from an SVRP (parenting group, N = 38) and those who had terminated an SVRP (termination group, N = 17). The findings show that a majority of SVRPs were conceived when participants were held in sexual captivity for prolonged periods of time. The SVRPs were disclosed to friends, family members, other sexual violence survivors, community members, spouses, health care providers, or perpetrators. The confidants were most often chosen because they were perceived by the participants as being discreet, trusted, and supportive. The confidants often provided advice about continuing or terminating the SVRP. Trust and discretion are the most important factors determining to whom women with SVRPs disclose their pregnancies. The vital role of confidants in giving support after disclosure cannot be overlooked. Providing opportunities for survivors to safely disclose their SVRPs, including to health care providers, is a necessary first step in allowing them to access safe and comprehensive post-assault care and services.
authors.affiliation: Boston University School of Public Health, Department of Global Health, Boston, Massachusetts, United States of America.
authors.forename: Monica Adhiambo
authors.initials: MA
authors.lastname: Onyango
authors.affiliation: Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America.|Boston University School of Medicine, Department of Obstetrics and Gynecology, Boston, Massachusetts, United States of America.
authors.forename: Gillian
authors.initials: G
authors.lastname: Burkhardt
authors.affiliation: Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America.|Beth Israel Deaconess Medical Center, Department of Obstetrics and Gynecology, Boston, Massachusetts, United States of America.|Brigham and Women's Hospital, Division of Women's Health, Boston, Massachusetts, United States of America.|Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Scott
authors.affiliation: Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America.|Harvard Medical School, Boston, Massachusetts, United States of America.|Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts, United States of America.
authors.forename: Shada
authors.initials: S
authors.lastname: Rouhani
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois, United States of America.
authors.forename: Sadia
authors.initials: S
authors.lastname: Haider
authors.affiliation: Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America.|Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts, United States of America.
authors.forename: Ashley
authors.initials: A
authors.lastname: Greiner
authors.affiliation: Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America.|Harvard Medical School, Boston, Massachusetts, United States of America.|Massachusetts General Hospital, Department of Surgery, Boston, Massachusetts, United States of America.
authors.forename: Katherine
authors.initials: K
authors.lastname: Albutt
authors.affiliation: Boston Medical Center, Department of Psychiatry, Boston, Massachusetts, United States of America.
authors.forename: Colleen
authors.initials: C
authors.lastname: Mullen
authors.affiliation: Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America.|Harvard Medical School, Boston, Massachusetts, United States of America.|Brigham and Women's Hospital, Department of Emergency Medicine, Boston, Massachusetts, United States of America.|Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Michael
authors.initials: M
authors.lastname: VanRooyen
authors.affiliation: Harvard Humanitarian Initiative, Cambridge, Massachusetts, United States of America.|Harvard Medical School, Boston, Massachusetts, United States of America.|Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts, United States of America.|Queen's University, Department of Emergency Medicine, Kingston, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Bartels
mesh_terms: D000293:Adolescent; D000328:Adult; D015023:Democratic Republic of the Congo; D030881:Disclosure; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D011247:Pregnancy; D011902:Rape; D012742:Sex Offenses; D017741:Survivors / Q000523:psychology; D014857:Warfare; D055815:Young Adult