Human Reproduction Archives
Human Reproduction Archives
RESEARCH ARTICLE Sexual violence, Reproductive health

Physical and sexual violence during pregnancy in the northeastern backlands of Brazil: a cross-sectional study

Maria Misrelma Moura Bessa, Jefferson Drezett, Hugo Macedo Ferraz e Souza Junior, Fernando Adami, Italla Maria Pinheiro Bezerra, Luiz Carlos de Abreu

Downloads: 0
Views: 194


Objective: To identify the prevalence and characteristics related to violence during the gestational period. Methods: A cross-sectional study performed at a Maternity Hospital in the city of Juazeiro do Norte, Ceará, Brazil. The population was composed of 360 postpartum women who were questioned about the occurrence of physical or sexual violence during pregnancy. Cases of violence committed by an intimate partner or other aggressors were considered. The instrument used was the Portuguese version of the Abuse Assessment Screen, applied confidentially. We used the prevalence of 20% violence against women during pregnancy estimated by the World Health Organization, with absolute error of 5%, significance level of 5% and test power of 80%. The data were analyzed with the Epinfo program, version 3.5.2. Pearson’s chi-square test was used, with a p-value of <0.05 and a 95% confidence interval. The study was approved by the Research Ethics Committee, ABC Medial School, N. 391,622. Results: Sexual violence 19.2% (69) surpassed the prevalence of physical violence 7.8% (28) among pregnant women who were surveyed. The common variable that showed relevance among women who suffered physical and sexual violence was low income in 96.4% and 78.2%, respectively. Conclusions: While a variety of factors influence gestational violence, low income women had higher rates of exposure to the cycle of violence in this population.


Violence against woman, Sex offenses, Physical abuse, Pregnant women, Intimate Partner Violence.


1. Fleming PJ, McCleary-Sills J, Morton M, Levtov R, Heilman B, Barker G. Risk factors for men’s lifetime perpetration of physical violence against intimate partners: results from the International Men and Gender Equality Survey (IMAGES) in eight countries. PLoS One. 2015;10(3):e0118639. PMid:25734544.

2. World Health Organization. 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: WHO; 2005. 206 p.

3. Hoang TN, Van TN, Gammeltoft T, Meyrowitsch DW, Thuy HNT, Rasch V. Association between intimate partner violence during pregnancy and adverse pregnancy outcomes in vietnam: a prospective cohort study. PLoS One. 2016;11(9):e0162844. http:// PMid:27631968.

4. Telles LEB, Barros AJ, Moreira CG, Almeida MR, Telles MB, Day VP. Intimate partner violence during pregnancy: case report of a forensic psychiatric evaluation. Rev Bras Psiquiatr. 2016;38(1):87-8. PMid:27111705.

5. Sigalla GN, Rasch V, Gammeltoft T, Meyrowitsch DW, Rogathi J, Manongi R, et al. Social support and intimate partner violence during pregnancy among women attending antenatal care in Moshi municipality, northern Tanzania. BMC Public Health. 2017;17(1):240. PMid:28274220.

6. Shamu S, Munjanja S, Zarowsky C, Shamu P, Temmerman M, Abrahams N. Intimate partner violence, forced first sex and adverse pregnancy outcomes in a sample of Zimbabwean women accessing maternal and child health care. BMC Public Health. 2018;18(1):595. PMid:29724216.

7. Martin-de-las-Heras S, Velasco C, Luna-del-Castillo JD, Khan KS. Maternal outcomes associated to psychological and physical intimate partner violence during pregnancy: a cohort study and multivariate analysis. PLoS One. 2019;14(6):e0218255. http:// PMid:31194820.

8. Ludermir AB, Valongueiro S, Araújo TV. Common mental disorders and intimate partner violence in pregnancy. Rev Saúde Pública. 2014;48(1):29-35. PMid:24789634.

9. Martin-de-las-Heras S, Velasco C, Luna-del-Castillo JD, Khan KS. Breastfeeding avoidance following psychological intimate partner violence during pregnancy: a cohort study and multivariate analysis. BJOG. 2019;126(6):778-83. 0528.15592. PMid:30575266.

10. Bessa MMB, Drezett J, Rolim M, Abreu LC. Violence against women during pregnancy: sistematized revision. Reprod Clim. 2014;29(2):71-9.

11. Kalra G, Bhugra D. Sexual violence against women: understanding cross-cultural intersections. Indian J Psychiatry. 2013;55(3):244-9. PMid:24082244.

12. Katiti V, Sigalla GN, Rogathi J, Manongi R, Mushi D. Factors influencing disclosure among women experiencing intimate partner violence during pregnancy in Moshi municipality, Tanzania. BMC Public Health. 2016;16(1):715. s12889-016-3345-x. PMid:27488516.

13. United Nations Women. UN Women annual report 2017-2018. New York: UN; 2018. 52 p.

14. Reichenheim ME, Moraes CL, Hasselmann MH. Equivalência semântica da versão em português do instrumento Abuse Assessment Screen para rastrear a violência contra a mulher grávida. Rev Saúde Pública. 2000;34(6):610-6. 89102000000600008. PMid:11175606.

15. Malaju MT, Alene GD. Women’s expectation of partner’s violence on HIV disclosure for prevention of mother to child transmission of HIV in north west Ethiopia. BMC Res Notes. 2013;6(1):96. PMid:23497642.

16. Das S, Bapat U, More NS, Alcock G, Joshi W, Pantvaidya S, et al. Intimate partner violence against women during and after pregnancy: a cross-sectional study in Mumbai slums. BMC Public Health. 2013;13(1):817. 13-817. PMid:24015762.

17. Durand JG, Schraiber LB. Violência na gestação entre usuárias de serviços públicos de saúde da Grande São Paulo: prevalência e fatores associados. Rev Bras Epidemiol. 2007;10(3):310-22.

18. Moraes CL, Reichenheim ME. Domestic violence during pregnancy in Rio de Janeiro, Brazil. Int J Gynaecol Obstet. 2002;79(3):269- 77. PMid:12446000.

19. Santos AS, Lovisi GM, Valente CCB, Legay L, Abelha L. Violência doméstica durante a gestação: um estudo descritivo em uma unidade básica de saúde no Rio de Janeiro. Cad Saúde Colet. 2010;18(4):483-93.

20. Adjah ESO, Agbemafle I. Determinants of domestic violence against women in Ghana. BMC Public Health. 2016;16(1):368. http:// PMid:27139013.

21. Shamu S, Abrahams N, Zarowsky C, Shefer T, Temmerman M. Intimate partner violence during pregnancy in Zimbabwe: a crosssectional study of prevalence, predictors and associations with HIV. Trop Med Int Health. 2013;18(6):696-711. http://dx.doi. org/10.1111/tmi.12078. PMid:23414103.

22. Drezett J, Junqueira L, Tardelli R, Antonio IP, Macedo Jr H, Vertamatti MAF, et al. Influência do exame médico-legal na responsabilização do autor da violência sexual contra adolescentes. J Hum Growth Dev. 2011;21(2):189-97.

23. Governo do Estado do Ceará [Internet]. Fortaleza: Governo do Estado do Ceará; 2015 [cited 2022 Feb 8]. Available from: http://

24. Cervantes-Sánchez P, Delgado-Quiñones EG, Nuño-Donlucas MO, Sahagún-Cuevas MN, Hernández-Calderón J, Ramírez-Ramos JK. Prevalence of domestic violence in pregnant women from 20 to 35 years in a family medicine unit. Rev Med Inst Mex Seguro Soc. 2016;54(3):286-91. PMid:27100972.

25. Hoang TN, Van TN, Gammeltoft T, Meyrowitsch DW, Thuy HNT, Rasch V. Association between intimate partner violence during pregnancy and adverse pregnancy outcomes in Vietnam: a prospective cohort study. Meliker PloS One. 2016;11(9):e0162844.

26. Koch AR, Rosenberg D, Geller SE. Higher risk of homicide among pregnant and postpartum females aged 10-29 years in Illinois, 2002-2011. Obstet Gynecol. 2016;128(3):440-6. PMid:27500340.

27. Lucena KDT, Deninger LSC, Coelho HFC, Monteiro ACC, Vianna RPT, Nascimento JA. Analysis of the cycle of domestic violence against women. J Hum Growth Dev. 2015;26(1):139-46.

28. Silva SA, Lucena KDT, Deininger LSC, Coelho HFC, Vianna RPT, Anjos UU. Analysis of domestic violence on women’s health. Rev Bras Crescimento Desenvolv Hum. 2015;25(2):182-6.

29. Sapkota D, Anderson D, Saito A, Baird K. Domestic and family violence and its association with mental health among pregnant women attending antenatal care in a tertiary hospital of eastern Nepal. J Nepal Health Res Counc. 2021;19(1):115-21. http:// PMid:33934145.

30. Dikmen HA, Çankaya S. The effect of exposure to sexual violence on sexual dysfunction and sexual distress in pregnant women. J Sex Med. 2020;17(12):2394-407.

31. Dinmohammadi S, Dadashi M, Ahmadnia E, Janani L, Kharaghani R. The effect of solution-focused counseling on violence rate and quality of life of pregnant women at risk of domestic violence: a randomized controlled trial. BMC Pregnancy Childbirth. 2021;21(1):221. PMid:33743632.

32. Bo M, Canavese A, Magnano L, Rondana A, Castagna P, Gino S. Violence against pregnant women in the experience of the rape centre of Turin: clinical and forensic evaluation. J Forensic Leg Med. 2020;76:102071. PMid:33075742.

Submitted date:

Accepted date:

62c89283a9539561635b1374 hra Articles
Links & Downloads

Hum Reprod Arch

Share this page
Page Sections