Rouhani Shada A, Scott Jennifer, Greiner Ashley, Albutt Katherine, Hacker Michele R, Kuwert Philipp, VanRooyen Michael, Bartels Susan
Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts;
Harvard Humanitarian Initiative, Cambridge, Massachusetts; Harvard Medical School, Boston, Massachusetts; Division of Women's Health and Departments of Obstetrics and Gynecology and.
Pediatrics. 2015 Nov;136(5):e1195-203. doi: 10.1542/peds.2014-3373. Epub 2015 Oct 5.
Since armed conflict began in 1996, widespread sexual violence in eastern Democratic Republic of Congo has resulted in many sexual violence-related pregnancies (SVRPs). However, there are limited data on the relationships between mothers and their children from sexual violence. This study aimed to evaluate the nature and determinants of these maternal-child relationships.
Using respondent-driven sampling, 757 women raising children from SVRPs in South Kivu Province, Democratic Republic of Congo were interviewed. A parenting index was created from questions assessing the maternal-child relationship. The influences of social stigma, family and community acceptance, and maternal mental health on the parenting index were assessed in univariate and multivariable analyses.
The majority of mothers reported positive attitudes toward their children from SVRPs. Prevalence of perceived family or community stigma toward the women or their children ranged from 31.8% to 42.9%, and prevalence of perceived family or community acceptance ranged from 45.2% to 73.5%. In multivariable analyses, stigma toward the child, as well as maternal anxiety and depression, were associated with lower parenting indexes, whereas acceptance of the mother or child and presence of a spouse were associated with higher parenting indexes (all P ≤ .01).
In this study with a large sample size, stigma and mental health disorders negatively influenced parenting attitudes, whereas family and community acceptance were associated with adaptive parenting attitudes. Interventions to reduce stigmatization, augment acceptance, and improve maternal mental health may improve the long-term well-being of mothers and children from SVRPs.
自1996年武装冲突爆发以来,刚果民主共和国东部广泛存在的性暴力导致了许多与性暴力相关的怀孕情况(SVRPs)。然而,关于性暴力中母亲与子女关系的数据有限。本研究旨在评估这些母婴关系的性质和决定因素。
采用应答驱动抽样法,对刚果民主共和国南基伍省757名抚养性暴力相关怀孕所生孩子的妇女进行了访谈。通过评估母婴关系的问题创建了一个育儿指数。在单变量和多变量分析中评估了社会耻辱感、家庭和社区接纳度以及母亲心理健康对育儿指数的影响。
大多数母亲对她们性暴力相关怀孕所生的孩子持积极态度。对这些妇女或其子女存在家庭或社区耻辱感的比例在31.8%至42.9%之间,家庭或社区接纳度的比例在45.2%至73.5%之间。在多变量分析中,对孩子的耻辱感以及母亲的焦虑和抑郁与较低的育儿指数相关,而对母亲或孩子的接纳以及配偶的存在与较高的育儿指数相关(所有P≤0.01)。
在这项大样本研究中,耻辱感和心理健康障碍对育儿态度产生了负面影响,而家庭和社区接纳度与适应性育儿态度相关。减少耻辱感、增强接纳度以及改善母亲心理健康的干预措施可能会改善性暴力相关怀孕所生孩子和母亲的长期福祉。