Violence and its related factors in infertile women

Abstract

Violence against women is a widespread problem and has serious implications on women’s health. Infertility, in many ways, is a very stressful condition that affect social and marital life of a couple; moreover, compared to fertile women, infertile women are twice as vulnerable against violence. Our objective was to determine the prevalence of violence and define the effect of infertility on violence on women receiving infertility treatment. Infertility, as a crisis in marital life, has multiple psychological and social consequences for couples, especially women. Infertile women are more vulnerable to violence than fertile women.Having a child is a very important goal for most couples. Therefore, a diagnosis of infertility often causes a state of crisis because it negatively affects a couple’s relationship.The worldwide infertility rate is 8–12%, while this rate is 10–20% in Turkey. Infertility shows itself as a sudden and unexpected life crisis, and a prolonged diagnostic and treatment process, and the limitations in the adaptation process lead to serious stress. The purpose of this study was to determine the degree of violence and its related factors in infertile women referring to Infertility centers of Rasht in Iran.Between November 1, 2015 and August 1, 2016, the study was conducted on 301 infertile women at the infertility department of the Tepecik Training and Research Hospital, which is the only in vitro fertilization center in the Aegean region affiliated with the Ministry of Health. The number of infertile women who were treated in the hospital in 2014 was 865. By calculating 95% confidence interval using a population-based formula, it was determined that 267 women should be included in the sample. The sample selection criteria were as follows: (1) women who were diagnosed with primary infertility, (2) attended the selected hospital for treatment, (3) were 18 years and older, (4) could speak the Turkish language, and (5) agreed to participate in the study. A written consent was obtained from all the women after explaining the purpose and method of the study, and guarantee was given for privacy of answers. After a questionnaire on sociodemographic characteristics was filled by the researcher using a face-to-face interview, it was expected that the questions on violence would be answered by the women themselves. The Ethics Committee of the Ege University of Nursing Faculty approved the study protocol.This cross-sectional, descriptive-analytic study was conducted on 245 women with primary infertility who referred to infertility centers in Rasht. Sampling was selected sequential. The data collection tool were; a researcher-made questionnaire to examine the personal, social, economic and infertility characteristics of couples and Onat's violence standard questionnaire for assessing the exposure of infertile women. The data were analyzed by descriptive and analytic statistical methods (Spearman, Mann Whitney and Kruskal Wallis correlation coefficients) and the results were announced. The results show that the mean total score of violence was 50.93±18.79. Descriptive and cross-sectional study was carried out 301 infertile women between November 2015 and August 2016 in a state hospital, Izmir. Data were collected as “Sociodemographic Characteristics Form” and “Infertile Women’s Exposure to Violence Determination Scale”.There was a significant relationship between the total score of violence and the duration of marriage, the duration of awareness and treatment of infertility, the age of married couples, occupation/education of couples, relationship with spouse, unwittingly marriage and the number of infertility treatment (p<0.05). The results of this study showed that infertility is not merely a biomedical disorder and can lead to violence against women, so consideration of its social dimensions is recommended in therapeutic evaluations. There we can conclude that Infertility is worldwide problem affecting people of all communities, though the cause and magnitude may vary with geographical location and socioeconomic status. Approximately 8-10 percent of couples within the reproductive age group present for medical assessment, generally following two years of failed efforts to reproduce. Evidences suggest that infertility is becoming a public health problem in India. It is estimated that globally 60-80 million cou-ples suffer from infertility every year, of which probably between 15-20 millions (25%) are in India alone. Globally studies show that, at least one in three women and / or girls have been beaten or sexually abused in their lifetime. National Family Health Survey 3 (NFHS-3) shows that approximately 21 percent of women who has been interviewed have experienced physical or sexual violence in last 12 months. It is now becoming more and more evident that Infertility and Gender-based Violence (GBV) are emerging health problems of India. The present analysis was carried out with objective to study the association between Infertil-ity and GBV. Data collected by NFHS-3 from 23,722 women in reproductive age group by household survey shows that 2,023 (8.5%) women were infertile and 21,699 (91.5%) women were having at least one child. Out of total 2,023 infertile women 1,574 (77.8%) have experi-enced physical and/or sexual violence in last 12 months. Out of total 21,699 women having at least one child, only 1,332 (6.1%) have experienced physical and/or sexual violence in last one year. This shows that there is significant association between Infertility and GBV (p<0.001). Based on the study findings the recommendations are: (i) Infertility management should be coupled with counseling on GBV; (ii) Appointing a professional counselor in infer-tility management team; (iii) Infertility management specialist should be sensitized about the GBV