The approach of the World Health Organisation Regional Office for Europe

Contents - SEMINAR : Men and Violence Against Women
COE - Strasbourg, 7-8 October 1999

The approach of the World Health Organisation Regional Office for Europe
to the issue of gender-based violence

Ms Kirsten Staehr JOHANSEN, WHO-EURO, Denmark

Abstract of the report

Research on violence against pregnant women and its effect on perinatal outcomes has primarily been conducted in North America. Until recently, only one study existed on this subject in Europe (1988, Norway, Dr Berit Shei, WHO/EURO consultant on women's health). At present, there are in the European region several projects on this subject that are connected directly or indirectly to the WHO/EURO programmes.

A Swedish study (Lena Widding Hedin, Göteborg University) as well as a study in the United Kingdom (Lauren Bacchus) have been completed this year. Both are prevalence studies focusing on obstetrical outcomes, and important in terms of implications for clinical practice.

WHO/EURO currently maintains a number of projects related to this issue which have been incorporated into several overall programme workplans; the most relevant to this context are:

A national survey in Tajikistan conducted by the Mother and Child Health Programme.

Data collection, analysis and feedback on violence during pregnancy as part of the OBSQID project (quality management and development in perinatal care) under the Quality of Care and Technologies Programme.

Additionally, the Mental Health Programme also addresses this issue.

These projects comprise work with violent as well as non-violent males.

1. National survey in Tajikistan:

This is a national survey on violence in situations of armed conflict. It focuses on women's experience of violence, but also deals with gender roles and men's perception of violence.

2. Violence during pregnancy, risk factors, prevention and intervention:

An integral part of the OBSQID project, it addresses directly the violence and pregnancy issue. In 1997, questions on violence was included among the 50 indicators and variables of the OBSQID Basic Information Sheet (BIS), a perinatal case-based data form. Also inserted into this form was a question on paternal wellbeing.

The objective of this comparative pilot study is to identify people at risk of domestic violence in different cultural and regional settings. Since this is primarily a prevalence study comprising various European countries (Belgium, Denmark, Israel, Malta, Albania, Poland, Slovakia, Estonia, Georgia, Kyrgyzstan and Russia), it will elucidate the magnitude of the problem in relation to violence during pregnancy cross-culturally.

The qualitative part of this study includes interviews with women that were conducted mostly in women's shelters in Copenhagen (1997-1998), and interviews with violent and non-violent men (in Denmark). Focus is on the male experience of their partner's pregnancy. Here, the so-called Couvade syndrome (the phenomenon where the expectant father experiences somatic or psychosomatic symptoms during the woman's pregnancy) has been demonstrated. Another important aspect of the interviews with men aims to examine how the experience of abuse, or of witnessing abuse, in the home during childhood can affect male behavior in a partnership and specifically during the pregnancy of his partner. Also addressed is the influence of abuse on planning pregnancy. When does violence begin? What are the triggers - were there any changes during their partners' pregnancies? How do these men justify their actions, and, in general, how do they themselves explain them?

Being different in population samples, objectives and study methods, all these studies show that violence does not stop during pregnancy, although its pattern may change.

Contents - SEMINAR : Men and Violence Against Women
COE - Strasbourg, 7-8 October 1999