Violence against women linked to reproductive health problems: PAHO

The Pan American Health Organization (PAHO) says unintended pregnancies, sexually transmitted infections, and miscarriages are more frequent among women in the Caribbean and other places who report having experienced violence at any point in their lives.

On the International Day for the Elimination of Violence against Women, observed each year on Nov. 25, PAHO called for the health sector—especially sexual and reproductive health services—to be involved in efforts to prevent and respond to violence against women. “This is a major problem with many health implications,” said Dr. Carissa F. Etienne, the Dominican-born PAHO’s director. “The health sector has a role to play in both prevention and response.”

PAHO said violence against women continues to be a serious public health problem in the Americas, including the Caribbean.

It said one in three women in the Americas experiences physical or sexual violence by a partner or sexual violence by a non-partner during their lifetime, and 20 percent of women report being sexually abused as children.

Young women aged 15-19 years are most at risk of suffering physical or sexual partner violence, with many reporting their first sexual encounter as unwanted or forced, PAHO said.

“This violence not only results in physical injury or death but also has an under-recognized impact on women’s reproductive health, leading to more complications of pregnancy, unwanted pregnancy, miscarriage and sexually transmitted infections (STI), including HIV,” PAHO said.

In some countries in the Americas, PAHO said levels of unwanted pregnancy are two to three times higher among women who report partner violence compared with women who do not.

It said pregnancy loss is twice as high among women who report experiencing violence, and the risk of premature labor is 1.6 times greater.

PAHO said studies have also found violence to be a significant cause of maternal mortality.

It said partner violence was the main cause of maternal death—responsible for 20 percent of such deaths— in three U.S. cities during 1993-1998.

It said between 3 percent and 44 percent of pregnant women in Latin America and Caribbean report experiencing partner violence during pregnancy.

“The role of health sector should include collecting data on violence prevalence that can be used to inform policy and programming, while training personnel to provide comprehensive, non-judgmental care for survivors of domestic violence,” PAHO said.

“Healthcare workers should also refer survivors to legal services and social support,” it added. “Public health strategies should include efforts to change social norms and behaviors that are linked to violence.”

Additionally, in the case of women who experience sexual assault, PAHO urged that health services asses their need for HIV or STI prophylaxis, make emergency contraception available, offer safe abortion in accordance with national law (when a woman accesses health services too late for emergency contraception or if emergency contraception fails), and provide mental health support.

In 2008-09 in Jamaica, PAHO 19.6 percent of women report experiencing physical or sexual partner violence; in Haiti (2005-06) 19.3 percent; and the Dominican Republic (2007) 6.6 percent.