A qualitative analysis of psychosocial outcomes among women with sexual violence-related pregnancies in eastern Democratic Republic of Congo.

Journal: International journal of mental health systems

Volume: 11

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Brookline Avenue, Kirstein rd Floor, Boston, MA USA. Department of Psychiatry, One Boston Medical Center Place, Boston Medical Center, Boston, MA USA. Harvard Humanitarian Initiative, Story Street, Cambridge, MA USA. Department of Psychiatry and Psychotherapy, and HELIOS-Hansehospital Stralsund, University of Greifswald, Greifswald, Germany. Department of Global Health, Boston University School of Public Health, Massachusetts Avenue, rd floor, Boston, MA USA.

Abstract summary 

Sexual violence is prevalent in eastern Democratic Republic of Congo (DRC) and has potentially devastating psychosocial consequences. Previous studies have reported on sexual violence and its impact on the mental health of survivors, but there are few studies conducted among women with sexual violence-related pregnancies (SVRPs). Women with SVRPs may be at greater risk of complex psychosocial outcomes, including social stigmatization. This study aimed to describe psychosocial outcomes among this subgroup of sexual violence survivors in order to inform future interventions.A mixed methods study was conducted in Bukavu, DRC in 2012 among adult women who self-reported an SVRP and either (1) were currently raising a child from an SVRP (parenting group) or (2) had terminated an SVRP (termination group). This manuscript presents qualitative findings from the mixed methods study. Participants were recruited using respondent-driven sampling and a proportion engaged in semi-structured qualitative interviews conducted by trained female interviewers. Thematic content analysis was conducted and key themes were identified.In total, 55 women were interviewed, of whom 38 were in the parenting group and 17 in the termination group. Women with SVRPs experienced a myriad of emotional responses as they navigated their social environments following the SVRPs. Negative reactions, including social stigmatization and/or social rejection, toward women with SVRPs and toward children born from SVRPs were important influences on psychological well-being. Women expressed both internalized emotionality intertwined with externalized experiences in the social environment. Many women demonstrated resilience, or what could be termed post-traumatic growth, identifying avenues of agency to advance the social conditions for women.The findings from the qualitative study, and in particular, the respondents' needs and suggested strategies, may be useful to inform future research, programs, and policies for women with SVRPs in eastern DRC. Future research could move beyond cross-sectional assessments to utilize innovative research methodologies to assess processes of psychological adaptation among women with SVRPs. Multi-dimensional psychosocial programs for women with SVRPs should consider basic needs such as shelter, food, and health care within the broader framework of trauma-informed care. Participatory programming, guided by beneficiaries, could provide further avenues for agency to advance social conditions for women with SVRPs in eastern DRC.

Authors & Co-authors:  Scott Jennifer J Mullen Colleen C Rouhani Shada S Kuwert Philipp P Greiner Ashley A Albutt Katherine K Burkhardt Gillian G Onyango Monica M VanRooyen Michael M Bartels Susan S

Study Outcome 

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Statistics
Citations :  Linden JA. Clinical practice. Care of the adult patient after sexual assault. NEng J Med. 2011;365(9):834–841. doi: 10.1056/NEJMcp1102869.
Authors :  10
Identifiers
Doi : 64
SSN : 1752-4458
Study Population
Women,Female
Mesh Terms
Other Terms
Mental health;Pregnancy;Psychosocial outcomes;Sexual violence;Social support;Stigma
Study Design
Study Approach
Qualitative,Mixed Methods
Country of Study
Democratic republic of Congo
Publication Country
England