Poor reproductive health among a group of socially damaged Middle Eastern women: a cross-sectional study

Gohar Mohammadi¹, Sedigheh Amiraliakbari², Ali Ramezankhani³, Hamid Alavi Majd^4
1The International Branch of Shahid Beheshti University of Medical Sciences, ²School of Nursing and Midwifery, ³School of Health, ⁴Department of Biostatistics, Faculty of Paramedical Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Background: Despite the scope of violence against women and its importance for reproductive health, few data are available on the reproductive health issues among women having experienced violence.
Methods: This study described the reproductive disorders complicating social harm among 98 socially damaged women seeking care from drop-in centers who were of Persian ancestry, able to communicate and comprehend the contents of the questionnaire, and had history of domestic violence. The questionnaire had five dimensions: demographics, reproductive health, sexual performance, sexual behavior, and violence. Reproductive health included data on gestation, unplanned pregnancy, abortion, contraception, and cervical cancer screening. Data on sexual performance was acquired via the Persian version of sexual function scale, which has been demonstrated to have acceptable external validity in Iranian population. For sexual function, data was gathered on age at first intercourse and whether a participant had ever engaged in an oral or anal sexual activity.
Results: Mean age of participants was 33.4 years. Forty-seven percent of participants were married, 34.8% were divorced, 9.8% were widowed, and 8.7% were single. Mean age at first marriage was 16.4 (4.3) years and mean age at first sexual relationship was 16 (3.9) years. Illiteracy was observed among 18.5% of participants. Elementary education was reported by 22.8%, while only 3.3% of participants reported academic studies. Fifty-five percent were unemployed and 44.6% reported to be working at the time of the study. It was observed that 72.8% of participants were inflicted physically, as well as emotionally and sexually. The violence was reported to be exerted by husband (42.6%), parents (38.4%), or both (19.0%). Among 39 participants who ran away from home, 38 participants reported to be inflicted by violence. Unwanted pregnancy was reported by 64.6% of the participants. Abortion was reported in 50.0% of participants. Contraception was completely ignored in 44.6% of participants. Among eligible women, 53.3% never participated in cervical cancer screening examination. Mean sexual performance scale score was 21.9 (5.5) and 75 (83.3%) participants scored less than 28.
Conclusion: A high prevalence of poor reproductive health was documented among a group of Middle Eastern socially damaged women.

Keywords: sexual behavior, domestic violence, pregnancy, drop-in center, abortion, contraception, cervical cancer screening