Attitudes that justify a husband's violence against his wife are often discussed as barriers to women's disclosure and help seeking after intimate partner violence (IPV). However, personal attitudes, perceived social expectations, and aggregate community attitudes represent different constructs. This focused narrative review examines how these distinctions affect the interpretation of evidence on women's responses to IPV. Survey studies from Bangladesh, India, Nepal, and multiple countries report associations between rejecting wife beating and greater disclosure or help seeking, but the findings are not uniform. Some adjusted analyses detect no statistically significant association with women's personal attitudes, and contextual associations differ by source of help. Recent longitudinal evidence also cautions against assuming a consistent relationship. These studies do not establish that changing attitudes alone increases help seeking. Normalization of abuse, anticipated stigma, and expectations about others’ responses provide useful explanatory pathways, but they are not demonstrated mediators in most survey analyses. The review distinguishes survivors’ beliefs from the attitudes of relatives, communities, and service providers, and separates disclosure, informal support, and formal service contact. Its contribution is an evidence framework linking whose attitudes are measured to which survivor response is observed. Research and practice should assess these relationships directly while addressing safety, material constraints, and the quality of available support.
ObjectiveThis study aimed to evaluate obstetric and neonatal outcomes following cervical cerclage and to identify maternal and cervical characteristics associated with gestational age at delivery in a ten-year retrospective cohort.MethodsWe retrospectively reviewed the records of 66 women who underwent cervical cerclage for cervical insufficiency between 1 January 2013 and 1 January 2023 (cerclage at 12 to 25 weeks; four multiple pregnancies, 6.1%). Cerclage was classified as emergency (examination-indicated; n = 23, 34.8%) or elective (history- or ultrasound-indicated; n = 43, 65.2%). Associations with gestational age at delivery were evaluated using correlation analysis, stratification by indication, multivariable regression, and a sensitivity analysis excluding multiple pregnancies.ResultsSixty-six women were included. In unadjusted analyses, later gestational age at cerclage (r = −0.349, p = 0.004), shorter cervical length (r = 0.562, p < 0.01), and greater cervical dilation (r = −0.540, p < 0.01) were associated with earlier delivery, whereas maternal age, parity, and previous cerclage were not. Emergency cerclage was associated with earlier delivery than elective cerclage (median 31 vs. 37 weeks, p = 0.007), and the association of cervical length with delivery timing differed between strata (interaction p = 0.016). In the primary adjusted model no variable was significant; cervical length (β = 0.21 weeks per mm, p = 0.055) and cervical dilation (β = −1.36 weeks per cm, p = 0.088) were borderline, and cervical length became significant when an emergency indicator replaced dilation (β = 0.31, p = 0.005). For delivery before 34 weeks, neither cervical dilation (OR 1.83 per cm, p = 0.062) nor cervical length (OR 0.90 per mm, p = 0.064) was significant. Excluding multiple pregnancies gave similar results. Apgar scores were delivery-related outcomes.ConclusionsIn this retrospective cohort, earlier cerclage, longer cervical length, and less advanced cervical changes were associated with later delivery in unadjusted analyses; in the primary adjusted model no variable was independently significant, although cervical length and dilation were borderline and findings were sensitive to model specification. These findings do not establish causal effectiveness, as no untreated control group was available. Prospective controlled studies are needed.
BackgroundChild marriage and attitudes that justify intimate partner violence remain important public health concerns. Whether women's experience of child marriage is independently associated with justification of wife-beating in Somalia is unclear.MethodsWe conducted a secondary cross-sectional analysis of 2020 Somali Health and Demographic Survey data for 7,341 ever-married women aged 20–49 years with complete information on age at first marriage and seven wife-beating justification items. Child marriage was defined as first marriage before age 18 years. The outcome was justification of wife-beating for at least one specified reason. We estimated weighted prevalence and used survey-weighted Poisson regression with robust standard errors to estimate prevalence ratios (PRs), adjusting for region, residence, wealth quintile, education, and current age.ResultsOverall, 56.7% [95% confidence interval (CI): 53.5–59.9] of women justified wife-beating for at least one reason. Justification was more common among women married before age 18 than among those married at age 18 or older (59.0% vs. 55.0%; crude PR: 1.07, 95% CI: 1.00–1.15). However, child marriage was not independently associated with justification after adjustment [adjusted PR (APR): 1.01, 95% CI: 0.95–1.08; p > 0.05; adjusted odds ratio (AOR): 1.02, 95% CI: 0.87–1.21]. Regional variation was pronounced: compared with Banadir, the adjusted prevalence was highest in Hiraan (APR: 1.91, 95% CI: 1.57–2.31), Bay (APR: 1.85, 95% CI: 1.56–2.19) and Bakool (APR: 1.83, 95% CI: 1.55–2.17).ConclusionWomen's history of child marriage was not independently associated with justification of wife-beating after accounting for demographic, socioeconomic, and geographic factors in cross-sectional models. These findings concern attitudes only and do not address the risk of experiencing IPV. Prevention efforts should address regional and community contexts that shape acceptance of intimate partner violence.
BackgroundSaudi Arabia's Vision 2030 has driven a significant rise in women's labor force participation — from under 20% to 36% within a decade — amid new professional demands for the workforce. Structural equation modeling (SEM) studies linking mental health, psychological wellbeing (PWB), and quality of life (QoL) within a single model remain scarce for this population. Grounded in the Job Demands–Resources (JD-R) model and drawing on the WHO-5, Ryff's Psychological Wellbeing Scale, and the WHOQOL-BREF, this cross-sectional study examined whether mental health (MH) is associated with psychological wellbeing (PWB) and quality of life (QoL), and whether PWB mediates the MH–QoL relationship, among working women in Saudi Arabia.MethodsA bilingual online questionnaire was administered to 549 working women (age range 18–60; 58.7% government sector; 63.2% with a bachelor's degree, 88.9% a bachelor's degree or higher). The instrument assessed six MH dimensions, seven PWB dimensions (including a culturally added Societal Empowerment dimension), and eight QoL domains (including culturally extended Professional and Religious domains), with internal consistency α = 0.84–0.89. A higher-order confirmatory factor analysis established the three-construct measurement structure, followed by an SEM with maximum-likelihood estimation and robust standard errors.ResultsMH predicted both PWB (β = 0.91, p < 0.001, R² = 0.83) and QoL (β = 0.88, p < 0.001, R² = 0.77). A bias-corrected accelerated bootstrap test (1,000 resamples) — a statistical technique for testing whether an indirect pathway is reliable — indicated an indirect effect of PWB on the MH–QoL association consistent with mediation (indirect β = 0.77, 95% CI [0.58, 0.98]; direct β = 0.11, p = 0.24, ns). Model fit was suboptimal (CFI = 0.81; RMSEA = 0.118; SRMR = 0.09), a limitation of the parcel structure discussed herein. All findings are interpreted as associative, not causal, given the cross-sectional design.ConclusionThese results suggest that workplace wellness initiatives aligned with Saudi Vision 2030 may be most effective when investing in eudaimonic wellbeing — particularly through structured PWB-building workshops and workplace psychological counseling services targeting self-acceptance, environmental mastery, and purpose in life — for future intervention research linking mental health to life-domain flourishing.
Indigenous families in Canada have long endured colonial violence in birthing spaces, including systemic racism, forced evacuations, and child welfare interventions. Parallel to these harms, academic research has often functioned as a tool of colonialism. The Decolonizing Birth Research (DBR) project, conducted between 2019 and 2022 across six Indigenous communities in British Columbia and Manitoba, sought to challenge these legacies by centering Indigenous leadership, knowledge systems, and governance through a community-based, participatory model. Two Indigenous scholars, with lived experience, anthropologic, and clinical research expertise in perinatal health services, as well as community-specific knowledge, were supported by an Elder and an academic midwife to co-lead this project. Having an Indigenous research organization as an integral part of the research team allowed the project to navigate and, in some cases, circumvent the colonial constraints of academic institutions, highlighting the capacity of Indigenous organizations to support communities in conducting rigorous, ethical, and culturally grounded research. This article explores both the innovations and structural barriers encountered throughout the project, offering a critical reflection on how academia continues to perpetuate epistemic and structural violence despite commitments to reconciliation. It calls for a reimagining of perinatal and health equity research as a practice that can and must be led by Indigenous communities, both within and beyond the academy.
