Sexual Domestic Violence Impact upon Reproductive Health during COVID-19 Pandemic among Women at Baghdad City

: Background: Sexual violence is widespread, affects women of all cultures globally, breeds in silence, and finds legitimacy through cultural norms. Proprietors are partners, husbands, family, and friends. It may be domestic violence (DV), sexual (SV), a serious violation of women’s rights as human beings. It is an important cause of physical, psychological and sexual reproductive health problems. Aims of the study: the aim is assessing domestic sexual violence on women's reproductive health during the coronavirus pandemic. Methodology: A descriptive analytical study was conducted on women exposed to physical domestic violence. Non Probabilistic Intentional sample of (150) of women exposed to violence by a member of her family through the questionnaire for the period from 26th Jun to 28th Feb, 2020. The information was collected by filling out the questionnaire, and the validity and reliability were determined through the exploratory study, and descriptive and inferential statistical methods were used in analyzing the data. Results: The result of the study showed that the highest percentage (79.4%) of the study sample members ranged in was at age group (20 to 34) years, most of whom were housewives, three-quarters of the study sample had a low educational level, and half of the study sample had a low socioeconomic status, and that the number of births ranging from (2-5) children and more. Conclusion: The results indicated that two-thirds of the study sample suffers from impact sexual domestic violence on them during childbearing age. Recommendations: The study recommends that women be screened for any type of domestic violence during childbearing age. Incorporating domestic violence topics into education curricula, using social media, the availability of health services, and supporting the strengthening of cooperation between social agencies, justice and the police through law enforcement and research to promote and protect women's rights.


INTRODUCTION
Domestic violence is defined as physical, sexual, emotional, financial, or psychic harm or threats directed towards another person.It encompasses any act that isolates, frightens, terrorizes, coerces, threatens, harms, injures, or wounds another person, or even negatively controls them (1) .During the covid-19 epidemic, there have been reports of growing domestic violence rates all around the world.Because ordinary people are forced to stay at home around the world, women and girls are more vulnerable to intimate partner abuse, domestic violence, and other forms of gender-based violence.In addition, the COVID-19 related economic and social pressures have resulted in a lengthy quarantine.Corona and the necessity for spouses to stay at home aggravate conventional conflicts and bring out unsolved issues, heightening sensitivity to marital weaknesses and defects (2) .
Violence against women (VAW) in both the developed and developing nations, violence against women (VAW) is recognized as a major public health issue.It has serious effects for women's physical, emotional, sexual, and reproductive health, in addition to violating human rights.Violence against women is a form of human rights violation as well as a public health issue.Household violence is the most common form of violence faced by women, with studies estimating that 30 percent of women globally have experienced physical and sexual assault by their partners.Domestic abuse can affect not only the victims' physical and psychological well-being, but also their sexual well-being (3) , to assess sexual domestic violence among women during the COVID-19 pandemic and assess the impact of sexual domestic violence on women's reproductive health during the COVID-19 pandemic.

AIMS OF THE STUDY
The aim is assessing domestic sexual violence on women's reproductive health during the coronavirus pandemic.

METHODOLOGY -Study Design
A descriptive-analytical research design was carried out through interview with women at reproductive age who suffering from sexual domestic violence.It was conducted in the primary health care centers at Baghdad city in order to determine the effects of family violence during the Coronavirus pandemic from the period 26th Jan to 28th Feb 2021.

-Study Setting
The non-probability sample consisted of one hundred and fifty (150) women who were victims of sexual domestic violence who entered primary health care centers in Baghdad City.Data were collected through the use of questionnaires and individuals interviewing technique.All study samples were interviewed by the investigator, the interviews were carried out in private setting (empty rooms) in the absence of their husband or their relative especially their mothers-in-law.A pilot study was conducted on (15) women who attended the primary health centers.And These samples were excluded from the study of the original sample The validity of the questionnaire was determined through the use of a panel of (15 experts) from different related specialties and agencies interested and experience to investigate the content of the questionnaire for its clarity, relevance and adequacy.The data was collected after obtaining the agreement from women to participant in this study.Data are analyzed through the use of (SPSS) ver.(23.0).(25-29 years) with the mean ± SD (28.9 5.7) year.while the lowest percentage was (3.3%) of the sample the study is in the category (40-44) years.Concerning the educational level the highest percentage (38.7%)were primary school graduated, while the lower percentage (2%) of study sample were secondary school graduated.Regarding occupation (88.6%) were housewife, the lower percentage (2.7%) of women's was self-employed.Regarding income the highest percentage (55.3%)were not enough, while the lower percentage (10.7%)was enough.Regarding type of family: The highest percentage (46%) was nuclear families, while the lower percentage (18%) was shared families.Regarding the increase of violence in light of coronavirus: Three quarters of the study sample (74.7%) had increased violence against them in light of the pandemic, while (25.3%) of the study sample did not increase violence against them.shows that the highest percentage (66.7%) of study sample are of a group whose duration of marriage is between (5-9) years, while (5.3%) of study sample are of a group whose duration of marriage was more than fifteen years.The mean ± SD (7.24 3.32) years, regarding the gravidity: The highest percentage (28.7%) of study sample were from (2-3) pregnancies, while (10.7%) of them were from (0-1) pregnancy.Regarding the parity: The highest percentage (38%) of study sample were from (2-3) deliveries, while the lowest percentage (8%) of them had more than six deliveries.Regarding the number of abortion: The highest percentage (52.%) of the study sample did not have any history of abortion, while (3.3%) of them had at least three abortion, regarding the number of stillbirth: More than three quarters of the study sample (85.3%) did not have stillbirth, while (14.7%) had one stillbirth.Regarding the number of alive child: The highest percentage (29.3%) of study sample had three alive child, while (6.1%) of them did not have a live child.(3) shows that the highest percentage (75%), (72%), ( 67%), (67%), (68%) and (68%) respectively of relative sufficiency at low level of the sexual domestic violence which refers to (Hurting or using force during sexual relation) and (Forcing for sex), (Inconsistency in the sexual relationship), (Unwanted pregnancy as a result of violence), (Infection with a sexually transmitted disease, for example, AIDSherpes) and (Fewer sexual relations than before as a result of violence).4) Shows that the percentage of the impacts of domestic violence as a whole is (65%) and that the highest percentage of the impacts of violence is the impact of psychological violence on women (18%), while the lowest percentage the impact of physical, menstruation, pregnancy and childbirth in the same percentage (16%).

DISCUSSION
The present study revealed that the most of the study sample (79.4%) were childbearing age with in (20-34) years.This results in line with study conducted by Gebrewahd (2020) who reported that 682 women more than (84%) of respondent who suffered domestic violence were below 30 years.The smallest age was 21 years, this mean that domestic violence occur within this age group (4) as shown in table 1.
Educationally, three-quarter of the study sample who suffered from sexual domestic violence had graduated from intermediate school graduate or less, which considers that have a low level of educational.This study agreement with Omar (2020) who stated that were three quarters of the sample (74.6%) from middle school or less and a minority from institutes and universities (5) .
Regarding employee most (88.6%) of the study sample were housewife, while (8.7%) of them were government employed and (2.7%) of them were self-employed.This study was consistent with study conducted by Yaya, et al., (2019) who stated that (81%) they do not have jobs and (19%) they have jobs (6) .
Regarding the monthly income, more than half (55.3%) of the study sample had low monthly income while (34.2%) of the study sample had moderate monthly income and (10.7%) their monthly income was good.This result is consistent with the study conducted by Gebrewahd (2020) who stated that (52%) of the study sample, had a low monthly income, while (31.2%) of them had moderate monthly income and (15.8%) of them had a good monthly income (4) .
Regarding the family type, (46%) of the study sample were nuclear families, while (54%) of them and were lived in the extended and sharing family.This finding is in agreement with the study was done by Hina Hussain et al., (2020) who stated that (48.8%) of study sample were nuclear families, while (51.3%) were joint families.Among 160 married women in Pakistan suffered from domestic violence (7) .Domestic violence has increased in light of the corona pandemic : The finding of the study concerning domestic violence has increased in light of the corona pandemic (74.7%) three-quarters of the sample experienced increased violence , while (25.3%) of study sample did not increase violence against them.This finding is in agreement with study was done by Boserup, et al., (2020) in the wake of the COVID-19 pandemic trends regarding domestic violence.Reports during the COVID-19 outbreak in China's Hubei province indicate that domestic violence tripled during February 2020 compared to February 2019.Also, according to the United Nations entity UN Women, domestic violence reports in France have increased 30%.Domestic violence calls in Argentina have increased 25%.The organization also reports a 30% increase in helpline calls in Cyprus and 33% increase in Singapore (8) .
According to table 2 regarding gravidity the highest percentage (60.6%) of the study sample range between two and five pregnancies.This finding is in agreement with study done by Aolymat (2020) a cross-sectional study was conducted in Jordan the sample consisted of 200 women stated that The mean and standard deviation number of pregnancies of the study sample was 2. 1. pregnancy (9) .
Reproductive characteristics: Regarding duration of marriage the highest percentage (66.7%) of the study sample their duration of marriage were ranged between (5-9) years, while the lowest percentage (5.3%)their duration of marriage was fifteen years and above.This finding is in agreement with the study was done Avanigadda (2021) who stated that more than two-thirds of the study sample were married between one and nine years facing one type of domestic violence (10) .
Regarding parity the result of the study showed that (80.7%) of the study sample have children between two to more than five children.This finding is in agreement with the study was conducted by Omid, et, al. (2020) who stated that (81.1%) have children between two to more than five children among 424 Afghan women suffered from domestic violence (11) .
Regarding abortion, half (52.4%) of the study sample did not have any previous history of abortion.This finding is in agreement with the study done by Defilipo, et al., (2020) who stated that three-quarters of the study sample was no history of abortion, while the rest have a history of abortion among 771 women who participated in the study (12) .
Regarding the number of stillbirths, (85.3%) of study sample did not have a history of stillbirth, while (14.7%) had one stillbirth.This finding is in agreement with the study was done by Omid, et al., (2020) who stated that (92.5%) of the study sample did not a have history of stillbirth (11) .
Regarding number of a live child more than three quarters (78.6%) of the study sample have from one to four live children.This result is consistent with study was conducted by Gebrewahd (2020) who stated that (89.6%) of the study sample have live children one to four live children.Every additional child above the average of two children was associated with a higher risk of unwanted pregnancy which was significantly related to intimate partner violence (4) .
Table (3) shows sexual violence the result of this study revealed that the highest RS refers to the items number (1, 3, 6, 7, 8, and 9) respectively as shown in table (1-3).whichconsidered a low level.The grand mean score of sexual domestic violence was (1.886) with relative sufficiency (60%), while the percentage of the total research is (23%).
A study was conducted by Hameed and Abd Al Hassan (2020) who stated that prevalence of the lifetime sexual IPV was 19.8%.Approximately (15.2%) reported that they had been forced to have sex during their life by husband.In comparison, (13.6%) of them reported that they were forced to do unwanted sexual acts that they caused indignity.Prevalence of the past-year sexual IPV was10.1% and about (7.7%) were frequently subjected to having sex by force in the past year and (47.8%) of these victims had subjected to such act many times (>5 times) (13) .
A study was conducted by Shahali, et al., (2020) who stated that sexual violence direct (physical) and indirect (psychological) has consequences against women.Sexual violence, itself, has many physical and emotional consequences Physical consequences include trauma, somatic problems, serious injuries, pregnancy, sexually transmitted infections, social isolation behavior, and sexual victimization.While psychological or mental consequences include the attempted suicide, depression, post-traumatic stress disorder (PTSD), stress, anxiety, sleep disorders, eating disorders, substance abuse, self-harm, panic attacks, quality of life, and selfesteem.And also it has negative impacts on society (e.g., influencing productivity and employment) (14) .

CONCLUSIONS
The result of the study indicates that two-thirds of the study sample suffers from impact sexual domestic violence on them during childbearing age.

Table ( 1
): Distribution of the total sample according to the socio-demographical characteristics (N = 150).

Table ( 3 ) :
Distribution of the study sample according to sexual domestic violence (N =150).

Table ( 4
): Distribution of the study sample according to impacts of sexual domestic violence on women's reproductive health (N=150).

Table ( 5): Association
between sexual domestic violence and socio-demographic characteristics and reproductive health among study sample (N = 150).

Table ( 5
) Shows that there are statistically significant relationship between sexual impacts and the socio-demographic variables and reproductive variables which are included (monthly income, Domestic violence has increased in light of the Corona pandemic and gravidity).