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UBC Theses and Dissertations

Perinatal nursing strategies to promote breastfeeding for women who have a history of sexual violence: a rapid evidence assessment Penrose, Christine Marie


For women with a history of sexual violence, establishing and continuing with breastfeeding can be challenging, with possible disruptions to the maternal-infant attachment process. This Rapid Evidence Assessment (REA) examined how perinatal nurses can optimize breastfeeding experiences and outcomes of increased breastfeeding initiation and duration rates for women who have experienced a history of sexual violence. The objective of this REA was to analyze existing evidence within the literature to construct nursing strategies and recommendations to support and enhance breastfeeding for women who have suffered a history of sexual violence. There were fourteen research studies chosen to be further examined and analyzed to inform the research question. A comprehensive critical appraisal of each study was conducted. Further thematic analysis and coding process utilizing the ecological theoretical perspective identified ten themes within the four ecological systems: 1) microsystem (mother-infant dyad): higher initiation rates, dissociation, and influence of sexual violence on emotional well-being; 2) mesosystem (family and support system): quality of relationships; 3) exosystem (health care system): powerlessness, issues of control and safety, disclosure, and gaps in education and training; & 4) macrosystem (societal and cultural influences): physical exposure of the breast and taboo of sexual violence. The findings of the REA revealed the complexities women face during the perinatal period when they have a history of sexual violence. The recommendations from this REA included nursing strategies within the categories of enhancing the mother and infant relationship, creating a safe and supportive environment, and facilitating women’s empowerment and control. It was identified that nurses need to have the knowledge and skill set to support women and be aware of the challenges they may face during the perinatal period. Further research was identified as needed in this area due to the limited research on the impacts of a history of sexual on the breastfeeding mother.

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