From the studies included in the review, one of the common themes was that women often described their experiences of physical violence as a use of force against their bodies resulting in visible outcomes. These ranged from minor to severe injuries. The discussion of visible injuries was seen in four studies (16, 18, 20, 22). Visible injuries varied from minor cuts and scratches (30) to more serious injuries such as swollen or black eyes, burn marks and bruises (16, 20, 22).

Severe head injuries which resulted in serious long-term consequences of neurological damage were reported. For example, one participant commented: “he banged my head against a wooden pillar of the house. He did it several times. My skull hurt badly” [(16), p.214]. Additionally, another visible long-term consequence was reported by a participant who stated her husband punched her in the face, knocking her front teeth out (16). Some injuries reported were acknowledged as not so distinct due to facial injuries not endured by the victim. For example, one participant stated “he used to squeeze my thighs and leave marks’’ [(20), p.804]. Another participant reported that her husband hit her with a stick several times, targeting her breasts and leaving scars (16).

A second theme that emerged from the interviews was that women suffered serious reproductive health problems resulting from domestic violence. Physical violence imposed by their partners was a dangerous experience for women during their pregnancy. The role of the mother-in-law in domestic violence is discussed in Kaur-Aujla (6), and evidence of extended family abuse is commonplace.

Miscarriages were associated with domestic violence in two studies (16, 23). A married 20-year-old participant discussed how her mother-in-law limiting her food intake during pregnancy resulted in a miscarriage: “I was without food for two and half days; then I ran from my in-laws' place. I just went to my sister place. After a week I felt feverish and at that time my bleeding (miscarriage) started” [(23), p.705]. Furthermore, another victim reported her husband kicking her abdomen and as a result, she experienced heavy bleeding and consequently suffered a miscarriage (16). Low infant birth weight was also identified and associated with reproductive health problems due to a victim's mother-in-law restricting her food intake (23).

Similarities were also noticed when victims reported unwanted forced pregnancies in three studies (16, 17, 20). One victim's husband did not like her using contraceptives and did not allow her to use any birth control methods: resulting in both her and her child suffering from chronic malnutrition (16). Hurwitz et al. (22) also documented malnutrition as a physical consequence. Hussain and Khan (17) found victims have difficulties in negotiating safe sex controlled by the husband which resulted in unwanted pregnancies, “My husband still wants to have more children and wants to keep on having unprotected sex” (p.474).

A widespread practice in dealing with unwanted pregnancies often led to the act of induced abortions as seen by Kallivayalil (16) and Chibber et al. (18). Evidentially, some victims had to terminate their pregnancies to contribute to the household income and continue working (18). Those that were unable to terminate their pregnancies gave birth to a stillborn baby. Even though the reason was unknown, she still blamed her husband; “He used to do that thing (sex) during the whole period of my pregnancy. I gave birth to a stillborn baby. I am sure it is the consequence of his activity” [(16), p.216].

Health consequences that kept victims incapacitated or out of work for a while were discussed across four studies (Table 5). Demonstratable outcomes of physical violence included longer-lasting medical effects such as requiring surgery due to broken bones (19). In another study, physician associates noticed indications of IPV through observations of broken limbs and fractures in their assessments (18). Fractures were also noted from one victim from Khan (16) who reported her husband fractured her leg after attacking her with a piece of stone. Similarly, another victim disclosed her husband fractured her leg after hitting her with an iron rod. During the interview, the researcher recognised that she could not walk normally (16). However, as this statement was from the researcher and not the victim, it questions how accurate and truthful this statement was, due to the presence of only one observer. Thus, lacking in inter-rater reliability (34). Mobility issues were reported by Hurwitz et al. (22); “That day he hurt me too bad with the beer bottle, my ankle got hurt and I was not able to walk properly … There were times when I would go to class with the limping” (p.255). This statement supports and shows how such profound consequences are affecting everyday life for participants and the resilience that victims show in continuing their daily activities despite coping with injury.

Psychosomatic symptoms refer to physical health problems such as sleep disturbances, fatigue, respiratory problems, headaches, back pains, stomach aches, or unexplained pains. These do not have a physical cause but may have an emotional or mental cause (35).

Body aches in different forms varied between victims and in reporting mechanisms (18, 20, 22). Severe headaches, back aches and general body aches were frequently reported due to physical stress. Victims seamlessly associated their suffering narratives on both psychological and physical dimensions as they made meaning of their abuse experiences (20).

Difficulties in sleeping were frequently seen in the literature. In the sample, women who were no longer with their abusers explained how they are haunted by nightmares recalling the abuse and consequently fearing bedtime, “ I still have the emotional stress. I mean, I even dream about the things that occurred with him when I was there… It is such a disturbed sleep now I do not want to go to bed” [(22), p.257]. Similarly, another participant stated, “I feel depressed, I cannot sleep” [(20), p.803]. The findings from Najma and Naz (21) demonstrate the major psychological problems faced by women after experiencing domestic violence included sleep problems, however, the article did not state the type of qualitative analysis conducted and thus no elements of interviews were included, resulting in no understanding of contextual data.

Women often recognised their physical expression of stress and directly associated the stress they were experiencing with the breakdown of their bodies. For example, heart palpitations, gastric problems and respiratory problems identified as psychosomatic symptoms were described by a participant; “Physically when you stress out too much, especially my body, I take everything inside me, I didn't share with no one. And finally, what happened, my stomach got upset and problems…. or I have a heart palpitation or something like my hands are blue, and I have breathing problem” [(20), p.805]. This statement highlights how unexplained pains can relate to the mental well-being of the patient. Psychological distress was embodied in physical symptoms, and this is particularly important when assessing this group in medical situations.

Isolation and withdrawal symptoms in the context of this theme are associated with symptoms of an already existing mental health condition, such as anxiety or depression. Individuals that are experiencing withdrawal or isolation will not participate in activities, they would usually enjoy being alone or with others (36). Indicators of isolation and withdrawal may include a change in appetite, lowered self-esteem, feeling helpless, lowered energy or motivation, recurring feelings of guilt, worthlessness, and self-loathing (37).

The loss of self-confidence was identified in two studies. Ahmad-Stout et al. (28) describe how a participant sample mentioned struggling with a reduced sense of confidence which they then associated with a feeling that they had lost a part of themselves. Female speakers explained how their lost capacity to enjoy life contributed to their impaired functioning: “(After the abuse) I started to lose my self-confidence and the, because earlier I used to be very bubbly, full of energy. But then I … I just lost everything …” [(22), p.257]. This statement also implies feelings of lowered energy and motivation.

Many victims also expressed feeling hopeless, helpless, and isolated from others even including their families of origin. “I was feeling … helpless and just like my life doesn't make sense” [(19), p.948]. Similarly, Najma and Naz (21) also found feelings of helplessness, worthlessness, and hopelessness to be emotions expressed by surviving women. Additionally, women who remained in the relationships were seen to display self-loathing behaviours; “At first (in the abusive relationship), I questioned my own sanity and wondered if there was something wrong with me. I felt very helpless’’ [(22), p.256]. However, these behaviours may have been induced because of the abuse and the perpetrator's gradual degradation of the victim.

Appetite and eating concerns were a recurring theme in the interviews shown in three studies (18, 20, 22). Isolation from family members often resulted in a change in eating behaviours as one woman described how she would cook for her children but not eat with them and preferred to sit in her room alone (20). Here, women described how the stress of abuse affected their appetite; “ I lost my appetite (in the abusive relationship). I mean I was not able to eat properly. I mean because the emotional stress maybe” [(22), p.257]. Similarly, loss of appetite was also reported by Chibber et al. (18).

Signs of psychological distress among women were noted as being uneasy, withdrawn, fearful or unhappy (18). Whereas Najma and Naz (21) highlighted key psychological issues faced by the survivors were anhedonia, poor self-concept, and low self-esteem, all of which were deemed appropriate to be categorised in this theme.

A range of mental health disorders stated by victims were commonly reported through the interviews. Examples of reported diagnoses seen throughout the literature included depression and post-traumatic stress disorder (PTSD) can be with or without suicidal ideation or attempts. Three studies investigated PTSD because of domestic abuse and violence (20–22). Women described mental health concerns once they had left the relationship, “ I have PTSD (posttraumatic stress disorder) … I've been losing some of my memory and I cannot pay attention to anything…” [(22), p.256]. Women in this sample had episodes of PTSD and found it challenging to fulfil their roles as mothers (20). The findings from Najma and Naz (21) also found PTSD to be a significant psychological problem faced by survivor women. However, again, the pathologisation of women in these circumstances must be acknowledged and rather, trauma informed responses are key. In that, there are women who have been great mothers to their children despite incurring abuse, battling with mental health, and these successes are less emphasised in medical works due to the “disease model”, Syme and Hagen (38).

The diagnosis of depression was stated in four studies. IPV was significantly associated with mental health resulting in impacting the general health of individuals, “My doctor says I am in depression. It does affect my health” [(22), p.256]. Depression was stated by Ahmad-Stout et al. (19) and Najma and Naz (21) through suicidal attempts and thoughts. One woman also discussed how her depression because of her abortion caused her to neglect her family, “I feel depressed, I cannot sleep, and I was negligent of the second child” [(20), p.803].

Three studies showed how women often discussed suicide attempts as they thought death appeared to be a better option than life; “one time I went to the river to commit suicide” [(22), p.256]. Another participant described, “I had a knife in my bathroom to slit myself” (19). Ideas of taking their own life remained in women's thoughts, “Often, I think so many people are dying every day so why not me?” [(16), p.216].