Background

Domestic violence (DV) is the most common cause of intentional injuries in women [1–3]. Globally, 1 in 3 women (approximately 30%) experience physical or sexual violence in their lifetime, with intimate partner violence being the most common form [4]. In Iran, recent studies indicate that domestic violence affects up to 66% of women, with significant regional variations [1]. Ardabil province is located in the northwest of Iran in Azerbaijan region [5]. Domestic violence is one of the greatest challenges to women’s health in this province. The amount of domestic violence in all areas of Ardabil province is 29.6 percent [6]. This experience is closely associated with an increase in medical issues such as physical injuries, mental illnesses, and fetal abortions [2,7].

Violence against women is a strong indicator of the erosion of moral standards, violating women’s fundamental human rights and freedoms, and hindering the attainment of peace and equality. The absence of laws supporting women and the presence of laws that perpetuate such violence have entrenched the persistence of this phenomenon in Iranian society [8].

Most victims of domestic violence live in isolation [9]. However, at a certain stage of the abusive relationship, women tend to seek help as they come to realize that the accumulated problems are insurmountable, and the escalation of physical violence prompts an increased request for assistance [10]. The process of seeking help involves both informal (family, friends, relatives, neighbors) and formal (police, medical centers, domestic violence agencies, etc.) avenue [11]. A study by Bibi et al. (2014) indicated that while approximately half of the domestic violence victims sought help from their relatives, around 48% did not seek help likely due to fear, limited access to resources, or societal constraints rather than an explicit preference for silence [12]. Choden (2019) reported that even two-thirds of women experiencing physical violence never seek help [10]. These findings can be interpreted in terms of deficiencies in the legal system, such as the unpreparedness of law enforcers to deal with domestic violence cases, stereotypic beliefs and attitudes, as well as the lack of specific training [13]. The negative experience of seeking help from institutions, the hostile environment at home, and the lack of support for victims only perpetuate learned helplessness in domestic violence victims [10], leading to the belief that resistance is futile [14]. This is because previous attempts to escape violence have been unsuccessful and have even led to increased suffering. On the other hand, due to the stigma prevalent in society, fear of blame, misunderstandings, and further harm by the perpetrator, victims of domestic violence avoid seeking help [15,16]. Despite the many consequences, a large part of Iranian women experiencing IPV do not seek help. Several factors may account for this, such as keeping marital conflict private [17–19]. Lack of professionalism, mistrust and not understanding the nature of formal support [17,18]. Other factors, such as economic dependence, low educational status, and unemployment are associated with staying with an abusive partner [17,20]. Staying with an abusive partner is sometimes facilitated by unhelpful responses from service providers, such as being dismissed, blamed, or advised to remain silent for the sake of family unity [21].

While numerous studies have explored domestic violence globally, there is limited qualitative research on the barriers to help-seeking among women in Iran, particularly in regions like Ardabil province. This study addresses this gap by providing an in-depth understanding of the cultural, social, and structural barriers faced by Iranian women, offering context-specific insights that are crucial for developing effective interventions.

Materials and methods

Setting and participants

The present study was conducted at the Legal Medicine Organization in Ardabil from July 27, 2023, to March 20, 2024. Purposeful sampling was employed based on maximum variation in age (15–45 years), occupational status, education level, duration of marriage, number of children, and socio-economic status to select suitable participants (Table 1). Therefore, the researcher continued sampling until data saturation was reached. Inclusion criteria for participation in the study included: married women aged 15–49 years, no prior participation in qualitative interviews on domestic violence, ability to speak Persian, literacy in reading and writing.

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Table 1. Profile of participants.

https://doi.org/10.1371/journal.pone.0326998.t001

Results

The participants consisted of 20 women who were victims of domestic violence. The age range of the participating women was 15–45 years old, with an average age of 30.65 years. The educational level of the women ranged from elementary school to postgraduate degrees, and the educational backgrounds of their spouses varied from elementary school to doctorate degrees (Table 1).

The data provided insights into women’s experiences of seeking formal and informal help, reflecting the pathways of seeking assistance, family support or lack thereof, the consequences of seeking help, inhibiting factors for seeking help, and factors contributing to domestic violence. Data analysis revealed 3 main categories and 12 sub-categories.

The first category was “ structural and economic barriers to empowerment,” the second category was “ ineffective support providers,” and the third category was “ efforts and struggles to preserve the family,” further details of the 200 results, including sub-categories, are presented in Table 2.

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Table 2. Categories and subcategories.

https://doi.org/10.1371/journal.pone.0326998.t002

Discussion

This is the first qualitative study in Iran specifically aimed to elucidate understanding and experiences of Iranian victims of domestic violence regarding barriers to seeking help. The present study demonstrates that women who are victims of domestic violence in Iran do not receive support services that establish justice and deserve it. This in turn leads the majority of domestic violence victims to refrain from seeking help to hold the perpetrator accountable, thus failing to prevent further violence. Low levels of assistance result from various structural barriers, such as social and cultural obstacles, which hinder victims from seeking help from both formal and informal sources. Among these factors, accepting IPV as a gender norm and instilling a sense of shame and embarrassment in help-seeking recipients are noteworthy. This leads victims of violence to prefer silence because they fear social consequences such as divorce, humiliation, and being ostracized by their families. In patriarchal societies, seeking help from domestic violence victims seems to result in the shame of those around them rather than the violent act itself. The cultural and social environment of Iran significantly influences women’s experiences of domestic violence and their capacity to seek assistance. A more subtle cause is the patriarchal values embedded in our society which not only bolster male supremacy but also discourage women from reporting domestic abuse. Many women fear social stigma, family shame or a potential backlash from their abuser if they seek external help. Furthermore, women’s rights and protection are restricted by legal and religious systems. Iran’s judicial system, informed by Islamic law, often favors men in family and legal disputes. For instance, a woman seeking a divorce due to domestic violence, must provide substantial evidence, which is often difficult to obtain such as medical certificates, police reports, or witness testimonies and the methods for doing so are still extremely harsh. Other regulations, such as child custody and economic assistance laws, further discourage women from leaving abusive relations out of fear that they will lose their children or economic security. The other major factor is the stigma surrounding divorce, which has a significant impact on women’s decisions to reach out for help. Divorced women often face social ostracism, decreased chances of remarriage and other opportunities, and impoverishment, which can create a reluctance to leave abusive marriages. Pressure to “protect the family” often supersedes personal health, compelling many women to remain in toxic situations.

The findings of the current study are consistent with the results of studies conducted by McCleary-Sills and colleagues (2016) and Jakobsen (2014), where gender norms legitimize IPV and portray women as obedient individuals who should obey their husbands as heads of the family even at the expense of sacrificing their own rights [29,30]. Victims of domestic violence often experience powerful barriers to disclosing the violence, which leads to learned helplessness and subsequently jeopardizes their mental health and physical safety. Therefore, most of them perceive violence as normal and consequently are deprived of taking the first step in the help-seeking process. The results of a study by Choden (2019) indicated that even women who recognize IPV as a violation of their rights are unlikely to progress in the help-seeking process because they lack sufficient social support to report violence through official channels. Consequently, women who successfully overcome these initial barriers prefer silence due to mistrust that service providers will adequately and fairly meet their needs [10]. These findings are consistent with the results of the present study.

Most participants in the present study expressed a lack of necessary and sufficient information about their rights and noted insufficient education in this regard. These findings are consistent with the results of studies conducted by Deuba et al. (2016) and Sabri et al. (2015), which emphasized the necessity of educating women to reduce violence and developing awareness programs in this area. Their studies showed that couples should receive education on reproductive health, such as safe sexual life, understanding the roles of women and men, maintaining individual values such as women’s rights, self-esteem, and women’s self-awareness, and be informed about the adverse effects of violence on the health of women and children, and empower themselves in this regard [31,32].

Most victims of violence expressed that one of the main barriers to seeking help and one of the significant factors contributing to women’s exposure to violence is their lack of financial independence and economic dependence on their spouses. In Iran, many employers tend to prefer hiring men, and under equal conditions, women have fewer opportunities for employment. Additionally, in some regions of Iran, men prevent their wives and daughters from pursuing employment or continuing their education, which poses a significant barrier to women’s financial independence. Although women who experience violence often face serious economic hardship and may expect support from government institutions, healthcare systems, or social workers, in reality, such support is often scarce, inaccessible, or insufficient. This finding is consistent with the results of a study by Fogarty et al. (2019), which emphasized the importance of financial support for women victims of IPV [33].

Victims of domestic violence in Iran lack sufficient support from the judicial system, so the legal system needs reform to provide effective services to women victims of violence. They need legal assistance in child custody cases, which often forces most women to endure a life of violence against their will and in violation of their rights. This finding is consistent with the results of a study by Sigalla et al. (2018), which supported considering legal aid for child custody [34].

The results of the present study indicate that women victims of violence, especially when faced with severe physical violence, need assistance from the police and the criminal justice system. Therefore, it is essential to assess and reform the protocols of these support systems according to the needs of women victims [35]. These findings are consistent with the results of a study by Gashaw et al. (2019), in which police officers stated that they prefer marital reconciliation over women defending their rights, which may lead to divorce [36]. The authors suggest these recommendations tailored to the Iranian context to support women against domestic violence:

• Creating community support centers for domestic violence victims: Establishing community support centers in Ardabil province that provide the necessary legal, psychological, and job training for women affected by domestic violence. They may be set up in conjunction with community health care centers to make it more convenient for people. Concerning the enhancement of current support systems, we suggest bolstering and broadening the functions of welfare organizations, shelters, and law enforcement agencies. In particular, we suggest that these organizations obtain increased financial support, specialized training regarding domestic violence, and enhanced legal protection to safeguard victims. A more organized strategy for coordination among the police, social services, and healthcare providers is crucial to guarantee that women receive the assistance they require at all phases
• Economic Empowerment Programs: Develop government-funded programs that provide women with access to microloans or grants to start microenterprises, thus reducing their economic dependence on their abuser.
• Cultural Awareness Initiatives: Work hand in hand with media campaigns and community and local faith leaders to culturally interrogate patriarchal norms and decrease the stigma around asking for help for domestic violence.
• Law Enforcement Practices: Ensure that police departments and the judicial system receive mandatory training and standards for responding to domestic violence and treatment of victims with respect and dignity.

Conclusion

Data analyses reveal the persistence of patriarchal norms in Iranian society and the systematic violations of legal rights, which constitutes the initial barrier for women when confronting domestic violence. This research shows that women find access to essential support services unattainable due to financial dependence on the abuser, oppressive legal frameworks, and the fear of social stigma. Moreover, both the legal system and social support structures fail them effectively, often leaving them trapped in abusive situations.

The high costs of legal processes and the long journey required to get satisfactory results from existing support organizations are significant challenges according to key findings. Economic and legal barriers prevent many women from reporting abuse or leaving their abusers. The stigma attached to divorce and the societal expectations of upholding family unity is another reason that prevents women from seeking help.

The study notes that such reforms will not be simple, but they are attainable. Iranian women can escape from domestic violence if such support systems are in place along with a supportive group of legal practitioners.