“I need to change something before I drown”: Experiences Related to Turning Points in Leaving Abusive Relationships among Mothers in Ontario, Canada 

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Davidson, Kimberley T. Jackson, Panagiota Tryphonopoulous, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4485527/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose: Intimate partner violence (IPV) – a global, pervasive, and significant public health concern – is a form of gender-based violence. Approximately one third of women in Canada experience IPV. With well-established negative health and psychosocial impacts of violence on mothers and their children, mothers’ decision to leave an abusive relationship is an important area of study. It has been suggested that there are ‘turning points’, events that initiate or precede the leaving process,in motherhood which are influenced by an awakened maternal identity as well as variable individual and sociocultural factors. Given that these factors are not well understood in the Canadian context, this study aimed to address the question, “How do Ontario mothers who have experienced IPV describe turning points”? Methods: Nested within a larger, mixed-methods study, this post-hoc case study was grounded in Secco et al.’s (2016) understanding of awakened maternal identity and involved in-depth interviews with five mothers. Results: Three distinct but interrelated themes emerged, including the mental shifts stemming from increased risk to the child(ren), planning to leave and prioritizing what is needed to ensure the safety of the child(ren), and the decision to leave which was made when mothers perceived the relationship to be over either as a result of culmination of events or a singular event that endangered the child(ren). Conclusion: Mothers are faced with complex and challenging decisions around leaving abusive relationships, but ultimately are driven by doing what was best for their children. The findings from this study add to a small, but important body of knowledge around the experiences of mothers facing IPV in Ontario, Canada. turning points intimate partner violence mothers decision-making case study Introduction Gender-based violence encompasses any harmful act directed at an individual because of their gender, with intimate partner violence (IPV) being the most common form (Division of International Protection, UNHCR, 2021). IPV encompasses any physical, sexual or emotional abuse perpetrated by an intimate partner within the context of coercive control (Tjaden & Thoennes, 2000). Globally, about one in three women aged 15 to 49 years who have been in a relationship, report experiencing some form of physical or sexual violence within an intimate relationship (World Health Organization, 2021). In Canada, approximately 44% of women experience IPV (Cotter, 2021). Motherhood is understood as a time of immense change, wherein a woman’s identity evolves to integrate a new identity of motherhood (Clenn et al., 2016). While motherhood is often ideologized as lifegiving and self-sacrificing (Benoit et al., 2016; Varcoe & Hartrick Doane, 2007), in actuality, motherhood is a multifaceted identity construct that can become even more complex when mothers experience violence (Mantler et al., 2020; Siwik et al, 2022). For example, for mothers who have experienced abuse, it has been established that peace keeping between the abusive partner and the child(ren), as well as shielding the child(ren) from abuse, are core maternal roles (Buchanan et al., 2014; Stewart, 2021). In a recent critical review of mothering in the context of abuse, Broughton et al. (2022) highlighted how mothers are consistently perceived as ‘at-risk’ - a conceptualization in direct contrast to idealized notions of motherhood. This ‘at-risk’ narrative is further reinforced by studies that have indicated experiences of violence are associated with poor motherhood experiences (Hooker et al., 2016). However, interestingly, the literature has been clear that while a mother in an abusive relationship may perceive they are a poor mother, violence was not predictive of negative mothering behaviours. Rather, mothering in the context of abuse tends to result in mothers prioritizing the child(ren) and working both to overcompensate and protect children (Broughton et al., 2022; Renner et al., 2021). The vulnerability of mothers, or their being ‘at-risk’ has well-established impacts for both mothers and children (Broughton et al., 2022). In some instances, abuse can reduce a mother’s capacity for sensitive and positive responsiveness toward her child and in turn decrease her ability to meet their social and emotional needs (Peled & Gil, 2011; Scheffer Lindgren & Renck, 2008). In this way, the presence of abuse in the home is a ‘toxic stress’ that can interfere with forming secure parent-infant attachment, a critical element of healthy childhood development (Shonkoff et al., 2012). It is important to note that maternal diminished capacity does not infer a lack of action or intention by the mother, but is largely because mothers who experience abuse expend energy and time shielding children from violence (Buchanan et al., 2014; Chang et al., 2010). Furthermore, for mothers, there are both physical and mental health consequences of abuse, such as injuries, headaches, vaginal infections, depression, post-traumatic stress disorder, and anxiety (Campbell, 2002; Trevillion et al., 2012). For children, exposure to abuse in the home increases the likelihood of psychological dysregulation, depression, and results in overall poorer physical health (Berg et al., 2022; Evans et al., 2022; Holmes et al., 2022). With evidence demonstrating the negative impacts of abuse on mothers and children, many struggle to understand why women remain in abusive relationships, often condemning women for doing so. In trying to understand why mothers remain in abusive relationships, studies have revealed that mothers and children are at the greatest risk of femicide, stalking, and physical violence when they are in the process of leaving an abusive relationship (Secco et al., 2016; Standish & Weil, 2021). In addition, leaving due to violence may be perceived as an acknowledgement or admission of violence in the home, introducing the risk of social service involvement and, for mothers, the fear of having their child(ren) apprehended ( Murray et al., 2015; Saunders & Oglesby, 2016; Velonis et al., 2017). Further, mothers leaving abusive relationships often have diminished socioeconomic and social support resources (Reichel, 2017; Wilson, 2015). Leaving also can result in decreased familial support and increased stigmatization surrounding divorce/separation requiring mothers to navigate instability in housing and lack of finances (Marcal et al., 2022; Scrafford et al., 2022). A mother’s decision to leave an abusive relationship is often referred to as a turning point – and understood as the event(s) that initiate or precede the leaving process (Chang et al., 2010; Sani & Pereira, 2020; Scrafford et al., 2022). Turning points have historically been studied within the context of single events such as ‘hitting rock bottom,’ a broken bond with the abuser, an explosive violent event, and/or infidelity (Idemudia, 2009). Becoming a mother, has been suggested as a potential turning point; however, the evidence is inconclusive. Some studies suggest that becoming a mother in and of itself is a turning point, while other studies have found that the turning point occurs along the mothering journey; for example, as a result of increased fear for the child’s safety or a desire to be a better mother (Chang et al., 2010). Secco and colleagues’ (2016) understanding of Awakened Maternal Identity (AMI) posited that turning points are influenced by motherhood ideologies and occur when a mother transitions from diminished-maternal identity (DMI- characterized by weakened maternal abilities and interrupted mother-infant bonds) to AMI. This transition occurs when a mother's sense of responsibility is heightened and she feels compelled to defend and protect her child(ren) (Secco et al., 2016). However, recent research by Barrios et al. (2021) reported that turning points are influenced by a wide range of individual and sociocultural factors, such as readiness to leave, age of child(ren), gender, and class, and that these factors intersect to create circumstances that either encourage or discourage women from formal and informal help seeking, including leaving an abusive relationship. Research on turning points outside of the motherhood context has highlighted the influence of external resources, such as access to finances and housing, as influential in a woman’s decision to leave an abusive relationship (Chang et al., 2010; Scheffer Lindgren & Renck, 2008). Whether turning points are the result of individual, sociocultural, or external factors, or some combination thereof, remains poorly understood, pointing to a lack of understanding of the intersection of motherhood and turning points among women who have experienced IPV in Ontario, Canada. As such, to address this critical gap, the study addressed the following research question: how do mothers who have experienced IPV describe turning points in Ontario, Canada? Methods Design This post-hoc secondary analysis case study was a sub-study of a larger cross-sectional, mixed-methods study designed to explore mothering, decision-making, and turning points in the context of IPV. The purpose of the case study was to explore how mothers who have experienced IPV describe turning points with the objective of developing a nuanced understanding of this poorly understood phenomenon. Ontario was selected as the research team has existing connections with shelters to support recruitment. A small-scale case study research designs was selected as it allows for all data from within and across individuals’ cases to be intensely examined and rigorously contrasted (Cresswell, 2009; Stake, 1995). Through the process of case study, an exemplar is described that can be used in other studies and to ground future research. Case studies are of critical importance as according to Flyvbjerg (2006), “a scientific discipline without a large number of thoroughly executed case studies is a discipline without a systematic production of exemplars, and a discipline without exemplars is an ineffective one” (p. 219). Further, when multiple interviews are combined to create a single case, it affords an exploration of what is common and particularly about the case providing insight into a given phenomenon (Hyett et al., 2014). Sampling, Recruitment, and Eligibility For this all mothers who met the inclusion criteria of mothers who had left an abusive relationship for a minimum of 6 months and described a turning point within their relationships were included in this sub-analysis. This sample size was selected to be consistent with previous case studies and qualitative studies among women who have experienced IPV (O’Brien et al., 2013). Recruitment was conducted via online advertising on Kijiji (a public, online community marketplace), as well as advertisements posted in domestic violence shelters. Interested participants were asked to contact the research team via email to determine their eligibility. Eligible participants included those who self-identified as a mother, resided in Ontario, were English-speaking, had access to a telephone or the internet, and experienced IPV as assessed using the validated Abuse Assessment Screen (Soeken et al., 1998). Participants In total, five mothers participated in the interviewing process. Participants ages ranged from 28 to 50 (M=36.4 years, SD=8.65). Three of the five participants reported living in urban centres (60%), and two of the participants reported living in a rural area (40%). The number of children per participant ranged from one to three, with a median of two children. The child’s ages ranged from 2 to 29 years (M=12.30, SD= 8.35). All participants (n=5) reported that at least one child was living with them full time (n=5), with two of the participants claiming to have other adult children who live outside of the home, and one of the participants has a child who lives with her on weekends only. All participants reports that their ex-abusive partners were male. Participants reported being in a relationship for a mean of 7.6 years, (SD= 7.23), and the length of time elapsed since leaving the relationship ranged from 1 month to 15 years (M=6.8 years, SD=5.95). Note that this timeline and duration is inclusive of two distinct partners disclosed by one participant, and that another participant chose not to disclose this information. Demographic details are comprehensively reported in Table 1. Procedures The data collection measures and methodology for this study was approved by the University of Western Ontario’s Non-Medical Research Ethics Board (Ethics Approval Number: 119964), and data collection occurred between January 2022 and July 2022 (survey and interview inclusive). Informed consents were obtained from all participants. Participants completed an online demographic survey that lasted approximately 5-10-minutes. At the end of the survey, participants were invited to participate in a 60-minute Zoom-based semi-structured interview. Interviews were conducted by a trained member of the research team and questions were designed to elicit data for the study’s in-depth analysis. ‘How’ and ‘what’ research questions were utilized as they are well suited for descriptive case study research (Yin, 2003). Questions included: What do you think makes it difficult for mothers to leave an abusive relationship?; What do you think motivates mothers to leave abusive relationships?; In your past relationship, did you ever feel stuck ?; Was there a moment, or turning point, in your relationship where you knew you had to leave?; Did having your child/children impact this turning point at all?; How might living in an [urban/rural] setting have shaped your decision-making when considering leaving?; and What types of system (e.g., health care, legal, social services, etc.) barriers did you encounter when leaving? It is important to note that these questions were not exhaustive, as other clarification questions were asked during the interviews. All interviews were audio-recorded and transcribed verbatim, inclusive of anonymization prior to analysis. To honour the time and contributions of participants, a $10 e-gift-card was offered for survey participation and a $20 e-gift-card was offered for interview participation. Data Analysis All interview transcripts were analysed using the Quirkos (2021) qualitative analysis software and guided by a multi-phased approach. Each transcript was independently coded by four research team members. The analysis team then met to create a preliminary coding structure. Next, random coding dyads were created, with each dyad assigned two transcripts to analyse via open and line-by-line coding in Quirkos. Each dyad met to discuss the preliminary coding structure and suggest refinements. The proposition (i.e., if mothers were put in a position where they needed to defend or protect their child(ren), a turning point would occur) was used during the coding process as it allowed the researchers to direct attention to an idea that will be analyzed in the case study (Baxter & Jack, 2008). These refinements were then discussed among all analysis team members to implement changes to codes and their definitions. When consensus was reached by the analysis team, changes were made and then cross-checked in the next round of coding. Consensus was reached in all rounds of coding. This iterative process was repeated once more to ensure that the entire analysis team agreed that the coded themes accurately represented the recounted meanings of the participants' narratives (Braun & Clarke, 2006). Reflective memoing was implemented as a method of identifying and reflecting upon assumptions, identifying outliers, and extracting meaning from the data (Braun & Clarke, 2006). Upon completion of coding, all Quirkos files were merged, and reports were generated for each code. Finally, the analysis team met to discuss and interpret the findings, build a consensus on how to best understand the data and present the data for knowledge translation purposes. The proposition was considered part of the criteria for interpreting any findings. Results The analysis illuminated three distinct but inter-related themes mothers used to describe their turning point experience: 1) shifting- the mental shifts that mothers underwent when realizing what protecting their child(ren) would require; 2) planning- the resources needed to leave the abusive relationship in a way that would ensure their child(ren)’s protection after leaving; and 3) deciding- the moment mothers determined they were leaving. Shifting You kind of have to have the courage and believe yourself that it’s not right. (N2) Mental Shift Mothers discussed how turning points began with mental shifts. For many mothers, the initial mental shift that took place was realizing they were in fact in a violent relationship and that violence would not change. This led mothers to conclude that the only way to protect themselves and their child(ren) was to leave—a realization often riddled with guilt and/or a sense of loss. One mother described arriving at the conclusion that her partner was not going to change, saying, “[the violence is] never going to change. He’s not – and there’s just – he’s never going to change. And that was always what I was trying to hope for, but it will never happen” (N2). For many mothers coming to this realization was difficult, as most had held out hope that change would happen. Mothers described the difficulty in the mental shift of letting go of hope as their abusers often showed remorse after a violence event: It would have been very easy to stay; it would have been easier to stay. Because he actually did go into the – he was really apologetic saying he was crying all the time and I just – like, he would flip-flop so he’d be angry one minute and then he would be in tears the next and begging me to stay and saying he could be different. And then, you know, he’d call me a name and have a tantrum and make me cry. … And I did feel really bad for him. Because he did get really depressed. And then I felt like I was doing the wrong thing [leaving] (N5). Realizing that the violence would not end, but rather that it was a cycle of abuse led mothers to a mental shift of realizing that staying was no longer an option. One mother explained this realization saying, “…finally realizing that [living in a home where mom is abused] is not good for the child also. And also, sometimes feeling that the child might be at risk or in danger of being hurt as well. It didn’t happen to the child but there’s just that fear” (N1). For other mothers, the shift occurred when the risk to their child(ren) became more pronounced. This could be a result of the fear that the child might be abused or an instance where the child could have been injured as a result of the abuse. One mother described this saying, The motivating factor was that my kids were being put in the middle. When my first was just a baby, the abuse, just for an example, like, I was pushed up against a wall and the picture and the glass broke off my head into her, like, playpen and then he had taken her and put her down in the playpen and there was, like, glass in her head….I just, you know, I thought you can do what you want to me because I can take it and I probably, like, I felt like I deserve it. I felt like I’m doing something wrong. Or kind of my penance for making bad decisions. But as soon as I saw my kids, you know, being affected by it I was like, this is bigger than me (N3). For mothers the mental shift and start of the turning point was when the risk to the children became imminent. For some mothers this risk became more urgent as they visualized the potential ongoing impact as their children grew up: I just tried to visualize what the future was going to look like there and the bigger she would be getting I know he would have less and less patience for her. And I didn’t want her living in that. I didn’t like even as an infant the looks I saw on her face and the crying. I realize as an older kid I didn’t want to have to walk in and soothe her because he said something nasty to her or backhanded or who knows, I just didn’t ever want to deal with that (N6). For other mothers, the risk became real when they realized that their child(ren) was/were already being impacted by the violence: Well, I think it’s when the children – when the children start noticing that they’re being – that the mom’s being abused because we try and hide it from them so much. And we think that we are, but when my youngest daughter starts saying certain things, to me it's, …. Well, it’s because [the abuse] seems normal to you [mother].” And [other daughter], “Yes. He’s done it 40 times in the last six months.” … [nervously laughs] I’m, oh my God, she’s counting (N2). Grieving to Make Space for Hope This mental shift of realizing that they needed to leave for their child(ren) was/were accompanied by grief that gave way to hope in the future. The grief for mothers stemmed from a loss of their dream of the way they perceived a family ought to be. Mothers had to grieve their mental shift and the future they were losing: Well, I had a dream that we would be a family forever’. And so that was – the emotional part was the hardest probably – just giving up on that dream. And seeing it – just realizing this isn’t normal – this isn’t good for any of us. So, coming to the decision that I’m the one responsible for breaking up – well I’m not responsible – but I’m the one that has to do the hard thing and say, ‘This is enough’… (N2). Borne out of this grief was a sense hope for the future, that in turn began to motivated mothers towards change. For mothers, the grief eventually gave way to a sense of increased resolve to leave and renewed hope for the future. This resolve was partly due to the realization that they did not deserve to be abused, which allowed them to lean into hope for the future and what leaving might mean for them:“... eventually as I got enough of, like, the courage and to convince myself, like, no, this actually isn’t right, and this [abuse] isn’t all of it is when I started thinking to myself that I could have something different” (N3). This hope for something different was liberating with one mother saying, “it felt more liberating, sort of I’m taking this risk and I’m going to leave for good and once I’m out of here I’m going to leave all this behind, so it feels kind of hopeful and liberating” (N1). The hope that mothers had once they had moved through grieving the relationship helped mothers to endure the ongoing abuse as they made moves towards leaving, saying, I don’t know if it’s a thing or anything, but I started imagining what – actually picturing myself in an apartment with my girls and what sort of things we’d be doing and how we’d be feeling and laughing and enjoying life. I would actually sit in that for – I would – just be a dream for 10, 15 minutes and just watch it, as if it was a movie of the three of us being happy and not being criticized – not [crying] being in that situation. So that really helped to bring up my hope and motivation to keep going and get out and leave, [laughs] if that makes sense (N2). Within the mental shift was a grieving process for the future mothers had lost and a hope for a new future, one free of abuse where mothers and their child(ren) could be safe. Planning “It felt like a bit hopeless sometimes and also very unsure of what the future will be and just uncertainty in general” (N1) Planning for mothers was about taking the time to figure out both the next steps in leaving the relationship as well as physical leaving the abusive residence. For many mothers, their turning point was constrained by their lack of resources, which meant planning was required, as mothers were concerned that leaving would disadvantage their child(ren) more than the threat or exposure to abuse associated with staying. The realities of poverty, homelessness, and food insecurity when leaving often meant mothers would stay for their child(ren). While this tension was described by mothers, they all revealed a point when they realized the potential risk to the physical and emotional safety for the child(ren) outweighed the risks of poverty, homelessness, and food insecurity. Once mothers had reached a turning point, they took a few weeks to plan, gathering resources to support their leaving. Mothers described working to identify employment, childcare, and local supports as key needs that were often unavailable in their communities. For many mothers, this required planning to secure a job and housing, as they did not want to have to go back to their abusive partner. One mother explained how her advanced planning made leaving possible saying, “I was able to find another job that had a higher paid salary, so that was kind of when I made the decision to leave” (N1). While some mothers were able to find employment which facilitated their turning point for other mothers this was not possible. Mothers also explained that often employment was not an option as the concerns for child safety and protection meant there were no childcare options that met their safety needs. This added pressure meant that many mothers relied on social safety nets instead of working, as they could not justify the risk to their child(ren): “I had a hard time with employment just because of childcare and there were some options I had available with childcare, but I also didn’t want to leave her just with anyone at that point. So, there was a time where I was just on welfare because I had just left, I didn’t really have any extra money, I had the bare minimum that I had saved” (N6). These difficulties were exacerbated for some mothers living in rural communities as they had a shortage of resources, a well-documented issue in rural communities. As a means to deal with the lack of resources, mothers in rural communities described that leaving their partners meant they had to depart entirely from their community due to the lack of available resources in these small towns. One mother explained, It was really difficult because there’s nothing in the town to support you other than other than the Ontario Works building. So, there was nothing really that kind of pushed or helped. You know? There was no, like, resources or anything. So that made it really difficult... I had to go out of my county in order to get out of the situation because the county’s so small …So I had to put literal kilometers in between me [and him] (N3). For mothers, lack of resources and safe resources meant planning to leave involves leaving more than just the relationship but also the community. Deciding …but something just snapped in my head that… what am I doing? (N5) Mothers described the process of turning points alongside planning that led to them make the final decision to leave- the point and time most mothers referred to as their turning point. Mothers described this as a culmination of factors leading to a point in time when they knew it was time to leave. While for some mothers this was an instance or a specific violent event for others it was when there was they realized there really was no hope left for or in the relationship. One mother who described a specific instance that precipitated leaving it was when she encountered her daughter in tears after her husband had gone into her daughter’s room and was ‘horsing around’ but then wouldn’t stop when the daughter asked him to stop. This was a reality check for the mom explaining, And when I went into her room, she was laying on the bed curled up in a ball crying. … I’ve been noticing it’s been happening, but I just couldn’t figure out how to get out because I didn’t have the money. I didn’t have – and there’s no place to live. I’m not going to bring them to the street. So, it’s that – it’s them noticing and me going, ‘OK. I can’t stand by and watch this anymore. This is – my little girl is just – she’s dying inside right now’ (N2). For other mothers the violent event in and of itself was not memorable or over a line she had set but rather it was just within the context of experiencing violence that the decision was made: It was in my head a lot the whole time, but if things weren’t so bad – it’s hard to leave when you’re having a good day, it’s just the blow ups and then those moments you want to escape, at least for me. But it was just during one of those blows ups I just decided I was going to take off the next morning when he had left for work” (N6). For some mothers, the turning point was not because of a violent event but rather a realization that the relationship was over. For one mother, it was recognizing the absurdity of the lie she and her children were living, pretending that everything was okay when it was not, and it was not ever going to be. This juxtaposition became a turning point for the mother, Because we were planning some things and then he just snapped. And I just – I thought I’m not going to just keep doing – like, we’re making plans… And he kind of went off and then I just told him that I’m not taking a holiday and I’m leaving and just it went from planning a fun holiday to I’m done. And – which he was kind of surprised and I don’t know why I did it that way, but something just snapped in my head that… what am I doing? Kind of like I’m pretending that I’m in this fun relationship when it’s really not. I don’t know. Mentally something just changed that second. I think he didn’t believe me (N5). For another mother, there was a personal toll on her led to the turning point. This mother describing the culmination of events and realizing that they were not right, and not going to change made her realize what staying the relationship was costing her. It was because of this that she decided to leave: “…so I think it was a build-up of I know this isn’t right, I know this isn’t right … So, it was just, like, kind of recognizing and being, like, I need to change something before I drown” (N3). Discussion This case study explored how mothers who have experienced IPV described turning points. An overarching goal was to recount mothers' experiences into a combined narrative that described the experiencing of turning points. Mothers in this case study explained the mental shift of realizing that the abuse cycle was never going to end and the associated impact that was/could have on their child(ren) as a start to their turning point. Within this mental shift was the process of grief, as mothers were losing their idealized families, but this grief gave way to hope which began to motivate mothers towards change. To facilitate leaving, mothers needed to plan as prioritizing the least amount of upheaval and disadvantage for their child(ren). For mothers, planning to leave meant that social determinants of health had to be prioritized, as attaining them all was not possible. In this planning mothers prioritized safety for their children above all else. Once the mental shift was done and planning underway, mothers described the moment of deciding to leave. For some mothers this was a singular violent event, one that endangered their child(ren), for others it was culmination of events that led mothers to realize that the cost of the relationship was outweighing the benefits. Mothers in this study described mental shifts and associated of process grief leading to hope as a precursor to turning points. The understanding of the important role of these mental shifts is in line with the work by Secco et al. ( 2016 ) understanding of awakened maternal identity and Dziewa & Glowacz ( 2022 ) that found women leaving abusive relationships had a change in perception of the relationship, as they identified it as abusive, and they no longer being willing to normalize abuse. However, unique to this study was that the mental shift mothers underwent was influenced by their children and stemmed from actual or perceived risk to their children. Further this study explored the emotional process of grief shifting to hope that mothers went through within their mental shift. While this grief and sense of profound loss are common in divorce studies among families where abuse is absent (Venta & Walker, 2021 ; Crosby et al., 2021 ). Understanding this emotional process in the context of abusive relationships is important and often overlooked. With the well-established stigma associated with breaking up a family unit (Rosenberg, 2017 ), mothers in abusive relationships have additional layers of complexity to contend with when deciding to leave. However, unique to this study was that grief made space for hope - a hope by mothers for a better life. Once mothers had experienced a mental shift, planning to leave began. Ford-Gilboe and colleagues ( 2005 ) described the importance of planning and positioning for the future after leaving an abusive relationship. This work was built on by Bermea et al. ( 2020 ) who reported that preparation was a distinct phase within the leaving process and that mothers engaged in both mental and active preparation to leave. Interestingly, Bermea and colleagues ( 2020 ) reported that mothers who engaged in active preparation tended to have older children, a finding not consistent with our study, as two of the mothers had young child(ren) and engaged in active preparation (i.e. housing, employment, childcare). However, all mothers in our study disclosed that they were experiencing financial strain, which appeared to hamper their leaving. This may have been related to three mothers in our study working part-time hours, which is associated with lower pay, temporary contracts (i.e., unstable employment), and additional, indirect resource constraints (Garnero, 2016 ). For example, part-time employment rarely includes access to benefits like health insurance, resulting in increased out-of-pocket costs. Further, most child(ren) in this study lived with their mother full-time, meaning that mothers had extensive unpaid familial and household labour demands that likely diminished their capacity for full-time employment. It has been established that inaccessible childcare, whether due to a lack of availability or affordability, is a prominent barrier to full-time employment (Garnero, 2016 ). In the context of these resourcing constraints, mothers disclosed fearing that their child(ren) would be more disadvantaged if they were to leave than if they were to stay in the abusive relationship. This lack of resources is well-established in violence literature (Moffit et al., 2022; Letourneau et al., 2022 ; Mantler et al., 2020 ). These sociocultural factors have been described as important to leaving and turning points for mothers (Barrios et al., 2021 ). However, unique to this study was an understanding of how mothers prioritized socioculture factors within their planning process, namely that safety of the child(ren) was above all else. Mothers described how the lack of safe resources meant that the turning point resulted in them leaving the abusive relationship and their community. Mothers depicted that the decision to leave that was either brought about a violent act that endangered their child(ren) or a realization that the relationship was over. This is in line with Secco and colleagues ( 2016 ) awakened maternal identity highlight that a mother’s decision to leave was when they realized that the violence impacting at the child(ren). However, unique to this study was that mothers did not described a diminished mothering capacity that precipitated this awakened identity, but rather this identity was influenced by an increased perception of risk to the child(ren). Limitations and Directions for Future Research There are several potential limitations of this study, the most obvious being the small sample size. While this sample was sufficient and in line with previous descriptive case studies, case studies are not sufficient to set policy directions; however, case studies do offer insights which provide catalysts for further research. The reliance on purposive sampling is also a limitation of this study. Specifically, mothers in this study had all left the abusive relationship as a result of their turning point, meaning only these experiences were captured. It is possible that there are women who have experienced turning points but have decided to stay, and these experiences were not captured in this study. Moreover, the act of volunteering for the study means our sample is biased in that the turning points were sufficient for mothers to have left the relationship (Magnani et al., 2005 ). Future research should explore impediments to turning points and leaving in the sample of women still in abusive relationships. A third limitation of this study is the lack of variability in sample demographics, as this sample was mostly Caucasian, and all experienced high levels of financial strain, had college/university level education, and had left heterosexual relationships. Despite the small sample size, considerations for future inquiry are encouraged to continue to analyze the accumulation of turning points rather than approaching the concept from an incident only standpoint. Additional research should ensure a more diverse sample with participants from different backgrounds, socio-economic statuses, and geographic locations are included to ensure this body of literature is built encompassing a variety viewpoints and factors that influence turning points. Conclusion This post-hoc secondary analysis case study explored turning points among mothers highlighting that this is a process that begins with mental shifts stemming from the perception of increased risk to their child(ren), which leads to mothers grieving the loss of their idealized family and in turn, hope which motivates them towards creating a better future. Mothers discussed how they planned to leave, with their children’s safety being of the utmost priority and then how the ultimate decision to leave was when they realized that the relationship is over. This turning point can either be the culmination of many events or a singular violent event wherein the child(ren) were endangered. This study begins to fill the gap of how motherhood is a turning point aligning with Secco et al.’s ( 2016 ) understanding of awakened maternal identity which underscores an increased sense of mothering responsibility as well as Barrios et al., ( 2021 ) understanding of individual and sociocultural factors influencing turning points among women. However, this study expands on Secco and colleagues ( 2016 ) understanding as for some mothers there was not a diminished-maternal identity driving the turning point, but rather the fear of risk to their child(ren) and/or hoping for a better future that instigated leaving. This case study further highlighted how mothers create hierarchy within sociocultural factors, which impacts their planning and leaving of abusive relationships. Declarations Competing Interests The authors have no relevant financial or non-financial interests to disclose. Contributions Authors TM, KTJ, and PT contributed to the study conception and design. Material preparation, data collection and analysis were performed by TM, KTJ, PT, and CAD. The first draft of the manuscript was written by TM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Funding This study was funded by the Children’s Health Research Institute’s Internal Research Grant Fund (2021). Author Contribution Authors TM, KTJ, and PT contributed to the study conception and design. Material preparation, data collection and analysis were performed by TM, KTJ, PT, and CAD. The first draft of the manuscript was written by TM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Data Availability The data of this study are not available due to the nature of this research (participants did not provide consent). References Barrios, V. R., Khaw, L. B. L., Bermea, A., & Hardesty, J. L. (2021). Future Directions in Intimate Partner Violence Research: An Intersectionality Framework for Analyzing Women’s Processes of Leaving Abusive Relationships. Journal of Interpersonal Violence, 36(23–24), NP12600–NP12625. https://doi.org/10.1177/0886260519900939 Baxter, P., & Jack, S. (2008). Qualitative case study methodology: Study design and implementation for novice researchers. The Qualitative Report, 13 (4), 544–559. https://doi.org/10.46743/2160-3715/2008.1573 Benoit, B., Goldberg, L., & Campbell-Yeo, M. (2016). Infant feeding and maternal guilt: The application of a feminist phenomenological framework to guide clinician practices in Breast Feeding Promotion. Midwifery , 34 , 58–65. https://doi.org/10.1016/j.midw.2015.10 . 011 Berg, K. A., Evans, K. E., Powers, G., Moore, S. E., Steigerwald, S., Bender, A. E., … Connell, A. M. (2022). Exposure to intimate partner violence and children’s physiological functioning: A systematic review of the literature. 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Review of sampling hard-to-reach and hidden populations for HIV surveillance. AIDS, 19 , S67–S72. https://doi.org/10.1097/01.aids.0000172879.20628.e1 Mantler, T., Jackson, K., & Walsh, E. (2020). Critical discourse analysis of policies impacting the intersection of health and experiences of intimate partner violence for rural women in Ontario, Canada. Rural and Remote Health, 20 (1). https://doi.org/10.22605/rrh5185 Marcal, K. E., Showalter, K., & Maguire-Jack, K. (2022). Intimate partner violence and depression of mothers and their adolescent children: the roles of housing insecurity and system contacts. Journal of interpersonal violence, 37(23–24), NP23419-NP23442. Murray, C. E., Horton, G. E., Johnson, C. H., Notestine, L., Garr, B., Pow, A. M., Flasch, P., & Doom, E. (2015). Domestic violence service providers’ perceptions of safety planning: A focus group study. Journal of Family Violence, 30 (3), 381–392. https://doi.org/10.1007/s10896-015-9674-1 O’Brien, K. L., Cohen, L., Pooley, J. A., & Taylor, M. F. (2013). Lifting the Domestic Violence Cloak of Silence: Resilient Australian Women’s reflected memories of their childhood experiences of witnessing domestic violence. Journal of Family Violence, 28 (1), 95–108. https://doi.org/10.1007/s10896-012-9484-7 Peled, E., & Gil, I. B. (2011). The mothering perceptions of women abused by their partner. Violence Against Women, 17 (4), 457–479. https://doi.org/10.1177/1077801211404676 Renner, L. M., Hartley, C. C., & Driessen, M. C. (2021). Provider, caretaker, nurturer, hero: Perceptions of parenting changes among women who experienced intimate partner violence. Journal of Child and Family Studies, 30 (9), 2191–2203. https://doi.org/10.1007/s10826-021-02033-y Rosenberg, R. T. (2017). Bad families: The navigation of stigma and marked identities of children of divorce. Reichel, D. (2017). 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(2022). “I did it to save my children”: Parenting strengths and fears of women exposed to intimate partner violence. Journal of interpersonal violence, 37(9–10), NP7775-NP7802. Scheffer Lindgren, M. & Renck, B. (2008) Intimate partner violence and the leaving process: Interviews with abused women, International Journal of Qualitative Studies on Health and Well-being , 3:2, 113–124, https://DOI.org/10.1080/17482620801945805 Secco, L., Letourneau, N., & Collins, E. (2016). ‘My eyes were open’: Awakened maternal identity and leaving violent relationships for the infant/children. Journal of Family Violence, 31 (5), 639–645. https://doi.org/10.1007/s10896-016-9799-x Shonkoff J. P., Garner A. S., Siegel B. S., Dobbins M. I., Earls M. F., McGuinn L., et al. (2012). The lifelong effects of early childhood adversity and toxic stress . Pediatrics. 129(1) Retrieved February 28, 2023, from https://pubmed.ncbi.nlm.nih.gov/22201156/ Siwik, E., Larose, S., Peres, D., Jackson, K. T., Burke, S. 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A mother’s love knows no bounds: Exploring ‘good mother’ expectations for mothers involved with children’s services due to their partner violence. Qualitative Social Work, 20 (3), 681–702. https://doi.org/10.1177/1473325020902249 Tjaden, P., Thoennes, N. (2000). Extent, Nature, and Consequences of Intimate Partner Violence: Findings from the National Violence Against Women Survey. National Institute of Justice. https://www.ojp.gov/pdffiles1/nij/181867.pdf Trevillion, K., Oram, S., Feder, G., & Howard, L. M. (2012). Experiences of domestic violence and mental disorders: A systematic review and meta-analysis. PLoS ONE, 7 (12). https://doi.org/10.1371/journal.pone.0051740 Varcoe, C and Hartrick Doane, GA. (2007). Mothering and Women’s Health. In: Hankivsky, O., Varcoe, C., & Morrow, M. H. (Eds.), Women's health in Canada: Critical perspectives on theory and policy (pp. 297–323). University of Toronto Press. Velonis, A. 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Tables Table 1 Sociodemographic Characteristics of Participants Participant Characteristics n % Age (in years) of mothers, M ( SD ) 36.40 (8.65) - Age (in years) of children, M ( SD ) 12.30 (8.35) - Gender of children Female 8 80.00 Male 2 20.00 Number of children One 2 40.00 Two 1 20.00 Three 2 40.00 Living situation of children Full-time with mother 6 66.67 Part-time with mother 1 11.11 Independently 2 22.22 Type of housing House 3 60.00 Apartment 1 20.00 Women’s shelter 1 20.00 Marital Status Common Law 3 60.00 Separated 1 20.00 Single 1 20.00 Community type Urban 3 60.00 Rural 2 40.00 Highest education University degree 1 20.00 College degree 4 80.00 Sexual orientation Heterosexual 4 80.00 Bisexual 1 20.00 Employment status Employed full-time 1 20.00 Employed part-time 3 60.00 Employed (did not specify type) 1 20.00 Household annual income < $30,000 1 20.00 $60,000 - $79,999 2 40.00 $80,000 - $110,999 1 20.00 Prefer not to answer 1 20.00 Financial strain Very strained 3 60.00 Somewhat strained 2 40.00 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4485527","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":325146229,"identity":"a48ad00a-9ba3-4e6d-a6e3-b4323f1320c7","order_by":0,"name":"Tara Mantler","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAr0lEQVRIiWNgGAWjYPCCGjl+otXygIgDCceMJRtI1MKcuOEAsVrs+Q8/fPzxBxvj5hs5hg8YauyIsEUizdjgQIIMs9mNHGMDhmPJxGjhYZM4kMDGZnYjd5sEYwMzEVr4z4C0MPMYzwBrqSdCC0MOWIuEgQRYy2EitNwA+uVM2jEDiTPvPxskHDtOWAt7/+GHDypsaur729MSH3yoqSasBRUkkKphFIyCUTAKRgF2AABIjDS/nXOrvgAAAABJRU5ErkJggg==","orcid":"","institution":"Western University","correspondingAuthor":true,"prefix":"","firstName":"Tara","middleName":"","lastName":"Mantler","suffix":""},{"id":325146233,"identity":"1b8b4698-a7f6-443f-8218-5269a3594b5d","order_by":1,"name":"Cara A. 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While motherhood is often ideologized as lifegiving and self-sacrificing\u0026nbsp;(Benoit et al., 2016; Varcoe \u0026amp; Hartrick Doane, 2007), in actuality, motherhood is a multifaceted identity construct that can become even more complex when mothers experience violence (Mantler et al., 2020;\u0026nbsp;Siwik et al, 2022). For example, for mothers who have experienced abuse, it has been established that peace keeping between the abusive partner and the child(ren), as well as shielding the child(ren) from abuse, are core maternal roles (Buchanan et al., 2014; Stewart, 2021). In a recent critical review of mothering in the context of abuse, Broughton et al. (2022)\u0026nbsp;highlighted how mothers are consistently perceived as \u0026lsquo;at-risk\u0026rsquo; - a conceptualization in direct contrast to idealized notions of motherhood. \u0026nbsp;This \u0026lsquo;at-risk\u0026rsquo; narrative is further reinforced by studies that have indicated experiences of violence are associated with poor motherhood experiences (Hooker et al., 2016). \u0026nbsp;However, interestingly, the literature has been clear that while a mother in an abusive relationship may perceive they are a poor mother, violence was not predictive of negative mothering behaviours. Rather, mothering in the context of abuse tends to result in mothers prioritizing the child(ren) and working both to overcompensate and protect children (Broughton et al., 2022;\u0026nbsp;Renner et al., 2021). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe vulnerability of mothers, or their being \u0026lsquo;at-risk\u0026rsquo; has well-established impacts for both mothers and children (Broughton et al., 2022). In some instances, abuse can reduce a mother\u0026rsquo;s capacity for sensitive and positive responsiveness toward her child and in turn decrease her ability to meet their social and emotional needs\u0026nbsp;(Peled \u0026amp; Gil, 2011; Scheffer Lindgren \u0026amp; Renck, 2008). In this way, the presence of abuse in the home is a \u0026lsquo;toxic stress\u0026rsquo; that can interfere with forming secure parent-infant attachment, a critical element of healthy childhood development\u0026nbsp;(Shonkoff et al., 2012). It is important to note that maternal diminished capacity does not infer a lack of action or intention by the mother, but is largely because mothers who experience abuse expend energy and time shielding children from violence\u0026nbsp;(Buchanan et al., 2014; Chang et al., 2010). Furthermore, for mothers, there are both physical and mental health consequences of abuse, such as injuries, headaches, vaginal infections, depression, post-traumatic stress disorder, and anxiety\u0026nbsp;(Campbell, 2002; Trevillion et al., 2012). For children, exposure to abuse in the home increases the likelihood of\u0026nbsp;psychological dysregulation, depression, and results in overall poorer physical health (Berg et al., 2022; Evans et al., 2022; Holmes et al., 2022).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWith evidence demonstrating the negative impacts of abuse on mothers and children, many struggle to understand why women remain in abusive relationships, often condemning women for doing so. In trying to understand why mothers remain in abusive relationships, studies have revealed that mothers and children are at the greatest risk of femicide, stalking, and physical violence when they are in the process of leaving an abusive relationship\u0026nbsp;(Secco et al., 2016; Standish \u0026amp; Weil, 2021). \u0026nbsp;In addition, leaving due to violence may be perceived as an acknowledgement or admission of violence in the home, introducing the risk of social service involvement and, for mothers, the fear of having their child(ren) apprehended\u0026nbsp;( Murray et al., 2015; Saunders \u0026amp; Oglesby, 2016; Velonis et al., 2017). \u0026nbsp;Further, mothers leaving abusive relationships often have diminished socioeconomic and social support resources\u0026nbsp;(Reichel, 2017; Wilson, 2015). \u0026nbsp;Leaving also can result in decreased familial support and increased stigmatization surrounding divorce/separation requiring mothers to navigate instability in housing and lack of finances (Marcal et al., 2022; Scrafford et al., 2022).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA mother\u0026rsquo;s decision to leave an abusive relationship is often referred to as a \u003cem\u003eturning point\u003c/em\u003e \u0026ndash; and understood as the event(s) that initiate or precede the leaving process (Chang et al., 2010; Sani \u0026amp; Pereira, 2020; Scrafford et al., 2022). Turning points have historically been studied within the context of single events such as \u0026lsquo;hitting rock bottom,\u0026rsquo; a broken bond with the abuser, an explosive violent event, and/or infidelity (Idemudia, 2009). Becoming a mother, has been suggested as a potential turning point; however, the evidence is inconclusive. Some studies suggest that becoming a mother in and of itself is a turning point, while other studies have found that the turning point occurs along the mothering journey; for example, as a result of increased fear for the child\u0026rsquo;s safety or a desire to be a better mother (Chang et al., 2010). Secco and colleagues\u0026rsquo; (2016) understanding of Awakened Maternal Identity (AMI) posited that turning points are influenced by motherhood ideologies and occur when a mother transitions from diminished-maternal identity (DMI- characterized by weakened maternal abilities and interrupted mother-infant bonds) to AMI. This transition occurs when a mother\u0026apos;s sense of responsibility is heightened and she feels compelled to defend and protect her child(ren) (Secco et al., 2016). However, recent research by Barrios et al. (2021) reported that turning points are influenced by a wide range of individual and sociocultural factors, such as readiness to leave, age of child(ren), gender, and class, and that these factors intersect to create circumstances that either encourage or discourage women from formal and informal help seeking, including leaving an abusive relationship. Research on turning points outside of the motherhood context has highlighted the influence of external resources, such as access to finances and housing, as influential in a woman\u0026rsquo;s decision to leave an abusive relationship (Chang et al., 2010; Scheffer Lindgren \u0026amp; Renck, 2008). Whether turning points are the result of individual, sociocultural, or external factors, or some combination thereof, remains poorly understood, pointing to a lack of understanding of the intersection of motherhood and turning points among women who have experienced IPV in Ontario, Canada. As such, to address this critical gap, the study addressed the following research question: how do mothers who have experienced IPV describe turning points in Ontario, Canada?\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eDesign\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis\u0026nbsp;post-hoc secondary analysis\u0026nbsp;case study was a sub-study of a larger cross-sectional, mixed-methods study designed to explore mothering, decision-making, and turning points in the context of IPV. The purpose of the case study was to explore how mothers who have experienced IPV describe turning points with the objective of developing a nuanced understanding of this poorly understood phenomenon.\u0026nbsp;Ontario was selected as the research team has existing connections with shelters to support recruitment. \u0026nbsp;A small-scale case study research designs was selected as it\u0026nbsp;allows for all data from within and across individuals\u0026rsquo; cases to be intensely examined and rigorously contrasted (Cresswell, 2009; Stake, 1995). Through the process of case study, an exemplar is described that can be used in other studies and to ground future research. Case studies are of critical importance as according to Flyvbjerg (2006), \u0026ldquo;a scientific discipline without a large number of thoroughly executed case studies is a discipline without a systematic production of exemplars, and a discipline without exemplars is an ineffective one\u0026rdquo; (p. 219).\u0026nbsp;Further, when multiple interviews are combined to create a single case, it affords an exploration of what is common and particularly about the case providing insight into a given phenomenon (Hyett et al., 2014).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSampling, Recruitment, and Eligibility\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFor this all mothers who met the inclusion criteria of mothers who had left an abusive relationship for a minimum of 6 months and described a turning point within their relationships were included in this sub-analysis. \u0026nbsp;This sample size was\u0026nbsp;selected to be consistent with\u0026nbsp;previous case studies and qualitative studies among women who have experienced IPV (O\u0026rsquo;Brien et al., 2013). Recruitment was conducted via online advertising on Kijiji (a public, online community marketplace), as well as advertisements posted in domestic violence shelters. Interested participants were asked to contact the research team via email to determine their eligibility. Eligible participants included those who self-identified as a mother, resided in Ontario, were English-speaking, had access to a telephone or the internet, and experienced IPV as assessed using the validated Abuse Assessment Screen (Soeken et al., 1998).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eParticipants\u003c/em\u003e\u003c/strong\u003e\u003cem\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn total, five mothers participated in the interviewing process. Participants ages ranged from 28 to 50 (M=36.4 years, SD=8.65). Three of the five participants reported living in urban centres (60%), and two of the participants reported living in a rural area (40%). The number of children per participant ranged from one to three, with a median of two children. The child\u0026rsquo;s ages ranged from 2 to 29 years (M=12.30, SD= 8.35). All participants (n=5) reported that at least one child was living with them full time (n=5), with two of the participants claiming to have other adult children who live outside of the home, and one of the participants has a child who lives with her on weekends only. All participants reports that their ex-abusive partners were male. Participants reported being in a relationship for a mean of 7.6 years, (SD= 7.23), and the length of time elapsed since leaving the relationship ranged from 1 month to 15 years (M=6.8 years, SD=5.95). Note that this timeline and duration is inclusive of two distinct partners disclosed by one participant, and that another participant chose not to disclose this information. Demographic details are comprehensively reported in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedures\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe data collection measures and methodology for this study was approved by the University of Western Ontario\u0026rsquo;s Non-Medical Research Ethics Board (Ethics Approval Number: 119964), and data collection occurred between January 2022 and July 2022 (survey and interview inclusive). Informed consents were obtained from all participants. \u0026nbsp;Participants completed an online demographic survey that lasted approximately 5-10-minutes. At the end of the survey, participants were invited to participate in a 60-minute Zoom-based semi-structured interview. Interviews were conducted by a trained member of the research team and questions were designed to elicit data for the study\u0026rsquo;s in-depth analysis. \u0026lsquo;How\u0026rsquo; and \u0026lsquo;what\u0026rsquo; research questions were utilized as they are well suited for descriptive case study research (Yin, 2003). Questions included: What do you think makes it difficult for mothers to leave an abusive relationship?; What do you think motivates mothers to leave abusive relationships?; \u0026nbsp;In your past relationship, did you ever feel \u003cem\u003estuck\u003c/em\u003e?; \u0026nbsp;Was there a moment, or turning point, in your relationship where you knew you had to leave?; Did having your child/children impact this turning point at all?; How might living in an [urban/rural] setting have shaped your decision-making when considering leaving?; and What types of system (e.g., health care, legal, social services, etc.) barriers did you encounter when leaving? \u0026nbsp;It is important to note that these questions were not exhaustive, as other clarification questions were asked during the interviews. All interviews were audio-recorded and transcribed verbatim, inclusive of anonymization prior to analysis. To honour the time and contributions of participants, a $10 e-gift-card was offered for survey participation and a $20 e-gift-card was offered for interview participation. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll interview transcripts were analysed using the Quirkos (2021) qualitative analysis software and guided by a multi-phased approach. Each transcript was independently coded by four research team members. The analysis team then met to create a preliminary coding structure. Next, random coding dyads were created, with each dyad assigned two transcripts to analyse via open and line-by-line coding in Quirkos. Each dyad met to discuss the preliminary coding structure and suggest refinements. The proposition (i.e., if mothers were put in a position where they needed to defend or protect their child(ren), a turning point would occur) was used during the coding process as it allowed the researchers to direct attention to an idea that will be analyzed in the case study (Baxter \u0026amp; Jack, 2008). These refinements were then discussed among all analysis team members to implement changes to codes and their definitions. When consensus was reached by the analysis team, changes were made and then cross-checked in the next round of coding. Consensus was reached in all rounds of coding. This iterative process was repeated once more to ensure that the entire analysis team agreed that the coded themes accurately represented the recounted meanings of the participants\u0026apos; narratives (Braun \u0026amp; Clarke, 2006). Reflective memoing was implemented as a method of identifying and reflecting upon assumptions, identifying outliers, and extracting meaning from the data (Braun \u0026amp; Clarke, 2006). Upon completion of coding, all Quirkos files were merged, and reports were generated for each code. Finally, the analysis team met to discuss and interpret the findings, build a consensus on how to best understand the data and present the data for knowledge translation purposes. The proposition was considered part of the criteria for interpreting any findings. \u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe analysis illuminated three distinct but inter-related themes mothers used to describe their turning point experience: 1) shifting- the mental shifts that mothers underwent when realizing what protecting their child(ren) would require; 2) planning- the resources needed to leave the abusive relationship in a way that would ensure their child(ren)\u0026rsquo;s protection after leaving; and 3) deciding- the moment mothers determined they were leaving.\u003c/p\u003e\n\u003ch3\u003eShifting\u003c/h3\u003e\n\u003cp\u003e \u003cem\u003eYou kind of have to have the courage and believe yourself that it\u0026rsquo;s not right. (N2)\u003c/em\u003e \u003c/p\u003e\n\u003ch3\u003eMental Shift\u003c/h3\u003e\n\u003cp\u003eMothers discussed how turning points began with mental shifts. For many mothers, the initial mental shift that took place was realizing they were in fact in a violent relationship and that violence would not change. This led mothers to conclude that the only way to protect themselves and their child(ren) was to leave\u0026mdash;a realization often riddled with guilt and/or a sense of loss. One mother described arriving at the conclusion that her partner was not going to change, saying, \u0026ldquo;[the violence is] never going to change. He\u0026rsquo;s not \u0026ndash; and there\u0026rsquo;s just \u0026ndash; he\u0026rsquo;s never going to change. And that was always what I was trying to hope for, but it will never happen\u0026rdquo; (N2). For many mothers coming to this realization was difficult, as most had held out hope that change would happen. Mothers described the difficulty in the mental shift of letting go of hope as their abusers often showed remorse after a violence event:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eIt would have been very easy to stay; it would have been easier to stay. Because he actually did go into the \u0026ndash; he was really apologetic saying he was crying all the time and I just \u0026ndash; like, he would flip-flop so he\u0026rsquo;d be angry one minute and then he would be in tears the next and begging me to stay and saying he could be different. And then, you know, he\u0026rsquo;d call me a name and have a tantrum and make me cry. \u0026hellip; And I did feel really bad for him. Because he did get really depressed. And then I felt like I was doing the wrong thing [leaving] (N5).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eRealizing that the violence would not end, but rather that it was a cycle of abuse led mothers to a mental shift of realizing that staying was no longer an option. One mother explained this realization saying, \u0026ldquo;\u0026hellip;finally realizing that [living in a home where mom is abused] is not good for the child also. And also, sometimes feeling that the child might be at risk or in danger of being hurt as well. It didn\u0026rsquo;t happen to the child but there\u0026rsquo;s just that fear\u0026rdquo; (N1). For other mothers, the shift occurred when the risk to their child(ren) became more pronounced. This could be a result of the fear that the child might be abused or an instance where the child could have been injured as a result of the abuse. One mother described this saying,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eThe motivating factor was that my kids were being put in the middle. When my first was just a baby, the abuse, just for an example, like, I was pushed up against a wall and the picture and the glass broke off my head into her, like, playpen and then he had taken her and put her down in the playpen and there was, like, glass in her head\u0026hellip;.I just, you know, I thought you can do what you want to me because I can take it and I probably, like, I felt like I deserve it. I felt like I\u0026rsquo;m doing something wrong. Or kind of my penance for making bad decisions. But as soon as I saw my kids, you know, being affected by it I was like, this is bigger than me (N3).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor mothers the mental shift and start of the turning point was when the risk to the children became imminent. For some mothers this risk became more urgent as they visualized the potential ongoing impact as their children grew up:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eI just tried to visualize what the future was going to look like there and the bigger she would be getting I know he would have less and less patience for her. And I didn\u0026rsquo;t want her living in that. I didn\u0026rsquo;t like even as an infant the looks I saw on her face and the crying. I realize as an older kid I didn\u0026rsquo;t want to have to walk in and soothe her because he said something nasty to her or backhanded or who knows, I just didn\u0026rsquo;t ever want to deal with that (N6).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor other mothers, the risk became real when they realized that their child(ren) was/were already being impacted by the violence:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eWell, I think it\u0026rsquo;s when the children \u0026ndash; when the children start noticing that they\u0026rsquo;re being \u0026ndash; that the mom\u0026rsquo;s being abused because we try and hide it from them so much. And we think that we are, but when my youngest daughter starts saying certain things, to me it's, \u0026hellip;. Well, it\u0026rsquo;s because [the abuse] seems normal to you [mother].\u0026rdquo; And [other daughter], \u0026ldquo;Yes. He\u0026rsquo;s done it 40 times in the last six months.\u0026rdquo; \u0026hellip; [nervously laughs] I\u0026rsquo;m, oh my God, she\u0026rsquo;s counting (N2).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003eGrieving to Make Space for Hope\u003c/h3\u003e\n\u003cp\u003eThis mental shift of realizing that they needed to leave for their child(ren) was/were accompanied by grief that gave way to hope in the future. The grief for mothers stemmed from a loss of their dream of the way they perceived a family ought to be. Mothers had to grieve their mental shift and the future they were losing:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eWell, I had a dream that we would be a family forever\u0026rsquo;. And so that was \u0026ndash; the emotional part was the hardest probably \u0026ndash; just giving up on that dream. And seeing it \u0026ndash; just realizing this isn\u0026rsquo;t normal \u0026ndash; this isn\u0026rsquo;t good for any of us. So, coming to the decision that I\u0026rsquo;m the one responsible for breaking up \u0026ndash; well I\u0026rsquo;m not responsible \u0026ndash; but I\u0026rsquo;m the one that has to do the hard thing and say, \u0026lsquo;This is enough\u0026rsquo;\u0026hellip; (N2).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eBorne out of this grief was a sense hope for the future, that in turn began to motivated mothers towards change. For mothers, the grief eventually gave way to a sense of increased resolve to leave and renewed hope for the future. This resolve was partly due to the realization that they did not deserve to be abused, which allowed them to lean into hope for the future and what leaving might mean for them:\u0026ldquo;... eventually as I got enough of, like, the courage and to convince myself, like, no, this actually isn\u0026rsquo;t right, and this [abuse] isn\u0026rsquo;t all of it is when I started thinking to myself that I could have something different\u0026rdquo; (N3). This hope for something different was liberating with one mother saying, \u0026ldquo;it felt more liberating, sort of I\u0026rsquo;m taking this risk and I\u0026rsquo;m going to leave for good and once I\u0026rsquo;m out of here I\u0026rsquo;m going to leave all this behind, so it feels kind of hopeful and liberating\u0026rdquo; (N1). The hope that mothers had once they had moved through grieving the relationship helped mothers to endure the ongoing abuse as they made moves towards leaving, saying,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eI don\u0026rsquo;t know if it\u0026rsquo;s a thing or anything, but I started imagining what \u0026ndash; actually picturing myself in an apartment with my girls and what sort of things we\u0026rsquo;d be doing and how we\u0026rsquo;d be feeling and laughing and enjoying life. I would actually sit in that for \u0026ndash; I would \u0026ndash; just be a dream for 10, 15 minutes and just watch it, as if it was a movie of the three of us being happy and not being criticized \u0026ndash; not [crying] being in that situation. So that really helped to bring up my hope and motivation to keep going and get out and leave, [laughs] if that makes sense (N2).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eWithin the mental shift was a grieving process for the future mothers had lost and a hope for a new future, one free of abuse where mothers and their child(ren) could be safe.\u003c/p\u003e\n\u003ch3\u003ePlanning\u003c/h3\u003e\n\u003cp\u003e \u003cem\u003e\u0026ldquo;It felt like a bit hopeless sometimes and also very unsure of what the future will be and just uncertainty in general\u0026rdquo; (N1)\u003c/em\u003e \u003c/p\u003e \u003cp\u003ePlanning for mothers was about taking the time to figure out both the next steps in leaving the relationship as well as physical leaving the abusive residence. For many mothers, their turning point was constrained by their lack of resources, which meant planning was required, as mothers were concerned that leaving would disadvantage their child(ren) more than the threat or exposure to abuse associated with staying. The realities of poverty, homelessness, and food insecurity when leaving often meant mothers would stay for their child(ren). While this tension was described by mothers, they all revealed a point when they realized the potential risk to the physical and emotional safety for the child(ren) outweighed the risks of poverty, homelessness, and food insecurity. Once mothers had reached a turning point, they took a few weeks to plan, gathering resources to support their leaving. Mothers described working to identify employment, childcare, and local supports as key needs that were often unavailable in their communities. For many mothers, this required planning to secure a job and housing, as they did not want to have to go back to their abusive partner. One mother explained how her advanced planning made leaving possible saying, \u0026ldquo;I was able to find another job that had a higher paid salary, so that was kind of when I made the decision to leave\u0026rdquo; (N1). While some mothers were able to find employment which facilitated their turning point for other mothers this was not possible. Mothers also explained that often employment was not an option as the concerns for child safety and protection meant there were no childcare options that met their safety needs. This added pressure meant that many mothers relied on social safety nets instead of working, as they could not justify the risk to their child(ren): \u0026ldquo;I had a hard time with employment just because of childcare and there were some options I had available with childcare, but I also didn\u0026rsquo;t want to leave her just with anyone at that point. So, there was a time where I was just on welfare because I had just left, I didn\u0026rsquo;t really have any extra money, I had the bare minimum that I had saved\u0026rdquo; (N6). These difficulties were exacerbated for some mothers living in rural communities as they had a shortage of resources, a well-documented issue in rural communities. As a means to deal with the lack of resources, mothers in rural communities described that leaving their partners meant they had to depart entirely from their community due to the lack of available resources in these small towns. One mother explained,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eIt was really difficult because there\u0026rsquo;s nothing in the town to support you other than other than the Ontario Works building. So, there was nothing really that kind of pushed or helped. You know? There was no, like, resources or anything. So that made it really difficult... I had to go out of my county in order to get out of the situation because the county\u0026rsquo;s so small \u0026hellip;So I had to put literal kilometers in between me [and him] (N3).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor mothers, lack of resources and safe resources meant planning to leave involves leaving more than just the relationship but also the community.\u003c/p\u003e\n\u003ch3\u003eDeciding\u003c/h3\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e\u0026hellip;but something just snapped in my head that\u0026hellip; what am I doing? (N5)\u003c/h2\u003e \u003cp\u003eMothers described the process of turning points alongside planning that led to them make the final decision to leave- the point and time most mothers referred to as their turning point. Mothers described this as a culmination of factors leading to a point in time when they knew it was time to leave. While for some mothers this was an instance or a specific violent event for others it was when there was they realized there really was no hope left for or in the relationship. One mother who described a specific instance that precipitated leaving it was when she encountered her daughter in tears after her husband had gone into her daughter\u0026rsquo;s room and was \u0026lsquo;horsing around\u0026rsquo; but then wouldn\u0026rsquo;t stop when the daughter asked him to stop. This was a reality check for the mom explaining,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eAnd when I went into her room, she was laying on the bed curled up in a ball crying. \u0026hellip; I\u0026rsquo;ve been noticing it\u0026rsquo;s been happening, but I just couldn\u0026rsquo;t figure out how to get out because I didn\u0026rsquo;t have the money. I didn\u0026rsquo;t have \u0026ndash; and there\u0026rsquo;s no place to live. I\u0026rsquo;m not going to bring them to the street. So, it\u0026rsquo;s that \u0026ndash; it\u0026rsquo;s them noticing and me going, \u0026lsquo;OK. I can\u0026rsquo;t stand by and watch this anymore. This is \u0026ndash; my little girl is just \u0026ndash; she\u0026rsquo;s dying inside right now\u0026rsquo; (N2).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor other mothers the violent event in and of itself was not memorable or over a line she had set but rather it was just within the context of experiencing violence that the decision was made:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eIt was in my head a lot the whole time, but if things weren\u0026rsquo;t so bad \u0026ndash; it\u0026rsquo;s hard to leave when you\u0026rsquo;re having a good day, it\u0026rsquo;s just the blow ups and then those moments you want to escape, at least for me. But it was just during one of those blows ups I just decided I was going to take off the next morning when he had left for work\u0026rdquo; (N6).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor some mothers, the turning point was not because of a violent event but rather a realization that the relationship was over. For one mother, it was recognizing the absurdity of the lie she and her children were living, pretending that everything was okay when it was not, and it was not ever going to be. This juxtaposition became a turning point for the mother,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u003cem\u003eBecause we were planning some things and then he just snapped. And I just \u0026ndash; I thought I\u0026rsquo;m not going to just keep doing \u0026ndash; like, we\u0026rsquo;re making plans\u0026hellip; And he kind of went off and then I just told him that I\u0026rsquo;m not taking a holiday and I\u0026rsquo;m leaving and just it went from planning a fun holiday to I\u0026rsquo;m done. And \u0026ndash; which he was kind of surprised and I don\u0026rsquo;t know why I did it that way, but something just snapped in my head that\u0026hellip; what am I doing? Kind of like I\u0026rsquo;m pretending that I\u0026rsquo;m in this fun relationship when it\u0026rsquo;s really not. I don\u0026rsquo;t know. Mentally something just changed that second. I think he didn\u0026rsquo;t believe me (N5).\u003c/em\u003e \u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eFor another mother, there was a personal toll on her led to the turning point. This mother describing the culmination of events and realizing that they were not right, and not going to change made her realize what staying the relationship was costing her. It was because of this that she decided to leave: \u0026ldquo;\u0026hellip;so I think it was a build-up of I know this isn\u0026rsquo;t right, I know this isn\u0026rsquo;t right \u0026hellip; So, it was just, like, kind of recognizing and being, like, I need to change something before I drown\u0026rdquo; (N3).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis case study explored how mothers who have experienced IPV described turning points. An overarching goal was to recount mothers' experiences into a combined narrative that described the experiencing of turning points. Mothers in this case study explained the mental shift of realizing that the abuse cycle was never going to end and the associated impact that was/could have on their child(ren) as a start to their turning point. Within this mental shift was the process of grief, as mothers were losing their idealized families, but this grief gave way to hope which began to motivate mothers towards change. To facilitate leaving, mothers needed to plan as prioritizing the least amount of upheaval and disadvantage for their child(ren). For mothers, planning to leave meant that social determinants of health had to be prioritized, as attaining them all was not possible. In this planning mothers prioritized safety for their children above all else. Once the mental shift was done and planning underway, mothers described the moment of deciding to leave. For some mothers this was a singular violent event, one that endangered their child(ren), for others it was culmination of events that led mothers to realize that the cost of the relationship was outweighing the benefits.\u003c/p\u003e \u003cp\u003eMothers in this study described mental shifts and associated of process grief leading to hope as a precursor to turning points. The understanding of the important role of these mental shifts is in line with the work by Secco et al. (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) understanding of awakened maternal identity and Dziewa \u0026amp; Glowacz (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) that found women leaving abusive relationships had a change in perception of the relationship, as they identified it as abusive, and they no longer being willing to normalize abuse. However, unique to this study was that the mental shift mothers underwent was influenced by their children and stemmed from actual or perceived risk to their children.\u003c/p\u003e \u003cp\u003eFurther this study explored the emotional process of grief shifting to hope that mothers went through within their mental shift. While this grief and sense of profound loss are common in divorce studies among families where abuse is absent (Venta \u0026amp; Walker, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Crosby et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Understanding this emotional process in the context of abusive relationships is important and often overlooked. With the well-established stigma associated with breaking up a family unit (Rosenberg, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), mothers in abusive relationships have additional layers of complexity to contend with when deciding to leave. However, unique to this study was that grief made space for hope - a hope by mothers for a better life.\u003c/p\u003e \u003cp\u003eOnce mothers had experienced a mental shift, planning to leave began. Ford-Gilboe and colleagues (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2005\u003c/span\u003e) described the importance of planning and positioning for the future after leaving an abusive relationship. This work was built on by Bermea et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) who reported that preparation was a distinct phase within the leaving process and that mothers engaged in both mental and active preparation to leave. Interestingly, Bermea and colleagues (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) reported that mothers who engaged in active preparation tended to have older children, a finding not consistent with our study, as two of the mothers had young child(ren) and engaged in active preparation (i.e. housing, employment, childcare). However, all mothers in our study disclosed that they were experiencing financial strain, which appeared to hamper their leaving. This may have been related to three mothers in our study working part-time hours, which is associated with lower pay, temporary contracts (i.e., unstable employment), and additional, indirect resource constraints (Garnero, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). For example, part-time employment rarely includes access to benefits like health insurance, resulting in increased out-of-pocket costs. Further, most child(ren) in this study lived with their mother full-time, meaning that mothers had extensive unpaid familial and household labour demands that likely diminished their capacity for full-time employment. It has been established that inaccessible childcare, whether due to a lack of availability or affordability, is a prominent barrier to full-time employment (Garnero, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). In the context of these resourcing constraints, mothers disclosed fearing that their child(ren) would be more disadvantaged if they were to leave than if they were to stay in the abusive relationship. This lack of resources is well-established in violence literature (Moffit et al., 2022; Letourneau et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Mantler et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). These sociocultural factors have been described as important to leaving and turning points for mothers (Barrios et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, unique to this study was an understanding of how mothers prioritized socioculture factors within their planning process, namely that safety of the child(ren) was above all else. Mothers described how the lack of safe resources meant that the turning point resulted in them leaving the abusive relationship and their community.\u003c/p\u003e \u003cp\u003eMothers depicted that the decision to leave that was either brought about a violent act that endangered their child(ren) or a realization that the relationship was over. This is in line with Secco and colleagues (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) awakened maternal identity highlight that a mother\u0026rsquo;s decision to leave was when they realized that the violence impacting at the child(ren). However, unique to this study was that mothers did not described a diminished mothering capacity that precipitated this awakened identity, but rather this identity was influenced by an increased perception of risk to the child(ren).\u003c/p\u003e\n\u003ch3\u003eLimitations and Directions for Future Research\u003c/h3\u003e\n\u003cp\u003eThere are several potential limitations of this study, the most obvious being the small sample size. While this sample was sufficient and in line with previous descriptive case studies, case studies are not sufficient to set policy directions; however, case studies do offer insights which provide catalysts for further research. The reliance on purposive sampling is also a limitation of this study. Specifically, mothers in this study had all left the abusive relationship as a result of their turning point, meaning only these experiences were captured. It is possible that there are women who have experienced turning points but have decided to stay, and these experiences were not captured in this study. Moreover, the act of volunteering for the study means our sample is biased in that the turning points were sufficient for mothers to have left the relationship (Magnani et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). Future research should explore impediments to turning points and leaving in the sample of women still in abusive relationships. A third limitation of this study is the lack of variability in sample demographics, as this sample was mostly Caucasian, and all experienced high levels of financial strain, had college/university level education, and had left heterosexual relationships.\u003c/p\u003e \u003cp\u003eDespite the small sample size, considerations for future inquiry are encouraged to continue to analyze the accumulation of turning points rather than approaching the concept from an incident only standpoint. Additional research should ensure a more diverse sample with participants from different backgrounds, socio-economic statuses, and geographic locations are included to ensure this body of literature is built encompassing a variety viewpoints and factors that influence turning points.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis post-hoc secondary analysis case study explored turning points among mothers highlighting that this is a process that begins with mental shifts stemming from the perception of increased risk to their child(ren), which leads to mothers grieving the loss of their idealized family and in turn, hope which motivates them towards creating a better future. Mothers discussed how they planned to leave, with their children\u0026rsquo;s safety being of the utmost priority and then how the ultimate decision to leave was when they realized that the relationship is over. This turning point can either be the culmination of many events or a singular violent event wherein the child(ren) were endangered. This study begins to fill the gap of how motherhood is a turning point aligning with Secco et al.\u0026rsquo;s (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) understanding of awakened maternal identity which underscores an increased sense of mothering responsibility as well as Barrios et al., (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) understanding of individual and sociocultural factors influencing turning points among women. However, this study expands on Secco and colleagues (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) understanding as for some mothers there was not a diminished-maternal identity driving the turning point, but rather the fear of risk to their child(ren) and/or hoping for a better future that instigated leaving. This case study further highlighted how mothers create hierarchy within sociocultural factors, which impacts their planning and leaving of abusive relationships.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eCompeting Interests\u003c/h2\u003e \u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eContributions\u003c/h2\u003e \u003cp\u003eAuthors TM, KTJ, and PT contributed to the study conception and design. Material preparation, data collection and analysis were performed by TM, KTJ, PT, and CAD. The first draft of the manuscript was written by TM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis study was funded by the Children\u0026rsquo;s Health Research Institute\u0026rsquo;s Internal Research Grant Fund (2021).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAuthors TM, KTJ, and PT contributed to the study conception and design. Material preparation, data collection and analysis were performed by TM, KTJ, PT, and CAD. The first draft of the manuscript was written by TM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data of this study are not available due to the nature of this research (participants did not provide consent).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBarrios, V. R., Khaw, L. B. 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Newbury Park, CA: SAGE Publications, Inc.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSociodemographic Characteristics of Participants\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003eParticipant Characteristics\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003eAge (in years) of mothers, \u003cem\u003eM\u003c/em\u003e (\u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e36.40 (8.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003eAge (in years) of children, \u003cem\u003eM\u003c/em\u003e (\u003cem\u003eSD\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e12.30 (8.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eGender of children\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Female\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e80.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eNumber of children\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;One\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e40.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Two\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Three\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e40.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eLiving situation of children\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; Full-time with mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e66.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Part-time with mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e11.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Independently\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e22.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eType of housing\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;House\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e60.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Apartment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Women\u0026rsquo;s shelter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Common Law\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e60.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Separated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Single\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eCommunity type\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Urban\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e60.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Rural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e40.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eHighest education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;University degree\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;College degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e80.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eSexual orientation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Heterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e80.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Bisexual\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eEmployment status\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Employed full-time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Employed part-time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e60.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Employed (did not specify type)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eHousehold annual income\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026lt; $30,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;$60,000 - $79,999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e40.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;$80,000 - $110,999\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eFinancial strain\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Very strained\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e60.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"57.40432612312812%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Somewhat strained\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.795341098169718%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.800332778702163%\" valign=\"top\"\u003e\n \u003cp\u003e40.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"turning points, intimate partner violence, mothers, decision-making, case study","lastPublishedDoi":"10.21203/rs.3.rs-4485527/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4485527/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e Intimate partner violence (IPV) – a global, pervasive, and significant public health concern – is a form of gender-based violence. Approximately one third of women in Canada experience IPV. With well-established negative health and psychosocial impacts of violence on mothers and their children, mothers’ decision to leave an abusive relationship is an important area of study. It has been suggested that there are ‘turning points’, events that initiate or precede the leaving process,in motherhood which are influenced by an awakened maternal identity as well as variable individual and sociocultural factors. Given that these factors are not well understood in the Canadian context, this study aimed to address the question, “How do Ontario mothers who have experienced IPV describe turning points”?\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Nested within a larger, mixed-methods study, this post-hoc case study was grounded in Secco et al.’s (2016) understanding of awakened maternal identity and involved in-depth interviews with five mothers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003eThree distinct but interrelated themes emerged, including the mental shifts stemming from increased risk to the child(ren), planning to leave and prioritizing what is needed to ensure the safety of the child(ren), and the decision to leave which was made when mothers perceived the relationship to be over either as a result of culmination of events or a singular event that endangered the child(ren).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Mothers are faced with complex and challenging decisions around leaving abusive relationships, but ultimately are driven by doing what was best for their children. The findings from this study add to a small, but important body of knowledge around the experiences of mothers facing IPV in Ontario, Canada.\u003c/p\u003e","manuscriptTitle":" “I need to change something before I drown”: Experiences Related to Turning Points in Leaving Abusive Relationships among Mothers in Ontario, Canada ","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-11 07:00:18","doi":"10.21203/rs.3.rs-4485527/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9ffa5d96-ad2a-40c9-a213-f68928104945","owner":[],"postedDate":"July 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-28T14:39:33+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-11 07:00:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4485527","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4485527","identity":"rs-4485527","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}