Background: In Sweden, domestic violence shelters have served as a safe haven for abused women since the late 1970s when non-profit women's shelters were established for women escaping domestic violence. In those days, such sheltered accommodations received abused women without administrative decision. However, this changed when the protection and support of abused women became a municipal responsibility and domestic violence shelters were regulated by Swedish regulations and guidelines.  Presently, a shelter stay is granted by the social services subsequent to investigation and risk assessment. The actual implementation of the intervention is then referred to a women's shelter, or to a private or municipal shelter, which nowadays is regulated by the Social Services Act and its quality and safety requirements. Studies show that the status of women's shelters as social service providers has led to professionalisation of their activities. In addition, the number of private shelters has increased. Domestic violence shelters, in other words, are undergoing a process of institutionalisation and marketisation. Our knowledge of what this entails for abused women is, to date, limited. The aim of the study is to explore how abused women's experiences of and access to protection and support are taking shape within the institutional shelter system. 

Methods: This is a qualitative interview study involving ten women from various parts of Sweden who had been placed in shelters because of domestic violence. The analysis is based on Dorothy E. Smith's concept of work in her institutional ethnography approach, which encompasses women's physical, mental, emotional and linguistic activities. 

Findings: The women's activities to get access to protection and support before, during and after their stay in domestic violence shelters are referred to as survival work. Results show that the women navigated between different actors and officials before being placed in a shelter. For some women the survival work involved finding a guide to social services. For others, it involved navigating in the specialised and fragmented organisation of the social services, which was experienced as contradictory because different units made different assessments of their needs of protection. Once in a shelter, the women worked on making sense of the safety rules of the shelter, but also on autonomy and freedom, for the purpose of bridging the restrictions of safety rules without jeopardising the protection provided by the shelter. During the shelter stay, they also worked on getting access to psychosocial support, the organisation of which made it unattainable. The pursuit of support continued after leaving the shelter, but now involving access to counselling to cope with the effects of violence. In addition, survival work included protecting themselves from further violence and finding permanent housing without the help of the social services.  

Conclusions and implications: The result of the study demonstrates that the institutional shelter system fails to meet the needs of abused women. This insight can serve as a basis for making protection and support more accessible to women in domestic violence shelters.