In the Women's Health Australia (WHA) study, women from rural and remote areas were more likely than women from urban areas to have ever lived with a violent partner or spouse. Women who had ever experienced domestic violence were significantly less physically and psychologically healthy than women who had never experienced domestic violence. To elaborate on the health and psychosocial impacts of experiencing domestic violence, a qualitative interview study was conducted using a sub-sample of mid-aged women from WHA who had experienced domestic abuse while living in small rural communities, or on isolated properties and who had since left the violent relationship. Of the 28 women who took part, 17 had lived in a rural or remote community for at least a proportion of the violent relationship. The semi-structured telephone interviews focussed on the impact of domestic abuse on health, and psychosocial factors that were perceived to improve or harm health. Results of the qualitative interviews indicate that most women experienced a decline in their physical health, and all of them experienced decreased emotional well-being. The major themes that emerged for women from rural and remote areas included: - Privacy and confidentiality - 'Small town gossip' - Poor access to confidential services, particularly counselling services - Responses of health workers - Poor access to friends/family - Isolation - Demanding responsibilities related to working on a property Conclusions: Issues of privacy and confidentially are key issues for abused women in rural and remote communities. All of the women said that the one thing that would have helped them during their abusive relationship would have been having someone to talk to, supporting abundant research on the importance of social support. However, women who have lived with an abusive partner often have difficulty with trusting people, and assurances of confidentiality were disbelieved by some of the women. Therefore, it is recommended that providing access to confidential counselling and mental health services in rural and remote areas is a pressing issue. To address privacy and confidentiality concerns, the feasibility of providing counselling services by people who do not live in the towns that they service should be investigated.