Associations between recent intimate partner violence and receipt and quality of perinatal health services in Uttar Pradesh (original) (raw)
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Associations of intimate partner violence with postnatal health practices in Bihar, India
BMC Pregnancy and Childbirth, 2017
Background: Reducing neonatal mortality is a global priority, and improvements in postnatal health (PNH) practices in India are needed to do so. Intimate partner violence (IPV) may be associated with PNH practices, but little research has assessed this relationship. Methods: A cross-sectional analysis of data from a representative household sample of mothers of neonates 0-11 months old in Bihar, India was conducted. The relationship between lifetime IPV experience (physical violence only, sexual violence only, or both physical and sexual violence) and PNH practices [clean cord care, kangaroo mother care, early initiation of breastfeeding (EIBF), delayed bathing, receipt of a postnatal care visit, exclusive breastfeeding, and current post-partum contraceptive use] was assessed using multivariate logistic regression. Results: Over 45% of the 10,469 mothers experienced IPV in their lifetime. The three types of IPV experiences differentially related to PNH practices. Adjusted analyses revealed that compared to those who had never experienced IPV, women who experienced physical violence only (29.0%) had higher odds of skin-to-skin care (AOR = 1.67, 95% CI = 1.42, 1.96) and delayed bathing (AOR = 1.19, 95% CI = 1.03, 1.37), but lower odds of EIBF (AOR = 0.81, 95% CI = 0.70, 0.93) and exclusive breastfeeding (AOR = 0.83, 95% CI = 0.71, 0.96). Mothers who had experienced sexual violence only (2.3%) had lower odds of practicing EIBF (AOR = 0.52, 95% CI = 0.36, 0.76). Those who had both experiences of physical and sexual violence (14.0%) had increased odds of postpartum modern contraceptive use (AOR = 1.35, 95% CI = 1.07, 1. 71) and lower odds of delayed bathing (AOR = 0.76, 95% CI = 0.63, 0.91). Conclusions: The results of this study found differing patterns of vulnerability to poor PNH practices depending on the type of IPV experienced. Efforts to increase access to health services for women experiencing IPV and to integrate IPV intervention into such service may increase PNH practices, and as a result, reduce neonatal mortality.
Objective: Intimate partner violence (IPV) during pregnancy can have serious health consequences for mothers and newborns. The aim of the study is to explore: 1) the influence of experiencing IPV during pregnancy on delayed entry into prenatal care; and 2) whether women's decision-making autonomy and the support for traditional gender roles act to mediate or moderate the relationship between IPV and delayed entry into prenatal care. Design: cross-sectional survey. Multivariate logistic regression models were estimated that control for various socio-demographic and pregnancy related factors to assess whether women who experienced IPV during pregnancy were more likely to delay entry into prenatal care compared with women who had not experienced IPV. The influence of traditional gender roles acceptance and decision-making autonomy were examined both as independent variables and in interaction with IPV, to assess their role as potential mediators or moderators. Setting: Chandpur district, Bangladesh. Participants: the sample comprised of 426 Bangladeshi women, aged 15–49 years. Postpartum mothers who visited vaccinations centres to receive their children's vaccinations constitute the sampling frame. Results: almost 70% of the women surveyed reported patterns consistent with delayed entry into prenatal care. Accounting for the influence of other covariates, women who experienced physical IPV during pregnancy were 2.61 times more likely (95% CI [1.33, 5.09]) to have delayed entry into prenatal care than their counterparts who did not report physical IPV. Neither sexual nor psychological IPV victimization during pregnancy was linked with late entry into prenatal care. Both gender role attitudes and levels of autonomy mediate the effect of IPV on prenatal care. Key conclusions: the results suggest that the high rates of IPV in Bangladesh have effects that can compromise women's health seeking behaviour during pregnancy, putting them and their developing fetus at risk. Specifically, Bangladeshi women who experience physical IPV during pregnancy are more likely to delay or forgo prenatal care, an effect that is further magnified by cultural ideals that emphasize women's traditional roles and limit their autonomy. Implications for practice: this study reinforces the need to detect and assist women suffering IPV, not only to offer them help and support but also to increase entry into prenatal care. Healthcare professionals involved in obstetrics and midwifery need to be aware of the risk factors of IPV during pregnancy and be able to identify women who are at risk for delayed entry into prenatal care.
A hospital-based study of intimate partner violence during pregnancy
International Journal of Gynecology & Obstetrics, 2017
Objective: Todeterminetheprevalenceandtypesofintimatepartnerviolence(IPV) during pregnancy, factors linked with IPV, and effects of IPV on maternal-fetal outcomes. Methods: In a prospective observational study at a tertiary care hospital in Delhi, India, 400 women at 20-28weeks of pregnancy were screened for IPV between December2013andApril2015.Thewomencompletedadetailedquestionnaireand werefollowedupuntildelivery. Results: Overall, 49 (12.3%) women experienced IPV during pregnancy. The most prevalenttypeofIPVwasemotional(43/400[10.7%]),followedbyphysical(40/400 [10.0%])andsexual(7/400[1.8%]).ThemostprevalentfactortriggeringIPVwasintimatepartner'sdesireforason(17/49[34.7%]).Womenandtheirintimatepartners wereolderintheIPVgroupthaninthecontrolgroup,anddurationofmarriagewas longer(P<0.05forall).Multigravidity,lowersocioeconomicstatus,loweducationlevel of intimate partner, and partners' addiction were more common in the IPV group (P<0.05forall).Obstetricoutcomesweresimilarinbothgroups.Depressionwasdiag-nosedin19(46.3%)womenaffectedbyIPV. Conclusion: IPVwasdocumentedinapproximately12%ofparticipants.Populationbasedsurveysneedtobedonetoinvestigatefurther.
Background: Preterm birth (PTB) is an important and under-reported public health problem in developing nations such as Ethiopia. Limited research has been conducted to date to address the effect of intimate partner violence (IPV) during pregnancy on PTB. This study was conducted to assess the association between IPV during pregnancy and PTB. Methods: A case control study was conducted on 138 cases and 276 controls in four randomly selected public hospitals from February to April 2018. Mothers who gave birth before 37 completed weeks of gestation were included as cases, and mothers who gave birth at 37 and above completed weeks of gestation were deemed as controls. A simple random sampling technique was employed to select the two consecutive controls. Bivariate and multivariate logistic regression analyses were done. Results: In this study, the prevalence of any IPV during pregnancy was 44.8% among cases and 25% among controls. Any IPV during pregnancy was significantly associated with PTB [AOR = 2.85; 95% CI: 1.42-6.22]. In addition, women who were exposed to emotional violence during the recent pregnancy were three times more likely to have a PTB compared to those who were not violated [AOR = 3.05; 95% CI: 1.35-6.91]. Similarly, women who experienced physical IPV during pregnancy were 2.6 times [AOR = 2.56; 95% CI: 1.27-6.78] more at risk of PTB compared to those who had no physical IPV. Conclusion: This study found that IPV during pregnancy is significantly associated with PTB. Hence, IPV screening needs to be integrated into routine antenatal care (ANC) services. [Ethiop.
Intimate Partner Violence During Pregnancy: Maternal and Neonatal Outcomes
Journal of Women's Health, 2015
The effects of intimate partner violence (IPV) on maternal and neonatal outcomes are multifaceted and largely preventable. During pregnancy, there are many opportunities within the current health care system for screening and early intervention during routine prenatal care or during episodic care in a hospital setting. This article describes the effects of IPV on maternal health (e.g., insufficient or inconsistent prenatal care, poor nutrition, inadequate weight gain, substance use, increased prevalence of depression), as well as adverse neonatal outcomes (e.g., low birth weight [LBW]), preterm birth [PTB], and small for gestational age [SGA]) and maternal and neonatal death. Discussion of the mechanisms of action are explored and include: maternal engagement in health behaviors that are considered ''risky,'' including smoking and alcohol and substance use, and new evidence regarding the alteration of the hypothalamic-pituitary-adrenal axis and resulting changes in hormones that may affect LBW and SGA infants and PTB. Clinical recommendations include a commitment for routine screening of IPV in all pregnant women who present for care using validated screening instruments. In addition, the provision of readily accessible prenatal care and the development of a trusting patient-provider relationship are first steps in addressing the problem of IPV in pregnancy. Early trials of targeted interventions such as a nurse-led home visitation program and the Domestic Violence Enhanced Home Visitation Program show promising results. Brief psychobehavioral interventions are also being explored. The approach of universal screening, patient engagement in prenatal care, and targeted individualized interventions has the ability to reduce the adverse effects of IPV and highlight the importance of this complex social disorder as a top priority in maternal and neonatal health.
Indian Journal of Community Medicine, 2020
Context:Violence against women is a major public health problem and a violation of their human rights. Intimate partner violence (IPV) during pregnancy has been linked to various adverse maternal health outcomes and birth outcomes.Aims:The aim of this study is to assess the magnitude of maternal complications and adverse birth outcomes in relation to IPV.Settings and Design:Prospective observational study was conducted from April 2015 to May 2018 in the antenatal clinic of a Tertiary Care Hospital in Delhi.Subjects and Methods:Sample of 1500 pregnant women (≤20 weeks gestation) were recruited and followed up at regular intervals, up to the birth outcome.Statistical Analysis Used:Data were analyzed using the Statistical Package for the Social Sciences version 25. Value of P < 0.05 was considered statistically significant.Results:Prevalence of IPV at baseline was 29.7%. Significantly higher proportion of IPV victims (47.2%) had poor weight gain during the pregnancy. Subjects reporting violence at any of the study contacts had a higher incidence of preterm delivery (12.7%), and a significantly higher incidence of low birth weight in the newborns (32.1% vs 22.3%) (P < 0.05).Conclusions:The findings reveal that IPV during pregnancy is common and significantly associated with adverse maternal and birth outcomes. The findings stress need for research and development of a screening tool to identify violence early in pregnancy and thus prevent its consequences.
Does intimate partner violence influence the utilization of maternal health services?
2019
Background Intimate partner violence [IPV] is public health problem globally and most common in developing countries that affects more than one fourth of women of reproductive age [WRA]. It is more critical during pregnancy. IPV not only affects physical and mental well-being but also leads in birth outcomes with negative consequences. Methods We use secondary data from Nepal Demographic and Health Survey 2016 to assess the association between IPV, and maternal service utilization: ANC visits and institutional delivery. Altogether 1374 WRA were randomly selected. Background characteristics of WRA and IPV were the independent variables, and ANC visits and institutional delivery were the dependent variables. Results Data show that 26 percent of WRA had faced at least one form of IPV, 68 percent had visited health facilities at least four times for ANC check-up during pregnancy, and the rate of institutional delivery was 61 percent. There were association among IPV with ANC visits and ...
Tropical Journal of Obstetrics and Gynaecology, 2021
IPV against women is associated with immediate and long-term adverse health outcomes for women and children, both directly and indirectly. This is particularly worse in the pregnancy where the condition of the woman makes her vulnerable to adverse outcomes. Aims: To assess the prevalence of IPV among pregnant women and determine the factors associated with it. Settings and design: A cross-sectional study carried out between November 2017 and March 2018 among pregnant women attending antenatal clinics in the Southern part of Nigeria. Subjects and Methods: A pre-tested structured questionnaire adapted from the WHO multi-country study on domestic violence was used for interview among the 529 participants. Statistical analysis used: The data were cleaned, coded and analyzed using statistical IBM SPSS Statistics version 21.0. Results: The overall prevalence of IPV during pregnancy was 15.5% with that of physical, sexual, controlling and emotional IPV during pregnancy in this study were 2.1%, 3.6%, 5.1% and 11.9%, respectively. Respondents who had higher education (AOR: 4.428, 95% CI: 1.729-11.342), made less than 4 ANC clinic visits (AOR: 5.543, 95% CI: 2.706-11.352) and those with partners in unskilled occupation (AOR: 3.065, 95% CI: 1.115-8.426) were more likely to experience IPV during pregnancy. In addition, respondents with professional or skilled occupation and those of high social class were less likely to experience IPV during pregnancy, (AOR: 0.476, 95% CI: 0.272-0.833) and (AOR: 0.157, 95% CI: 0.053-0.467), respectively. Conclusions: Our findings underscore the importance of empowering the woman and indeed, the home and improving her social status.