Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 19;15(1):109.
doi: 10.1186/s12978-018-0551-2.

Associations between intimate partner violence and reproductive and maternal health outcomes in Bihar, India: a cross-sectional study

Diva Dhar  1 , Lotus McDougal  2 , Katherine Hay  1 , Yamini Atmavilas  1 , Jay Silverman  2 , Daniel Triplett  2 , Anita Raj  3
Affiliations

Associations between intimate partner violence and reproductive and maternal health outcomes in Bihar, India: a cross-sectional study

Diva Dhar et al. Reprod Health. .

Abstract

Background: Bihar, India has higher rates of intimate partner violence (IPV) and maternal and infant mortality relative to India as a whole. This study assesses whether IPV is associated with poor reproductive and maternal health outcomes, as well as whether poverty exacerbates any observed associations, among women who gave birth in the preceding 23 months in Bihar, India.

Methods: A cross-sectional analysis of data from a representative household sample of mothers of children 0-23 months old in Bihar, India (N = 13,803) was conducted. Associations between lifetime IPV (physical and/or sexual violence) and poor reproductive health outcomes ever (miscarriage, stillbirth, and abortion) as well as maternal complications for the index pregnancy (early and/or prolonged labor complications, other complications during pregnancy or delivery) were assessed using multivariable logistic regression, adjusting for demographics and fertility history of the mother. Models were then stratified by wealth index to determine whether observed associations were stronger for poorer versus wealthier women.

Results: IPV was reported by 45% of women in the sample. A history of miscarriage, stillbirth, and abortion was reported by 8.7, 4.6, and 1.3% of the sample, respectively. More than one in 10 women (10.7%) reported labor complications during the last pregnancy, and 16.3% reported other complications during pregnancy or delivery. Adjusted regressions revealed significant associations between IPV and miscarriage (AOR = 1.35, 95% CI = 1.11-1.65) and stillbirth (AOR = 1.36, 95% CI = 1.02-1.82) ever, as well as with labor complications (AOR = 1.27, 95% CI = 1.04-1.54) and other pregnancy/delivery complications (AOR = 1.68, 95% CI = 1.42-1.99). Women in the poorest quartile (Quartile 1) saw no associations between IPV and miscarriage (Quartile 1 AOR = 0.98, 95% CI = 0.67-1.45) or stillbirth (Quartile 1 AOR = 1.17, 95% CI = 0.69-1.98), whereas women in the higher wealth quartile (Quartile 3) did see associations between IPV and miscarriage (Quartile 3 AOR = 1.55, 95% CI = 1.07, 2.25) and stillbirth (Quartile 3 AOR = 1.79, 95% CI = 1.04, 3.08).

Discussion: IPV is highly prevalent in Bihar and is associated with increased risk for miscarriage, stillbirth, and maternal health complications. Associations between IPV and miscarriage and stillbirth do not hold true for the poorest women, possibly because other risks attached to poverty and deprivation may be greater contributors.

Keywords: Delivery complications; Induced abortion; Intimate partner violence; Miscarriage; Physical abuse; Pregnancy complications; Reproductive health; Sexual abuse; Stillbirth.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for the original Ananya evaluation study was provided by the Screening Committee of Government of India’s Ministry of Health and Family Welfare. Ethical approval for this analysis was provided by the University of California, San Diego (UCSD). Written informed consent was provided prior to any data collection for this study. This information is included in the text of the grant.

Consent for publication

Not Applicable.

Competing interests

The authors declare that they have no competing interests. However, we should note that this study includes authors employed by the Bill and Melinda Gates Foundation (BMGF), the funder of the original evaluation study providing data for this paper and the funder of non-BMGF-based co-authors on this study from the University of California, San Diego.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Garcia-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts CH. Prevalence of intimate partner violence: findings from the WHO multi-country study on women's health and domestic violence. Lancet. 2006;368(9543):1260–1269. doi: 10.1016/S0140-6736(06)69523-8. - DOI - PubMed
    1. Devries KM, Mak JY, Garcia-Moreno C, Petzold M, Child JC, Falder G, Lim S, Bacchus LJ, Engell RE, Rosenfeld L, et al. Global health. The global prevalence of intimate partner violence against women. Science (New York, NY) 2013;340(6140):1527–1528. doi: 10.1126/science.1240937. - DOI - PubMed
    1. Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and nonpartner sexual violence. In. Edited by World Health Organization LSoHaTM, South African Medical Research Council. Geneva, Switzerland: World Health Organization; 2013.
    1. Pallitto CC, Garcia-Moreno C, Jansen HA, Heise L, Ellsberg M, Watts C. Intimate partner violence, abortion, and unintended pregnancy: results from the WHO multi-country study on Women's health and domestic violence. Int J Gynaecol Obstet. 2013;120(1):3–9. doi: 10.1016/j.ijgo.2012.07.003. - DOI - PubMed
    1. Sarkar NN. The impact of intimate partner violence on women's reproductive health and pregnancy outcome. J Obstet Gynaecol. 2008;28(3):266–271. doi: 10.1080/01443610802042415. - DOI - PubMed

MeSH terms