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. 2020 May 14;15(5):e0232079.
doi: 10.1371/journal.pone.0232079. eCollection 2020.

Associations between recent intimate partner violence and receipt and quality of perinatal health services in Uttar Pradesh

Jay G Silverman  1 , Ruvani W Fonseka  1 , Nabamallika Dehingia  1 , Sabrina C Boyce  1 , Dharmendra Chandurkar  2 , Kultar Singh  2 , Katherine Hay  3 , Yamini Atmavilas  4 , Anita Raj  1
Affiliations

Associations between recent intimate partner violence and receipt and quality of perinatal health services in Uttar Pradesh

Jay G Silverman et al. PLoS One. .

Abstract

Background: India suffers some of the highest maternal and neonatal mortality rates in the world. Intimate partner violence (IPV) can be a barrier to utilization of perinatal care, and has been associated with poor maternal and neonatal health outcomes. However, studies that assess the relationship between IPV and perinatal health care often focus solely on receipt of services, and not the quality of the services received.

Methods and findings: Data were collected in 2016-2017 from a representative sample of women (15-49yrs) in Uttar Pradesh, India who had given birth within the previous 12 months (N = 5020), including use of perinatal health services and past 12 months experiences of physical and sexual IPV. Multivariate logistic regression models assessed whether physical or sexual IPV were associated with perinatal health service utilization and quality. Reports of IPV were not associated with odds of receiving antenatal care or a health worker home visit during the third trimester, but physical IPV was associated with fewer diagnostic tests during antenatal visits (beta = -0.30), and fewer health topics covered during home visits (beta = -0.44). Recent physical and recent sexual IPV were both associated with decreased odds of institutional delivery (physical IPV AOR 0.65; sexual IPV AOR 0.61), and recent sexual IPV was associated with leaving a delivery facility earlier than recommended (AOR = 1.87). Neither form of IPV was associated with receipt of a postnatal home visit, but recent physical IPV was associated with fewer health topics discussed during such visits (beta = -0.26).

Conclusions: In this study, reduced quantity and quality of perinatal health care were associated with recent IPV experiences. In cases where IPV was not related to care receipt, IPV remained associated with diminished care quality. Additional study to understand the mechanisms underlying associations between IPV and care qualities is required to inform health services.

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Conflict of interest statement

JGS, RWF, ND, SCB and AR received funding from BMGF via Sambodhi Research and Communications Private Limited, where DC and KS are staff and received BMGF funding directly [all funded through #OPP1083531]. DC and KS are employees of Sambodhi Research and Communications Private Limited. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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