Abstract
BackgroundReducing 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.MethodsA 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.ResultsOver 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).ConclusionsThe 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.
Highlights
Reducing neonatal mortality is a global priority, and improvements in postnatal health (PNH) practices in India are needed to do so
Research from India indicates physical and sexual Intimate partner violence (IPV) history is associated with not using contraception postpartum [23]. Despite this evidence linking IPV and a subset of PNH practices, we found no published research from India or globally that was specific to key PNH practices beyond breastfeeding and contraceptive use, such as clean cord care, kangaroo mother care, and delayed bathing of newborns [28, 30,31,32]
The current study aims to elucidate the relationship between IPV, when a woman has experienced physical violence only, sexual violence only, or both forms of violence, and PNH practices among a representative sample of mothers of living infants in Bihar, India
Summary
Reducing neonatal mortality is a global priority, and improvements in postnatal health (PNH) practices in India are needed to do so. Boyce et al BMC Pregnancy and Childbirth (2017) 17:398 rate is 28 per 1000 live births, national programs to strengthen maternal and neonatal health services have likely contributed to reducing the neonatal mortality rate by half over the last 15 years, yet low rates of healthy PNH practices persist, likely inhibiting further improvement [10,11,12,13]. Intimate partner violence (IPV), a human rights violation faced by more than one in three married women in India and two in five married women in Bihar, has been documented to play an important role in maternal and infant health in India and other national contexts, and may have important implications for PNH practices [11, 17,18,19,20].
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