Abstract
BackgroundIntimate partner violence (IPV) is a major public health problem with serious consequences for women’s physical, mental, sexual and reproductive health. Reproductive health outcomes such as unwanted and terminated pregnancies, fetal loss or child loss during infancy, non-use of family planning methods, and high fertility are increasingly recognized. However, little is known about the role of community influences on women's experience of IPV and its effect on terminated pregnancy, given the increased awareness of IPV being a product of social context. This study sought to examine the role of community-level norms and characteristics in the association between IPV and terminated pregnancy in Nigeria.MethodsMultilevel logistic regression analyses were performed on nationally-representative cross-sectional data including 19,226 women aged 15–49 years in Nigeria. Data were collected by a stratified two-stage sampling technique, with 888 primary sampling units (PSUs) selected in the first sampling stage, and 7,864 households selected through probability sampling in the second sampling stage.ResultsWomen who had experienced physical IPV, sexual IPV, and any IPV were more likely to have terminated a pregnancy compared to women who had not experienced these IPV types.IPV types were significantly associated with factors reflecting relationship control, relationship inequalities, and socio-demographic characteristics. Characteristics of the women aggregated at the community level (mean education, justifying wife beating, mean age at first marriage, and contraceptive use) were significantly associated with IPV types and terminated pregnancy.ConclusionFindings indicate the role of community influence in the association between IPV-exposure and terminated pregnancy, and stress the need for screening women seeking abortions for a history of abuse.
Highlights
The use of “any acts of physical, sexual or emotional abuse by a current or former partner whether cohabitating or not” is commonly referred to as intimate partner violence (IPV) [15]
We provide evidence of the role of community-level factors associated with terminated pregnancy - a subject that is difficult to study in contexts where abortion is severely restricted by law
Association between IPV types and explanatory factors All the IPV types were significantly associated with factors reflecting relationship control, such as having a husband/partner who exhibited controlling behaviour compared to husband/partner without controlling behaviour, justifying wife beating compared to not justifying wife beating, and decision-making autonomy compared to not having decision-making autonomy
Summary
The use of “any acts of physical, sexual or emotional abuse by a current or former partner whether cohabitating or not” is commonly referred to as intimate partner violence (IPV) [15]. Reproductive health outcomes associated with IPV include unwanted and terminated pregnancies, fetal loss, non-use of family planning methods, and high fertility [16,17,18,19,20]. Intimate partner violence (IPV) is a major public health problem with serious consequences for women’s physical, mental, sexual and reproductive health. Reproductive health outcomes such as unwanted and terminated pregnancies, fetal loss or child loss during infancy, non-use of family planning methods, and high fertility are increasingly recognized. This study sought to examine the role of community-level norms and characteristics in the association between IPV and terminated pregnancy in Nigeria. Studies have consistently shown that the high rates of terminated pregnancies reflect high levels of unintended pregnancies [1,6]; out of the estimated 6.8 million pregnancies occurring yearly in Nigeria, one in five is unplanned, with half of these ending in induced abortion [1]
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