Background India contends with a high rate of intimate partner violence (IPV), which is associated with unintended pregnancy and reflects low levels of women’s decision-making control in relation to their reproductive health. Few studies from South Asia have examined the relationship between pregnancy decision-making, IPV and unintended pregnancy.
Aim This study examined associations between unintended (mistimed and unwanted) pregnancy, women’s reports of pregnancy decided externally by husband or in-laws, and IPV, among a sample of married, postpartum women.
Methods Data from the ‘Mechanisms for Relations of Domestic Violence to Poor Maternal and Infant Health in India’ study were analysed. Descriptive comparisons between levels of unintended pregnancy were run on all major variables. Unadjusted and adjusted multinomial logistic regression analyses assessed women’s reports of having externally-decided pregnancies and IPV victimisation in the year prior to pregnancy as factors in mistimed and unwanted pregnancies.
Results Mistimed and unwanted pregnancies were reported by 12.2% and 7.2% of women, respectively. Externally-decided pregnancies were reported by 8.8% of women. Some 29.4% of women reported experiencing physical and/or sexual IPV in the year prior to pregnancy. Women reporting externally-decided pregnancies were significantly more likely to have had mistimed pregnancies than intended pregnancies, as were women reporting IPV. Neither external pregnancy control nor IPV were associated with unwanted pregnancy.
Conclusions Women’s exclusion from pregnancy decision-making and violence from husbands relate to their ability to time their pregnancies as they wish. The lack of significant association between external decision-making and IPV with unwanted pregnancy may be due to low reporting of unwanted pregnancy. The overall findings highlight the importance of integrating women’s involvement in reproductive health decision-making and IPV reduction messaging in programming for the women’s health sector.
- intimate partner violence
- unintended pregnancy
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Contributors AD is responsible for the overall content of the manuscript; AD led conceptualisation, implementation of the current analysis, and writing of results from the analysis for this manuscript. AR and JS supported conceptualisation and planning of the analysis, and writing of the manuscript. SN, DDN, NS and BD all provided substantial contributions to the writing of this manuscript.
Funding The authors wish to acknowledge the following funding agencies: the US National Institute on Drug Abuse (T32DA023356; PI: S.Strathdee; T32DA037801; PIs: N.El-Bassel, L.Metsch), and the US Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Indian Council on Medical Research Indo-US Program on Maternal and Child Health and Human Development (R03HD055120; PIs: J.Silverman, B.Donta).
Competing interests None declared.
Patient consent Not required.
Ethics approval Harvard School of Public Health, and National Institute for Research on Reproductive Health.
Provenance and peer review Not commissioned; externally peer reviewed.
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