Intimate partner violence in pregnancy: a cross-sectional study from post-conflict northern Uganda

Abstract

ObjectivesTo determine the prevalence of intimate partner violence (IPV) in pregnancy and to understand associations and determinants.DesignCross-sectional survey.SettingTwo rural health clinics in post-conflict northern Uganda.ParticipantsWomen attending two rural health clinics for a new service providing cervical cancer screening, who had experienced pregnancy.Primary and secondary outcome measuresData were collected by a questionnaire using validated questions from the demographic health survey women’s questionnaire and the domestic violence module. Data were entered into tablets using Questionnaire Development System software. Bivariate and multivariate logistic regression was performed, using experience of IPV in pregnancy as the dependent variable. SPSS V.25 was used for all analysis.ResultsOf 409 participant women, 26.7% (95% CI 18.6% to 35.9%) reported having been slapped, hit or beaten by a partner while pregnant. For 32.3% (95% CI 20.2% to 37.9%) of the women the violence became worse during pregnancy. Women who had ever experienced IPV in pregnancy were more likely to have experienced violence in the previous 12 months (OR 4.45, 95% CI 2.80 to 7.09). In multivariate logistic regression, the strongest independent associations with IPV in pregnancy were partner’s daily drinking of alcohol (OR 2.02, 95% CI 1.19 to 3.43) and controlling behaviours (OR 1.17, 95% CI 1.03 to 1.33).ConclusionsThe women in this study had more exposure to IPV in pregnancy than previously reported for this region. Women’s previous experience of intimate partner violence, partner’s daily use of alcohol and his controlling behaviours were strong associations with IPV in pregnancy. This study highlights the uneven distribution of risk and the importance of research among the most vulnerable population in rural and disadvantaged settings. More research is needed in local rural and urban settings to illuminate this result and inform intervention and policy.

Exploring the impact of a community participatory intervention on women's capability: a qualitative study in Gulu Northern Uganda

“…As a result of the post-conflict situation, Gulu region has a high prevalence of intimate partner violence [ 29 , 30 ]. Women discussed domestic violence, its root causes, and its consequences during their group meetings.…”

Prevalence of Intimate Partner Violence Among Intimate Partners During the Perinatal Period: A Narrative Literature Review

“…At the community level , factors relating to the extended family, family's residency, and the nature of marriage are explored and included. Pregnant women being related to their husbands more distantly, as well as their less frequent communication with their natal family ( 43 ) were found to be a significant factor for increasing IPV. Living in rural areas ( 35 , 68 ) such as tea plantation sectors in Sri Lanka ( 91 ), and lack of social support ( 92 , 98 , 104 ) were found to increase the odds of experiencing IPV.…”

“…At the individual level , risk factors were either related to victims or perpetrators of IPV. Victim-related factors such as pregnant women's lower education ( 30 , 32 , 34 , 36 , 43 , 51 , 54 , 63 , 95 , 98 , 112 , 113 ), younger age ( 35 , 36 , 51 , 53 , 64 , 72 , 76 , 92 ), unemployment ( 52 , 53 , 72 , 98 ), or being self-employed ( 62 ), marital status ( 30 , 38 , 53 , 64 ), mental health issues ( 34 , 38 ), alcohol use ( 38 ), drug use ( 64 , 77 ), having previous experience of IPV ( 92 , 103 , 110 ), and having witnessed or been a victim of physical violence during childhood ( 34 , 43 , 54 , 55 , 64 , 76 , 77 , 98 , 100 ) were all associated with higher victimization of IPV. Inappropriate utilization of prenatal care services for pregnant women ( 40 ) constituted another significant association, whereas early initiation of antenatal care could be considered a protective factor ( 35 ).…”

“…Moreover, dowry demand ( 67 , 98 ), low ability for decision-making as well as low self-esteem ( 68 , 97 ) were also associated with increased risk for IPV. Perpetrator-related factors related to IPV included perpetrator's younger age ( 34 , 78 , 96 , 103 , 104 ), lower education ( 35 , 50 , 57 , 97 , 104 ), substance use, including alcohol ( 34 – 36 , 43 , 44 , 51 , 52 , 68 , 77 , 78 , 96 , 98 , 103 , 104 , 112 , 113 ), unemployment ( 34 , 50 , 57 , 59 , 72 , 112 ), and having witnessed or been a victim of physical violence during childhood ( 100 ).…”

“…Pregnant women with a certain ethnicity such as being Jewish women of Sephardic descent, ( 57 ), being non-Caucasian ( 30 , 33 ), with an immigrant status ( 30 ), being HIV-positive ( 48 , 49 ) and having an HIV-positive child ( 48 ), or belonging to a certain religion, i.e., Catholic, Muslim, or Hindu ( 56 , 59 , 91 ), as well as endorsing a higher degree of religiosity (religious vs. non-religious) were at higher risk for IPV ( 57 ). Studies found that women who endorsed violence supporting attitude were also at risk for experiencing IPV ( 43 , 52 , 77 , 104 ).…”