Association between domestic violence and unintended, terminated pregnancy and complications during pregnancy among Indian women: Findings from nationally representative survey

Premkumar Ramasubramani; Yuvaraj Krishnamoorthy; Karthika Ganesh; Lalithambigai Kathiresan; Vinodhini Kadir

doi:10.1016/j.heliyon.2024.e27158

Association between domestic violence and unintended, terminated pregnancy and complications during pregnancy among Indian women: Findings from nationally representative survey

Heliyon. 2024 Feb 27;10(5):e27158. doi: 10.1016/j.heliyon.2024.e27158. eCollection 2024 Mar 15.

Authors

Premkumar Ramasubramani¹, Yuvaraj Krishnamoorthy², Karthika Ganesh³, Lalithambigai Kathiresan⁴, Vinodhini Kadir⁵

Affiliations

¹ Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.
² PROPUL Evidence Synthesis Unit (PROPUL ESU), PROPUL (Partnership for Research Opportunity Planning Upskilling and Leadership) Evidence, Chennai, Tamilnadu, India.
³ Department of Community Medicine, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, India.
⁴ Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India.
⁵ Department of Obstetrics and Gynaecology, AIIMS, Bhubaneshwar, Odissa, India.

Abstract

Background: Women experiencing domestic violence might have restrictions in the pregnancy-related decision-making and care-seeking process leading to adverse pregnancy outcomes. We explored the association between domestic violence and undesirable pregnancy events.

Methods: 63,796 women aged 18-49 years covered under the domestic violence module of National Family Health Survey-5, 2019-21. Stratification and clustering in the complex sampling design of the survey were accounted in analysis. Using Poisson regression, prevalence ratio (PR) was reported to provide association of domestic violence with undesirable pregnancy events.

Results: Prevalence of undesirable pregnancy events was 25.0% (95%CI: 24.4%-25.7%) amongst women aged 18-49 years. Prevalence of unintended, terminated pregnancy and complications during pregnancy was 3.2%, 5.1% and 20.9%, respectively. Women aged ≥35 years, educated, unemployed, primi or multi parity, intimate partner/husband being uneducated, facing problem with access to healthcare, belonging to large number of household members (≥4) and poorest or poorer quintile had significantly higher chance of having undesirable pregnancy events. Sexual violence (aPR: 1.11, p = 0.02) had higher chance of having undesirable pregnancy events.

Conclusion: One-fourth of reproductive-age group women had undesirable pregnancy events. Sexual violence was significantly associated with these events. Effective policy should protect women from domestic violence to promote maternal well-being.

Keywords: Gender-based violence; Low- and Middle-Income country; National survey data; Physical abuse; Pregnancy outcome; Secondary analysis; South East Asian region; Spatial distribution; Spouse abuse; Unwanted pregnancy.