Prevalence and evolution of intimate partner violence before and during pregnancy: a cross-sectional study

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Abstract

Background

Intimate partner violence (IPV) before and during pregnancy is associated with a broad range of adverse health outcomes. Describing the extent and the evolution of IPV is a crucial step in developing interventions to reduce the health impact of IPV.

The objectives are to study the prevalence of psychological abuse, as well as physical & sexual violence, and to provide insight into the evolution of IPV 12 months before and during pregnancy.

Methods

Between June 2010 and October 2012, a cross-sectional study was conducted in 11 antenatal care clinics in Belgium. Consenting pregnant women were asked to complete a questionnaire (available in Dutch, French and English) in a separate room. Ethical clearance was obtained in all participating hospitals.

Results

The overall percentage of IPV was 14.3% (95% CI: 12.7 - 16.0) 12 months before pregnancy and 10.6% (95% CI: 9.2 - 12.1) during pregnancy. Physical partner violence before as well as during pregnancy was reported by 2.5% (95% CI: 1.7 - 3.3) of the respondents (n = 1894), sexual violence by 0.9% (95% CI 0.5 - 1.4), and psychological abuse by 14.9% (95% CI: 13.3 - 16.7). Risk factors identified for IPV were being single or divorced, having a low level of education, and choosing another language than Dutch to fill out the questionnaire. The adjusted analysis showed that physical partner violence (aOR 0.35, 95% CI: 0.22 - 0.56) and psychological partner abuse (aOR 0.7, 95% CI: 0.63 - 0.79) were significantly lower during pregnancy compared to the period of 12 months before pregnancy. The difference between both time periods is greater for physical partner violence (65%) compared to psychological partner abuse (30%). The analysis of the frequency data showed a similarly significant evolution for physical partner violence and psychological partner abuse, but not for sexual violence.

Conclusion

The IPV prevalence rates in our study are slightly lower than what can be found in other Western studies, but even so IPV is to be considered a prevalent problem before and during pregnancy. We found evidence, however, that physical partner violence and psychological partner abuse are significantly lower during pregnancy.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2393-14-294) contains supplementary material, which is available to authorized users.

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Most cited references 64

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Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review.

Jane Fisher, Meena Cabral de Mello, Vikram Patel … (2012)

To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4-15.9) antenatally and 19.8% (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3-0.9). CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.

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Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries.

Karen M Devries, Sunita Kishor, Holly Johnson … (2010)

We aimed to describe the prevalence of intimate partner violence (IPV) during pregnancy across 19 countries, and examine trends across age groups and UN regions. We conducted a secondary analysis of data from the Demographic and Health Surveys (20 surveys from 15 countries) and the International Violence Against Women Surveys (4 surveys from 4 countries) carried out between 1998 and 2007. Our data suggest that intimate partner violence during a pregnancy is a common experience. The prevalence of IPV during pregnancy ranged from approximately 2.0% in Australia, Cambodia, Denmark and the Philippines to 13.5% in Uganda among ever-pregnant, ever-partnered women; half of the surveys estimated prevalence to be between 3.9 and 8.7%. Prevalence appeared to be higher in African and Latin American countries relative to the European and Asian countries surveyed. In most settings, prevalence was relatively constant in the younger age groups (age 15-35), and then appeared to decline very slightly after age 35. Intimate partner violence during pregnancy is more common than some maternal health conditions routinely screened for in antenatal care. Global initiatives to reduce maternal mortality and improve maternal health must devote increased attention to violence against women, particularly violence during pregnancy. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

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A Systematic Review of African Studies on Intimate Partner Violence against Pregnant Women: Prevalence and Risk Factors

Simukai Shamu, Naeemah Abrahams, Marleen Temmerman … (2011)

Background Intimate partner violence (IPV) is very high in Africa. However, information obtained from the increasing number of African studies on IPV among pregnant women has not been scientifically analyzed. This paper presents a systematic review summing up the evidence from African studies on IPV prevalence and risk factors among pregnant women. Methods A key-word defined search of various electronic databases, specific journals and reference lists on IPV prevalence and risk factors during pregnancy resulted in 19 peer-reviewed journal articles which matched our inclusion criteria. Quantitative articles about pregnant women from Africa published in English between 2000 and 2010 were reviewed. At least two reviewers assessed each paper for quality and content. We conducted meta-analysis of prevalence data and reported odds ratios of risk factors. Results The prevalence of IPV during pregnancy ranges from 2% to 57% (n = 13 studies) with meta-analysis yielding an overall prevalence of 15.23% (95% CI: 14.38 to 16.08%). After adjustment for known confounders, five studies retained significant associations between HIV and IPV during pregnancy (OR1.48–3.10). Five studies demonstrated strong evidence that a history of violence is significantly associated with IPV in pregnancy and alcohol abuse by a partner also increases a woman's chances of being abused during pregnancy (OR 2.89–11.60). Other risk factors include risky sexual behaviours, low socioeconomic status and young age. Conclusion The prevalence of IPV among pregnant women in Africa is one of the highest reported globally. The major risk factors included HIV infection, history of violence and alcohol and drug use. This evidence points to the importance of further research to both better understand IPV during pregnancy and feed into interventions in reproductive health services to prevent and minimize the impact of such violence.

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Author and article information

Contributors

An-Sofie Van Parys: ansofie.vanparys@ugent.be

Ellen Deschepper: ellen.deschepper@ugent.be

Kristien Michielsen: kristien.michielsen@ugent.be

Marleen Temmerman: marleen.temmerman@ugent.be

Hans Verstraelen: hans.verstraelen@ugent.be

Journal

Journal ID (nlm-ta): BMC Pregnancy Childbirth

Journal ID (iso-abbrev): BMC Pregnancy Childbirth

Title: BMC Pregnancy and Childbirth

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2393

Publication date (Electronic): 28 August 2014

Publication date PMC-release: 28 August 2014

Publication date Collection: 2014

Volume: 14

Issue: 1

Electronic Location Identifier: 294

Affiliations

[ ]Faculty of Medicine and Health Sciences, Department of Obstetrics and Gynaecology, Ghent University, International Centre for Reproductive Health, Belgium, De Pintelaan 185, UZP 114, 9000 Gent, Belgium

[ ]Faculty of Medicine and Health Sciences, Department of Public Health, Biostatistics Unit, Ghent University, De Pintelaan 185, 4K3, 9000 Gent, Belgium

Article

Publisher ID: 1167

DOI: 10.1186/1471-2393-14-294

PMC ID: 4159505

PubMed ID: 25169813

SO-VID: 0ad03341-06ab-4331-bac1-db9aba9ee338

License:

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 17 March 2014

Date accepted : 19 August 2014

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: intimate partner violence,abuse,pregnancy,prevalence,evolution,pattern

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: intimate partner violence, abuse, pregnancy, prevalence, evolution, pattern

Prevalence and evolution of intimate partner violence before and during pregnancy: a cross-sectional study

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Most cited references 64

Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review.

Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries.

A Systematic Review of African Studies on Intimate Partner Violence against Pregnant Women: Prevalence and Risk Factors

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