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Intimate partner violence and unwanted pregnancy, miscarriage, induced abortion, and stillbirth among a national sample of Bangladeshi women.

Silverman JG, Gupta J, Decker MR, Kapur N, Raj A

Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA 02115, USA. jsilverm@hsph.harvard.edu

OBJECTIVE: To estimate (1) lifetime prevalence of physical and sexual victimisation from husbands among a national sample of Bangladeshi women, (2) associations of unwanted pregnancy and experiences of husband violence, and (3) associations of miscarriage, induced abortion, and fetal death/stillbirth and such victimisation. DESIGN: Cross-sectional, nationally representative study utilizing matched husband-wife data from the 2004 MEASURE Bangladesh Demographic Health Survey. SETTING: Bangladesh. POPULATION: Married Bangladeshi women ages 13-40 years old (n = 2677). METHODS: Bivariate and multivariate logistic regression analysis. MAIN OUTCOME MEASURES: Relations of intimate partner violence to unwanted pregnancy, miscarriage, induced abortion and stillbirth. RESULTS: Three out of four (75.6%) Bangladeshi women experienced violence from husbands. Less educated, poorer, and Muslim women were at greatest risk. Women experiencing violence from husbands were more likely to report both unwanted pregnancy (ORs(adj) 1.46-1.54) and a pregnancy loss in the form of miscarriage, induced abortion, or stillbirth (ORs(adj) 1.43-1.69). Assessed individually, miscarriage was more likely among victimised women (OR(adj) 1.81). A nonsignificant trend was detected for increased risk of induced abortion (OR(adj) 1.64); stillbirth was unrelated to violence from husbands. CONCLUSION: Intimate partner violence is extremely prevalent and relates to unwanted pregnancy and higher rates of pregnancy loss or termination, particularly miscarriages, among Bangladeshi women. Investigation of mechanisms responsible for these associations will be critical to developing interventions to improve maternal, fetal, and neonatal health. Such programmes may be vital to reducing the significant health and social costs associated with both husband violence and unwanted and adverse pregnancy outcomes.

Published 19 September 2007 in BJOG, 114(10): 1246-52.
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