Patterns of Domestic Violence against women during Pregnancy and the Postpartum Period in Kathmandu, Nepal

Abstract

Background: Domestic violence is most pervasive yet underrecognized human rights violation in the world. It is also a profound public health problem which affects anyone irrespective of age, sex, religion, and economic status. All pregnant and postpartum period women are at high risk of developing an unpredictable complication and if they suffered from violence then condition becomes worse. Domestic violence against woman during pregnancy and the postpartum period, not only affects the health of the mother but also to the fetus and child. It is rooted in social norms, socialization practices and structural factors against women in Nepal. This study aims to examine the prevalence and patterns of domestic violence during pregnancy and the postpartum period, determine the association between domestic violence against women and husband’s alcohol consumption across the periods of pregnancy and postpartum and to identify associated factors in a Nepalese society. Methods: A cross-sectional study was conducted in the antenatal care and immunization clinics of Paropakar maternity and women’s hospital in Kathmandu district, Nepal. The study was conducted from December 2017 to March 2018. The sample of the study were all women aged 15-49, who attended antenatal care clinic and immunization clinic to immunized their children from Paropakar maternity and women’s hospital. In each trimester of pregnancy and the postpartum period, 165 women aged 15-49 years were consecutively recruited (660 altogether). Domestic violence information was elicited using a questionnaire adapted from a WHO multicountry study on women’s health and domestic violence and modified some questionnaire after the pilot study. The characteristic of women, their husband and mother-in-law were analyzed using chi square or fisher exact test as appropriate. Multiple logistic regression models were used to identify the associated factors of domestic violence. Results: The overall prevalence of domestic violence among women during pregnancy and the postpartum period was 26.2% (17.6%, 34.5%, 32.7% and 20.0% in the first trimester, second trimester, and third trimester of pregnancy and the postpartum period, respectively). The patterns of domestic violence experienced by women has fluctuated during the period of pregnancy and postpartum. High prevalence of domestic violence was found in the second trimester of pregnancy. Among all types of violence, the most common form experienced by women was sexual violence (16%), followed by psychological violence (15%) and physical violence (9.4%). Women who belong to Janjati ethnicity (AOR= 1.94, CI: 1.22-3.09), whose family preference of new born child gender (AOR= 2, CI: 1.07-3.47), who had a history of domestic violence (AOR= 26.32, CI: 14.86-46.63),whose husbands were illiterate (AOR= 1.77, CI=1.06- 2.96) and whose mother-in-law’s had controlling behavior (AOR=5.69, CI: 2.51-12.9) were associated with domestic violence during pregnancy and the postpartum period. Conclusion: The study findings suggest that domestic violence during pregnancy and the postpartum period is common in Nepalese women, especially in the second trimester of pregnancy. Women were mostly experienced by sexual violence during their pregnancy and postpartum periods. Screening for domestic violence in women during their pregnancy and postpartum is warranted to prevent from adverse consequences of violence.