TY - JOUR
T1 - Impact of the COVID-19 pandemic on intimate partner violence during pregnancy
T2 - Evidence from a multimethods study of recently pregnant women in Ethiopia
AU - Wood, Shannon N.
AU - Yirgu, Robel
AU - Wondimagegnehu, Abigiya
AU - Qian, Jiage
AU - Milkovich, Rachel Mait
AU - Decker, Michele R.
AU - Glass, Nancy
AU - Seid, Fatuma
AU - Zekarias, Lensa
AU - Zimmerman, Linnea A.
N1 - Publisher Copyright:
© 2022 BMJ Publishing Group. All rights reserved.
PY - 2022/4/12
Y1 - 2022/4/12
N2 - Objectives This multimethods study aimed to: (1) compare the prevalence of intimate partner violence (IPV) during pregnancy pre-COVID-19 and during the COVID-19 pandemic using quantitative data and (2) contextualise pregnant women's IPV experiences during the COVID-19 pandemic through supplemental interviews. Design Quantitative analyses use data from Performance Monitoring for Action-Ethiopia, a cohort of 2868 pregnant women that collects data at pregnancy, 6 weeks, 6 months and 1-year postpartum. Following 6-week postpartum survey, in-depth semistructured interviews contextualised experiences of IPV during pregnancy with a subset of participants (n=24). Participants All pregnant women residing within six regions of Ethiopia, covering 91% of the population, were eligible for the cohort study (n=2868 completed baseline survey). Quantitative analyses were restricted to the 2388 women with complete 6-week survey data (retention=82.7%). A purposive sampling frame was used to select qualitative participants on baseline survey data, with inclusion criteria specifying completion of quantitative 6-week interview after the onset of the COVID-19 pandemic, and indication of IPV experience. Interventions A State of Emergency in Ethiopia was declared in response to the COVID-19 pandemic approximately halfway through 6-week postpartum interview, enabling a natural experiment (n=1405 pre-COVID-19; n=983 during-COVID-19). Primary outcome measures IPV during pregnancy was assessed via the 10-item Revised Conflict and Tactics Scale. Results 1-in-10 women experienced any IPV during pregnancy prior to COVID-19 (10.5%), and prevalence of IPV during pregnancy increased to 15.1% during the COVID-19 pandemic (aOR=1.51; p=0.02). Stratified by residence, odds of IPV during the pandemic increased for urban women only (aOR=2.09; p=0.03), however, IPV prevalence was higher in rural regions at both time points. Qualitative data reveal COVID-19-related stressors, namely loss of household income and increased time spent within the household, exacerbated IPV. Conclusions These multimethods results highlight the prevalent, severe violence that pregnant Ethiopian women experience, with pandemic-related increases concentrated in urban areas. Integration of IPV response and safety planning across the continuum of care can mitigate impact.
AB - Objectives This multimethods study aimed to: (1) compare the prevalence of intimate partner violence (IPV) during pregnancy pre-COVID-19 and during the COVID-19 pandemic using quantitative data and (2) contextualise pregnant women's IPV experiences during the COVID-19 pandemic through supplemental interviews. Design Quantitative analyses use data from Performance Monitoring for Action-Ethiopia, a cohort of 2868 pregnant women that collects data at pregnancy, 6 weeks, 6 months and 1-year postpartum. Following 6-week postpartum survey, in-depth semistructured interviews contextualised experiences of IPV during pregnancy with a subset of participants (n=24). Participants All pregnant women residing within six regions of Ethiopia, covering 91% of the population, were eligible for the cohort study (n=2868 completed baseline survey). Quantitative analyses were restricted to the 2388 women with complete 6-week survey data (retention=82.7%). A purposive sampling frame was used to select qualitative participants on baseline survey data, with inclusion criteria specifying completion of quantitative 6-week interview after the onset of the COVID-19 pandemic, and indication of IPV experience. Interventions A State of Emergency in Ethiopia was declared in response to the COVID-19 pandemic approximately halfway through 6-week postpartum interview, enabling a natural experiment (n=1405 pre-COVID-19; n=983 during-COVID-19). Primary outcome measures IPV during pregnancy was assessed via the 10-item Revised Conflict and Tactics Scale. Results 1-in-10 women experienced any IPV during pregnancy prior to COVID-19 (10.5%), and prevalence of IPV during pregnancy increased to 15.1% during the COVID-19 pandemic (aOR=1.51; p=0.02). Stratified by residence, odds of IPV during the pandemic increased for urban women only (aOR=2.09; p=0.03), however, IPV prevalence was higher in rural regions at both time points. Qualitative data reveal COVID-19-related stressors, namely loss of household income and increased time spent within the household, exacerbated IPV. Conclusions These multimethods results highlight the prevalent, severe violence that pregnant Ethiopian women experience, with pandemic-related increases concentrated in urban areas. Integration of IPV response and safety planning across the continuum of care can mitigate impact.
KW - COVID-19
KW - PUBLIC HEALTH
KW - Public health
KW - QUALITATIVE RESEARCH
KW - REPRODUCTIVE MEDICINE
KW - SEXUAL MEDICINE
UR - http://www.scopus.com/inward/record.url?scp=85128135487&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85128135487&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-055790
DO - 10.1136/bmjopen-2021-055790
M3 - Article
C2 - 35414554
AN - SCOPUS:85128135487
SN - 2044-6055
VL - 12
JO - BMJ open
JF - BMJ open
IS - 4
M1 - e055790
ER -