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Association between spousal emotional abuse and reproductive outcomes of women in India: findings from cross-sectional analysis of the 2005–2006 National Family Health Survey

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Abstract

Purpose

Spousal violence against women is a global public health problem. In India, approximately 40% of women report spousal violence. Like physical and sexual violence, emotional violence may be a determinant of women’s health. This study explores the association between exposure to spousal emotional abuse and poor reproductive outcomes in Indian women.

Methods

Data on 60,350 women, collected in the Third Indian National Family Health Survey were analysed to assess the impact of spousal emotional abuse on seven reproductive outcomes: age at first birth, number of children, terminated pregnancies, unwanted pregnancies, access to prenatal and skilled delivery care, and breastfeeding. Spousal emotional abuse was assessed using two overlapping constructs: emotional violence and controlling behaviour. Multivariable logistic regression was used for analysis.

Results

Spousal emotional violence and controlling behaviour was reported by 16 and 38% of the women, respectively. In unadjusted analyses, spousal emotional violence was associated with all adverse reproductive outcomes, except breastfeeding. Controlling for socio-demographic risk factors attenuated the association, and further adjustment for other forms of violence removed all significant associations. Spousal controlling behaviour was significantly associated with all outcomes, except breastfeeding. The effects remained statistically significant in multivariable regression.

Conclusions

Women’s experience of violence may be under-reported. When other forms of violence were adjusted for, emotional violence was not associated with adverse reproductive outcomes, whereas controlling behaviour remained associated with all but one adverse reproductive outcome. Therefore, spousal controlling behaviour requires further investigation as a determinant of reproductive health.

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Funding

The initial analysis was conducted as part of ST’s MSc Global Health Science, at the University of Oxford, where she was funded by an ExxonMobil Foundation studentship.

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Authors and Affiliations

  1. Department of Psychiatry, Lady Hardinge Medical College, New Delhi, India

    Sucheta Tiwari

  2. National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK

    Ron Gray

  3. Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK

    Crispin Jenkinson

  4. National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK

    Claire Carson

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  1. Sucheta Tiwari
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  2. Ron Gray
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  4. Claire Carson
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Correspondence to Sucheta Tiwari.

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Tiwari, S., Gray, R., Jenkinson, C. et al. Association between spousal emotional abuse and reproductive outcomes of women in India: findings from cross-sectional analysis of the 2005–2006 National Family Health Survey. Soc Psychiatry Psychiatr Epidemiol 53, 509–519 (2018). https://doi.org/10.1007/s00127-018-1504-3

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  • DOI: https://doi.org/10.1007/s00127-018-1504-3

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