Objectives: Spousal violence is common and results in costly problems both for society and for the reproductive health of women. Despite the recognition that violence may be associated with serious consequences for women's reproductive health, our understanding of the relationship between the two remains limited. In this study, we assessed the association between spousal violence and women's reproductive health. Methods: Data from an interviewer-administered questionnaire assessing socioeconomic, demographic, behavioral profiles, and spousal violence-related information was collected from 496 women. Subjects were chosen from eight randomly selected urban slums from four metropolitan cities. Results: Spousal violence was significantly higher amongst the group of less educated women who had been in several marriages; indicating that the social and behavioral traits of women act as catalysts for spousal violence. Abusive husbands also had been married several times and were more likely to be addicted to alcohol or drugs. This demonstrates that the behavioral traits of husbands were also responsible for spousal violence. Spousal violence injuries adversely affect the health and well-being of women. More than three-quarters of physically violated women suffered injuries as a result of this violence. About 50% of these injuries were minor and about 10% serious. Sexual violence adversely affected women's health; more than 80% of sexually violated women complained of pelvic pain, more than 50% reported reproductive tract infections, and more than 50% reported symptoms of irritable bowel syndrome. Abused women suffered from gynecological problems at the time of pregnancy significantly more than non-abused women (p<0.05) and abused women suffered from reproductive tract infections significantly more than non-abused women (p<0.01). Abusive husbands suffered from sexually transmitted diseases (STD) significantly more than non-abusive husbands (p<0.05). Abused women used contraception significantly less than non-abused women (p<0.01). Logistic regression analysis suggested that spousal violence was the most important contributing factor for reproductive health problems in women. Conclusions: The findings of this study may enhance our understanding of the impact of spousal violence against women and their reproductive health and therefore highlight the importance of spousal violence prevention measures. Increasing the awareness and understanding of the relationship between violence against women and reproductive health could be achieved if lawyers, researchers, clinicians, practitioners, and government workers from multiple disciplines and agencies worked together.
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Kennedy LW. Violence against women in Canada. In: Foreword to Dangerous Domains by Holly Johnson. Scarborough, Ontario: International Thomas Publishing, 1996.
Okojie CEF. Gender inequalities of health in the third world. Soc Sci Med 1994;39(9):1237–47.
Sadik N. Men and women in a time of change. In: State of World Population 2000. United Nations Population Fund, 2000.
Kornblit AL. Domestic violence—An emerging health issue. Soc Sci Med 1994;39(9):1181–8.
WHO. Abortion: A tabulation of available data on the frequency and mortality of unsafe abortion. (3rd ed.) Geneva: World Health Organization (WHO), 1997.
Heise L, Ellsberg M, Gottemoeller M. Ending violence against women. Population Reports, Series L., 11. Baltimore, MD: Johns Hopkins University School of Public Health, 1999.
Heise L, Pitanguy J, Germain A. Violence against women: The hidden health burden. Discussion Paper 255, Washington, DC: The World Bank, 1993.
United Nations. Programme of action of the UN international conference on population and development. New York: United Nations, 1994.
WHO. Violence against women: A priority health issue. Geneva, Switzerland: World Health Organization, WHO/FRH/WHD/97.8, 1997.
Zaman H. Violence against women in Bangladesh: Issues and responses. Women Stud Int Forum 1999;22(1):37–48.
GOB. Unpublished report on the violence against women. Bangladesh: Ministry of Women and Children, Government of the People's Republic of Bangladesh, 2000.
Ain-O-Shalish Kendra. Compilation of data from 8 daily newspapers from 1996 to 1999. An unpublished report. Dhaka, Bangladesh: Ain-O-Shalish Kendra, 2000.
Fauveau V, Blanchet T. Deaths from injuries and induced abortion among rural Bangladeshi women. Soc Sci Med 1989;29(9):1121–7.
Khan K, Rob AKU, Hossian SMI. Gender based violence and its impact on women's life: Some observation from Bangladesh. Paper presented at the Regional Workshop on Impact of Gender Based Violence on the Health of Women, Organized Jointly by Social Operations Research and Training and CORT, Baroda, Delhi, India, 2000.
Marcus R. Violence against women in Bangladesh, Pakistan, Egypt, Sudan, Senegal and Yemen. Report No. 10. Brighton, UK: Institute of Development Studies, 1993:1–16.
Feldman CM, Ridley CA. The etiology and treatment of domestic violence between adult partners. Clin Psychol Sci Pract 1995;2(4):317–48.
Kabeer N. Monitoring poverty as if gender mattered: A methodology for rural Bangladesh. IDS Discussion Paper 255. Bringhton, UK: Institute of Development Studies, 1989.
Roy KC, Tisdell C, Alauddin M. Rural–urban migration and poverty in South Asia. J Contemp Asia 1992;22(1):57–72.
Kuhn R. The logic of letting go: Family and individual migration from rural Bangladesh. Labor and Population Working Papers, RAND Corporation, 2000.
Nabi I. Village-end considerations in rural–urban migration. J Dev Econ 1984;14:129–45.
Afser R, Baker J. Interaction between rural areas and rural towns. Background paper on ‘Prerequisites of Future Swedish Support to Rural Towns Development and Poverty Alleviation’. Norway: AGDER Research Foundation, 1999.
Skeldon R. Migration and development: A global perspective. London: Belhaven Press, 1997.
Hugo GJ. Rural–urban migration, economic development and social change: Some important issues. Paper presented at the workshop on Urbanization and Urban Poor on July 27–29, 1991, Dhaka: Bangladesh Institute of Development Studies, 1991.
Afsar R. Onus of poverty on women in the poorer settlements of Dhaka city: Women and Poverty. Dhaka, Bangladesh: Women for Women Research and Study Group, 1996.
Afser R. Rural urban migration in Bangladesh: Causes, consequences and challenges. Dhaka: Dhaka University Press, 2000.
Afsar R. Internal migration and the development nexus: The case of Bangladesh. Paper presented at the Regional Conference on Migration, Development and Pro-Poor Policy Choices in Asia jointly organized by the Refugee and Migratory Movements Research Unit, Bangladesh and the Department for International Development, UK on 22–24 June, 2003 in Dhaka, Bangladesh, 2003:15.
UN. World urbanization prospects: The 2001 revision. New York: Population Division, Department of Economic and Social Affairs, UN Secretariat.
Hossain M, Afsar R, Bose M. Growth and distribution of income and incidence of poverty in Dhaka city. Paper presented at the National Seminar organized by Grameen Bank, Mirpur, Dhaka, Bangladesh, February 6, 1999.
Gelles R, Tanner M, editors. Current controversies on family violence. London: Sage Publications, 1993.
Wilsnak SC, Vogeltanz ND, Klassen AD, Harris TR. Childhood sexual abuse and women's substance abuse: National survey findings. J Stud Alcohol 1997;58:264–71.
Fleming J, Mullen PE, Sibthrope B, Bammer G. The long-term impact of childhood sexual abuse in Australian women. Child Abuse Negl 1999;23:145–59.
Plichta SB, Abraham C. Violence and gynecologic health in women <50 years old. Am J Obset Gynecol 1996;174:903–7.
ADB. Women in Bangladesh: Country briefing paper. Asian Development Bank, Programs Department (West) 2001:1–69.
Hashemi SM, Schuler SR, Riley AP. Rural credit programs and women's empowerment in Bangladesh. World Dev 1996;24(4):635–53.
Khan ME, Ahmed SM, Bhuiya A, Chowdhury M. Domestic violence against women: Does development intervention matter? In: Three Studies on the Effect of BRAC Interventions on the Lives of the Poor Women Working Paper Number 28, BRAC-ICDDR, B Joint project, Dhaka, Bangladesh, 1996.
Schuler SR, Hashemi SM, Riley AP. Men's violence against women in rural Bangladesh: Undermined or exacerbated by microcredit programs? Paper presented at the 1997 Population Association of America Annual Meetings, Washington DC, March, 1997.
Schuler SR, Hashemi SM, Riley AP, Akhter S. Credit programs, patriarchy and men's violence against women in rural Bangladesh. Soc Sci Med 1996;43(12):1729–42.
Rodriguez MA, Bauer HM, McLoughhlin E, et al. Screening and intervention for intimate partner abuse: Practices and attitudes of primary care physicians. JAMA 1999;282:468–74.
Lipsky S, Holt VL, Easterling TR, Critchlow CW. Police-reported intimate partner violence during pregnancy and the risk of antenatal hospitalization. Matern Child Health J 2004;8(2):55–63.
Greenfeld LA, Rand MR, Craven D, Klaus PA, Perkins CA, Ringel C, et al. Violence by intimates: Analysis of data on crimes by current or former spouses, boyfriends, and girlfriends. Washington, DC: Bureau of Justice Statistics, 1998.
Bachman R, Saltzman LE. Violence against women: Estimates from the redesigned survey. Bureau of Justice Statistics Special Report. Washington, DC: U.S. Department of Justice, 1995.
Peters SD, Wyatt GE, Finkelhor D. Prevalence. In: Finkelhor D, editor. A sourcebook on child sexual abuse. Beverly Hills, California: Sage Publishers, 1986:15–59.
Eskenazi B, Pearson K. Validation of a self-administered questionnaire for assessing occupational and environmental exposures of pregnant women. Am J Epidemiol 1988;128(5):1117–29.
Douglas AD, Nicholas JT, Leserman J, Olden KW, Barreioro MA. Sexual and physical abuse and gastrointestinal illness. Ann Intern Med 1995;123:82–795.
Feldman CM, Ridley CA. The role of conflict-based communication reponses and outcomes in male domestic violence toward female partners. J Soc Pers Relationships 2000;17:552–73.
Ridley CA, Feldman CM. Female domestic violence toward male partners: Exploring conflict responses and outcomes. J Fam Violence 2003;18(3):157–70.
Bushman BJ. Human aggression while under the influence of alcohol and other drugs: An integrative research review. Curr Dir Psychol Sci 1993;2(5):148–52.
Collins JJ, Messerschmidt PM. Epidemiology of alcohol-related violence. Alcohol Health Res World 1993;17(2):93–100.
Cunradi CB, Caetano R, Clark CL, Schafer J. Alcohol-related problems and intimate partner violence among White, Balck and Hispanic couples in the U.S. Alcohol Clin Exp Res 1993;23(9):1492–501.
Murphy CM, O'Farrell TJ. Factors associated with marital aggression in male alcoholics. J Fam Psychol 1994;8(3):321–35.
Field CA, Caetano R, Nelson S. Alcohol and violence related cognitive risk factors associated with the perpetration of intimate partner violence. J Fam Violence 2004;19(4):249–53.
Caetano R, Schafer J, Cunradi C. Alcohol-related intimate partner violence among White, Blacks and Hispanics. Alcohol Res Health 2001;25(1):58–65.
Hamberger LK, Hastings JE. Personality correlates of men who batter and non-violent men: Some continuities and discontinuities. J Fam Violence 1991;6(2):131–47.
Scott KD, Schafer JC, Greenfield TK. The role of alcohol in physical assault perpetration and victimization. J Stud Alcohol 1999;60(4):528–36.
Tjaden P, Thoennes N. Extent, nature, and consequences of intimate partner violence, Findings From the National Violence Against Women Survey, Report No. NCJ 181867. Washington, DC: National Institute of Justice, 2000.
Golding JM. Sexual assault history and women's reproductive and sexual health. Psychol Women Q 1996;20:101–21.
Goodman LA, Koss MP, Russo NF. Violence against women: Physical and mental health effects: Part I: Research findings. Appl Prev Psychol 1993;2:79–89.
Walling MK, Reiter RC, O'Hara MW, Milburn AK, Lilly G, Vincent SD. Abuse history and chronic pain in women: I. Prevalences of sexual abuse and physical abuse. Obstet Gynecol 1994;84:193–9.
Domino JV, Harver JD. Prior physical and sexual abuse in women with chronic headache: Clinical correlates. Headache 1987;27:310–4.
Drossman DA, Leserman J, Nachman G, Li Z, Gluck H, Toomey TC, et al. Sexual and physical abuse in women with functional or organic gastrointestinal disorders. Ann Intern Med 1990;113:828–33.
Heise L, Garcia-Moreno C. Violence by intimate partners. World Report on Violence and Health. Geneva: World Health Organization, 2002.
Krahe B, Scheinberger-Olwig R, Waizenhofer E, Kolpin S. Childhood sexual abuse and revictimization in adolescence. Child Abuse Negl 1999;23:383–94.
Irwin KL, Edlin BR, Wong L, Faruque S, McCoy HV, Word C, et al. Urban rape survivors: Characteristics and prevalence of human immunodeficiency virus and other sexually transmitted infections. Obstet Gynecol 1995;85:330–6.
Coker AL, Smith PH, Bethea L, King MR, McKeown RE. Physical health consequence of physical and psychological intimate partner violence. Arch Fam Med 2000;9:451.
Heise L, Moore K, Toubia N. Sexual coercion and women reproductive health: A focus on research. New York: Population Council, 1995.
Curry MA, Perrin N, Wall E. Effects of abuse on maternal complications and birth weight in adult and adolescent women. Obstet Gynecol 1998;92(4):530–4.
Benedict MI, Paine LL, Paine LA, Brandt D, Stallings R. The association of childhood sexual abuse with depressive symptoms during pregnancy, and selected pregnancy outcomes. Child Abuse Negl 1999;23:659–70.
McFarlane J, Parker B, Soeken K. Abuse during pregnancy: Associations with maternal health and infant birth weight. Nurs Res 1996;45(1):313–20.
Parker B, McFarlane J, Soeken K. Abuse during pregnancy: Effects on maternal complications and birth weight in adult and teenage women. Obstet Gynecol 1994;84(3):323–8.
Petersen R, Gazmararian J, Spitz AM, Rowley DL,Goodwin MM, Saltzman LE, et al. Violence and adverse pregnancy outcomes: A review of the literature and directions for future research. Am J Prevent Med 1997;13(5):366–73.
Gazmararian JA, Lazorick S, Spitz A, Ballard TJ, Saltzman LE, Marks JS. Prevalence of violence against pregnant women. JAMA 1996;275:1915–20.
Goodwin MM, Gazmararian JA, Johnson CH, Gilbert BC, Saltzman LE, The PRAMS Working Group. Pregnancy intendedness physical abuse around the time of pregnancy: Findings from the pregnancy risk assessment monitoring system, 1996–1997. Matern Child Health J 2000;4(2):85–92.
Ronsmans C, Khlat M. Adolescence and risk of violent death during pregnancy in Matlab, Bangladesh. The Lancet 1999;23:1448.
Campbell JC. Abuse during pregnancy: Progress, policy and potential. Am J Public Health 1998;2:185–6.
Lindergren ML, Hanson IC, Hammett TA, Beil J, Fleming PL, Ward JW. Sexual abuse of children: Intersection with the HIV epidemic. Pediatrics 1998;102:E46.
Jenny C, Hooten TM, Bowers A, Copass MK, Krieger JN, Hillier SL, et al. Sexually transmitted diseases in victims of rape. N Engl J Med 1991;322:713–6.
Gutman LT, St. Claire KK, Weedy C, Herman-Giddens ME, Lane BA, Niemeyer JG, et al. Human immunodeficiency virus transmission by child sexual abuse. Am Dis Child 1991;145:137–41.
Glaser JB, Schachter J, Benes S, Cummings M, Frances CA, McCormack WM. Sexually transmitted diseased in postpubertal female rape victims. Infect Dis 1991;164:726–30.
Kimerling R, Armistead L, Forehand R. Victimization experiences and HIV infection in women: Associations with serostatus, psychological symptoms, and health status. J Trauma Stress 1999;12:41–58.
Nilsson U, Hellberg D, Shoubnikova M, Nilsson S, Mardh P. Sexual behavior risk factors associated with bacterial vaginosis and Chlamydia trachomatis infection. Sex Transm Dis 1997;24:241–6.
He H, McCoy HV, Stevens SJ, Stark MJ. Violence and HIV sexual risk behaviors among female sex partners of male drug users. Women Health 1998;27:161–5.
Hawkes S, Morison L, Foster S, Gausia K, Chakraborty J, Weeling R. Reproductive-tract infections in women in low-income, low-prevalence situations: Assessment of syndromic management in Matlab, Bangladesh. The Lancet 1999;354:1776–81.
Grosskurth H, Mosha F, Todd J, et al. Impact of improved treatment of sexually tranmitted diseases on HIV infection in rural Tanzania: Randomized control trial. The Lancet 1995;346:530–6.
Cohen MS, Hoffman IF, Royce RA, et al. Reduction of concentration of HIV-1 in semen after treatment of urethritis: Implications for prevention of sexual tranmision of HIV-1. The Lancet 1997;349:1868–73.
World Bank. World development report: Investing in health. New York: Oxford University Press, 1993.
Gazmararian JA, Adams MM, Saltzman LE, Johnson CH, Bruce FC, Marks JS, et al. The relationship between pregnancy intendedness and physical violence in mothers of newborns. Obstet Gynecol 1995;85:1031–8.
Cokkinides V, Coker A, Sappenfield W. Prevalence and correlates of physical violence during pregnancy. Paper presented at the Annual Meeting of the American Public Health Association, New York, November 20, 1996.
Hillard PJA. Physical abuse in pregnancy. Obstet Gynecol 1985;66:185–90.
Stewart DE, Cecutti A. Physical abuse in pregnancy. Can Med Assoc J 1993;149:1257–63.
Evins G, Chescheir N. Prevalence of domestic violence among women seeking abortion services. Women Health Issues 1996;4:204–9.
Glander SS, Moore ML, Michielutte R, Parsons LH. The prevalence of domestic violence among women seeking abortion. Obstet Gynecol 1998;91:1002–6.
Campbell JC, Pugh LC, Campbell D, Visscher M. The influence of abuse on pregnancy intention. Women Health Issues 1995;5:214–23.
Conant M, Hardy D, Sernatinger J, Spicer D, Levy JA. Condoms prevent transmission of AIDS-associated retrovirus (Letter). JAMA 1986;255:1706.
Macaluso M, Demand M, Artz L, Fleenor M, Robey L, Kelaghan J, et al. Female condom use among women at high risk of sexually transmitted disease. Fam Plann Persp 2000;32(3):138–44.
Koenig LJ, Moore J. Women, violence, and HIV: A critical evaluation with implications for HIV services, 2000.
Population Reports. Youth and HIV/AIDS: Can we avoid catastrophe? Popul Rep 2001;XIX(3):1–39.
Worth D. Sexual decision making and AIDS: Why condom promotion among vulnerable women is likely to fail. Stud Fam Plann 1990;20:297–307.
Wingood G, DiClemente R. Partner influences and gender-related factors associated with noncondom use among young adult African American women. Am J Commun Psychol 1998;26(1):29–51.
Neighbors C, O'Leary A, LaBouvie E. Domestically violent and nonviolent male inmates' responses to their partners' requests for condom use: Testing a social-information processing model. Health Psychol 1999;18(4):427–31.
This study was supported by the World Bank through the Bangladesh Medical Research Council (BMRC), Bangladesh. The authors gratefully acknowledge the cooperation of all the staff of BMRC. This article was written when the first author was a fellow of the Japan Society for the Promotion of Science (JSPS)'s post-doctoral fellowship program.
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Salam, M.A., Alim, M.A. & Noguchi, T. Spousal Abuse Against Women and Its Consequences on Reproductive Health: A Study in the Urban Slums in Bangladesh. Matern Child Health J 10, 83–94 (2006). https://doi.org/10.1007/s10995-005-0030-6
- spousal violence
- reproductive health
- gynecological disorder
- reproductive tract infection
- sexually transmitted disease
- urban slums