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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.

Original publication

DOI

10.1007/s00127-018-1504-3

Type

Journal article

Journal

Soc Psychiatry Psychiatr Epidemiol

Publication Date

05/2018

Volume

53

Pages

509 - 519

Keywords

Emotional abuse, India, Intimate partner violence, Reproductive health, Women’s health, Abortion, Induced, Adult, Cross-Sectional Studies, Family Characteristics, Family Health, Female, Health Surveys, Humans, India, Logistic Models, Middle Aged, Parity, Pregnancy, Pregnancy, Unwanted, Reproductive Behavior, Risk Factors, Spouse Abuse, Violence