Voluntary termination of pregnancy and intimate partner violence in Cameroon

Background: According to the World Health Organization, one in seven maternal deaths in Africa results from unsafe abortion. Approximately half of women in sub-Saharan Africa report abuse by a male partner. Recent research has begun to explore the intersection between violence and reproductive decision-making; however, the linkage between voluntary/induced abortion and intimate partner violence (IPV) in Africa is relatively under-studied. Methods: We utilized data from the Cameroon Demographic Health Survey to examine the association between induced abortion and IPV. Female respondents were asked about their contraceptive behavior and experiences with IPV. Descriptive statistics, chi-square tests, and logistic regression analyses were performed. Women reporting no exposure to IPV were the referent category. We also estimated the proportion of preventable abortions at various levels of violence reduction. Results: Of 2,570 women interviewed, 4.9% reported receiving at least one induced abortion, and 50.9% reported experiences of IPV. All forms of IPV were significantly associated with induced abortion, with sexual violence showing the strongest linkage (OR=2.54, 95% CI: 1.70, 3.79). The proportion of preventable abortions was 23%, 35%, and 47%, assuming that the prevalence of sexual abuse could be reduced to 50%, 75%, or entirely eliminated respectively. Conclusion: We found IPV to be a marker for induced abortion in Cameroon, where voluntary termination of pregnancy is illegal and performed underground. A considerable proportion of abortions is attributable to spousal violence, and therefore, potentially preventable. IPV screening among women of childbearing age could help identify high-risk sub-groups for timely counseling and appropriate interventions.