Online Program

Domestic violence during pregnancy, maternal education, maternal autonomy, and rural-urban status as predictors of Indian women's maternal health care utilization and breastfeeding

Wednesday, November 6, 2013

Mili Duggal, MPH, PGDHM, Department of Family Science, University of Maryland School of Public Health, College Park, MD
Sally A. Koblinsky, PhD, Department of Family Science, University of Maryland, College Park, MD
Raul Cruz-Cano, PhD, Department of Epidemiology and Biostatistics, University of Maryland College Park, College Park, MD
Violence against women is an important public health problem. Although research suggests domestic violence is prevalent in India, estimates of Indian women ever experiencing such violence range from 18%-70%. Data on domestic violence during pregnancy in India is scarce. Some studies suggest that most Indian women hold a privileged position during pregnancy, but others are at-risk for victimization. Women who experience domestic violence while pregnant can be considered at high-risk since it may reduce their interest in the child's health, during pregnancy and after the birth. This study uses National Family Health Survey data (2005-06) to examine the role of emotional and physical violence during pregnancy, as well as potential protective factors, in predicting maternal/child health outcomes. Potential protective factors include maternal education and maternal autonomy. The study further examines the role of geographic location (rural, urban). A nationally-representative sample of 7,951 Indian women who delivered in the previous year was used to examine the role of emotional violence, physical violence, maternal education, maternal autonomy, and rural/urban status in predicting four outcomes: adequate antenatal care, institutional delivery, low infant birth-weight, and breastfeeding. Control variables include caste, parity, and family income. Prevalence of domestic violence was lower in pregnancy than lifetime: 10.4% vs 13.1% for emotional violence, and 21.5% vs 29.6% for physical violence. Findings from regression analyses summarize associations of domestic violence and other independent variables with health care utilization, low birth-weight, and breastfeeding. Recommendations for Indian policymakers/practitioners working to prevent and respond to domestic violence during pregnancy are provided.

Learning Areas:

Advocacy for health and health education
Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Describe the prevalence of emotional and physical domestic violence during pregnancy in a nationally representative sample of Indian mothers. Explain the role of domestic violence variables, education, and women's autonomy in predicting Indian women's maternal health care utilization. Identify one strategy that public health practitioners could use to improve maternal health care utilization of pregnant Indian women experiencing domestic violence.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral candidate in Maternal and Child Health and the proposed study is my dissertation. I am from India and have spent three years working with underserved Indian families on maternal health care utilization, maternal and child immunizations, and breastfeeding. I am also instructor of a University of Maryland course that introduces college students to the Indian public health system through a study abroad program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.