Intimate partner violence in timor-leste: Are there associations with reproductive healthcare or birth outcomes?

BACKGROUND: Patriarchal traditions and a history of armed conflict in Timor-Leste contribute to widespread violence against women. Thirty-five percent of Timorese women report physical and/or sexual violence by an intimate partner (IPV). IPV violates women's human rights and can threaten their physical, mental, and reproductive health. We examined lifetime exposure to IPV in Timor-Leste in relation to 1) use of reproductive health services and 2) birth size. METHODS: Using logistic regression and Pearson's chi-square tests, we examined 2009-10 Demographic and Health Survey data on IPV from a nationally representative sample of 2,951 women in Timor-Leste. We controlled for wealth and education, and we limited our analyses of pregnancy care and birth outcomes to women who gave birth in the five years preceding the survey. RESULTS: In rural areas, women who ever experienced IPV were more likely than other women to have had an unplanned pregnancy (OR=1.6; 95% CI 1.0-2.4). Among women in rural areas, IPV was also associated with having a baby born smaller than average, as reported by the mother (OR=3.8; 95% CI 2.5-5.8). IPV was not associated with measures of reproductive healthcare in the prenatal or postnatal periods or during birth. CONCLUSIONS: Given high rates of IPV internationally, relationships between lifetime exposure to IPV and unplanned pregnancy and birth outcomes among Timorese women have important implications. Clearly, reducing IPV can benefit both women and future generations. Furthermore, women who experience IPV may benefit from targeted interventions that mediate the risks of unplanned pregnancy and small birth size.