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

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.