DETERMINANTS OF VIOLENCE DURING PREGNANCY AND ITS ASSOCIATION WITH POSTNATAL DEPRESSION AMONG WOMEN IN MULTAN, PAKISTAN

Abstract

This study aimed to explore the health impacts of intimate partner violence (IPV) on the physical and mental health of pregnant women. This was a cohort study in which 400 pregnant mothers attending the antenatal outpatient departments of six Public and private hospitals in Multan, Pakistan, were selected through a systematic random sampling technique. The Hurt, Insulted, Threatened and Screamed at (HITS) screening tool was used to assess the level of violence during pregnancy, and the Edinburgh Postnatal Depression Scale (EPDS) was used to assess postpartum depression. Associations were also investigated between violence in pregnancy and selected sociodemographic variables, residential differences in the occurrence of violence and depression in the postpartum period, with descriptive statistics and chi-square tests. A p-value <0.05 was deemed to be statistically significant. Although there was a high proportion of respondents who screened positive for violence during pregnancy, a significant number also had a negative score indicating no violence occurred. Violence was found to be significantly associated with demographics (place of residence, education and husband's occupation), economic well-being (household income), previous history of violence, attitudes of husband, substance abuse, controlling behavior and support for antenatal care (p < 0.05). Women who lived in rural areas had higher levels of all types of physical, psychological and sexual violence than women in urban areas. There was no significant difference in the incidence of economic violence across the residential settings; however, the frequency of psychological violence differed most across residential settings. Women who experienced violence during pregnancy had a significantly higher proportion of probable depression relative to those who screened negative on the HITS scale (p=0.001). Women who experienced violence during pregnancy had a significantly higher proportion of probable depression relative to women who screened negative on the HITS scale (p=0.001). Violence during pregnancy was considerable and had a significant relationship with the various sociodemographic, behavioral, and household factors.