Associations of intimate partner violence and reproductive coercion with contraceptive use in Uttar Pradesh, India: How associations differ across contraceptive methods

Abstract

Intimate partner violence (IPV) and reproductive coercion (RC)-largely in the form of pressuring pregnancy-appear to contribute to low use of contraceptives in India; however, little is known about the extent to which these experiences differentially affect use of specific contraceptive methods. The current study assessed the association of IPV and RC with specific contraceptive methods (Intrauterine Devices [IUDs], pills, condoms) among a large population-based sample of currently married women (15-49 years, n = 1424) living in Uttar Pradesh. Outcomes variables included past year modern contraceptive use and type of contraceptive used. Primary independent variables included lifetime experience of RC by current husband or in-laws, and lifetime experiences of physical IPV and sexual IPV by current husband. Multivariate logistic regression models were developed to determine the effect of each form of abuse on women's contraceptive use. Approximately 1 in 7 women (15.1%) reported experiencing RC from their current husband or in-laws ever in their lifetime, 37.4% reported experience of physical IPV and 8.3% reported experience of sexual IPV by their current husband ever in their lifetime. Women experiencing RC were less likely to use any modern contraceptive (AOR: 0.18; 95% CI: 0.9-0.36). Such women also less likely to report pill and condom use but were more likely to report IUD use. Neither form of IPV were associated with either overall or method specific contraceptive use. Study findings highlight that RC may influence contraceptive use differently based on type of contraceptive, with less detectable, female-controlled contraceptives such as IUD preferred in the context of women facing RC. Unfortunately, IUD uptake remains low in India. Increased access and support for use, particularly for women contending with RC, may be important for improving women's control over contraceptive use and reducing unintended pregnancy.

Using machine learning to understand determinants of IUD use in India: Analyses of the National Family Health Surveys (NFHS-4)

“…This finding corresponds with a smaller study from Rajasthan, India, that indicates that joint marital decision-making regarding contraceptive use among IUD users is associated with IUD continuation ( Singal et al, 2022 ). However, it is not in line with research from younger married women from Maharashtra, India, which found a trend in the association between IPV and IUD use, or with a state-representative sample of married women aged 15–49 in Uttar Pradesh that found an association between reproductive coercion and IUD use ( Chen et al, 2020 ; Tomar et al, 2020 ). Our national findings suggest that male engagement and support for IUDs, and likely couple communication, are important to support the uptake of IUDs ( Dey, Acharya, et al, 2021 ).…”

“…However, there is a paucity of research examining whether such issues correlate with IUD use in India. That which exists has relied on smaller samples and found that married women who have experienced reproductive coercion or physical violence from partners are more likely to use IUDs, perhaps because it is a contraceptive more easily hidden from a partner and managed by the woman ( Chen et al, 2020 ; Tomar et al, 2020 ).…”

How does the sex composition of children affect men's higher ideal family size preference relative to women and contraceptive use patterns among couples? A cross-sectional analysis of dyadic couple's data in India

“…However, most of these studies, focused on women's fertility preferences with very few studies considering men's fertility preferences alongside that of women. This is despite strong evidence from other contexts, which shows that men play an important and often overbearing role in a couple's reproductive decision-making ( Ampofo, 2001 ; Bankole & Singh, 1998 ; Becker, 1996 ; Blanc, 2001 ; Dodoo, 1995 , 1998 ; Dodoo & Seal, 1994 ; Dodoo & Van Landewijk, 1996 ; Dudgeon & Inhorn, 2004 ; Ezeh et al, 1996 ; Tomar et al, 2020 ). Given that fertility preference plays an important role in contraceptive use and fertility, and that men have a significant role in a couple's fertility decision making, it is critical to study the effect of sex composition of children by parity on the relative fertility preferences of both men and women instead of considering women's fertility preference alone.…”

Low use of Modern Family Planning Methods in women suffering from Physical and Psychological abuse by their partiners: Findings from Cross-Sectional Study

“…Moreover, a study done in India assessed knowledge, attitude and practice of FP methods and found that 53% of married women had used family planning methods with IUD 46% highly utilized, condom 22% and 11% oral pill accounts lowest (35). The probably reason of most married women in the current study using injectable method of FP could be associated with IPV, since this method can be used with less detection and it is given on one occasion after every three months, which could explain the con dentiality to partners (36). Likewise, low use of condom as a FP method could be due to husband disagreement and poor women autonomy in making decision regarding use of FP (22,36).…”