Intimate partner violence, abortion, and unintended pregnancy: Results from the WHO Multi-country Study on Women's Health and Domestic Violence

Objective: To explore how intimate partner violence (IPV) is associated with unintended pregnancy and abortion in primarily low- and middle-income countries. Methods: Population data are presented from 17 518 ever-partnered women participating in the WHO Multi-country Study on Women's Health and Domestic Violence in 15 sites in 10 countries. Using multiple logistic regression analyses, associations between physical and/or sexual partner violence and abortion and unintended pregnancy were explored. Results: Women with a history of IPV had significantly higher odds of unintended pregnancy in 8 of 14 sites and of abortion in 12 of 15 sites. Pooled estimates showed increased odds of unintended pregnancy (adjusted OR 1.69; 95% CI, 1.53-1.86) and abortion (adjusted OR 2.68; 95% CI, 2.34-3.06), after adjusting for confounding factors. Reducing IPV by 50% could potentially reduce unintended pregnancy by 2%-18% and abortion by 4.5%-40%, according to population-attributable risk estimates. Conclusion: IPV is a consistent and strong risk factor for unintended pregnancy and abortion across a variety of settings. Unintended pregnancy terminated through unsafe abortion can result in death or serious complications. Therefore, reducing IPV can significantly reduce risks to maternal and reproductive health.