Assessing the relationship between intimate partner violence, externally-decided pregnancy and unintended pregnancies among women in slum communities in Mumbai, India

Background: India contends with a high rate of intimate partner violence (IPV), which is associated with unintended pregnancy and reflects low levels of women\u27s decision-making control in relation to their reproductive health. Few studies from South Asia have examined the relationship between pregnancy decision-making, IPV and unintended pregnancy. Aim This study examined associations between unintended (mistimed and unwanted) pregnancy, women\u27s reports of pregnancy decided externally by husband or in-laws, and IPV, among a sample of married, postpartum women. Methods: Data from the \u27Mechanisms for Relations of Domestic Violence to Poor Maternal and Infant Health in India\u27 study were analysed. Descriptive comparisons between levels of unintended pregnancy were run on all major variables. Unadjusted and adjusted multinomial logistic regression analyses assessed women\u27s reports of having externally-decided pregnancies and IPV victimisation in the year prior to pregnancy as factors in mistimed and unwanted pregnancies. Results: Mistimed and unwanted pregnancies were reported by 12.2% and 7.2% of women, respectively. Externally-decided pregnancies were reported by 8.8% of women. Some 29.4% of women reported experiencing physical and/or sexual IPV in the year prior to pregnancy. Women reporting externally-decided pregnancies were significantly more likely to have had mistimed pregnancies than intended pregnancies, as were women reporting IPV. Neither external pregnancy control nor IPV were associated with unwanted pregnancy. Conclusions: Women\u27s exclusion from pregnancy decision-making and violence from husbands relate to their ability to time their pregnancies as they wish. The lack of significant association between external decision-making and IPV with unwanted pregnancy may be due to low reporting of unwanted pregnancy. The overall findings highlight the importance of integrating women\u27s involvement in reproductive health decision-making and IPV reduction messaging in programming for the women\u27s health sector