Unravelling dual violence against women in Ethiopia: Experiences of obstetric violence and postpartum intimate partner violence

• Nearly one in three postpartum women in Addis Ababa experienced dual violence (both obstetric and intimate partner violence). • Lack of privacy and non-consented care were the most common forms of obstetric violence. • Emotional abuse was the most prevalent form of postpartum intimate partner violence. • Unemployment, absence of postnatal checks, and prior IPV during pregnancy significantly increased the risk of dual violence. • Private facility births were associated with lower odds of experiencing dual violence. To examine the prevalence of dual violence—experience of obstetric violence (OV) and postpartum intimate partner violence (IPV)—and factors associated with it among women in Addis Ababa, Ethiopia. As part of a broader longitudinal study, we surveyed 354 postpartum women six to sixteen weeks after childbirth. OV was assessed across seven domains (e.g., verbal abuse, non-consented care, lack of privacy), and IPV across three (physical, sexual, emotional). Dual violence was defined as experiencing at least one form of both OV and IPV. We used logistic regression to identify factors associated with dual violence. Experience of OV was reported by 87.0% (95% CI: 82.9%-90.2%) of the participants, while 31.2% (95% CI: 26.1–36.0%) reported experiencing postpartum IPV. The prevalence of dual violence was 29.4% (95% CI: 24.9%–34.2%). Most prevalent OV forms were: lack of privacy, confidentiality, or access to information (65.5%) and non-consented care (61.6%), whereas emotional violence was the most experienced form of IPV (29.4%). Dual violence was significantly associated with unemployment (AOR: 2.31, 95% CI: 1.20–4.54), lack of postnatal check (AOR: 2.23; 95% CI: 1.06–4.72), and experience of IPV during pregnancy (AOR: 6.91, 95% CI: 3.92–12.55). Conversely, women who gave birth in private facilities had lower odds of experiencing dual violence (AOR: 0.41, 95% CI: 0.15–0.99). The high prevalence of dual violence identified by our study underscores the need for integrated interventions to strengthen OV and IPV prevention and response actions.