Domestic violence prior to and during pregnancy among Pakistani women

OBJECTIVE: Abuse of women has been associated with adverse pregnancy outcomes. Data about abuse from developing countries are scarce, especially from Muslim societies. Our objective was to investigate domestic violence before and during pregnancy among women in an urban area of Pakistan. DESIGN: Population-based cohort study. SETTING: An urban community in Hyderabad, Pakistan. POPULATION: Thousand three hundred and twenty-four pregnant women at 20-26 weeks gestation. METHODS: Socio-demographic and reproductive history data were obtained through structured interviews. We used a modified World Health Organization screening instrument to assess women's experience of domestic violence. MEASURES: Physical, sexual, and verbal abuse and demographic characteristics. RESULTS: The majority of women had received some schooling and in most households the husbands were employed; by Pakistani standards, they were middle class. Young maternal age, having an unemployed husband and one with other wives/partners, and having had a prior pregnancy were significant predictors of abuse. In the six months prior to and/or during pregnancy, 51% reported experiencing verbal, physical or sexual abuse. Twenty percent reported physical or sexual abuse alone. Sixteen percent of women considered suicide as a response to the abuse. CONCLUSIONS: Domestic violence is common among urban Pakistani women of reproductive age, suggesting a need for universal screening during antenatal care, and for support and referral. Further research is needed to determine factors that place women at greatest risk, and to assess the impact of domestic violence on pregnancy outcomes.