Globally intimate partner violence (IPV) during pregnancy is rising alarmingly but still is a preventable health problem affecting millions of women worldwide. Intimate partner violence during pregnancy has many serious public health issues and thus results in significant negative health consequences for woman and child’s well-being [1–6].

The IPV includes psychological abuse, progressive isolation, deprivation, intimidation, stalking, emotional trauma, controlling behaviour, physical impairment or even sexual assault jeopardising the pregnancy, chronic health problems and eventually death in some cases [7].

Regardless of the age, race, ethnicity, culture, socioeconomic status, religion, educational status and sexual orientation, it is seen worldwide and this burden of violence is borne by women and may have lifelong consequences.

52.1 Global Prevalence

A multi-country study conducted by WHO on women health and domestic violence (Fig. 52.1) found that the prevalence of IPV in pregnancy has a varied range from 28% in Peru province to only 1% in Japan with the average ranging between 4 and 12% in different parts of the world [8].

The data on IPV analysed by International Violence Against Women Survey found that IPV during pregnancy is between 2% in Denmark, Cambodia, Australia and the Philippines and 13.5% in Uganda, and this study also concluded that the majority is between 4% and 9%. Some of the clinical studies worldwide found that IPV during pregnancy is highest in Egypt with 32% followed by India (28%) and Saudi Arabia (21%) [9, 10].

52.2 Causes and Risk Factors for Intimate Partner Violence

A multi-country study conducted by WHO on domestic violence against women and their health clearly reported that the women who had physical abuse during pregnancy also had the history of abuse prior to the pregnancy. But almost 50% of the women according to the WHO study stated that they were abused for the first time in pregnancy [8].

A research done by Jasinski in 2004 clearly states that pregnancy does not stop or prevent the occurrence of intimate partner violence, but there is no strong evidence about whether IPV increase or decreases during pregnancy [11].

1. 1.
   
   
   

   Individual Factors
   

   
   

   
   
   1. (a)
      
      
      

      Male factors which increase likelihood of abusing or committing violence [12–14]:
      

      
      

      
      
      • 
        

        Witnessing or experiencing abuse or violence as a child

        
        
      • 
        

        Young age

        
        
      • 
        

        Use of alcohol or drugs

        
        
      • 
        

        Low level of education

        
        
      • 
        

        Personality disorders

        
        
      • 
        

        Acceptance of violence (i.e. a man can beat his partner)

        
        
      • 
        

        Past history of IPV

      
      
       
      
      
   2. (b)
      
      
      

      Women factors which increase likelihood of accepting the abuse or experiencing violence [12, 13, 15]:
      

      
      

      
      
      • 
        

        Low level of education

        
        
      • 
        

        Sexual abuse during childhood

        
        
      • 
        

        Exposure to abuse or violence between parents

        
        
      • 
        

        Acceptance of violence

        
        
      • 
        

        Prior exposure to other forms of violence or abuse

      
      
       
   
   
    
   
   
2. 2.
   
   
   

   Relationship Factors

   
   

   Factors associated with increased risk of both perpetration of men and victimisation of women [12, 13, 16]:
   

   
   

   
   
   1. (a)
      
      
      

      Dissatisfaction or conflict in the relationship

      
      
       
      
      
   2. (b)
      
      
      

      Economic stress

      
      
       
      
      
   3. (c)
      
      
      

      Male dominance

      
      
       
      
      
   4. (d)
      
      
      

      Man having multiple partners

      
      
       
      
      
   5. (e)
      
      
      

      Difference or the disparity of education, i.e. female partner is more educated than her male counterpart

      
      
       
   
   
    
   
   
3. 3.
   
   
   

   Social and Community Factors [12, 13]
   

   
   

   
   
   1. (a)
      
      
      

      Inequality regarding genders

      
      
       
      
      
   2. (b)
      
      
      

      Poverty

      
      
       
      
      
   3. (c)
      
      
      

      Women with low socioeconomic status

      
      
       
      
      
   4. (d)
      
      
      

      Lack of civil rights for female partners, including inequitable and restrictive divorce and marriage laws

      
      
       
      
      
   5. (e)
      
      
      

      For IPV weak community sanctions

      
      
       
   
   
    

There are many beliefs around the globe about gender role and IPV (Table 52.1) [13, 17, 18].

Table 52.1

Gender role in IPV

Beliefs that support IPV associated with the gender role
1.	A man is considered socially superior to a woman and can assert power over a woman as his right
2.	For incorrect behaviour, the man can physically discipline her as his right
3.	For resolving conflicts in a personal relationship, physical violence is accepted at some places
4.	A man has every right in marriage for sexual intercourse
5.	It’s the duty of the women to tolerate IPV to keep her family together
6.	There are some situations in which women deserve to be beaten
7.	Any sexual activity is regarded as a marker of masculinity (including rape)
8.	Considering that the girls are solely responsible for sexual urge in males

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