Background: Existing evidence suggests that there is an association between maternal exposure to Intimate Partner Violence (IPV) and the uptake of skilled maternal healthcare services. This study aims to explore if women’s educational attainment and wealth status moderate any relationship between IPV and maternal health outcomes in a low-middle-income country, using a large nationally representative data.

Methods: The analyses included 2836 currently married women with one live birth in the five years preceding the 2016 Ethiopian Demographic and Health Survey, who participated in the domestic violence sub-study. Exposure is determined by maternal reports of physical, emotional, or sexual IPV. The utilization of antenatal care (ANC) and place of delivery were used as proxy outcome variables for uptake of skilled maternal healthcare utilization. Multilevel logistic regression analyses were used to explore the association between spousal IPV and maternal health outcomes. Moderation effects by education and wealth status were tested, and the data stratified. Using statistical software Stata MP 16.1, the restricted maximum likelihood method, we obtained the model estimates.

Results: After adjusting for potential confounding factors, the association between maternal exposure to emotional IPV and adequate use of ANC was statistically significant (OR = 0.77, (95% CI:0.61 - 0.98)). Associations with physical or sexual IPV was not identified. In the stratified analyses, we demonstrate a statistical significant association between exposure to emotional IPV and use of ANC service in women with low levels of education (OR = 0.74, (95% CI:0.57 - 0.96)), and those living in low household wealth status (OR = 0.71, (95% CI:0.52 - 0.97)), but not in their counterparts with higher education and high household wealth status.

Conclusion: Exposure to emotional IPV seems to be associated with poor uptake of adequate ANC service for married Ethiopian women. When targeting expecting mothers reluctant to use maternal healthcare services, prevention of IPV appears relevant, especially among those in the low-income and education levels.