Abstract

Background: Intimate partner violence during pregnancy (IPVP) is a strong predictor of maternal postpartum depression (PPD). In Ethiopia, evidence on the association of IPVP with PPD is very limited. To design appropriate intervention, it is thus important to understand how PPD varies as a function of the type and severity of IPV victimization during pregnancy. The aim of this study is to explore the association of different types of IPVP and its severity with PPD in Eastern Ethiopia.

Method: A community based cross-sectional study was conducted from January to October 2018. The study included a sample of 3015 postpartum women residing in Eastern Ethiopia. The cutoff point for PPD was defined as ≥ 13 points according to the Edinburgh Postnatal Depression Scale (EPDS). The prevalence ratio (PR) with 95% confidence intervals (CIs) was calculated, and association between the main predictor (i.e., IPVP) and outcome variable (PPD) was determined using log-binomial regression model.

Results: 16.3% (95% CI: 14.9-17.7) of women experienced postpartum depression. The prevalence of overall IPVP was 30.5%; psychological violence being commonest at 24.4%, followed by physical violence at 11.9% (of which 7.9% reported the severe and 4.0% the moderate level) and sexual violence at 11.0%. After controlling potential confounding factors, the prevalence of PPD among women exposed to severe physical IPVP was 1.98 times higher as compared to those not exposed to the physical IPVP (Adjusted prevalence ratio, APR=1.98; 95% CI: 1.53-2.54). Exposure to psychological IPVP was found to increase the prevalence of PPD by 1.79 as compared to non-exposure to psychological IPVP (APR=1.79; 95% CI: 1.48-2.18). No significant association was observed between PPD and the rest types of violence (moderate level physical IPVP, sexual IPVP and husband’s controlling behavior).

Conclusion and recommendation: The study provides evidence that psychological and severe physical IPV during pregnancy were significantly associated with maternal PPD. Screening of pregnant women for IPV and providing them the necessary support can minimize the risk to PPD.

Implication for the COVID-19 Pandemic

Stress due to disruption of livelihood as well as the disruption of social and protective networks due to the pandemic can all further exacerbate the risk of IPV and depression for the mothers. Therefore, the risks of partner violence and depression that mothers face during the current COVID-19 crisis cannot be ignored and essential services to them including and availability of special hotline counselling need to be designed.

Key words: Intimate partner violence, pregnancy, postpartum depression, women, Ethiopia