Domestic Violence and Contraceptive Use

There are many theories on the relationship between the use of contraceptives and domestic violence, and their implications are very important to women's empowerment in the majority of developing countries. In India, approximately 36% of women reported experiencing some form of physical abuse from their current spouse, and 8% reported being victims of sexual abuse by the hands of their current spouse. Domestic violence has been shown to have numerous negative side effects and is usually coupled with unemployment, low education, low socioeconomic status, low standard of living, and childhood malnutrition.

Relationship between Domestic Violence and Contraceptives

Dominant Theory:

There are a couple of conflicting theories as to what the relationship between contraceptives and domestic violence is. Research in rural India shows that women were less likely to use contraceptives if they had experienced any type of intimate partner violence (i.e. physical, emotional, sexual) . This was thought to be due to the fact that women who are abused are more fearful of the potential consequences of overt or covert contraceptive use. Also, the women that were abused are more likely to have a lower education, live in rural areas, be Muslim, or be of lower socioeconomic status. Women of those demographics usually have more limited access to contraceptives as well. In the United States, a study of 255 women found contradictory results when battered women reported higher levels of contraceptive use. These results were not able to be generalized to the developing world, however, as attitudes towards domestic violence are vastly different in the United States compared to countries such as India and Bangladesh. However, in Sub-Saharan Africa, it was found that women that had been subjected to intimate partner violence were subsequently more likely to resort to contraceptive use. Although researchers were unable to find a direct causal link for why this result might have occurred, it has been theorized that these women use contraceptives in order to avoid raising a child in a destructive home environment.

A 2008 study of the effects of domestic violence on women and their children can attest to the fact that women may increase contraceptive use in order to avoid raising their children in a negative environment. These children are more likely to suffer from anemia as well as malnutrition, as were their mothers when they reported spousal abuse. Researchers offered two explanations as to why this occurs. The first is that husbands in India use starvation as a form of punishment on a woman or child in the family. When the husband withholds food as a form of physical and psychological abuse, malnutrition and anemia are likely to occur. The second reason is that underfeeding occurs due to a lack of empowerment with the wife. This means that she lacks the ability to make decisions about how much and what kind of food her children should be consuming. This theory is supported by the fact that children under the age of 12 months were unaffected by a woman's lack of autonomy, as it was being fed solely through beast milk and the mother had full control over its nutritional intake.

Reverse-Causal Link:

One limitation of these studies is the possibility of a reverse-causal link between domestic violence and the use of contraceptives. In theory, husbands could be resorting domestic violence after discovering covert contraceptive use by their spouse, which would explain the correlation. Reasons could include fear of infidelity and loss of bargaining power, which will be discussed further below.

Further Research

More research needs to be conducted on the possible third party factors that could be influencing both of these factors in a similar way. Working status, for example, is associated with higher contraceptive use as well as higher domestic violence.

Domestic Violence and Evolutionary Ties

Researchers have theorized that domestic violence may occur as a result of tens of thousands of years of evolution of the male brain. Feminist theory states that males feel the need to control their partners sexuality, and often resort to physical violence. Evolutionary theory is in agreement, as it has been found that domestic violence occurs as a result of reproductive uncertainty. Prehistoric males feared that their partner might be mating with others, which made them uncertain whether or not they were the father of their child. As there were no paternity tests or other methods to prove otherwise, men resorted to using physical violence in order to control their partners sexuality and ensure that their genes are passed on. These men were more likely to pass on their genes, therefore their inherited behaviour was passed down and still exists today. Evidence of this fact has been found in India, where working women are more likely to face abuse. Researchers believe that this could be due to the fact that their wives are out of the house for long periods of time, during which they have more opportunities for infidelity. In these cases, it is believed that domestic violence is used as a means to ensure loyalty as well as increase bargaining power that may be lost when the wife has her own income. Strangely, among the working class women, those in the agricultural sector end up facing the most domestic violence of any occupation. These women are the least educated, literate, and empowered of all the working women.

Negative Outcomes of Domestic Violence

The consequences of domestic violence are numerous as well as inter-generational in many developing countries.

Physical Health Effects:

Domestic violence results in negative health effects that extend far beyond the actual time of abuse. Battered women in the US are injured more often in the head, neck, thorax, breasts, and abdomen than other women seeking medical attention. Intimate partner violence has also been linked to an increase in gastrointestinal disorders, hypertension, suppression of the immune system, and more. These women are also more likely to have early pregnancies and contract sexually transmitted infections.

Mental Health Effects:

Abused women are more likely to suffer from a multitude of mental disorders, including depression, anxiety, insomnia, social dysfunction, post-traumatic stress disorder, as well as an increase in suicidal tendencies. A 2006 study looking into the prevalence of PTSD (post traumatic stress disorder) among battered women in Bosnia and Herzegovina. They found that 52.6% of women that reported experiencing abuse reported symptoms that met the criteria for PTSD. Experiencing PTSD was actually more common in battered women than those who had lived through traumatic war experiences or suffered through the loss of a loved one.

Effects on Fetal Health:

Abuse during pregnancy can result in sexually-transmitted diseases, urinary tract infections, substance abuse, depression, and more. All of these consequences are associated with negative health outcomes for fetal health.

Pregnancy-Associated Mortality

A study showed that homicide is the leading cause of death among pregnant women, while it is heart disease among the general population in the US. The youngest and oldest pregnant women were the most likely to die from homicide during pregnancy, and African-American women made up the largest racial demographic.

Economic Impact of Domestic Violence

In addition to severe health effects, domestic violence has a negative impact on the economy as a whole as well. The costs are estimated to be $12.6 billion in the US per year, £5.7 billion in England and Wales plus £17 billion in emotional costs for the victim, and $1.1 billion per year in Canada.

Demographics

Male:

The characteristics linked to increased domestic violence were usually from the men rather than the women, and included: histories of arrest, substance abuse, low education, and unemployment. In the US alone, murder by the hands of an intimate partner on women accounts for 40-60% of total murders.

Female:

Minorities in America are more likely to be victims of intimate partner violence over their lifetimes, include 44% of black women, 46% of first nations women, and 54% of multiracial women. Other than race, characteristics associated with higher prevalence of domestic violence for women include: low education, history of substance abuse, unemployment, cohabitation of unmarried partners, pregnancy, and low income. Women are most likely to experience domestic violence between the ages 18-24 (38.6%).

Inter-State Differences

Among the different states in India there are significant variations in the results and demographics. The results of the studies discussed above are normally not able to be generalized from state to state for this reason, and results should be taken with caution. For example, 60% of women in Bihar reported experiencing some form of non-sexual intimate partner violence, while only 25% of the women in the state of Punjab reported such occurrences. Given that India is such a large and densely populated country, some states have much higher rates of education, employment, literacy, and wealth index. Domestic violence as well as the use of contraception often move hand in hand with this variables.

Alcohol Abuse and Intimate Partner Violence

Alcohol use has been linked to increases in frequency and severity of domestic violence. In India alone, women are twice as likely to be abused when their husband consumes alcohol. Although the correlation between alcohol use and domestic violence has been contested due to the fact that they are both related to education, socioeconomic status, and personality flaws, the relation is still significant holding third party factors constant. Reasons for increased domestic violence due to alcohol consumption include financial stress due to overspending on alcohol, increased risk of infidelity due to lowered inhibitions and lower cognitive function leading to weakened conflict resolution. A possible reverse causation is possible, as partners may increase alcohol consumption due to guilt from spousal abuse.

The consequences of alcohol-related spousal violence reach children as well, who are more likely to show violent and delinquent behaviour during adolescence and alcohol dependence during adulthood. This leads to an inter-generational cycle of abuse and alcohol dependency.

Several preventative measures have been implemented around the world in order to combat the rampant alcohol-related domestic violence that exists today. In the 1980’s, Greenland introduced a coupon-based system that limited adults to 72 beers per month. The result was a 58% reduction in police call-outs for domestic violence. Other measures included raising prices of alcohol, treatment for alcohol abuse disorders, and screening and brief interventions. All resulted in a decrease in domestic violence in their respective areas.