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Stud Fam Plann. 1998 Sep;29(3):300-8.

Associations between wife-beating and fetal and infant death: impressions from a survey in rural India.

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  • 1Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland.


This report examines the linkages between wife-beating and one health-related consequence for women, their experience of fetal and infant mortality. Community-based data are used drawn from women surveyed in two culturally distinct sites of rural India: Uttar Pradesh in the north, in which gender relations are highly stratified, and Tamil Nadu in the south, in which they are more egalitarian. Results suggest that wife-beating is deeply entrenched, that attitudes uniformly justify wife-beating, and that few women can escape an abusive marriage. They also suggest that the health consequences of domestic violence--in terms of pregnancy loss and infant mortality--are considerable and that Indian women's experience of infant and fetal mortality is powerfully conditioned by the strength of the patriarchal social system. Results are tentative because of data limitations, but they are consistent and strong enough to warrant concern. They argue for the integration of services to identify, refer, and prevent domestic violence in the primary or reproductive health programs of the country and for the safe motherhood programs to be particularly vigilant, sensitive, and responsive to the conditions of battered women during pregnancy and the postpartum period.


Data from a 1993-94 survey of 1842 women 15-39 years old to compare women's autonomy in Uttar Pradesh and Tamil Nadu were analyzed to provide an exploratory, preliminary look at the effect of domestic violence on pregnancy outcomes. The sample included 894 women who had 1 or more pregnancies and were married 10 or fewer years. A socioeconomic profile reveals regional differences in women's decision-making authority and mobility but fewer differences in their ability to make purchases for themselves. Domestic violence affected 40-46% of the sample in Uttar Pradesh and 33-35% in Tamil Nadu and was widely accepted by women and by husbands. At least 27% of the sample reported pregnancy loss (including induced abortion), and 13% of the women who had a live birth experienced an infant death (16% from Uttar Pradesh and 10% from Tamil Nadu). Victims of domestic abuse were significantly more likely to experience fetal wastage or infant death regardless of religion or region of residence. This association survives logistic regression for other factors, such as education, age, number of children ever born, having worked for cash in the past year, number of consumer goods owned, religion, and autonomy. Strategies to combat domestic violence must deal with the root cause, which is women's powerlessness, as well as women's immediate needs. Community education programs must stress women's rights, the likely consequences of domestic violence, and the need to reverse social norms about male supremacy. Additional research is also needed on the sequelae of domestic violence and the attitudes of violent men.

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