PT  - JOURNAL ARTICLE
AU  - Shannon N. Wood
AU  - Robel Yirgu
AU  - Abigiya Wondimagegnehu
AU  - Jiage Qian
AU  - Rachel Mait Milkovich
AU  - Michele R Decker
AU  - Nancy Glass
AU  - Fatuma Seid
AU  - Lensa Zekarias
AU  - Linnea A. Zimmerman
TI  - Impact of the COVID-19 pandemic on intimate partner violence during pregnancy: evidence from a multimethods study of recently pregnant women in Ethiopia
AID  - 10.1136/bmjopen-2021-055790
DP  - 2022 Apr 01
TA  - BMJ Open
PG  - e055790
VI  - 12
IP  - 4
4099  - http://bmjopen.bmj.com/content/12/4/e055790.short
4100  - http://bmjopen.bmj.com/content/12/4/e055790.full
SO  - BMJ Open2022 Apr 01; 12
AB  - Objectives This multimethods study aimed to: (1) compare the prevalence of intimate partner violence (IPV) during pregnancy pre-COVID-19 and during the COVID-19 pandemic using quantitative data and (2) contextualise pregnant women’s IPV experiences during the COVID-19 pandemic through supplemental interviews.Design Quantitative analyses use data from Performance Monitoring for Action-Ethiopia, a cohort of 2868 pregnant women that collects data at pregnancy, 6 weeks, 6 months and 1-year postpartum. Following 6-week postpartum survey, in-depth semistructured interviews contextualised experiences of IPV during pregnancy with a subset of participants (n=24).Participants All pregnant women residing within six regions of Ethiopia, covering 91% of the population, were eligible for the cohort study (n=2868 completed baseline survey). Quantitative analyses were restricted to the 2388 women with complete 6-week survey data (retention=82.7%). A purposive sampling frame was used to select qualitative participants on baseline survey data, with inclusion criteria specifying completion of quantitative 6-week interview after the onset of the COVID-19 pandemic, and indication of IPV experience.Interventions A State of Emergency in Ethiopia was declared in response to the COVID-19 pandemic approximately halfway through 6-week postpartum interview, enabling a natural experiment (n=1405 pre-COVID-19; n=983 during-COVID-19).Primary outcome measures IPV during pregnancy was assessed via the 10-item Revised Conflict and Tactics Scale.Results 1-in-10 women experienced any IPV during pregnancy prior to COVID-19 (10.5%), and prevalence of IPV during pregnancy increased to 15.1% during the COVID-19 pandemic (aOR=1.51; p=0.02). Stratified by residence, odds of IPV during the pandemic increased for urban women only (aOR=2.09; p=0.03), however, IPV prevalence was higher in rural regions at both time points. Qualitative data reveal COVID-19-related stressors, namely loss of household income and increased time spent within the household, exacerbated IPV.Conclusions These multimethods results highlight the prevalent, severe violence that pregnant Ethiopian women experience, with pandemic-related increases concentrated in urban areas. Integration of IPV response and safety planning across the continuum of care can mitigate impact.Quantitative data are available on request from pmadata.org. Qualitative data are not available to maximise participant confidentiality.