Prevalence and predictors of intimate partner violence among women attending infertility clinic in south-western Nigeria

Abstract

Objective

The study evaluated the prevalence and predictors of intimate partner violence among infertile women attending infertility clinic of Ekiti State University Teaching Hospital, Ado-Ekiti.

Study design

A cross sectional study of infertile women presenting at the clinic between 1st November 2012 and 31st October 2013 was done. A semi-structured questionnaire on violence was administered to 170 consecutive women who consented to participate. The data were analysed using SPSS 17 and significances test were performed on variables associated with violence with Student's t test and Chi square test. Logistic regression was done to determine predictive factors associated with intimate partner violence.

Results

The prevalence of intimate partner violence associated with infertility among the women was 31.2%. There were no significant differences in the age of the women, duration of marriage and duration of infertility between the women who had experienced violence and those who had not experienced it; p > 0.05. Unemployment, polygamous marriage, husbands’ social habits, primary infertility and prolonged duration of infertility were associated with violence in these women; p < 0.05. Education of the women and their husbands, their religion and ethnicity were not significantly associated with violence; p > 0.05. However with logistic regression, the unemployment status of the women and prolonged duration of infertility were the predictors of violence against women with infertility in this study, p value < 0.05. More than 50% of the women reported psychological violence as the commonest form of violence experienced by them ever, since the diagnosis of infertility was made and in the past one year. All forms of violence experienced were aggravated by infertility in these women.

Conclusion

Women with infertility are prone to intimate partner violence and this would further aggravate the challenges of infertility being faced by these women.

Introduction

Infertility is a common gynaecological problem that is associated with social stigma, social neglect, economic deprivation, emotional stress, unhappiness and marital instability [1]. It is a global problem with regional variation in the prevalence rate and the World Health Organisation (WHO) estimates that 8–12% of couples would experience difficulty in conception after 1 year of regular unprotected sexual intercourse [2], [3]. Both male and female factors have been implicated in the aetiology of infertility with each factor being responsible in about 30–40% of cases while the remaining 30% are due to the interaction of both female and male factors [4]. However, the woman is often blamed for the couple's infertility in most cases and suffers deprivation economically, socially and emotionally as consequences [3], [5], [6]. In fact, infertility is a major cause of marital discord and divorce [2].

Violence against women is a global major health and human right concerns as this affects millions of women all over the world across ethnicity, culture, socioeconomic and educational classes. The Declaration on the elimination of violence against women, adopted by the United Nation in 1992, defines violence against women as “any act of gender based violence that results or likely to result in physical, sexual or psychological harm or suffering to women including threats of such harm, coercion or arbitrary deprivation of liberty whether occurring in public or private life [7]. The World Health Organization (WHO) estimates that at least one in five women have experienced violence in their lives [8].

There are several studies on risk factors for domestic violence in pregnancy while studies on domestic violence and infertility are limited in Nigeria. It has been found that women with infertility are twice more likely to be at risk of suffering from violence than women who have children [2], [6]. The life time prevalence of domestic violence against women with infertility varies widely all over the world: it is 1.8% in Hong Kong [9], 33.6% in Turkey [2] and 61.8% in Iran [6] while one of the few available studies from Nigeria reported 41.8% [10]. Women who experience violence are more likely to have depression, anxiety, psychosomatic symptoms, eating problems and sexual dysfunctions. The effects of violence may also be fatal as a result of intentional homicide, severe injury or suicide [2].

Despite the magnitude and enormous nature of violence against women, there is paucity of studies on violence against women with infertility in Sub-Saharan Africa especially Nigeria. This study was carried out to determine the prevalence of violence and its predictive factors among women attending infertility clinic of Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria.