Intimate partner violence and late entry into antenatal care in Ethiopia

Background: Utilization of maternal health care services and timely initiation of antenatal care (ANC) positively influence pregnancy outcomes. The prevalence of intimate partner violence(IPV) during pregnancy is very high in Ethiopia, but we have limited knowledge on the link between IPV and initiation of ANC. Aim: To determine the association between IPV and late entry into ANC. Methods: A cross sectional study was conducted among pregnant women attending ANC at the governmental health institutions. A total of 720 pregnant women were interviewed by five trained nurses or midwives, using standardized and pretested questionnaire. Descriptive, bivariate and multivariate logistic regression and parity-stratified analyses were employed. Findings: Over half of the pregnant women (51.8%; 95% CI = 48.1, 55.5) entered ANC late (> 16 weeks). Controlling for demographic, behavioural and reproductive health related variables, among multiparous women, any lifetime emotional or physical abuse was associated with late ANC [Adjusted odds ratio (AOR) = 2.28; 95%CI = 1.18, 4.39]. However, reporting recent experience of partner sexual violence was associated with late ANC in the full sample (AOR = 1.55; 95%CI = 1.09, 2.19). Conclusion: The proportion of pregnant women entering ANC late is high in Ethiopia and associated with prior and recent experience of IPV in the current pregnancy, especially among multiparous women. Efforts for preventing IPV in pregnancy are needed to ensure that all pregnant women initiate ANC early in pregnancy. Aims of improving the health sector responses should include training health care workers on IPV that could facilitate ongoing screening, awareness creation, and women's social support networks. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of Australian College of Midwives.