Intimate Partner Violence and Uptake of Antenatal Care: A Scoping Review of Low- and Middle-Income Country Studies

CONTEXT: Intimate partner violence (IPV) is associated with negative physical and mental health outcomes. Antenatal care can act as a link to IPV services, but experiencing IPV may be associated with reduced uptake of antenatal care, an issue that has received little attention from researchers. METHODS: A scoping review was conducted to synthesize quantitative research on IPV and uptake of antenatal care in low-resource settings. Keyword searches of PubMed and other databases and snowball searches of reference lists were conducted to identify articles published in 2005-2015 that measured one or more types of IPV (physical, sexual or emotional) or controlling behavior and assessed the relationship of such abuse with use of antenatal care. For each identified article, key characteristics and findings were abstracted, and study quality was assessed. RESULTS: Sixteen articles, representing 10 low- and middle-income countries, met the inclusion criteria. Most studies were of medium-to-high quality but low rigor, reflecting the abundance of cross-sectional studies in the literature. In all 16 studies, IPV was negatively associated with initiation of antenatal care, number of visits or use of a skilled provider. Analyses revealed reduced odds of antenatal care use among women who had experienced IPV (odds ratios, 0.5-0.8) and elevated odds of antenatal care use among women who had not experienced IPV or of nonuse among women who had experienced IPV (1.2-4.1). CONCLUSION: Women in low-resource settings who experience IPV have a reduced likelihood of obtaining optimal antenatal care and may benefit from interventions to mitigate barriers to care.