Association between intimate partner violence and modern contraceptive use among women presenting for abortion care in Lusaka, the capital city of Zambia
This cross-sectional study of 367 women seeking abortion care in Lusaka, Zambia, found that experiencing intimate partner violence significantly reduces the likelihood of modern contraceptive use, highlighting the need for targeted interventions addressing violence and the specific reproductive health needs of adolescents and peri-urban women.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer
Imagine the human body as a bustling city, and within that city, the reproductive system is a highly guarded, exclusive club. To enter or leave this club without permission (an unwanted pregnancy), you need a special key: contraception. Sometimes, however, the person holding the keys to your life—your partner—decides you aren't allowed to have them. This is where Intimate Partner Violence (IPV) comes in. Think of IPV not just as a physical fight, but as a storm that can be emotional, financial, or physical, shaking the very foundations of a relationship. When a storm rages, it becomes incredibly hard to plan for the future, including whether or not to use a "key" to prevent a pregnancy. Scientists have long wondered: when women face this kind of storm, do they stop using their keys, or do they try to grab them even tighter to protect themselves? This question matters because if we don't understand how violence blocks access to these keys, we can't fix the broken locks, and too many women end up in dangerous situations trying to undo a pregnancy they didn't plan.
This paper is like a detective story set in the capital city of Zambia, where researchers went to four different hospitals to interview women who were there for abortion care. They wanted to solve a specific mystery: Is there a connection between the violence these women experienced and whether they had been using modern contraception (like pills, injections, or implants) in the six months before they got pregnant? The team gathered 372 women, asking them about their lives, their relationships, and whether they had faced any kind of abuse from their partners. They treated the data like a giant puzzle, sorting through the pieces to see which patterns fit together.
The story they uncovered is quite clear and a bit heartbreaking. Out of the women they interviewed, a whopping 63% (that's 231 out of 372) said they had experienced some form of violence from their partner in the last six months. The most common type wasn't a punch or a shove, but "emotional violence"—things like name-calling, humiliation, or controlling behavior, which happened to nearly half of those women. When the researchers looked at the contraception side of the puzzle, they found that less than half (41%) of the women had been using modern methods before they got pregnant.
Here is the big reveal: The paper found a strong link between the violence and the lack of keys. Women who had experienced IPV were significantly less likely to have been using contraception. In fact, the odds of a woman using contraception dropped to just 0.3 times that of a woman who hadn't experienced violence. It's as if the storm of abuse made it nearly impossible for them to keep their keys. The study also noticed that age played a huge role; women over 24 were 14 times more likely to have used contraception than the younger girls and women (aged 14–24). Interestingly, where a woman went for care mattered too; those visiting a specific local hospital (Chawama First Level Hospital) were much more likely to have used contraception than those at the big university teaching hospital, though the researchers couldn't say exactly why that difference existed.
The authors are careful to point out that this doesn't mean violence caused the lack of contraception in every single case, but the two things are tightly connected. They suggest that when a partner is abusive, they might control the woman's body, forbid her from using protection, or make her too afraid to go to a clinic. While some other studies in different parts of the world have suggested that abused women might use contraception more to avoid having more children in a violent home, this study in Zambia found the opposite: the violence seemed to block access to protection entirely. The researchers conclude that to help women avoid unwanted pregnancies and unsafe abortions, we can't just hand out more keys; we also need to stop the storms. Policies need to address the violence itself, especially the emotional and financial control that keeps women trapped, and pay special attention to the younger women who seem to be the most vulnerable.
Drowning in papers in your field?
Get daily digests of the most novel papers matching your research keywords — with technical summaries, in your language.