Is there an association between pregnant women's experience of violence and their partner's drinking? A Swedish population-based study

Abstract

Objective: Pregnancy is a time of heightened vulnerability for women, especially for experiencing violence in their close and intimate relationships. Alcohol misuse by a male intimate partner is a known contributor to increased risk and severity of intimate partner violence generally, however less is known about the relationship between partner drinking patterns and women's experience of violence in their relationship, and particularly in early pregnancy. This study aimed to explore these associations in a large, population-based sample of Swedish expectant parents.

Design, setting and participants: Data for this cross-sectional study were drawn from 11 461 couples (22 922 participants) enrolled in Salut, a child health promotion programme in Västerbotten County Council, Sweden. Data were collected at women's antenatal care visits during the first trimester of pregnancy.

Measurements: Questionnaires included male partners' self-reported drinking patterns using AUDIT (Alcohol Use Disorders Identification Test) and pregnant women's reports of violence. Descriptive and logistic regression analyses were undertaken to examine prevalence of reported violence and association with partner drinking patterns.

Findings: There was a strong association between male partner alcohol misuse and the odds of pregnant women experiencing violence in general, experiencing violence since becoming pregnant, and fear for their own safety at the time of enrolment in ANC. The odds of having experienced being controlled or physically hurt in a relationship, or having ever experienced sexual violence, were higher with more serious alcohol misuse by the male partner. Most striking was that women whose partners reported hazardous drinking or alcohol dependence had nearly nine times higher odds of experiencing being physically hurt by a partner since becoming pregnant, compared to women whose partners reported non-harmful alcohol use (OR 8.50, CI 2.39-30.17, p = 0.001). Fearing for current safety was also strongly linked to more severe alcohol use by their current male partner (OR 7.65, CI 1.02-57.24, p = 0.048).

Key conclusions and implications for practice: This study contributes population-level evidence that the risk for women of experiencing violence in general or in early pregnancy is exacerbated when a male partner drinks in harmful ways. Health professionals and those supporting pregnant women should pay attention to the role of risk factors such as partner alcohol use. Ensuring the health of pregnant women and safety in their relationships is important for maternal, foetal and infant health and family functioning.

Keywords: Alcohol drinking; Cross-sectional study; Intimate partner violence; Pregnancy; Risk factors; Sweden.