Intimate Partner Violence is Associated with Voluntary Sterilization in Women

Intimate partner violence (IPV) may interfere with women's use of preferred forms of contraception, resulting in unwanted pregnancies forcing women to seek permanent sterilization. A history of child sexual abuse (CSA) presages the risk for IPV in adulthood setting the stage for adverse reproductive outcomes.

To determine whether CSA and IPV are associated with women's voluntary sterilization when adjusting for demographics and reproductive health history.

This cross-sectional study is based on in-person interviews of women (N = 278) drawn from outpatients surveyed in more than 10 different clinics (N = 2465). Women's history of gender-based violence and bilateral tubal ligation (BTL) were assessed.

About half of the women had a past history of IPV and 29% disclosed CSA. CSA predicted later entry into an abusive relationship (odds ratio [OR] = 6.7). Sterilization was reported by 19.6%. Parity (3+ children), having had an abortion, and receipt of welfare were associated with sterilization in univariate tests. Among those women receiving a BTL, 74% had violent partners. Adjusted multivariate logistic regressions, adjusted for demographics and reproductive history, indicated that having had an abusive partner increased the odds of sterilization; parity was also highly associated. CSA exerted only an indirect influence on sterilization via entry into violent relationships.

IPV raises the likelihood that women will choose sterilization. Despite the importance of women's access to permanent contraception, priority should be given to screening for gender-based violence and promoting interventions.