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Published on: February 3, 2026
Patterns of intimate partner violence after abortion seeking in Nepal (2019-2024): a prospective cohort study
Rachel Murro1, Nadia G Diamond-Smith1,2, Mahesh C Puri3
1Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, USA.
Background:
Women in Nepal commonly experience intimate partner violence. This study aims to understand how abortion access, a key indicator of reproductive autonomy, may be linked to partner violence in this setting.
Methods:
Between April 2019 and December 2020, pregnant women seeking an abortion at 22 facilities across all provinces in Nepal were recruited into a prospective cohort study. The primary exposure was pregnancy outcome (gave birth vs. did not give birth). The outcome, intimate partner violence, was measured at baseline and then every 12 months using indicators of emotional, physical, economic, and sexual violence. Sociodemographic, health, and care-seeking characteristics were collected at baseline. Mixed effects multivariable logistic regression models, adjusted via propensity score weighting, were used to assess the association between birth and subsequent intimate partner violence via risk differences (RDs).
Findings:
A total of 1742 pregnant women were followed for a median duration of 62 months. At baseline, 15% reported experiencing emotional violence in the past year, 12% physical, seven percent economic, and nine percent sexual violence. Weighted models showed no significant change in violence risk from baseline among individuals who gave birth (five-year RD = 0.02; 95% CI -0.09 to 0.14). In contrast, overall violence declined among those who did not give birth (one-year RD = -0.05; 95% CI -0.08 to -0.03, five-year RD = -0.08; 95% CI -0.16 to -0.01). This group also experienced declines in physical and economic violence specifically. In comparing the two groups, women who did not give birth experienced less violence overall than those who gave birth, particularly in years two (RD = 0.05; 95% CI 0.00 to 0.10), three (RD = 0.07; 95% CI 0.01 to 0.13), four (RD = 0.07; 95% CI 0.01 to 0.13), and five (RD = 0.10; 95% CI 0.03 to 0.16) after abortion seeking.
Interpretation:
Compared to those who were able to end their pregnancy, women who gave birth were at higher risk of partner violence, even several years after abortion seeking. Abortion access may offer protection against intimate partner violence compared to carrying an unwanted pregnancy to term.
Funding:
This study was supported by the National Institutes of Health and the David and Lucile Packard Foundation.