Domestic violence as risk factor for unwanted pregnancy and induced abortion in Mulago Hospital, Kampala, Uganda

OBJECTIVE: To compare pregnancy intention and domestic violence among women with induced and spontaneous abortion. METHOD: Case-control study in Mulago Hospital, Uganda, from September 2003 to June 2004 of 942 women seeking post-abortion care. Direct inquiry, records review and clinical examination identified 333 with induced abortion (cases) and 609 with spontaneous abortion (controls), who were compared regarding socio-demographic characteristics, contraceptive use, domicile (rural or urban, nuclear or extended families), pregnancy intention, household decision-making and domestic violence. Data was analysed with EPI-INFO and STATA, using Student t-test and analysis of variance for continuous and chi-square for categorical variables. Stratified and multivariate logistic regression analyses were used to adjust for confounding and interaction at the 95% confidence level. RESULTS: Cases significantly differed from controls as they were younger or more often single; had lower parity and education, less household decision-making and fewer living children. They were similar to controls (P > 0.05) regarding employment, spouse's age, years spent in marital relationship and domicile. Cases more frequently (P < 0.001) had mistimed, unplanned or unwanted pregnancy at conception and presentation. Cases were more likely to have a recent history of domestic violence (physical, sexual or psychological) [OR: 18.7 (95%CI: 11.2-31.0)] after adjusting for age, pregnancy intention and marital status. CONCLUSION: Domestic violence is a risk factor for unwanted pregnancy and induced abortion among women seeking post-abortion care. © 2006 Blackwell Publishing Ltd.