Impact of law against domestic violence (DV) on the reproductive health of abuse victims in India.

Objectives: Assess the effect of law against DV on the prevalence of abuse and reproductive health.

Methods: I analyzed DV data from National Family Health Surveys (NFHS 3&4- 2005-06 and 2015-16) of India. The analytical sample was 69,438 NFHS3; n=66,013 NFHS4 of ever-married women aged 15-49 years. The main outcomes were unwanted pregnancy, termination of pregnancy, contraceptive use, age of first birth, and sexually transmitted infections in abuse victims and DV was the main independent variable. Covariates choice was guided by the socioecological model. I used the difference-in-difference model to compare the prevalence between the two surveys.

Results: The prevalence of DV was 39.8% in 2005-06 and 33.3% in 2015-16. In 2005 38.5% of victims were sterilized versus 1% having partner sterilized. In 2015 41% of victims were sterilized and only 0.29% had partners sterilized. There was no difference in the prevalence of victims experiencing STI between NFHS3 (16.5%) and NFHS4 (16.2%). About 29% did not want a pregnancy in 2005 versus 16.5% in 2015; 12.7% had terminated pregnancy in 2005 versus 13.7% in 2015; 66.4% had first birth before 20 years in 2005 versus 49% in 2015. The difference in female sterilization, male sterilization, unwanted pregnancy, and termination of pregnancy between two surveys was not significant. The probability of adolescent pregnancy increased by 3.8% points (p<0.001) and STIs decreased by 1% points (p<0.01) in 2015.

Conclusion: There was a mixed effect on reproductive health outcomes related to DV post-law. There is a need for stringent measures against DV to improve the sexual and reproductive health of women in India.