Poor sexual and reproductive health is a very real consequence of intimate partner violence (IPV) – albeit one that is not often talked about.

Intimate partner violence is disproportionately experienced by women. In New Zealand, 55% of women who have ever had an intimate partner (spouse, boyfriend/girlfriend, partner, casual partner) have reported physical, sexual or psychological abuse from a partner.

The Guttmacher Institute reports that the impact of IPV on a woman’s sexual and reproductive health and autonomy can be vast and can influence unintended pregnancy and STI rates, poor birth outcomes and infant health, risky sexual activity, and reduced access to health care.

Intimate partner violence increases the risk of unintended pregnancy and abortion

Intimate partner violence is closely linked with a higher rate of unintended pregnancies and abortion.

There are two main reasons for this:

• Rape by an intimate partner, which may prevent a woman using contraception, particularly condoms.
• Reproductive coercion, including withholding or sabotaging contraception. This can also include pressuring her to keep an unintended pregnancy, or to get an abortion against her wishes.

If a woman is not able to confidently use contraception when she wants to prevent an unintended pregnancy, her bodily autonomy is restricted.

Intimate partner violence is associated with higher rates of STIs, including HIV

Another outcome of sexual violence or the refusal to use condoms can be exposure to STIs, including HIV.

When women experience intimate partner violence, evidence suggests they find it harder to negotiate with their partner to be monogamous – which would give them more protection against STIs.

They may also be more unlikely to get treatment for STIs, as partners may withhold money for sexual health appointments, or prevent them from going to appointments.

Untreated STIs can lead to a range of issues such as infertility, pelvic inflammatory disease, cancer and some pregnancy complications. Untreated HIV can lead to devastating health consequences.

Research also shows that having experienced intimate partner violence increases a woman’s likelihood to be more risky in her own behaviour, for example having more sexual partners and not using condoms consistently.

Partner violence is linked to poorer maternal and infant health outcomes

The Guttmacher Institute’s research also highlights IPV’s negative effect on pregnant and postpartum women.

Most seriously, this can be seen in physical violence towards a pregnant woman, sometimes with the aim of causing a miscarriage.

Women who are victims of IPV just before or during a pregnancy are also less likely to access pre-natal care and are more likely to go into premature labour and have underweight babies.

One study shows that IPV before a delivery is linked to a four times greater chance of stillbirth.

Several pregnancies in quick succession can also be an indicator of IPV, if women are unable to control their fertility through contraception. This also limits the health benefits of spacing pregnancies. 

Understanding the impact that intimate partner violence can have on a woman’s sexual and reproductive health highlights the need for our services to be client-centred, accessible, affordable, confidential and non-judgemental.