Implications of the effect of different types of intimate partner violence on the use of contraceptives by mothers: evidence from the Philippines
Date
2023-07-12
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Abstract
With the prevalence of unplanned pregnancies and low contraceptive use in the Philippines, there are few existing studies that study the effect of the different types of intimate partner violence (IPV) on use of specific contraceptive methods. This study explores the effect of IPV dimensions such as physical violence, emotional abuse, sexual violence, and controlling behavior on general use of contraceptives and usage per type in both modern and natural methods. The study uses the Cebu Longitudinal Health and Nutrition Survey (CLHNS) that contains information on the 1) presence of
IPV in the household, (2) demographic characteristics, (3) mother’s status, characteristics, autonomy, and exposure and perception to abuse, (4) status and characteristics of the partner, and (5) mother’s use of contraceptives. Propensity Score
Matching (PSM) was used to analyze the effect of IPV on contraceptive use conditional on some observed background characteristics. Our results show that mothers who are susceptible to physical violence increase their use of modern contraceptives [ATE: 0.1200, p ≤ 0.01], specifically ligation [ATE:
0.1008, p ≤ 0.05], but reduce the use of injections [ATE: -0.0236, p ≤ 0.05]. These mothers reduce the use of natural contraceptives, particularly the use of rhythm calendar [ATE: -0.1238, p ≤ 0.01] and rhythm temperature [ATE: -0.0051, p ≤ 0.05]. Maternal exposure to emotional abuse increases the use of withdrawal method [ATE: 0.0804, p ≤ 0.01] as well as condom use [ATE: 0.0364, p ≤ 0.05]. On the other hand, mothers who are vulnerable to sexual violence significantly reduce the use of condom [ATE: -0.0396, p ≤ 0.05] and instead, increases the use of abstinence [ATE: 0.0225, p≤ 0.05]. Lastly, being exposed to controlling behavior, mothers reduce the use of pills [ATE: -0.0503, p ≤ 0.05] and abstinence [ATE: -0.0150, p ≤ 0.10]. We observed that the use of contraceptive methods vary with one’s exposure to a specific type of IPV. Exposure to physical violence affects a mother's decision on using contraceptives wherein they prefer something more effective, lasting, less repetitive, and can completely be hidden to their partners as a way to gain control,
protect their bodies, and prevent bringing a child into a violent household. Conversely, exposure to emotional abuse, sexual violence, and controlling behavior shows that these mothers feel powerless and they still lack participation in decision making as the methods used are dependent to their partner’s decision. Thus, this shows that exposure, perception, and experiencing violence, together with lack of
knowledge, accessibility, and availability of contraceptives shows a cycle of unresolved problems that negatively impacts the overall well-being of our citizens, especially women. This study suggests close monitoring and increased accessibility to
reproductive health services together with improved implementation of the RH Law in addressing these significant issues and gaps in the policies that are detrimental to our country’s vulnerable sectors.
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Keywords
intimate partner abuse, contraceptives, Philippines