Intimate partner violence (IPV) is one of the most common forms of violence against women and girls. This includes psychological, emotional, physical and sexual abuse and controlling behaviors by an intimate partner. IPV undermines women’s personal freedom, autonomy and basic human rights and is a major public health problem throughout Pakistan. It has massive social and economic impacts on women, adolescent girls and the wider community.
Pakistan has a patriarchal society where women’s lives are often controlled by male family members. Husbands attempt to control and closely monitor their wives through the use of IPV. Pakistan’s latest Demographic and Health Survey reveals that almost 34% of unmarried women aged 15-49 have experienced domestic violence.
IPV is rooted in widely accepted harmful social norms, including: “sex (including rape) is the right of men in a marriage”, “husbands have the right to exercise power over their wives” and “Girls are responsible for controlling a man’s life. sexual urges”. Women’s reproductive health and rights continue to be violated due to these deeply rooted harmful social norms.
Women in Pakistan are often expected to have children as soon as they are married and are unable to plan their first pregnancy, practice birth spacing and decide on a certain number of children. Women are also “valued” based on their ability to reproduce due to patriarchal concepts of their roles within the family. According to UN Women: “Early marriages and pregnancies, or repeated pregnancies too close together with the aim of producing male offspring due to son preference, have a devastating impact on women’s health with sometimes fatal consequences. »
IPV is perpetrated against women and girls to control their sexual and reproductive health and has been significantly associated with unwanted and unwanted pregnancies and unsafe abortions. According to UN Women, Pakistan has the highest population growth rate – 2.4% – with the lowest contraceptive prevalence rate – 35% – in South Asia. The fertility rate stands at 3.6 births per woman and four million unwanted pregnancies in one year. Women often lack the status and knowledge to negotiate safe sex and contraceptive practices, which increases the likelihood of unwanted and unwanted pregnancies. It also puts women at risk of contracting sexually transmitted infections including HIV, pregnancy complications, pelvic inflammatory disease, urinary tract infections and sexual dysfunctions.
This is seen most significantly in teenage girls who are married to older male spouses with more sexual experience. A UNICEF report revealed that 21% of girls are married before the age of 18 in Pakistan. According to Girls Not Brides, girls who marry before age 15 are 50% more likely to suffer from IPV than those who marry later. It has also been revealed that child marriages are also closely linked to female genital mutilation/cutting (FGM/C), which negatively affects their sexual and reproductive health and rights (SRHR).
Adult spouses can control and wield significant power over young brides through the use of IPV. Further, child brides are not physically and mentally prepared to engage in sexual activity. Children have limited knowledge of their SRHR and limited access to sexual and reproductive health (SRH) services. According to the World Health Organization (WHO), pregnancy and childbirth complications are the leading causes of death for girls aged 15-19. A WHO multi-country study found that teenage mothers were at higher risk of several adverse outcomes, including low birth weight, premature eclampsia and infections, compared to adult mothers.
Various studies have indicated high levels of physical IPV during pregnancy worldwide. According to data revealed by the United States Center for Disease Control (CDC), IPV affects up to 324,000 pregnant women each year in the United States. However, this has not been studied or researched in Pakistan, leaving a significant gap in the protection of women and girls. Physical IPV during pregnancy can affect women’s reproductive health and can also account for a proportion of maternal mortality. Moreover, IPV during pregnancy can lead to miscarriage, late entry into antenatal care, stillbirth, premature labor and birth, etc. However, the WHO notes that this association is often overlooked by policy makers.
According to the CDC, pregnancy can present a unique opportunity for women and girls to connect with health care providers. It is important to ensure that healthcare providers are trained to regularly screen for signs of IPV.
Healthcare providers should educate couples about the risk of adverse birth outcomes from IPV exposure as well as the immediate, medium, and long-term effects on their SRH. Hospitals and clinics should have strong referral mechanisms and should refer women and girls who test positive for IPV to response services, such as shelters, police stations, women’s protection cells, etc. with the consent of the patients/survivors.
The Sindh Reproductive Health Rights Act 2019 is progressive legislation that has been enacted to facilitate reproductive health care and promote reproductive health rights in Sindh. Article 4 specifically grants the right to be free from ill-treatment and to be protected from sexually transmitted diseases such as HIV/AIDS, rape, sexual assault, sexual abuse, sexual harassment and others forms of gender-based violence.
It is undeniable that the role of IPV as an underlying factor in women’s SRHR in Pakistan remains an area that lacks solid data. This association has not been researched or studied in Pakistan, even though the country has a high prevalence of maternal mortality and morbidity and gender-based violence, including IPV.
It is necessary to study the link between IPV and SDSR; this will help policymakers examine the issue at the local level and address the issue with evidence-based information that appropriately addresses the issue. This includes setting up intervention programs that work, such as raising awareness about IPV and SRHR among newlyweds and young couples, building the capacity of health providers, and integrating SRHR into existing health training programs.
According to Section 7(1) of the 2019 Act, the Departments of Health and Population of the Government of Sindh are responsible for supervising the Act and implementing it effectively. However, it is unfortunate that the 2019 law is still not enforced and women and children continue to suffer.
The writer is a lawyer. She tweets @RidaT95 and can be reached at: