Do Maternal Depression and Self-Esteem Moderate and Mediate the Association Between Intimate Partner Violence After Childbirth and Postpartum Suicidal Ideation?

Abstract

Intimate partner violence (IPV) during the perinatal period is believed to have an adverse effect on maternal mental health. Given the risks of suicide and related public health concerns, the aim of this study is to examine (1) the association of experiencing physical, psychological, and sexual IPV after childbirth on postpartum suicidal ideation (SI), and (2) whether postpartum depression and self-esteem act to mediate or moderate the relationship between IPV and postpartum SI. A cross-sectional survey was conducted from October 2015 to January 2016 in the Chandpur District of Bangladesh among 426 new mothers, aged 15 to 49 years, who were in the first 6 months postpartum. Multivariate logistic regression models were used to examine the association between experiencing IPV and postpartum SI, controlling for a range of other known influences. The prevalence of postpartum SI was 30.8%. Accounting the influence of other confounders, the odds of postpartum SI were significantly higher among women who reported physical IPV victimization (adjusted odds ratio: 2.65; 95% confidence interval = 1.36, 5.18) at any point during the first 6 months following childbirth as opposed to those who did not. In addition, postpartum depression increased postpartum SI, while high self-esteem significantly reduced reports of SI. Both postpartum depression and maternal self-esteem notably mediate and moderate the effect of physical IPV after childbirth on postpartum SI. The findings illuminate that IPV victimization after childbirth significantly increases the odds of postpartum SI. This study reinforces the need to detect women with a history of IPV who may be at risk for SI, not only to offer them help and support but also to prevent or reduce SI.

Keywords:

• intimate partner violence
• women’s mental health
• postpartum suicidal ideation
• postpartum depression
• self-esteem
• Bangladesh

Acknowledgments

We would like to acknowledge all individuals and institutions in Bangladesh involved in the data collection process. We also express our sincere thanks to Dr. Shehlina Ahmed, Health and Population Advisor, DFID Bangladesh, and Md. Helal Uddin, Joint Chief, Ministry of Planning, Bangladesh for providing funding for the study, and for encouraging us to conduct a study on this important issue.

Disclosure statement

The authors declare that they have no competing interests.

Notes

1 Among the children, 88 were 1 to 2 months old, 168 were 3 to 4 months, and 170 children were 5 to 6 months old.

Additional information

Funding

The study was partially funded by the Joint Donors Technical Assistance Fund (JDTAF) at the Ministry of Health and Family Welfare, Bangladesh. The funding authority had no role in study design, data collection, data analysis, data interpretation, or writing of the manuscript. The corresponding author had full access to all data in the study and had final responsibility for the decision to submit for publication.

Notes on contributors

Md. Jahirul Islam

Md. Jahirul Islam, School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland, Australia; Ministry of Planning, Bangladesh Planning Commission, Sher-e-Bangla Nagar, Dhaka, Bangladesh.

Lisa Broidy

Lisa Broidy, School of Criminology and Criminal Justice, Griffith University, Brisbane, Queensland, Australia; Department of Sociology, University of New Mexico, Albuquerque, New Mexico, USA.

Paul Mazerolle

Paul Mazerolle, University of New Brunswick, New Brunswick, Canada.

Kathleen Baird

Kathleen Baird, School of Nursing and Midwifery, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.

Nurunnahar Mazumder

Nurunnahar Mazumder, Department of Law, Jagannath University, Dhaka, Bangladesh.

Khondker Mohammad Zobair

Khondker Mohammad Zobair, Department of International Business and Asian Studies, Griffith University, Brisbane, Queensland, Australia.