Intimate partner violence during pregnancy and its impact on early initiation of breastfeeding: Exploring mediation and moderation by childbirth complications

Background: Recent research has unveiled a significant link between intimate partner violence (IPV) during pregnancy and challenges in the early initiation of breastfeeding (EIBF) among new mothers. Nonetheless, the potential mechanisms underpinning this interconnection remain elusive. Objectives This study aims to investigate two pivotal aspects: 1) the link between various forms of IPV during pregnancy and EIBF in Bangladesh; and 2) the potential mediating and moderating role of complications during childbirth in this association. Methods A cross-sectional study was undertaken among 426 new mothers of Bangladesh aged 15–49 years who were six months postpartum. IPV was evaluated using a modified version of the domestic violence questionnaire of the WHO Multi-country study. The timing of breastfeeding initiation was determined by asking mothers how long after the birth they put their infant to the breast. Results Nearly three in five women reported EIBF. Based on the adjusted logistic regression model, women subjected to physical and sexual IPV during pregnancy were respectively 46% (AOR: 0.54, 95% CI [0.31, 0.96]) and 51% (AOR: 0.49, 95% CI [0.27, 0.87]) less likely to engage in EIBF, compared to non-abused counterparts. Additionally, complications during childbirth were found to both mediate and moderate the link between IPV and EIBF, even after adjusting for pertinent covariates. Specifically, mothers experiencing both IPV during pregnancy and childbirth complications reported a significantly lower likelihood of EIBF. Conclusions The current findings underscore how IPV during pregnancy can adversely affect maternal breastfeeding practices. Healthcare providers and birth attendants should recognize that mothers experiencing IPV during pregnancy, coupled with childbirth complications, are less inclined to embrace EIBF. Policy interventions concerning antenatal and postnatal care should incorporate IPV screening and breastfeeding support to enhance EIBF rates.