Intimate partner violence and early resumption of sexual intercourse among married postpartum women in Ethiopia: a survival analysis using Performance Monitoring for Action (PMA) data

Eyob Tilahun Abeje^1*Fekade Demeke Bayou¹Fekadeselassie Belege Getaneh²Lakew Asmare¹Abel Endawkie¹Alemu Gedefie³Amare Muche¹Anissa Mohammed¹Aznamariam Ayres¹Dagnachew Melak¹

• ¹Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Wollo University, Dessie, Ethiopia, Dessie, Ethiopia
• ²2Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia, Dessie, Ethiopia
• ³Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia, Dessie, Ethiopia

Introduction: Many women worldwide resume sexual activity soon after childbirth, often before the recommended six-week recovery period. Early postpartum intercourse poses health risks, including infections and delayed healing. This study aims to assess the timing of resuming sexual intercourse and its associated factors among postpartum women in Ethiopia using PMA data.The data was from the Performance Monitoring for Action (PMA) project, a crosssectional design followed by cohort follow-up, employed to analyze the sociodemographic and reproductive characteristics of women aged 15-49. Pregnant women and five up to nine weeks postpartum at baseline were included in the study. Descriptive statistics and Cox proportional hazard model were used for analysis using R 4.4.1 software. Proportional hazard assumption was fulfilled using graphical and statistical tests. The model fitness was checked using martingale residual plot.The study found that 29% of participants resumed sexual intercourse before the recommended 42 days postpartum, while 91% resumed by 68 days. The median survival time was 8 weeks (57 days). Intimate partner pressure significantly influenced early resumption, women who were pressured by their intimate partner were 5.56 times more likely to resume sexual activity early.Discussion: Many postpartum women in Ethiopia resume sexual activity earlier than recommended, often due to pressure from their intimate partners. Intimate Partner violence significantly influences this early resumption. The findings highlight the need for better support and education on postpartum sexual health, addressing both physical recovery and social pressures women face.