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The Marital Implications of Bereavement: Child Death and Intimate Partner Violence in West and Central Africa

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The Marital Implications of Bereavement: Child Death and Intimate Partner Violence in West and Central Africa Demography (2020) 57:347–371 https://doi.org/10.1007/s13524-019-00846-7 The Marital Implications of Bereavement: Child Death and Intimate Partner Violence in West and Central Africa Abigail Weitzman1 & Emily Smith-Greenaway2 Published online: 27 January 2020 # Population Association of America 2020 Abstract In high-mortality contexts, research examining the effects of child mortality has focused almost exclusively on couples’ fertility responses while overlooking other potential family consequences. Using nationally representative survey data from 13 West and Central African countries, we estimate multilevel discrete-time hazard models to determine how women’s risk of intimate partner violence (IPV) varies with the death of children. We assess heterogeneity in this association across two surrounding cir- cumstances: children’s age at death and regional prevalence of child bereavement. Findings indicate that the risk of IPV initiation rises with the death of children under age 5—for whom women are most intensely responsible—but not with the death of older children. The effect of young child bereavement is most pronounced in regions where it is least prevalent among mothers—a finding not explained by concomitant regional variation in gender inequality, family norms, and infrastructural development. These findings highlight the importance of child mortality for family outcomes beyond fertility in the African context and demonstrate the prominent role of the broader mortality context in shaping these implications. Keywords Intimate partner violence . Child mortality . Bereavement . West and Central Africa Electronic supplementary material The online version of this chapter (https://doi.org/10.1007/s13524-019- 00846-7) contains supplementary material, which is available to authorized users. * Abigail Weitzman [email protected] 1 Department of Sociology, University of Texas at Austin, 305 East 23rd Street, A1700, RLP 3.306, Austin, TX 78712–1086, USA 2 Department of Sociology, University of Southern California, 851 Downey Way, Hazel & Stanley Hall 314, Los Angeles, CA 90089–1059, USA Downloaded from http://read.dukeupress.edu/demography/article-pdf/57/1/347/844657/347weitzman.pdf by guest on 24 September 2021 348 A. Weitzman, E. Smith-Greenaway Introduction The death of a child can be a highly stressful experience with the potential to alter the course of couples’ relationships. Although many studies have examined the effects of child bereavement (experiencing the death of a child) on parents’ relationship quality and stability in the United States and Europe (for a review, see Albuquerque et al. 2016; Oliver 1999), surprisingly little research has taken up similar questions in countries where child mortality is concentrated. Instead, studies of high-mortality contexts have focused primarily on couples’ fertility responses (Aksan 2014; Bongaarts et al. 1984; Defo 1998; Gyimah and Fernando 2004; Lindstrom and Kiros 2007). The resulting chasm prevents scholars from fully comprehending the familial consequences of child mortality in areas of the world where most child deaths occur. We examine how the death of a child affects the risk of intimate partner violence (IPV) among mothers in West and Central Africa, where both IPV and child mortality rates remain particularly high (Devries et al. 2013; World Bank 2015). West and Central African countries today host 17 of the world’s 20 highest child mortality rates (World Bank 2015). For instance, in Angola, Chad, and the Central African Republic, 16%, 14%, and 13% of children (respectively) die before age 5 (World Bank 2015). Within these countries, however, child mortality is unevenly spatially distributed (Balk et al. 2004), meaning that some communities experience higher rates of child mortality and bereavement than others (Smith-Greenaway and Trinitapoli 2019). Previous research suggests that the community prevalence of child bereavement should shape local interpretations of child loss, social support for be- reaved parents, and perceptions of the average woman’s ability to protect her child from harm (Sandberg 2006; Scheper-Hughes 1992; Trinitapoli and Yeatman 2018). We therefore also investigate how the broader mortality context in which a child’sdeath takes place conditions its implications for IPV. To ensure that we do not conflate the prevalence of child bereavement with underlying conditions, we additionally assess concomitant heterogeneity in the effects of child bereavement across contextual levels of gender inequality, family norms, and infrastructural development. Leveraging new information on the timing of IPV initiation, collected through the most recent wave of Demographic and Health Surveys (DHS), we estimate a series of multilevel discrete-time hazard models that assess how the risk of IPV onset varies with child bereavement and how this relationship varies across context. Given that most child mortalities occur before age 5, and that the effects of child bereavement may vary with a child’s age at death (Rogers et al. 2008; Song et al. 2010), we distinguish between the effects of losing children under and over age 5. To bolster our conclusions, we further use information on the timing of IPV to conduct a supplementary analysis in which we carefully assess the reverse scenario—for example, whether IPV predicts subsequent child fatalities. Our emphasis and assessment of IPV as a potential consequence of child death not only expands current understandings of the familial repercussions of child mortality but further moves beyond long-standing assumptions that negative associations between IPV and child well-being are driven exclusively by an effect of IPV on the quality of parental caregiving and the household environment (Emery et al. 2015; Letourneau et al. 2013; Nixon et al. 2017;Sullivanetal.2001). Drawing on previous studies indicating a degradation of parents’ marriage following the death of a child (Lyngstad 2013;Rogersetal.2008) and suggesting that women are often blamed for children’s Downloaded from http://read.dukeupress.edu/demography/article-pdf/57/1/347/844657/347weitzman.pdf by guest on 24 September 2021 The Marital Implications of Bereavement 349 adverse outcomes (Castle 1994;Hawsetal.2010), we propose and test an alternative account of positive associations between IPV and child mortality. Our analyses chal- lenge common conceptualizations of the relationship between IPV and child survival, broaden current understandings of the implications of child death for parents in Africa, and illustrate how the surrounding mortality context shapes these implications. Background Child Death and IPV Numerous studies have found that mothers’ history of IPV is associated with negative child health outcomes (Karamagi et al. 2007;Ricoetal.2011; Silverman et al. 2009; Sobkoviak et al. 2012; Yount et al. 2011) and higher rates of child mortality before age 5(AckersonandSubramanian2009; Åsling-Monemi et al. 2003;Jejeebhoy1998;Rico et al. 2011). Although negative associations between IPV and child health and survival are documented across diverse countries, most studies have drawn on data sources in which IPV is measured in terms of lifetime prevalence or the last year only (Ackerson and Subramanian 2009; Åsling-Monemi et al. 2003;Jejeebhoy1998;Karamagietal. 2007;Ricoetal.2011). As such, scholars have been unable to disentangle the temporal ordering of events. It thus remains possible that some of the previously observed associations are due to child illness or death elevating women’sriskofabuse. In fact, extant scholarship points to a number of reasons why women may be at heigh- tened risk of IPV after a child’s death. One is that social narratives of “good mothering” (Hays 1998; Lupton 2012) blame women when children do not thrive (Dunn et al. 1991; Fish 1986; Sisay et al. 2014; Wing et al. 2001), including in sub-Saharan Africa, where caring for young children is considered women’s work. That is, because women are predominantly responsible for childrearing, their husbands, in-laws, and other community members often view and treat them as responsible for child health outcomes (Hays 1998; Jackson and Mannix 2004;Lupton2012) and correspondingly blame women for the death of young children (Castle 1994;Hawsetal.2010). If a husband blames his wife for the death of their child, this blame could spawn IPV, as one study from the United States suggests (Gold et al. 2018). Notably, however, maternal blame may be conditional on a child’s age at death: to the extent that children become less fragile, gain physical indepen- dence (e.g., discontinue breastfeeding), and spend less time with mothers as they age (Abdullah et al. 2007; Milkie et al. 2004), women may be perceived as decreasingly responsible for children’s outcomes as they grow older (Ricci et al. 1996). Even if men do not directly blame wives for a child’s death, the psychological distress experienced as a result of bereavement may exacerbate the risk of IPV. Research from the United States and Europe suggests that in the wake of bereavement, parents experience stress, anxiety, grief, depression, and identity loss (Wijngaards-de Meij et al. 2008;Murphyetal.2002; Toller 2008). These conditions can persist for years (Murphy et al. 2002, 2003a, b) and, because of a longer attachment period, may be especially pronounced after the death of an older child (Rogers et al. 2008). Such distress can lead to anxious attachment, in which one spouse becomes troubled that the other will not be available when needed (Wijngaards-de Meij
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