Across 81 countries around the world, one-third of all women suffer domestic abuse at some point in their lives.

Domestic abuse has significant direct and indirect costs. Direct costs are those borne by the women who have been physically or sexually abused themselves, while indirect costs are borne by other household members, especially children.

An important source of data on domestic abuse in developing countries comes from Demographic and Health Surveys – nationally representative studies of population and health, compiled using more than 300 surveys carried out in more than 90 developing countries.

In our yet-to-be-published research, we analyzed 48 surveys from 32 developing countries between 2000 and 2014, which included a questionnaire on domestic abuse. Women aged 18 to 49 were interviewed for the surveys, and fertility histories were collected so that data on all births and deaths of children that respondents have ever had was documented.

We analyzed a sample of approximately 0.8 million children born between 1975 and 2013, investigating the impact of a mother’s abuse on the mortality – or death rate –of their children. Since we know that mortality will also depend on other things, such as parent’s education, mother’s age, child gender, birth order, urban location, country and survey year, we controlled for these factors.

We found that children born in families where the mother experienced domestic abuse are 0.4 percentage points more likely to die within their first 30 days (neonatal mortality), 0.7 percentage points more likely to die within a year (infant mortality), and 1.1 percentage points more likely to die within five years of being born (under-five mortality), compared to children whose mothers did not suffer abuse.

These effects are substantial given that neonatal, infant and under-five mortality rates are 3.2 percent, 6.5 percent and 9.6 percent, respectively. In relative terms, this suggests that being born to a mother who suffered domestic abuse makes a child 12.5 percent more likely to die within 30 days of birth, 10.7 percent more likely to die by one year of age, and 11.5 percent more likely to die before the age of five.

There are several mechanisms that could be behind the relationship we find between domestic abuse and child mortality.

In the case of neonatal mortality, an unborn child’s health could be directly affected if the mother suffers physical domestic violence when she is pregnant, causing physical trauma to the fetus. It’s also possible that victims of domestic abuse have inadequate access to prenatal health care or adequate nutrition, and experience high levels of psychological stress which are associated with low birth weight and pre-term delivery.

Growing up in an abusive environment also affects children’s health, leading to higher rates of infant and under-five mortality. Mothers who suffer domestic abuse may also have restricted access to postnatal health care and adequate nutrition, and we cannot rule out the fact that children themselves may become directly subject to abuse and violence.

Domestic Violence Laws

In the developing world, 72 countries passed domestic violence legislation between 1993 and 2013. But implementation matters as much as the legal framework.

Cambodia, for example, passed the Law on the Prevention of Domestic Violence and the Protection of Victims in 2005, which criminalizes domestic violence. But a report by the Cambodian NGO Committee on the Convention on the Elimination of All Forms of Discrimination Against Women found enforcement was hampered by a lack of awareness about laws among women, limited supporting infrastructure for women wishing to report domestic violence or escape their abusers, corruption among the judiciary, the prevalence of bribes to avoid prosecution, and improper training of the authorities to deal with domestic violence cases.

With this in mind, the OECD Development Centre’s Social Institutions and Gender Index assigns countries a score based on whether there is legislation in place to address domestic violence in the country, and also whether there are reported problems with implementation of the law.

We used the OECD measure to investigate whether having domestic violence laws in place makes a difference to the relationship between abuse and child mortality.

Our results suggest that a stronger legal framework supporting women against domestic violence does indeed lead to reduced incidence of domestic violence. This could be either because the laws deter violence, or because the sanctions they impose incapacitate the perpetrators.

Our work clearly indicates that domestic abuse imposes costs beyond those borne directly by the mother. Even when you account for effective laws, there is still a strong positive relationship between domestic violence and child mortality in the data.

Large numbers of women across the globe continue to suffer from domestic violence. They suffer economically, mentally and physically. But our research shows their children may also be facing disadvantages which they would otherwise not need to face.

In particular, it affects the ability of parents to invest in their child’s health in developing countries. This means that in the long run, domestic violence is likely to influence adult health and well-being, social performance and labor market productivity.

The good news is that legal sanctions can make a significant difference. This means that providing a proper legal framework, and enforcing it, is likely to safeguard women against domestic violence, and will improve not only their lives, but those of their children.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Women & Girls.