Intimate Partner Violence, Reproductive Coercion, Unintended Pregnancy, and Birth Outcomes in Pregnancy Risk Assessment Monitoring System

Male-partner reproductive coercion (RC) includes explicit attempts to promote pregnancy, irrespective of a woman’s desires. Research supports links between intimate partner violence (IPV), RC, and unintended pregnancy (UIP). However, the association between RC, IPV, and UIP is largely limited to community-based samples. Moreover, there is limited evidence of how RC impacts birth outcomes. This study used the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2012 to 2015 to examine the prevalence and the associations between RC, IPV, UIP and birth outcomes. The finding showed that the prevalence of RC or IPV was higher among women who were younger (18-30 years of age), minority race/ethnicity, single, received less than a high school education and were from a low socioeconomic status. Women experiencing IPV had an increased odds of also experiencing RC.
In regards to race and ethnic groups, overall Blacks, Hispanics, and Asians were more likely to report RC than Whites. Black and Hispanic women were more likely to report IPV and an UIP while Asian women were the least likely to report IPV and an UIP. In a sociodemographic adjusted model while accounting for RC and IPV, only Blacks remained at a significantly increased odds for an UIP. With regards to adverse neonatal outcomes including low birth weight (LBW) and preterm birth (PTB), the prevalence of LBW was higher among women reporting IPV or RC that was not statistically significant but clinically significant. Women experiencing IPV reported a higher rate of delivering a PTB while women experiencing RC reported a lower rate of PTB compared to their non-abused counterparts. This study supports the screening for IPV and RC that can help to alleviate health disparities in vulnerable groups of women. Future studies are needed to understand the contexts (e.g. sociodemographic, cultural factors) surrounding RC and its impact on UIP and birth outcomes.