22: Intimate partner violence and pregnancy: Narratives of pregnant and parenting teens

Abstract

PurposeAdolescent intimate partner violence (IPV) is closely associated with pregnancy and unprotected sex in multiple epidemiologic samples, but potential mechanisms for this association have not been clearly elucidated. The purpose of this qualitative study is to describe the chronologies of pregnancy and IPV experiences among adolescent girls with known history of abusive relationships.MethodsWe report on a subsample of pregnant and parenting teens recruited for a study on adolescent IPV and sexual health. A convenience sample of 31 adolescent girls who have been pregnant, currently pregnant, and/or parenting, were referred by health care providers and DV advocates for an IPV history. The clinical sites are all located in low-income, urban, underserved communities. The girls, ages 14-20, completed a health survey and 60 minute open-ended narrative interview about their experiences in abusive relationships, with a focus on the relationship between IPV experiences and pregnancy. The interviews were also coded for multiple contextual factors including education, family violence, sexual health and behaviors, as well as substance use and mental health.ResultsPregnancy (intended, unintended, and undesired) is common in the context of adolescent IPV. The temporal association of IPV to pregnancy experiences varies significantly, with IPV both preceding as well as following pregnancy. Specifically, IPV is often a direct factor leading to unintended pregnancy including forced sex, birth control sabotage (where the perpetrator intends pregnancy), and condom refusal. However, in other cases, the pregnancy precedes experiences of IPV (whether perpetrated by father of the baby or new partner), highlighting the complex vulnerabilities of pregnant and parenting teens in the context of familial, financial, educational and social constraints.ConclusionsAdolescent IPV is often associated with experiences of pregnancy, in the context of power and control in an abusive relationship. These results underline the need to incorporate discussions of healthy and unhealthy relationships in the context of teen sexual health education. In addition, these patterns underscore the need to include relationship violence screening consistently and repeatedly when providing care for pregnant, parenting teens and their children.SupportWilliam T Grant Foundation Scholars Award; Centers for Disease Control. PurposeAdolescent intimate partner violence (IPV) is closely associated with pregnancy and unprotected sex in multiple epidemiologic samples, but potential mechanisms for this association have not been clearly elucidated. The purpose of this qualitative study is to describe the chronologies of pregnancy and IPV experiences among adolescent girls with known history of abusive relationships. Adolescent intimate partner violence (IPV) is closely associated with pregnancy and unprotected sex in multiple epidemiologic samples, but potential mechanisms for this association have not been clearly elucidated. The purpose of this qualitative study is to describe the chronologies of pregnancy and IPV experiences among adolescent girls with known history of abusive relationships. MethodsWe report on a subsample of pregnant and parenting teens recruited for a study on adolescent IPV and sexual health. A convenience sample of 31 adolescent girls who have been pregnant, currently pregnant, and/or parenting, were referred by health care providers and DV advocates for an IPV history. The clinical sites are all located in low-income, urban, underserved communities. The girls, ages 14-20, completed a health survey and 60 minute open-ended narrative interview about their experiences in abusive relationships, with a focus on the relationship between IPV experiences and pregnancy. The interviews were also coded for multiple contextual factors including education, family violence, sexual health and behaviors, as well as substance use and mental health. We report on a subsample of pregnant and parenting teens recruited for a study on adolescent IPV and sexual health. A convenience sample of 31 adolescent girls who have been pregnant, currently pregnant, and/or parenting, were referred by health care providers and DV advocates for an IPV history. The clinical sites are all located in low-income, urban, underserved communities. The girls, ages 14-20, completed a health survey and 60 minute open-ended narrative interview about their experiences in abusive relationships, with a focus on the relationship between IPV experiences and pregnancy. The interviews were also coded for multiple contextual factors including education, family violence, sexual health and behaviors, as well as substance use and mental health. ResultsPregnancy (intended, unintended, and undesired) is common in the context of adolescent IPV. The temporal association of IPV to pregnancy experiences varies significantly, with IPV both preceding as well as following pregnancy. Specifically, IPV is often a direct factor leading to unintended pregnancy including forced sex, birth control sabotage (where the perpetrator intends pregnancy), and condom refusal. However, in other cases, the pregnancy precedes experiences of IPV (whether perpetrated by father of the baby or new partner), highlighting the complex vulnerabilities of pregnant and parenting teens in the context of familial, financial, educational and social constraints. Pregnancy (intended, unintended, and undesired) is common in the context of adolescent IPV. The temporal association of IPV to pregnancy experiences varies significantly, with IPV both preceding as well as following pregnancy. Specifically, IPV is often a direct factor leading to unintended pregnancy including forced sex, birth control sabotage (where the perpetrator intends pregnancy), and condom refusal. However, in other cases, the pregnancy precedes experiences of IPV (whether perpetrated by father of the baby or new partner), highlighting the complex vulnerabilities of pregnant and parenting teens in the context of familial, financial, educational and social constraints. ConclusionsAdolescent IPV is often associated with experiences of pregnancy, in the context of power and control in an abusive relationship. These results underline the need to incorporate discussions of healthy and unhealthy relationships in the context of teen sexual health education. In addition, these patterns underscore the need to include relationship violence screening consistently and repeatedly when providing care for pregnant, parenting teens and their children. Adolescent IPV is often associated with experiences of pregnancy, in the context of power and control in an abusive relationship. These results underline the need to incorporate discussions of healthy and unhealthy relationships in the context of teen sexual health education. In addition, these patterns underscore the need to include relationship violence screening consistently and repeatedly when providing care for pregnant, parenting teens and their children.