Effects of Intimate Partner Violence, Mental Health, and Relational Resilience on Perinatal Health.

Abstract

Intimate partner violence (IPV) during and prior to pregnancy has been linked to higher rates of pregnancy complications and early labor and delivery. However, to our knowledge, no studies have examined prenatal mental health problems and relational resilience as parallel mechanisms by which past-year IPV exposure impacts pregnancy and labor. The current study aimed to (a) examine the contribution of IPV exposure to pregnancy complications and early labor and delivery, controlling for childhood adversity, and (b) assess prenatal mental health and relational resilience as mediators of the effect of IPV exposure on pregnancy complications and early labor and delivery. We hypothesized that IPV would predict higher levels of mental health problems and lower levels of relational resilience, each of which would contribute to women's risk of labor complications such that fewer mental health problems and higher levels of relational resilience would each be associated with fewer pregnancy complications and early labor and delivery. Participants were (n = 76) interviewed during pregnancy and 6 weeks postdelivery. No direct effect of IPV exposure on either pregnancy complications or labor complications was found. Parallel indirect effects of IPV on labor via prenatal mental health, indirect effect size = -.09; 95% CI [-.224, -.011]; and relational resilience, indirect effect size = .13, 95% CI [.036, .329] were found. Brief, empirically tested IPV screens at prenatal clinics may help healthcare providers better identify IPV-exposed patients. Clinical interventions targeting prenatal mental health and relational resilience may help improve labor outcomes for IPV-exposed mothers.