The Effects of Intimate Partner Violence Before, During, and After Pregnancy in Nurse Visited First Time Mothers

Abstract

To determine the prevalence of intimate partner violence (IPV) before, during and after pregnancy in a national sample of women enrolled in the Nurse Family Partnership (NFP); and, to determine correlates of IPV exposure. Clients enrolled in the NFP between 2002 and 2005 were selected. Data were extracted from NFP client encounter forms including demographic, health habits, family and relationships, and maternal and infant health information. IPV was measured by self-report and assessed during three time periods: 12months prior to enrollment into the NFP program; during pregnancy up to 36weeks; and, 12months since the infant's birth. Multiple imputation methods were used to account for missing data; univariate, and multivariate analyses were conducted to determine characteristics of IPV exposure over time. IPV in the 12months prior to pregnancy and at NFP enrollment was 8.1% (95% CI: 5.8-11.2%); 4.7% (4.3.0-5.1%) of women reported IPV during the first 36weeks of their pregnancy; and, 12.4% (8.5-17.6%) of women reported IPV in the 12months following delivery. Several IPV correlates were noted, including relationship status (having a partner before and after pregnancy, p<0.001, p=0.023, respectively), and maternal health and habits such as smoking (before, during and after pregnancy, p<0.001, p<0.001, p=0.001, respectively). In longitudinal follow-up, reduced use of contraception following the birth of her infant, and rapid repeat pregnancy were significantly associated with IPV exposure. For NFP visited mothers, IPV prevalence is lowest during pregnancy, compared to periods before and after pregnancy. IPV had no demonstrable effect on perinatal outcomes such as gestational age, and birth weight; however, IPV was associated with lower rates of contraceptive use and higher rates of rapid repeat pregnancy in longitudinal follow-up.