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Intimate Partner Violence around the Time of Pregnancy and Postpartum Contraceptive Use

Adrienne A. Stevenson
x
Adrienne A. Stevenson
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Affiliations

  • Emory University Department of Gynecology and Obstetrics, Atlanta, Georgia
, MDa
,
Brenda L. Bauman
x
Brenda L. Bauman
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Affiliations

  • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
, MSPHb
,
Lauren B. Zapata
x
Lauren B. Zapata
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Affiliations

  • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
, PhD, MSPHb
,
Indu B. Ahluwalia
x
Indu B. Ahluwalia
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Affiliations

  • Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
, PhD, MPHc
,
Naomi K. Tepper
x
Naomi K. Tepper
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Affiliations

  • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

Correspondence

  • Correspondence to: Naomi K. Tepper, MD, MPH, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S107-2, Atlanta, GA 30341. Phone: (770) 488-6506.
, MD, MPHb,∗,'Correspondence information about the author MD, MPH Naomi K. Tepper
x
Naomi K. Tepper
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Affiliations

  • Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

Correspondence

  • Correspondence to: Naomi K. Tepper, MD, MPH, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S107-2, Atlanta, GA 30341. Phone: (770) 488-6506.
Intimate Partner Violence around the Time of Pregnancy and Postpartum Contraceptive Use
DOI: https://doi.org/10.1016/j.whi.2019.11.006

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Abstract

Objectives

We sought to examine postpartum contraceptive use among women who reported physical intimate partner violence (IPV) during or within 12 months before pregnancy compared with women who did not report physical IPV and to identify factors associated with nonuse of contraception among women who reported physical IPV.

Methods

Data were obtained from women with a recent live birth from 2012 to 2015 who participated in the Pregnancy Risk Assessment and Monitoring System. We described characteristics of women and postpartum contraceptive use by method effectiveness (most effective [female sterilization, male sterilization, intrauterine device, implant], moderately effective [injectable, pill, patch, ring], less effective [condoms, natural family planning, withdrawal, other]) or no method, stratified by reported physical IPV. Multivariable logistic regression was used to examine characteristics associated with nonuse of contraception among women who reported physical IPV.

Results

The proportion of women using most or moderately effective contraception was similar for women reporting and not reporting physical IPV. Less effective contraceptive use was lower among women who reported physical IPV (13.9%) than who did not report physical IPV (25.1%) (p < .001). Nonuse was higher among women who reported physical IPV (33%) than who did not report physical IPV (21%) (p < .001). Having no health insurance at the time of survey and experiencing traumatic stress within 12 months before delivery were associated with nonuse of contraception among women who reported physical IPV.

Conclusions

The higher proportion of contraception nonuse among women who reported physical IPV indicates a potential unmet need for contraception among this vulnerable population. Recommended screening for IPV and counseling about the full range of contraceptive methods should begin during pregnancy and continue through the postpartum period.

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Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

1Women were reclassified as using sterilization if they answered no to the first question but reported “I had my tubes tied or blocked” or “My husband or partner had a vasectomy” to the question “What are your reasons or your husband's or partner's reasons for not doing anything to keep from getting pregnant now?”
Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health.
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