Associations between reproductive coercion, intimate partner violence, and adverse birth outcomes among postpartum women

Abstract

Background: Reproductive coercion (RC) is a form of intimate partner violence (IPV) involving a partner’s control of a woman’s reproductive health decisions regarding pregnancy and childbearing. RC is associated with numerous negative health consequences; however, the impact on a pregnancy and developing fetus and association with adverse birth outcomes is not known.Design: Secondary analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data, 2012 – 2015, from five states. Purpose: To examine whether RC before pregnancy is associated with an increased likelihood of experiencing preterm birth (< 37 weeks gestational age), neonatal intensive care (NICU) after birth, and infant death. Method: Data on women ages 17 years and older who gave birth to a live infant (N = 18,728) were analyzed. Logistic regression procedures were used to determine the odds of preterm birth, infant death, and need for NICU care among women experiencing RC while controlling for known risk factors (age, race, ethnicity, education, marital status, depression, drinking, and smoking). The moderation effect of IPV on the relationship of RC and birth outcomes was tested by including an interaction term (product of RC and IPV) in the model. Results: No significant association between RC and preterm birth, need for NICU care, or infant death was detected. Additionally, exposure to IPV did not have a moderating effect on either the direction or magnitude of the relationship between RC and birth outcomes. Conclusions: Despite these findings, RC remains a significant concern for nurses caring for pregnant women and women of reproductive age. This study highlights a current gap in knowledge about the ways RC can affect a pregnancy and birth outcomes. Replication studies using more robust measures of RC and data collection approaches that can most accurately identify RC experiences are needed to increase understanding.