Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling.
OBJECTIVE
Intimate partner violence (IPV) is a major problem that could affect reproductive decision making. The aim of this study is to examine the association between IPV and contraceptive use and assess whether the association varies by receipt of prenatal birth control counseling and race/ethnicity.


METHODS
This study analyzed the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS) that included 193,310 women with live births in the United States. IPV was determined by questions that asked about physical abuse by a current or former partner in the 12 months before or during pregnancy. The outcome was postpartum contraceptive use (yes vs. no). Multiple logistic regression analyses were conducted to assess the influence of experiencing IPV at different periods (preconception IPV, prenatal IPV, both preconception and prenatal IPV, preconception and/or prenatal IPV). Data were stratified to assess differential effects by race/ethnicity and receipt of birth control counseling.


RESULTS
Approximately 6.2% of women reported IPV, and 15.5% reported no postpartum contraceptive use. Regardless of the timing of abuse, IPV-exposed women were significantly less likely to report contraceptive use after delivery. This was particularly true for Hispanic women who reported no prenatal birth control counseling and women of all other racial/ethnic groups who received prenatal birth control counseling.


CONCLUSIONS
IPV victimization adversely affects the use of contraceptive methods following delivery in women with live births. Birth control counseling by health providers may mitigate these effects; however, the quality of counseling needs further investigation. Better integration of violence prevention services and family planning programs is greatly needed.


CONCLUSIONS
Consistent with national recommendations by the U.S. Preventive Service Task Force, clinicians and public health workers are strongly encouraged to screen for IPV. Health providers should educate women on effective contraceptive options and discuss long-acting reversible contraceptives that are not partner dependent within the context of abusive relationships.
Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA. Electronic address: chas@vcu.edu.
Susan
S
Cha
Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA.
Derek A
DA
Chapman
Department of Biostatistics, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA.
Wen
W
Wan
Department of Family and Community Health Nursing, Virginia Commonwealth University, School of Nursing, Richmond, VA 23298, USA.
Candace W
CW
Burton
Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA.
Saba W
SW
Masho
D000328:Adult; D003267:Contraception / Q000379:methods*; D003268:Contraception Behavior / Q000208:ethnology*; D003376:Counseling; D005006:Ethnicity / Q000193:education*; D005193:Family Planning Services / Q000193:education*; D005260:Female; D006801:Humans; D000066511:Intimate Partner Violence / Q000208:ethnology*; D016015:Logistic Models; D049590:Postpartum Period; D011247:Pregnancy; D011295:Prenatal Care; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
Birth control; Contraception; Family planning; Intimate partner violence; PRAMS