Study: Disabled, Pregnant Women at Much Greater Risk for IPV

Science Update: Pregnant people with disabilities at higher risk for intimate partner violence, NIH-funded study suggests

Compared to pregnant people without a disability, pregnant people with disabilities may have about two and a half times the risk of experiencing intimate partner violence in the year before pregnancy and during pregnancy, suggests a study funded by the National Institutes of Health. Researchers analyzed survey responses from nearly 44,000 people, of whom 6.5% reported at least one disability. The study authors conclude that health care providers should be vigilant in screening persons with disabilities for intimate partner violence before and during pregnancy and refer them to appropriate information and resources.

The study was conducted by Jeanne Alhusen, Ph.D., of the University of Virginia School of Nursing and colleagues. It appears in the Journal of Advanced Nursing. Funding was provided by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Background

According to the World Health Organization, nearly 30% of women have experienced physical or sexual violence by an intimate partner. Studies have found that 3 to 9% of women experience intimate partner violence during pregnancy. Other studies suggest that up to 50% of high-risk groups—younger women, single women and those with low household income and low educational attainment—may experience intimate partner violence during pregnancy.

Women who experience intimate partner violence in the perinatal period—just before, during and after pregnancy—are less likely to receive adequate prenatal care and to gain sufficient weight gain during pregnancy. Intimate partner violence in the perinatal period is also associated with higher rates of depression, post-traumatic stress disorder, suicidal ideation, suicide, and homicide. Newborns whose mothers have experienced intimate partner violence are at higher risk of low birthweight and preterm birth, leading causes of infant health problems and death. Compared to women without disabilities, women with disabilities are more likely to experience intimate partner violence. However, few studies have looked at the risk of intimate partner violence during pregnancy for women with disabilities.

For the current study, the researchers analyzed data from the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS), which collects data from the time before, during and shortly after pregnancy among persons who recently had a live birth. PRAMS recently began collecting disability information along with pregnancy-related health information. The study included data from 43,811 persons who gave birth from 2018 to 2020 in 24 states. Disability-related questions sought information about difficulty seeing, hearing, walking, remembering or concentrating, communicating, understanding, or being understood in their usual language. Respondents were asked if they had been pushed, hit, slapped, kicked, choked or physically hurt by a husband or partner in the year before pregnancy or during pregnancy.

Results

In the year before pregnancy, 9.5% of respondents with disability reported experiencing interpersonal violence from a partner, compared to 2.4% of those with no disability. A total of 5.8% of respondents with disability had experienced interpersonal violence during pregnancy, while 1.7% who did not have a disability experienced interpersonal violence. Women with a disability were 2.6 times more likely to experience interpersonal violence before pregnancy and 2.5 times more likely to experience it during pregnancy, compared to women without a disability.

Significance

Although screening all women for interpersonal violence during the perinatal period is important, it is especially so for women with a disability, the authors concluded. It is also important to provide them with accessible information, referrals, and resources for their own health and wellbeing, and for that of their infants.

Reference

Alhusen J. L., Lyons, G., Laughon, K., & Hughes, R. B. (2022). Intimate partner violence during the perinatal period by disability status: Findings from a United States population-based analysis. Journal of Advanced Nursing. Advance online publication. https://doi.org/10.1111/jan.15340