Racial and Ethnic Disparities in the Effects of Group Prenatal Care On Identification of Intimate Partner Violence: Findings from a Randomized Controlled Trial of CenteringPregnancy

Abstract

Purpose

Intimate Partner Violence (IPV) during pregnancy can have serious consequences for maternal, infant, and child health. Importantly, the risk and consequences of IPV are greater for Black and Hispanic pregnant individuals than for White pregnant individuals. Thus, identification of IPV and referral to services during pregnancy is important, particularly for Black and Hispanic patients. Continuity of care and patient-centered care are thought to be essential for the identification of IPV in healthcare settings. Thus, we proposed that group prenatal care, which involves prenatal care providers delivering health, education, and support services to patients in a group setting, would create an atmosphere that is conducive to the identification of IPV. We specifically expected to see this effect among Black and Hispanic patients because group prenatal care has been hypothesized to increase the quality of the provider-patient relationship and reduce clinical bias against patients of color.

Methods

We conducted a secondary analysis of data from a randomized controlled trial of CenteringPregnancy (N = 523).

Results

We found that group prenatal care does have a significant, positive effect on IPV identification among prenatal care patients, but only for White women. Members of other racial and ethnic groups, who are at increased risk of experiencing IPV and its harmful consequences, do not receive this benefit.

Conclusions

Moving forward, researchers and practitioners should establish whether group prenatal care could be improved by intentionally incorporating a curriculum that directly addresses racial and ethnic disparities in quality of healthcare.

Trial Registration Number and Date

NCT02640638 (Prospectively registered 12/29/2015).