State abortion restrictiveness and prevalence of intimate partner violence and domestic violence among recently birthing black and white individuals.

Abstract

Objectives: Intimate partner violence (IPV) and non-intimate domestic violence (DV) during pregnancy may result in poor maternal and infant health outcomes. Whether state-level abortion restrictions, enacted by many states even prior to the 2022 Dobbs v. Jackson Women's Health Organization decision, are associated with IPV/DV remains unknown. This study aimed to investigate the relationship between IPV/DV during pregnancy and abortion restrictions among Black and White birthing people.

Study design: We analyzed 2020 data from 36 states participating in the CDC Pregnancy Risk Assessment Monitoring System representing 1,931,458 deliveries of which 1,368,237 deliveries (70.84%) are from Black and White birthing individuals. We divided states into restrictive (N = 17) and less restrictive (N = 19) based on a modified Guttmacher Abortion Policy Hostility Index. We used weighted logistic regression to assess the relationship between state abortion restrictiveness and self-reported IPV/DV.

Results: Overall, birthing individuals in restrictive states had higher odds of reporting IPV/DV during pregnancy than those in less restrictive states (aOR: 1.36, 95% CI: 1.15-1.60). Within racial groups, we found that Black birthing individuals in restrictive states had higher odds of reporting IPV/DV than Black birthing individuals in less restrictive states (aOR:1.75, 95% CI: 1.24-2.47). We saw a similar relationship for White birthing individuals (aOR:1.50, 95% CI: 1.17-1.94).

Discussion: Even when access to abortion was federally protected, individuals in restrictive states had higher odds of experiencing IPV/DV than those in less restrictive states, particularly among Black individuals. These findings suggest possible detrimental impacts of abortion restrictions and their potential to worsen existing health inequities.