Pregnancy, Birth, and Mental Health Outcomes Associated With Recent Reproductive Coercion and Intimate Partner Violence in a Crowd-Sourced National Sample.

Abstract

Introduction: Reproductive coercion (RC) is a type of intimate partner violence (IPV) in which partners control reproductive health decision-making. More evidence is needed on peripartum health outcomes related to RC, with and without IPV, to inform interventions and health care response. The purpose of this study was to determine the impact of RC, with and without other forms of IPV, on pregnancy, birth, and mental health outcomes in a sample of people who were currently or recently pregnant.

Methods: We conducted a cross-sectional survey with people who had been pregnant in the past 2 years (N = 1941). Logistic regression models examined predicted outcomes with RC as a primary exposure and explored combinations of RC and IPV.

Results: A total of 23.8% of the sample reported any past-2-years RC. RC was significantly associated with most pregnancy, birth, neonatal, and mental health outcomes. People who experienced RC alone had 2.44 higher odds of having a low birth weight newborn (95% CI, 1.04-5.71) and 1.78 higher odds of postpartum depression (95% CI, 1.03-3.08) compared with people who did not experience RC or IPV. RC with other forms of IPV had a significant impact on suicidality even controlling for depression and anxiety (odds ratio, 2.85; 95% CI, 1.94-4.18), compared with those who did not experience either.

Discussion: Our findings underscore the importance of studying RC as its own construct due to its clear, independent impact on maternal health outcomes. RC, with and without physical violence, is common and detrimental to the health of pregnant and postpartum people. Greater attention to mechanisms for these associations (and the disproportionate burden on populations experiencing marginalization) is needed to interrupt and prevent harmful downstream effects.