Citation

Cha S, Chapman DA, Wan W, Burton CW, Masho SW. Contraception 2015; 92(3): 268-275.

Affiliation

Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.contraception.2015.04.009

PMID

25935298

Abstract

OBJECTIVES: 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. STUDY DESIGN: This study analyzed the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS) which included 193,310 women with live births in the U.S. 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 need further investigation. Better integration of violence prevention services and family planning programs is greatly needed. IMPLICATIONS: 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.

Language: en