Prevalence, Types, Risk Factors, and Course of Intimate Partner Violence in Appalachian Pregnant Women

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Intimate partner violence (IPV) during pregnancy can lead to myriad poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and the course of specific types of IPV throughout pregnancy. The current project investigated the prevalence of IPV and the risk factors for different types of IPV in an Appalachian sample that contained pregnant women from rural and non-rural locations (Study 1). Additionally, for women reporting IPV, the different types of IPV were examined throughout the course of their pregnancies (Study 2). Study 1 included 1063 pregnant womenparticipating in the Tennessee Intervention for Pregnant Smokers (TIPS) program. IPV prevalence was measured using a modified Hurt Insult Threaten Scream (HITS) screen administered at entry into prenatal care, and rural status was defined using Rural Urban Commuting Area Codes based on the participants’ ZIP codes. Self-report prevalence rates during pregnancy were 26% for psychological, 2% for physical, and 1% for sexual IPV. With the exception of one woman, all women that reported physical or sexual violence also reported experiencing psychological violence occurring at the same time (3.5%). Chi-squared analyses indicated that rural pregnant women were not significantly more likely to experience any of the types of IPV compared to non-rural pregnant women.Furthermore, logistic regression analysis supported previous literature findings that pregnant women who are younger, have an unplanned pregnancy, have high levels of stress, and have low levels of social support, are at a greater risk of experiencing anytype of IPV during pregnancy compared to those without these risk factors. To investigate IPV over the course of pregnancy, Study 2 participants included a TIPS participant subsample of 337 pregnant women who indicated they had experienced IPV at any timeduring their current pregnancy. The modified HITS screen was administered up to four times throughout the course of pregnancy, with responses coded based on gestational age at the time of assessment (first trimester, first half of second trimester, secondhalf of second trimester, and third trimester). Generalized estimating equation logistic models indicated that women who experienced IPV at some point during pregnancy were most likely to experience IPV during the third trimester. These results speak to the importance of screening for all types of IPV multiple times throughout the course of pregnancy. If multiple screens do not occur as the pregnancy progresses, some women may not be identified as having experienced IPV, and therefore miss opportunities toassuage the possible negative health outcomes due to IPV. Information obtained from the current research is valuable to prenatal health care providers who need to be aware of IPV risk factors, and that different types of IPV, especially psychological IPV,can occur at any time during pregnancy.


Johnson City, TN

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