Five Things

to Know about Intimate Partner Violence and Reproductive Health

September 17, 2015

Sad Teenage Girl Sitting In Bedroom Whilst Boyfriend SleepsIntimate partner violence—often defined as physical, sexual, or psychological abuse committed by a romantic partner—is experienced by people of all racial and ethnic backgrounds, sexual orientations, and income levels. Intimate partner violence is prevalent in the United States; estimates from the National Intimate Partner and Sexual Violence Survey find that over one-third of women and more than a quarter of men have experienced some type of violence perpetrated by a romantic partner in their lifetime. Women are at greatest risk of experiencing intimate partner violence during their early reproductive years. About half of women were between 18 and 24 years old, and 22 percent were under the age of 18, the first time they experienced intimate partner violence. Here are five things we know from data and research about the negative impact of intimate partner violence on women’s reproductive health:

Intimate partner violence during pregnancy is associated with poor pregnancy and birth outcomes.

Estimates from a 2012 review suggest that relationship violence occurs in between 3 and 17 percent of all pregnancies. Experiencing intimate partner violence during the prenatal period is associated with poorer maternal and infant health. Women who experience relationship violence during pregnancy are less likely to access prenatal care, and more likely to have insufficient weight gain, miscarry, give birth prematurely, and have infants with low birth weight or injuries. Physical abuse such as hitting a woman’s abdomen can cause harm to a growing fetus, or even maternal death, contributing to higher rates of hospitalization and emergency health care to treat injuries to pregnant mothers and/or their infants. Women who experience relationship violence during pregnancy also have elevated stress levels, increased rates of smoking, and increased risk for substance use—all of which are linked to poor maternal and infant health.

A synthesis of research studies found that physical intimate partner violence is linked to a greater risk of unplanned pregnancy and abortion. For adolescent females, dating violence is associated with increased risk of pregnancy, according to a nationally representative study. A rigorous review that included research from multiple countries also found that intimate partner violence is associated with termination of pregnancy.

 

Women involved in violent romantic relationships are less likely to access necessary reproductive health care. One survey administered to 14- to 20-year-old female clients seeking care in five urban adolescent clinics found that teen girls in violent relationships were more than twice as likely to have forgone reproductive health care as their counterparts who were not in violent relationships. A recent review of rigorous research found that women of childbearing age benefit from routine screening; consequently, screening for intimate partner violence in health care visits is now recommended by the U.S. Preventive Services Task Force. The American College of Obstetrics and Gynecology has recommended screening pregnant women for intimate partner violence for many years, though research finds this is done inconsistently.

Research consistently finds that intimate partner violence is associated with reduced condom use and oral contraceptive use, and higher rates of sexual risk taking, having multiple sexual partners, sexually transmitted infections, and sexual dysfunction. This is true for both adults and adolescents. Males who perpetrate relationship violence are less likely to use a condom, as are adolescent females in violent relationships. Notably, both physically and verbally abusive relationships are associated with decreased condom use. Recent Child Trends research finds that among young adults, condom use is lower in relationships in which both partners mutually perpetrate violence and in which a male or female respondent reports having a more violent partner.

According to the National Intimate Partner and Sexual Violence Survey, an intimate partner is controlling of a person’s reproductive or sexual health when they try to get that person pregnant when they do not want to be—for example, by refusing to use a condom. Almost nine percent of women in the United States, and roughly 10 percent of men, reported ever having a partner who tried to control their reproductive or sexual health. Some researchers have also examined the issue of birth control sabotage—a male partner’s attempt to interfere with a woman’s use of contraception. This can include removing condoms during sex, throwing away birth control pills or other contraceptive methods, and even trying to remove a woman’s vaginal ring or intrauterine device (IUD).  Due to the sensitive nature of this topic, research in this area has been limited, but a large study of teen and young adult women in Northern California found that more than half had experienced intimate partner violence and 15 percent of all respondents reported birth control sabotage in the past. Another study of women attending OB-GYN offices in Philadelphia found that those who reported intimate partner violence were also more likely to report having a partner who was unwilling to use birth control or who made it more difficult for her to use birth control.

Contributors:
Shelby Hickman, Claudia Vega, Jennifer Manlove

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