Relationships of Reproductive Coercion and Intimate Partner Violence to Unintended Pregnancy.

OBJECTIVE: To examine the prevalence, correlates, and influences of male partner reproductive coercion (RC) and intimate partner violence (IPV) on unintended pregnancy (UIP). DESIGN: Retrospective cohort study using population-based data. SETTING: Six participating states contributed data from the Pregnancy Risk Assessment Monitoring System (PRAMS). PARTICIPANTS: Data were obtained for 20,252 women who gave birth between 2012 and 2015 and completed the PRAMS survey within 9 months of giving birth. METHODS: Weighted descriptive statistics and multivariate logistic regression models were used to assess the influence of RC and IPV on odds of UIP. RESULTS: Approximately 2.7% (n = 600) of participants reported physical IPV, and 1.1% (n = 285) reported RC. Participants less than 30 years of age, with low socioeconomic status, who were single and of Black or Hispanic race/ethnicity were at significantly increased risk of IPV. With the exception of Hispanic race/ethnicity, these sociodemographic characteristics were also associated with an increased risk for RC. Participants who experienced IPV had a nearly eightfold increased risk of RC (adjusted odds ratio = 7.98, 95% confidence interval [CI] [4.68, 13.59]) than their nonabused counterparts. In univariate models, RC, IPV, or RC with IPV were significantly associated with increased odds of UIP (odds ratio [OR] = 2.18, 95% CI [1.38, 3.44]; OR = 2.36, 95% CI [1.75, 3.19]; OR = 3.55, 95% CI [1.56, 8.06], respectively); however, results were nonsignificant after adjusting for sociodemographic factors. CONCLUSION: In this population-based sample, we confirmed that there were links among IPV, RC, and UIP, all factors associated with poor maternal and infant outcomes. Screening for IPV and RC is an important step toward reducing rates of UIP.

Effect of Home Visiting with Pregnant Teens on Maternal Health.

PURPOSE: Determine the extent that participation in Resource Mothers Program (RMP) home visiting improves maternal health at 3 months postpartum. STUDY DESIGN AND METHODS: A randomized controlled trial using RMPs in two urban and one rural location in a mid-Atlantic state. Community health workers from these RMPs enrolled teens into the study and the research team assigned participants to either the intervention group or telephone support control group using computerized randomization assignments. Data collection from baseline and 3 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS) and the Prenatal Psychosocial Profile (PPP) is reported. RESULTS: The sample included 150 pregnant teens with a mean age of 17 years. Mean self-esteem scores between groups were not significantly different at baseline, but the RMP group self-esteem scores improved significantly at the 3 months postpartum interview (36.40 ± 5.63 for RMP vs. 34.10 ± 4.29 telephone control group, p = 0.049). Neither group was at risk for depression at baseline or 3 months postpartum. Because 60% of the total sample identified as Hispanic, post hoc analysis revealed significantly different baseline stress mean scores between Hispanic and non-Hispanic teens (p = 0.038); however, these differences were no longer significant by 3 months postpartum (p = 0.073). The EPDS scores by ethnicity were not different at baseline (p = 0.875) but were significantly different at 3 months (p = 0.007). CLINICAL IMPLICATIONS: The RMP home-visiting intervention can lead to improved self-esteem scores in teens, particularly in Hispanic teens. Improved self-esteem has been shown to lead to better parenting.