Intimate Partner Violence Before and During Pregnancy, and Prenatal Counseling Among Women with a Recent Live Birth, United States, 2009-2015

Background: Intimate partner violence (IPV) is a leading cause of injury for reproductive-aged women. Clinical guidelines exist to assist providers in counseling women for IPV, but information on provider counseling among pregnant women from population-based sources is limited. Methods: Data for 2009-2015 from 37 states and New York City participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed (n = 258,263). We compared prevalence estimates overall and by site, of physical IPV occurring before and/or during pregnancy, and prenatal counseling on physical IPV. Multivariable logistic regression was used to identify factors associated with receiving prenatal counseling on physical IPV. Results: Overall, 3.8% of women reported experiencing any physical IPV in the 12 months before and/or during pregnancy (range: 1.5% [Connecticut] to 7.2% [Mississippi]). Prevalence of prenatal IPV counseling was 51.0% (range: 30.2% [Utah] to 63.1% [New Mexico]). Receipt of prenatal counseling on depression predicted a fourfold increase in prevalence of receiving counseling on physical IPV (adjusted prevalence ratio [aPR] = 4.20, 95% confidence interval [CI]: 4.06-4.34). In addition, non-Hispanic black race versus non-Hispanic white race, and having less than a high school education were associated with higher prevalence of receipt of IPV counseling ([aPR = 1.16, 95% CI: 1.14-1.18] and [aPR = 1.11, 95% CI: 1.08-1.13], respectively). Conclusion: Almost 4% of women with a recent live birth reported physical IPV before and/or during pregnancy. Only half of women received counseling on IPV during prenatal care, with counseling rates varying widely among states. Increased adherence to guidelines for universal screening and counseling of women could ensure all women are offered appropriate support and referral.