Publication Date

5-2021

Date of Final Oral Examination (Defense)

3-11-2021

Type of Culminating Activity

Thesis

Degree Title

Master of Public Health

Department

Community and Environmental Health

Major Advisor

Ellen Schafer, Ph.D., MPH, MCHES

Advisor

Megan L. Smith, Ph.D.

Advisor

Nichole Lasich, BSN, MPH

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Abstract

Background: Intimate Partner Violence (IPV) is a public health issue that is known to have deleterious health effects for pregnant women and their babies. Women who experience IPV during pregnancy are also likely to develop and exacerbate already existing mental health conditions. Experiences with IPV are thought to impact health behaviors, particularly how a mother copes or cares for her baby. The objective of this study is to explore the potential relationships between experiencing IPV (before and/or during pregnancy), maternal mental health, and health-related infant care behaviors (i.e., breastfeeding initiation, breastfeeding duration, well-child visits).

Methods: Data from phases 6 (years 2009-2011), 7 (2012-2015), and 8 (2016-2018) of the Centers for Disease Control and Prevention Pregnancy Risk Assessment Monitoring System (PRAMS) were used to explore maternal experiences of IPV, mental health, and infant care behaviors. Participants included in the study responded to questions regarding experiences of IPV either before or during pregnancy. Statistical procedures used included descriptive statistics, logistic regression, and survival analysis.

Results: Among the 20,363 participants who responded to IPV-related questions, 15% reported experiencing IPV before pregnancy, 20% during pregnancy, and 21% either before or during pregnancy. Most participants (85%) initiated breastfeeding, were still breastfeeding at the time of the survey (56%) and sought well-child checks (97%). On average, participants had healthful indicators for experiencing depression (mean=3.96) and lack of interest (mean=3.92). Experiencing IPV before pregnancy is highly correlated with experiencing IPV during pregnancy; of those who experienced IPV before, 90.3% experienced IPV during pregnancy. Compared to those who did not experience IPV, and controlling for relevant demographic variables, experiencing IPV was significantly associated with breastfeeding initiation (OR=1.38, 95%CI: 1.19-1.61). While experiencing IPV was significantly associated with breastfeeding duration in bivariate analysis, the relationship did not remain significant when controlling for relevant demographic variables. Similarly, experiencing IPV was significantly associated with seeking well-child check in bivariate analysis, but that significance did not remain when relevant demographic variables were added to the model. Maternal mental health was not found to mediate any of the explored relationships between experiencing IPV and infant care behaviors.

Discussion: Results of this study support recommendations to perform routine screening for IPV in all women of reproductive age and highlight the importance of asking pregnant women about their history of experiencing IPV. Efforts to increase breastfeeding initiation should consider a mother’s experience with IPV and her marital status, as both could have implications on breastfeeding outcomes.

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