Perceived Fertility Control and Pregnancy Outcomes Among Abused Women

Abstract

Objective: To describe the degree of perceived fertility control and associated likelihood of unintended pregnancy and poor pregnancy outcomes among women who report intimate partner violence.

Design: Cross-sectional cohort study design.

Setting: Five domestic violence shelters and one district attorney's office in a large urban metropolis in the United States.

Participants: A total of 282 women who reported intimate partner violence and reached out for the first time to a shelter or district attorney's office for assistance.

Methods: This 7-year prospective longitudinal study began in 2011. Participants in the overarching study are being interviewed every 4 months. During the 32-month interview period, participants responded to a one-time, investigator-developed, fertility control questionnaire in addition to the ongoing repeated measures.

Results: Almost one third (29%) of the participants reported at least one unintended pregnancy attributed to their abusers' refusal to use birth control, and 14.3% of the participants reported at least one unintended pregnancy as a result of their abusers' refusal to allow them to use birth control. Participants were 28 times more likely to have abuse-induced miscarriages if their pregnancies resulted because their abusers did not use birth control (OR = 28.70, p < .05). Finally, participants were 8 times more likely to report premature births if they were abused because of their use of birth control (OR = 8.340, p < .05).

Conclusion: Women in abusive relationships reported compromised fertility control associated with abuse and increased risk for unintended pregnancy as well as the adverse pregnancy outcomes of premature birth and miscarriage.

Keywords: fertility control; intimate partner violence; miscarriage; premature birth; unintended pregnancy.