Understanding reproductive coercion experiences in marginalized populations is important to assist in tailoring care and services. Reproductive coercion is consistently associated with intimate partner violence (IPV), engaging in sexual risk-taking, and is more commonly reported among non-White women. We conducted a secondary analysis of data from a mixed methods study to examine reproductive coercion in relationship contexts among a sample ( N = 130) of young adult, primarily African American women recruited from three women's health clinics; 12 also participated in an in-depth interview. Thirty-six women (27.7%) reported reproductive coercion in the past year. Past-year reproductive coercion was associated with relationship trust, ( t(128) = -3.01, p = .003), and past-year IPV (Fisher's exact test, p = .005). In the best-fit model, odds of past-year reproductive coercion increased by 4% with each one-point increase in relationship trust score (indicating reproductive coercion increased with lower trust; adjusted odds ratio [AOR] = 1.04; 95% confidence interval [CI] = [1.00, 1.08]), and by more than 4 times with past experience of IPV (AOR = 4.74; 95% CI = [1.07, 20.86]). Qualitative analysis revealed women's awareness of reproductive coercion whether or not they personally experienced it. Those who experienced reproductive coercion identified it as a form of abuse and additionally described experiences of pressure to conceive from the partner's family. Our results support routine screening for IPV and reproductive coercion. Furthermore, the intersection of partner reproductive coercion with family pressure related to reproductive decision making should be explored to better inform clinical interventions.
Intimate partner violence (IPV) is a serious concern for women that is associated with significant adverse health effects. Routine screening for IPV is recommended, but there are many barriers to screening that have been identified by providers, including discomfort, lack of training, and not knowing how to respond to a positive screen. This article reviews IPV screening and appropriate techniques for responding to a positive screen. IPV screening best practices include using a systematic protocol, developing a screening script, using a validated screening tool, and considerations for privacy and mandatory reporting. Responding to a positive screen should include acknowledging the experience, asking if the woman desires help, offering support and referrals, encouraging safety planning, and completing additional assessments to determine level of danger and to identify any comorbidities. Using these techniques along with therapeutic communication may increase IPV identification and create an environment in which women feel empowered to get help.
Substance use disorders (SUDs) are a growing problem for pregnant and parenting women. Woman-to-woman peer support may positively influence perinatal outcomes but little is known about the impact of such support on the women who are providing support. The purpose of this study was to describe experiences of addiction in pregnancy, recovery, and subsequently serving as a peer mentor to other pregnant women with active SUD among women in recovery in a rural setting. We conducted one digital storytelling workshop with five women serving as peer mentors with lived experience of perinatal SUD. The mentors faced significant stigma in pregnancy. They had each done the "inside work" to achieve recovery, and maintained recovery by staying balanced. Peer mentoring supported their own recovery, and story sharing was integral to this process. Peer-led support models may be an effective, self-sustaining method of providing pregnancy-specific peer support for SUD.
Student nurses trained as doulas have the opportunity to provide a variety of interventions for laboring clients. An increase in the number of interventions, especially physical interventions, provided by doulas may decrease the likelihood of epidural use and cesarean birth.
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