An Integrated Intervention to Reduce Intimate Partner Violence in Pregnancy

Abstract

OBJECTIVE We estimated the efficacy of a psycho-behavioral intervention in reducing intimate partner violence (IPV) recurrence during pregnancy and postpartum, and in improving birth outcomes in African-American women METHODS We conducted a randomized controlled trial in which 1,044 women were recruited. Individually-tailored counseling sessions were adapted from evidence-based interventions for IPV and other risks. Logistic regression was used to model IPV victimization recurrence, to predict minor, severe, physical and sexual IPV. RESULTS Women randomized to the intervention were less likely to have recurrent episodes of IPV victimization (OR=0.48, 95%CI=0.29-0.80). Women with minor IPV were significantly less likely to experience further episodes during pregnancy (OR=0.48, 95%CI=0.26-0.86, OR=0.53, 95%CI=0.28-0.99) and postpartum (OR=0.56, 95%CI=0.34-0.93). Numbers needed to treat were 17, 12, and 22, respectively as compared to the usual care Women with severe IPV showed significantly reduced episodes at postpartum (OR=0.39, 95%CI=0.18-0.82) and number needed to treat is 27. Women who experienced physical IPV showed significant reduction at the first follow-up (OR=0.49, 95%CI=0.27-0.91) and postpartum (OR=0.47, 95%CI=0.27-0.82) and number needed to treat is 18 and 20, respectively. Intervention women had significantly fewer very preterm infants (p=0.03) and an increased mean gestational age (p=0.016). CONCLUSION A relatively brief intervention during pregnancy had discernable effects on IPV and pregnancy outcomes. Screening for IPV as well as other psychosocial and behavioral risks and incorporating similar interventions in prenatal care is strongly recommended.

Examining the Prevalence, Bidirectionality, and Co-Occurrence of Sexual Intimate Partner Violence Among Women During Pregnancy and Postpartum

“…Participants in our sample reported similar rates of sexual IPV victimization compared to findings from other studies (Amaro et al, 1990;Bailey & Daugherty, 2007;Kiely et al, 2010). Our findings add to the existing literature by providing the first prevalence estimate of pregnant women's sexual IPV perpetration.…”

Surveillance for Violent Deaths — National Violent Death Reporting System, 17 States, 2013

“…It is important that screening and counseling about abuse be done in a culturally sensitive and supportive way to address concerns about health and safety (25). An intervention with multiple counseling sessions to assess the risk for danger, discuss prevention options, develop a safety plan, and share appropriate community resources has been reported to reduce recurrence of partner violence among pregnant women (26).…”

Cochrane in CORR ®: Screening Women for Intimate Partner Violence in Healthcare Settings (Review)

“…In fact, these findings highlight the fact that screening alone does not necessarily lead to improvements in any meaningful outcomes for patients, and perhaps a more rigorous ''active'' intervention is warranted. Trials evaluating IPV identification paired with referral or counselling services, which were not included in this review, demonstrate a positive impact on the lives of patients who have experienced IPV [5,6]. We recommend that IPV interventions go beyond identification alone, and are evaluated based on patient-important outcomes such as reduction in IPV frequency and/or severity, or IPV-related health outcomes that directly impact a patient's health and well-being.…”