Associations Between Reproductive Coercion, Partner Violence, and Mental Health Symptoms Among Young Black Women in Baltimore, Maryland

Abstract

This study examined the associations of reproductive coercion (RC) with mental health of Black adolescent and young adult women. We tested RC as a predictor of depression and post-traumatic stress disorder (PTSD) symptoms. We also explored the interaction of exposure to RC and physical and sexual intimate partner violence (IPV) as they relate to depression and PTSD symptoms. A primarily community-based convenience sample of 188 self-identified Black women, aged 18 to 25 years, in Baltimore, Maryland, completed computer-based cross-sectional surveys. Lifetime RC (37.8%) and IPV (48.9%) were prevalent in this sample. Nearly 10% of the young women reported experiencing RC without IPV; 38% of the sample reported experiencing both types of violence. Depression (69%) and PTSD (47.1%) symptoms were more prevalent among women with RC than among women without RC. Adjusted results revealed RC and IPV were independently associated with depression (adjusted odds ratioRC = 2.86, 95% CI = [1.38, 5.94] and adjusted odds ratioIPV = 5.15, 95% CI = [2.47, 10.76]). Similarly, RC and IPV were independently associated with PTSD (adjusted odds ratioRC = 2.41, 95% CI = [1.15, 5.08] and adjusted odds ratioIPV = 3.04, 95% CI = [1.39, 6.63]). Findings suggest that RC and IPV independently contribute to mental health morbidities among this population of women. Current policies in health care practice increasingly recommend provision of screening for IPV, including RC. These practices should extend to women receiving services in community-based settings, thus strengthening the linkage to referral for further mental health treatment and victim service support. In the context of the social burdens affecting young Black women’s health, a comprehensive approach that integrates mental health and reproductive/sexual health care is essential for women reporting RC experiences.

Intimate Partner Violence and the Role of Child Maltreatment and Neighborhood Violence: A Retrospective Study of African American and US Caribbean Black Women

“…This finding contradicts other research trends that find that exposure to violence generally reduces with age [ 61 ]. Finally, women living in poverty were found to be at increased risk for intimate partner violence, which is consistent with previous research [ 5 , 62 , 63 , 64 , 65 , 66 ]. Known to many, poverty contributes to stress and increases the possibility of violent explosive encounters in relationships [ 67 ].…”

Sexual and Reproductive Health and Reproductive Coercion in Women Victim/Survivors Receiving Housing Support

“…RC was significantly associated with frequency and severity of IPV as well as PTSD, possibly as a result of the severe violence; these results are consistent with other studies of similar populations which included non-IPV victim/survivors (Alexander et al, 2019), as well as other studies of exclusively IPV victim/ survivors (Grace et al, 2020b). In this sample, RC was not associated with depression, though other studies do find an association (Alexander et al, 2019;Capasso et al, 2019;Fasula et al, 2018). Our sample consisted solely of IPV victim/survivors and nearly half (46.4%) screened positive for depression; this high prevalence in such a small sample may have precluded ability to discern the independent impact of RC on depression, and the small sample may have limited statistical power to detect small differences.…”

“…Prevalence of past-3 months RC was consistent with or higher than community samples that were similar in timeframe and/or demographics (Capasso et al, 2019;Hill et al, 2019;McCauley et al, 2017;Paterno et al, 2018;Thaller & Messing, 2014), but lower than other samples of IPV victim/survivors which used longer measurement timeframes (Decker et al, 2017;Grace et al, 2020b;Hess & Del Rosario, 2018). RC was significantly associated with frequency and severity of IPV as well as PTSD, possibly as a result of the severe violence; these results are consistent with other studies of similar populations which included non-IPV victim/survivors (Alexander et al, 2019), as well as other studies of exclusively IPV victim/ survivors (Grace et al, 2020b). In this sample, RC was not associated with depression, though other studies do find an association (Alexander et al, 2019;Capasso et al, 2019;Fasula et al, 2018).…”

“…Additionally, it is possible that other participants did experience RC, but outside of the study measurement timeframe, when those children were conceived. Other studies did not find parity to be a significant risk factor for RC (Alexander et al, 2019;Paterno et al, 2017;Rosenfeld et al, 2017), but did not look at RC behaviors specifically perpetrated by the father of the participant's children. Risk of intimate partner homicide is elevated among women who have children that were not fathered by their abusive partner, related to sexual proprietariness and jealousy (Spencer & Stith, 2020).…”

Women’s perceptions and experiences of reproductive coercion and abuse: a qualitative evidence synthesis

“…However, well before this, pregnancy-controlling behaviours by male partners have been described in the gender-based violence literature without being labelled as reproductive coercion and abuse [ 7 ]. Prevalence rates of reproductive coercion and abuse have ranged from 8.6% of all women in The National Intimate Partner and Sexual Violence Survey in the United States of America (USA) to as high as 37.8% among young, self-identified Black or African American women in Baltimore, Maryland [ 8 ]. However, a lack of consistent measurement and conceptual clarity around reproductive coercion and abuse mean that true prevalence rates are inconclusive [ 9 ].…”