Birth Outcomes Among Women Affected by Reproductive Coercion

Reproductive coercion is a form of intimate partner violence that includes behaviors that interfere with autonomous decision-making over reproductive outcomes. Unintended pregnancy is associated with exposure to reproductive coercion; however, little is known about the outcomes of continued pregnancies. The purpose of this study is to assess whether women who reported reproductive coercion during their last pregnancy experienced differences in birth outcomes compared with women without contemporaneous reproductive coercion.

This was a cross-sectional survey study administered in obstetric and gynecologic offices. A survey comprised of standardized reproductive coercion, birth outcome, and intimate partner violence questions was given to English- or Spanish-speaking women with at least one prior pregnancy. Self-reported birth outcomes of interest included late or no prenatal care, low birth weight, prolonged neonatal hospitalization, preterm birth, and intrauterine fetal demise or neonatal death. Descriptive and bivariable comparisons were performed.

Of 202 participants, 8.6% of women reported reproductive coercion during their last pregnancy. Women with a reported reproductive coercion history were younger, more likely to be a student, more likely to have anemia and anxiety at the time, and less likely to be married to the father of the incident pregnancy. Women with this history were more likely to express that they never wanted to be pregnant (29.4% vs 6.2%, P = .04), report other forms of intimate partner violence (35.3% vs 11.9%, P = .02), and have low-birth-weight neonates (17.6% vs 3.1%, P = .03). There were no observed differences in other birth outcomes. The response rate was 68%.

In this exploratory study, women who reported reproductive coercion during their most recent completed pregnancy were more likely to report pregnancy ambivalence, other tactics of intimate partner violence, and low-birth-weight neonates. These data provide insight into the impact of violence on women's reproductive outcomes.