Patterns of Intimate Partner Violence Before and During Pregnancy: A Cohort Study

Intimate partner violence (IPV) during pregnancy is a risk factor for the health of both the mother and the offspring, and its prevalence is higher than that of other obstetric complications. However, it is unclear if IPV decreases or increases during pregnancy. This research examines the prevalence of IPV, the co-occurrence and changing patterns of psychological, physical and sexual IPV before and during pregnancy in a cohort study in 21 public primary health antenatal care centers in the south of Spain. Consecutive eligible mothers who received antenatal care were tested for IPV by trained midwives using the World Health Organization IPV questionnaire in the first and third trimester of pregnancy to ascertain their experiences of IPV before and during pregnancy, respectively. Our results revealed that 21.5% of participants had experienced at least one episode of IPV before pregnancy and 10.7% during pregnancy (McNemar's test, p = <.001). The prevalence of psychological, physical, and sexual IPV before and during pregnancy were 21.3% versus 10.5% (p = <.001), 4.7% versus 1% (p = <.001), and 1.9% versus 0.8% (p = .18), respectively. The co-occurrence analysis showed that the most common pattern was the presence of psychological IPV before and during pregnancy. However, the next common pattern changes between periods: during pregnancy, this pattern was exposed to the three types of IPV (6% of the women), while before pregnancy, it was the co-occurrence of psychological and physical IPV. Longitudinal analyses revealed that of those women experiencing IPV before pregnancy, more than 30% also reported victimization during pregnancy (recidivist pattern). The implications for clinical practice and research are discussed.