Differences in intimate partner violence screening preconception to postpartum for US-born versus foreign-born...

This study aimed to investigate whether socioeconomic barriers to healthcare unique to foreign-born birthing people in the United States are reflected in reduced frequency of screening for intimate partner violence (IPV) in the preconception, pregnancy, and postpartum periods.

This was a cross-sectional study using Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2020 to 2021. PRAMS collected data on screening for physical and emotional IPV before, during, and after pregnancy, as well as the experience of IPV before and during pregnancy. The primary outcomes, frequency of reported IPV experience and having been screened for IPV, were compared between foreign-born versus US-born status and relative risks (RRs) were calculated. Weighted analyses of PRAMS data were employed to be reflective of representative state populations using predefined methods.

A total of 63,761 participants were included. Sociodemographic characteristics differed between US-born and foreign-born status. Approximately one in four individuals reported not being screened for IPV during pregnancy, with screening rates lower before and after pregnancy. Among those who reported experiencing IPV, over one-third were not screened. Foreign-born respondents were overall less likely to be screened for IPV before pregnancy than US-born respondents, 49.3% versus 54.3% (RR, 0.84 [0.78-0.91]), but more likely to be screened during and after pregnancy. There was also no significant association between being screened for IPV and foreign-born status among those reporting having previously experienced IPV before and during pregnancy (RR, 0.80 [0.47-1.34] and RR, 1.60 [0.90-2.84], respectively).

Screening for IPV during pregnancy remains inadequate, with approximately one in four individuals reporting not being screened. While multiple barriers to IPV screening exist, foreign-born status was not associated with lower rates of IPV screening during or after pregnancy. This finding should be interpreted with caution, considering various barriers related to birthing status that cannot be adequately evaluated using PRAMS. This also highlights the importance of IPV screening among all pregnancies, regardless of perceived risk status.