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The purpose of this review is to provide an overview of the current state of knowledge regarding the experience of intimate partner violence (IPV) during pregnancy. Pregnancy IPV is a significant problem worldwide, with rates varying significantly by country and maternal risk factors. Pregnancy IPV is associated with adverse newborn outcomes, including low birth weight and preterm birth. Many mechanisms for how IPV may impact birth outcomes have been proposed and include direct health, mental health, and behavioral effects, which all may interact. Screening for IPV during pregnancy is essential, yet due to time constraints and few clear recommendations for assessment, many prenatal providers do not routinely inquire about IPV, or even believe they should. More training is needed to assist health care providers in identifying and managing pregnancy IPV, with additional research needed to inform effective interventions to reduce the rates of pregnancy IPV and resultant outcomes.

Although physical abuse during pregnancy has been linked to poor birth outcomes, the role of psychological abuse is less well understood. Associations between birth outcomes and types of psychological abuse during pregnancy (being threatened, screamed at, or insulted) were examined in 489 women with no history of physical abuse. Being threatened was significantly associated with adverse birth outcomes, with women reporting any instance during pregnancy twice as likely to deliver a low birth weight baby. These results remained after controlling for background factors. Finally, most of the variance between threats and birth weight was accounted for by mediating health behaviors (specifically prenatal care utilization and pregnancy weight gain), suggesting pathways for the negative effects of being threatened by an intimate partner during pregnancy.

Intimate Partner Violence and COVID-19 Erin G. Siegel, BA, Rachel K. Carpenter, MS, & Jill D. Stinson, PhD Department of Psychology, College of Arts & Sciences, East Tennessee State University, Johnson City, TN Intimate partner violence includes physical, sexual, or psychological harm by a current or former partner or spouse. In the US, a decline in reported rates over the past two decades may have been reversed by the onset of the COVID-19 pandemic, particularly during the initial lockdown in March 2020. A majority of Americans were isolated at home, potentially increasing the occurrence of IPV assaults. Few studies have evaluated changes in IPV rates throughout the pandemic. This study aims to estimate and compare the rates of intimate partner assaults during the COVID-19 pandemic to previous years, while also examining the influence of geographic location (e.g., rurality versus urban areas), age of the victim, and nature of the assault type. The hypotheses are as follows: 1) an increase in cases of IPV during the first quartile of the pandemic, followed by a decline in the later recent quartiles (i.e., end of 2020); 2) an increase in IPV during the COVID-19 pandemic being more pronounced in counties with greater rurality; 3) an increase in IPV in persons over 18 during the first quartile of the pandemic compared to those under 18 age (who are less likely to live with a partner); and 4) predominant assault type rates (e.g., forcible rape versus murder) may have changed during the pandemic. Data for this project were obtained from the Tennessee Incident-Based Reporting System (TIBRS) for secondary data analysis. From 2016 to 2020 there were 371,196 reported IPV assaults. Variables of interest include all 95 Tennessee counties, age of victim (e.g., over or under 18), and the type of assault (forcible rape, forcible fondling, forcible sodomy, sexual assault with an object, simple assault, aggravated assault, homicide, intimidation, and stalking). Data describing county rurality were obtained from the online County Health Rankings and Roadmaps. County-level rates of IPV are separated by quartile during the pandemic months (Q1, Q2, Q3, Q4). Descriptive analyses will determine the yearly rates of IPV assaults from 2016-2020, with a specific examination of rates during the pandemic quartiles, age distribution, variability among types of assaults, and which counties demonstrate the highest reports. Percent change analyses will evaluate the previous years and determine if there was a significant change in IPV rates throughout the pandemic. Subsequent analyses will compare rates of IPV in rural and urban counties. This project aims to examine how the COVID-19 pandemic has affected rates of IPV, which may inform current prevention and intervention efforts. Additionally, data from urban and rural communities will potentially highlight treatment disparities, providing valuable information pertaining to resource allocation.

Background: Intimate Partner Violence (IPV) is recognized globally as a major public health concern linked to numerous adverse physical, mental, sexual and reproductive health outcomes. IPV is associated with both pregnancy and HIV-infection independently, but there are few data on IPV in populations of HIV-infected pregnant women. We examined the prevalence and predicators of IPV among pregnant women initiating lifelong antiretroviral therapy (ART) in a large primary care clinic in Cape Town, South Africa. Methods: Consecutive pregnant women seeking antenatal care in Gugulethu, Cape Town were recruited into the MCH-ART study examining service models for postpartum ART care. IPV, depression, alcohol and drug use, and emotional distress were assessed using the 13-item WHO Violence Against Women questionnaire, the Edinburgh Postnatal Depression Scale (EPDS), alcohol and drug use disorders identification test (AUDIT/DUDIT) and the Kessler-10 (K-10) scale, respectively. Questionnaires were administered privately by trained interviewers. Women identified with specific IPV or mental health concerns were referred to appropriate services. Logistic regression was used to examine factors independently associated with experiences of IPV after adjusting for age and socioeconomic status. Results: From April 2013-May 2014, 623 women were enrolled (median age, 28 years):97% reported being in a relationship, 38% were married and/or cohabiting and 70% reported not having discussed or agreed on pregnancy intentions prior to conception . Overall, 21%(n=132) reported experiencing ≥ 1 act of IPV in the past 12 months, including emotional violence(15%), physical violence(15%) and sexual violence(2%). Of those reporting any IPV, 48% reported experiencing multiple types. Emotional and physical violence were most prevalent among women 18-24 years old, while sexual violence was most commonly reported among women 25-29 years old. Women who reported not discussing or disagreeing on pregnancy intentions with their partners prior to conception were significantly more likely to experience violence(p=0.030), and women who experienced IPV reported higher levels of substance abuse, depression and emotional distress(p<0.001 for all associations). Discussion: These data demonstrate high levels of IPV in this population. While the potential impact of HIV-infection, pregnancy and pregnancy intention on the risk of IPV and related factors require further research, IPV-related screening and support services should be considered as part of the package of care for ART in pregnancy.

Intimate partner violence (IPV) is a problem that is present and pervasive globally and in South Africa. In the South African context, IPV exists within a larger context of high levels of interpersonal violence and violence against women. Understanding the context in which IPV occurs from the perspective of survivors is important for informing effective intervention and prevention programs to counteract its effects. This study explores the life histories of South African women who have experienced IPV. Framed through the lens of intersectionality, it gauges the broader context within which IPV emerges and is sustained, and explores how experiences of IPV are shaped at the intersection of women’s identity markers of race, class and gender. This study is one of a few studies that have used life history methods with women to explore their life contexts and experiences of IPV. Purposive sampling was used to recruit a sample of 11 women based in a Cape Town women’s shelter for abused women and children. Two semi-structured qualitative life history interviews were conducted with each participant. The interviews were transcribed and analysed through thematic narrative analysis, where four noteworthy narrative themes emerged, namely An unsteady and violent beginning, No place called home: A search for belonging and survival, IPV: The unanticipated cost of love and belonging, and Normalisation of IPV experiences: The effects of withdrawal from support. The findings and their relation to existing literature as well as recommendations for future IPV research are discussed. One of the key findings of the study was that the childhood context of the participants was the first point of identifying intersectional oppression and marginalisation that may have shaped a vulnerability to the women’s later experiences of IPV. Another key finding was recognising the value that women place on love and belonging in the context of a difficult, violent and low socioeconomic childhood background, and how this could have an impact on the vulnerability of women to IPV. The use of a life history approach framed by intersectionality thus demonstrated significant benefits in tracking the contextual experiences of women who have experienced IPV. These benefits are of significance because they made it possible to identify points of intervention and prevention of IPV amongst marginalised South African women.

In families where parents present with intimate partner violence dynamics, courts routinely impose restraints restricting communications between those parents. However, the same courts also routinely fashion arrangements whereby those same parents share custody of their children. Children in families with this dynamic are often used as communication facilitators and triangulated by parental conflict. This grounded theory study generated a theory about parenting coordination work with high conflict couples with intimate partner violence dynamics. This theory may have utility for parenting coordinators working more effectively with the described population. Semi-structured interviews were conducted with 10 professional parenting coordinators who have worked with high conflict parents with intimate partner violence. The qualitative data collected were analyzed through open, axial, and selective coding procedures with the additional use of research/mentor triangulation and researcher journaling. Results of this study yielded adaptive parenting coordination for intimate partner violence theory (APCIPV). This theory incorporates findings that specific modifications to the parenting coordination process, along with a concentrated effort to implement structured communication techniques and focused monitoring of exchanges between the parties can lead to coparenting despite the intimate partner violence dynamic. Further, it was revealed that high conflict parents, in general, often present with and report many of the same problematic behaviors even without a formal adjudication of domestic violence. Findings from this study can serve as an evidence basis for promoting the use of parenting coordinators as communication facilitators between high conflict parents with intimate partner violence to remove children from familial triangulation.

In relationships between men and women, women are still more likely than men to take family leave and reduce work hours after the birth of their first child. This results in economic changes between partners at the transition to parenthood. Gendered changes in income may impact relationship dynamics within couples and contribute to the elevated risk of intimate partner violence (IPV) seen at this time. Previous research has linked both relative and absolute income to IPV; however, it is unlikely that income directly impacts IPV. For this reason, the current study explored potential mediators of the relationship between income and IPV such as decision-making power (i.e., the ability to influence another person’s opinions and decisions) and quality of alternatives (i.e., the availability of options outside of the current relationship) by following 196 first time parents across four timepoints (the third trimester of pregnancy, one year, two years, and four years postpartum). Multilevel modelling was used to test whether decision-making power mediates the relationship between relative income and IPV and whether quality of alternatives mediates the relationship between absolute income and IPV. Despite low base rates of physical IPV, findings indicated that at times when the gender wage gap within couples was smaller, overall levels of physical violence within the relationship were reduced. However, at times when the gender wage gap was smaller women’s psychological IPV perpetration increased. There were mixed findings regarding decision-making power and quality of alternatives as mediators of the relationship between income and IPV. Implications for the current conceptualization of the link between income and power are discussed. / Graduate