COVID-19 and perinatal intimate partner violence: a cross-sectional survey of pregnant and postpartum individuals in the early stages of the COVID-19 pandemic

Katherine A Muldoon; Kathryn M Denize; Robert Talarico; Carlie Boisvert; Olivia Frank; Alysha L J Harvey; Ruth Rennicks White; Deshayne B Fell; Meagan Ann O'Hare-Gordon; Yanfang Guo; Malia S Q Murphy; Daniel J Corsi; Kari Sampsel; Shi Wu Wen; Mark C Walker; Darine El-Chaar

doi:10.1136/bmjopen-2021-049295

COVID-19 and perinatal intimate partner violence: a cross-sectional survey of pregnant and postpartum individuals in the early stages of the COVID-19 pandemic

BMJ Open. 2021 May 27;11(5):e049295. doi: 10.1136/bmjopen-2021-049295.

Authors

Katherine A Muldoon^{1

2}, Kathryn M Denize³, Robert Talarico³, Carlie Boisvert^{3

4}, Olivia Frank^{3

5}, Alysha L J Harvey³, Ruth Rennicks White³, Deshayne B Fell^{6

7}, Meagan Ann O'Hare-Gordon³, Yanfang Guo^{3

8}, Malia S Q Murphy³, Daniel J Corsi^{3

7}, Kari Sampsel^{3

9}, Shi Wu Wen^{3

6}, Mark C Walker^{3

2}, Darine El-Chaar^{3

4}

Affiliations

¹ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada kmuldoon@ohri.ca.
² Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada.
³ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
⁴ Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁵ Mailman School of Public Health, Columbia University, New York City, New York, USA.
⁶ School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
⁷ Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
⁸ BORN Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
⁹ Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Abstract

Objective: The objectives of this study were to: (1) document violent and controlling behaviours within intimate partnerships during the perinatal period; and (2) determine individual, interpersonal and household-level factors influencing the risk of perinatal intimate partner violence (IPV).

Design: Cross-sectional survey.

Setting: The Ottawa Hospital, Department of Obstetrics and Gynecology, Ottawa, Ontario, Canada.

Participants: Patients who gave birth at The Ottawa Hospital and were >20 days post partum between 17 March and 16 June 2020.

Main outcomes and measures: Perinatal IPV was defined as regular controlling behaviours or act-based forms of emotional/physical/sexual abuse in the 12 months before pregnancy, during pregnancy and/or post partum. Log-binomial multivariable regression models were used to compute adjusted risk ratios (aRRs) and 95% CIs to identify potential risk factors for IPV: maternal age, postpartum depression, parity, increase in partner substance use and household income.

Results: Among 216 participants, the median maternal age was 33 years (IQR: 30-36). In total, 52 (24.07%) reported some form of perinatal IPV, 37 (17.13%) reported regular controlling behaviour and 9 (4.17%) reported both. Household income below the municipal median was the strongest risk factor for perinatal IPV (aRR: 3.24, 95% CI: 1.87 to 5.59). There was no apparent association between maternal age (aRR: 0.99, 95% CI: 0.94 to 1.04), postpartum depression (aRR: 1.03, 95% CI: 1.00 to 1.07), nulliparity (aRR: 1.18, 95% CI: 0.71 to 1.97) or increases in partner substance use (aRR: 0.73, 95% CI: 0.42 to 1.25) with IPV.

Conclusion: One in four individuals in this study experienced perinatal IPV. Household income was the strongest risk factor, and surprisingly, many hypothesised risk factors (eg, mental health, partner substance use, etc) were not significantly associated with perinatal IPV in this sample. This highlights the challenges in both measuring IPV and identifying individuals exposed to perinatal IPV during the high stress of the COVID-19 pandemic.

Keywords: COVID-19; maternal medicine; obstetrics; public health; social medicine.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19*
Cross-Sectional Studies
Female
Humans
Intimate Partner Violence*
Ontario / epidemiology
Pandemics
Postpartum Period
Pregnancy
Prevalence
Risk Factors
SARS-CoV-2