D'Angelo Denise V, Bombard Jennifer M, Basile Kathleen C, Lee Rosalyn D, Ruvalcaba Yanet, Clayton Heather, Robbins Cheryl L
Division of Violence Prevention, National Center for Injury Prevention & Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Womens Health (Larchmt). 2025 Apr;34(4):525-538. doi: 10.1089/jwh.2024.0535. Epub 2024 Nov 27.
Reproductive coercion has been associated with adverse reproductive health experiences. This study examined the relationship between nonuse of contraception due to partner objection, one aspect of reproductive coercion, and selected pregnancy-related outcomes. We used 2016-2020 data from the Pregnancy Risk Assessment Monitoring System in 22 jurisdictions to assess the prevalence of nonuse of contraception due to a partner objection by select characteristics among individuals with a recent live birth who reported an unintended pregnancy. We calculated adjusted prevalence ratios (aPRs) to understand associations with health care utilization, postpartum behaviors and experiences, postpartum contraceptive use, and infant birth outcomes. Among people with a recent live birth in the study jurisdictions ( = 29,071), approximately 5% reported nonuse of contraception due to a partner objection and unintended pregnancy. This experience was associated with lower prevalence of attending a health care visit before pregnancy (aPR 0.8, 95% confidence interval [CI] 0.7-0.9), first trimester prenatal care, and attending a postpartum checkup (aPR 0.7, 95% CI 0.6-0.9 for both). Higher prevalence was observed for postpartum depressive symptoms (aPR 1.3, 95% CI 1.1-1.6) and partner objecting to using birth control postpartum (aPR 2.8, 95% CI 2.1-3.9). Nonuse of contraception due to a partner objection at conception was associated with poor mental health and lower health care utilization around the time of pregnancy. Prevention efforts may include strategies that ensure provider screening for intimate partner violence, and evidence-based approaches that teach about healthy relationships, enhance self-efficacy, and address underlying drivers of violence.
生殖胁迫与不良的生殖健康经历有关。本研究考察了因伴侣反对而未采取避孕措施（生殖胁迫的一个方面）与选定的妊娠相关结局之间的关系。我们使用了22个司法管辖区2016 - 2020年妊娠风险评估监测系统的数据，以评估在报告意外怀孕的近期有活产的个体中，因伴侣反对而未采取避孕措施的选定特征的患病率。我们计算了调整后的患病率比值（aPRs），以了解与医疗保健利用、产后行为和经历、产后避孕措施使用以及婴儿出生结局之间的关联。在研究司法管辖区近期有活产的人群（n = 29,071）中，约5%报告因伴侣反对和意外怀孕而未采取避孕措施。这种经历与怀孕前进行医疗保健就诊的患病率较低（aPR 0.8，95%置信区间[CI] 0.7 - 0.9）、孕早期产前检查以及进行产后检查的患病率较低（两者的aPR均为0.7，95% CI 0.6 - 0.9）相关。产后抑郁症状的患病率较高（aPR 1.3，95% CI 1.1 - 1.6），且伴侣反对产后使用节育措施的患病率较高（aPR 2.8，95% CI 2.1 - 3.9）。受孕时因伴侣反对而未采取避孕措施与心理健康不佳以及怀孕前后医疗保健利用率较低有关。预防措施可能包括确保医疗服务提供者筛查亲密伴侣暴力的策略，以及传授健康关系、增强自我效能并解决暴力潜在驱动因素的循证方法。
