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

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.

Figure 1

Different forms of regular controlling behaviour from partner during COVID-19 (n=216). *measured using items from the WHO multicountry study on domestic violence.

Figure 2

Forms and timing of act-based perinatal IPV (n=216). *participants can report multiple forms of IPV. Cases of physical and sexual abuse were identified, but suppressed because of small cell sizes. IPV, intimate partner violence.