Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr;34(4):525-538.
doi: 10.1089/jwh.2024.0535. Epub 2024 Nov 27.

Nonuse of Contraception at Conception Due to Partner Objection and Pregnancy-Related Health Care Utilization, Postpartum Health, and Infant Birth Outcomes

Denise V D'Angelo  1 , Jennifer M Bombard  2 , Kathleen C Basile  1 , Rosalyn D Lee  1 , Yanet Ruvalcaba  1 , Heather Clayton  1 , Cheryl L Robbins  2
Affiliations

Nonuse of Contraception at Conception Due to Partner Objection and Pregnancy-Related Health Care Utilization, Postpartum Health, and Infant Birth Outcomes

Denise V D'Angelo et al. J Womens Health (Larchmt). 2025 Apr.

Abstract

Objective: 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. Methods: 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. Results: Among people with a recent live birth in the study jurisdictions (n = 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). Conclusions: 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.

Keywords: PRAMS; contraceptive use; intimate partner violence; pregnancy; reproductive coercion.

PubMed Disclaimer

Conflict of interest statement

Author Disclosure Statement

The authors have no financial conflicts of interest to disclose.

Figures

FIG. 1.
FIG. 1.
Reasons for nonuse of contraception at time of conception flowchart.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. About Intimate Partner Violence. 2024. Available from: https://www.cdc.gov/intimate-partner-violence/about/ [Last accessed: August 19, 2024].
    1. Breiding MJ, Basile KC, Smith SG, et al. Intimate Partner Violence Surveillance Uniform Definitions and Recommended Data Elements CDC. National Center for Injury Prevention and Control: Atlanta, GA; 2015. Available from: https://stacks.cdc.gov/view/cdc/31292
    1. American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 554: Reproductive and sexual coercion. Obstet Gynecol 2013;121(2 Part 1):411–415. Available from: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articl... - PubMed
    1. Fay K, Yee L. Reproductive coercion and women’s health. J Midwifery Womens Health 2018;63(5):518–525; doi: 10.1111/jmwh.12885 - DOI - PubMed
    1. Basile KC, Smith SG, Liu Y, et al. Prevalence of intimate partner reproductive coercion in the United States: Racial and ethnic differences. J Interpers Violence 2021;36(21–22): NP12324–NP12341; doi: 10.1177/08862605198882 - DOI - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources