Physical and emotional abuse in pregnancy: a comparison of adult and teenage women

Abstract

A sample of 691 African American, Hispanic, and white pregnant teenage and adult women were interviewed in the prenatal setting. On their first prenatal visit, 182 (26%) women reported physical or sexual abuse within the past year. There were significant differences between the teens and adults, with a higher percentage of teens (31.6%) reporting abuse during the prior year than adults (23.6%). The rate of abuse during pregnancy was 21.7% for teens and 15.9% for adult women. Adult women scored significantly higher than teens on two measures of mental abuse. Mental abuse was significantly correlated with physical abuse for all subjects.

PIP: The aim was to obtain and compare measures of physical and emotional abuse among 691 urban, pregnant women. 31% (214) were teenagers aged 13-19 years, and 69% were adults aged 20-42 years. 38% were African-American, 34% Hispanic, and 27% White. 95% lived below the poverty level. 22% of teenagers and 39% of adults were married. 18% of teenagers and 63% of adults were pregnant for the first time. The Abuse Assessment Screen (AAS), the Index of Spouse Abuse (ISA), the Conflicts Tactics Scale (CTS), and the Danger Assessment Screen (DAS) were the study instruments. Assessment during the first trimester was based on the initial administration of the AAS, and later followed with the CTS and the ISA. Only abused women received the DAS. Instruments were readministered during the second and third trimester. The findings showed that abused women tended to delay prenatal care. For example, only 9% of nonabused, but 24% of abused pregnant teenagers began prenatal care in their third trimester. 11% of nonabused adults and 20% of abused in the past year on the first prenatal visit (31.6% of teenagers and 23.6% of adults). Over 50% of women abused prior to the pregnancy were abused during the pregnancy. In subsequent visits, 8% of nonabused women (48% of teenagers) reported abuse in the second or third trimesters. Adults scored higher on severity of abuse on the ISA and CTS tests for severe and minor violence. Adults also scored higher on the DAS. For nonphysical abuse, adults also scored higher on the ISA-NP and the CTS. These findings are particularly significant because the levels of reported abuse were much higher, by two times, than previous reports: 1 in 5 pregnant teenagers, and 1 in 6 pregnant adults. Also significant was the finding that physical and emotional abuse occurred concurrently rather than separately, as had previously been believed. The AAS proved to be a reliable screening tool for identifying women who had been physically or sexually abused. Just three questions could be integrated into a routine nursing assessment form.