Is Prenatal Contraceptive Counseling Enough? Intimate Partner Violence Timing and Postpartum Contraception in Hispanic Women

Abstract Purpose Intimate partner violence (IPV) is a major public health concern that can impact women’s reproductive decisions, but how IPV timing and prenatal contraceptive counseling are associated with postpartum contraceptive use in Hispanic women is poorly understood. This study examines the association between IPV timing, prenatal contraceptive counseling, and postpartum contraceptive use among Hispanic women. Methods Data were drawn from the 2019–2020 Pregnancy Risk Assessment Monitoring System and included 11,721 Hispanic women who had recently given birth. IPV was classified based on timing as none, preconception, prenatal, or both. Multivariable logistic regression models were estimated with analyses moderated and stratified by receipt of prenatal contraceptive counseling, to assess associations between the timing of IPV and postpartum contraceptive use. Results IPV exposure was associated with a decrease in the likelihood of using postpartum contraception. Postpartum contraception use was lower among women who reported preconception IPV and among women who reported prenatal IPV compared to women reporting no IPV, and effect estimates were similar in magnitude between the two exposure windows. In moderated analyses, the negative relationship between IPV and postpartum contraceptive use remained among women who received prenatal contraceptive counseling. Conclusions Hispanic women who experienced IPV before pregnancy or during pregnancy had lower odds of using contraception postpartum, and associations were not limited to exposure during one particular exposure window. Findings suggest that prenatal contraceptive counseling may not be sufficient alone to address reproductive health decision-making. Trauma-informed, and culturally responsive reproductive health services that screen for IPV and respond to safety and reproductive health decision-making concerns may better support postpartum contraceptive use among IPV survivors.