Experiences of Violence Among Puerto Rican Women Before, During and After Pregnancy: Prevalence and Associated Health Factors using Data from the Puerto Rico Pregnancy Risk Assessment Monitoring System

Abstract

Objective: Interpersonal violence (IPV) is associated with negative physical, mental, and reproductive health outcomes. This study described the characteristics of Puerto Rican women experiencing IPV before, during, and after the time of pregnancy and explored disparities in their health outcomes, risk factors, and healthcare utilization behaviors. Methods: We analyzed 2017–2020 data from the Puerto Rico Pregnancy Risk Assessment Monitoring System for 3,893 respondents, calculating weighted prevalence estimates of IPV, 95% CIs, and odds ratios for IPV before, during, and after pregnancy. Results: Overall, 8.0% of Puerto Rican women reported experiencing violence in the 12 months before or during pregnancy. Physical violence, most often perpetrated by a current or former intimate partner, was reported by 4%. Emotional violence during pregnancy was reported by 5.2% of participants, and 1.2% reported being forced to have sex while pregnant. Experiences of violence were significantly associated with age, marital status, type of health insurance at the time of delivery, symptoms of depression or anxiety 3 months before pregnancy, postpartum depressive symptoms, pregnancy intention, smoking 3 months before pregnancy, adequacy of prenatal care, and being asked by a healthcare professional about experiencing violence in the 12 months before pregnancy. Conclusions: Puerto Rican women face a significant risk of experiencing violence before, during and after pregnancy; this violence is associated with detrimental physical and mental health outcomes and lower health care utilization. Culturally sensitive interventions and improved health care practices are critical to support affected women and enhance perinatal health outcomes.