Mental Health, Demographic, and Risk Behavior Profiles of Pregnant Survivors of Childhood and Adult Abuse

Authors

  • Julia S. Seng CNM, PhD,

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    • Julia S. Seng, CNM, PhD, is a certified nurse-midwife and research associate professor at the University of Michigan Institute for Research on Women and Gender and the School of Nursing and research assistant professor in the Department of Obstetrics and Gynecology, Ann Arbor, MI.]

  • Mickey Sperlich CPM, MA,

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    • Mickey Sperlich, CPM, MA, is a certified professional midwife and the study coordinator for the study on which this paper is based at the University of Michigan Institute for Research on Women and Gender, Ann Arbor, MI.

  • Lisa Kane Low CNM, PhD

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    • Lisa Kane Low, CNM, PhD, FACNM, is a certified nurse-midwife and assistant professor of Nursing and Women's Studies at the University of Michigan, Ann Arbor, MI.


University of Michigan Institute for Research on Women and Gender, G120 Lane Hall, 204 S. State St., Ann Arbor, MI 48109-1290. E-mail: jseng@umich.edu

Abstract

Our objective was to address the gap in knowledge about the extent to which perinatal mental health and risk behaviors are associated with childhood and adult experiences of abuse that arises because of barriers to screening and disclosure about past and current abuse. Survey data from an ongoing study of the effects of posttraumatic stress on childbearing were used to describe four groups of nulliparous women: those with no abuse history, adult abuse only, childhood abuse only, and abuse that occurred during both periods. The rates of abuse history disclosure were higher in the research context than in the clinical settings. Mental health morbidity and risk behaviors occurred in a dose-response pattern with cumulative abuse exposure. Rates of current posttraumatic stress disorder ranged from 4.1% among those never abused to 11.4% (adult only), 16.0% (childhood only), and 39.2% (both periods). Women abused during both periods also were more likely to be using tobacco (21.5%) and drugs (16.5%) during pregnancy. We conclude that mental health and behavioral risk sequelae affect a significant portion of both childhood and adult abuse survivors in prenatal care. The integration into the maternity setting of existing evidence-based interventions for the mental health and behavioral sequelae of abuse is needed.

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