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Keywords:

  • interpersonal violence;
  • contraception

Paper Presentation

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  2. Paper Presentation

Objective

Intimate partner violence is a significant public health issue, with approximately 25% of women reporting lifetime violence. Intimate partner violence has been associated with unintended pregnancy, possibly due to partner coercion or interference with contraceptive. The specific aim of this study was to describe the association between intimate partner violence and contraceptive patterns, contraceptive interruptions, and choice of contraceptive method among women seeking reproductive health services.

Design

Retrospective chart review of existing medical record data.

Setting

Four reproductive health clinics in the northeast United States.

Patients/Participants

The final sample size was 2,000. The majority of the participants were between the ages of 15 and 26.

Methods

Data were extracted from a sample of 2,000 medical charts. Inclusion criteria were female, reproductive age (menarche through menopause), and seeking reproductive health services. Institutional Review Board approval was granted for the study.

Results

Data analysis was performed using Statistical Package for the Social Sciences version 19. The overall rate of lifetime violence for this sample was approximately 28%. The majority of the participants were between the ages of 15 and 26 (79.1%). Regression analysis indicated that a history of lifetime violence was predictive of an increased number of contraceptive method changes in the previous year (B = .283; p < .000). Additionally, a recent history of violence (past 12 months) predicted the use of a “hidden” method of contraception (injectables, implants, intrauterine devices, and sterilization) that is less vulnerable to partner interference or tampering (B = .059; p < .000). A history of lifetime violence was also predictive of not using a contraceptive method since last menses (B = .763; p < .000) and increased use of emergency contraception (B = .796; p < .000).

Conclusion/Implications for Nursing Practice

There is a high rate of intimate partner violence among young women seeking reproductive health services. Intimate partner violence affects patterns of contraception use and may place women who experience intimate partner violence at greater risk for unintended pregnancy due to increased method changes and lack of contraception. Nondaily contraceptive methods may be one alternative to increasing adequate contraception. Nurses who work with childbearing women need to assess for intimate partner violence when providing contraceptive counseling and discuss a wide range of contraceptive options that may increase the woman's control of use.