Screening for intimate partner violence in the early postpartum period: pregnancy, maternal, and child outcomes from the prenatal period to five years post-delivery
In Manitoba, government policy is for public health nurses to screen families with newborns within one week post-discharge for a number of risk factors associated with poor child developmental health, including a question on a past or current history of intimate partner violence (IPV) between parenting partners. The purpose of this study was to examine differences in the developmental trajectories of mothers and their children from the prenatal period to 5-years post-delivery based on the IPV screen response. Administrative databases housed at the Manitoba Centre for Health Policy provided data for this study. Manitoban women giving birth to a live singleton infant from January 1, 2003 to December 31, 2006 were included in analyses. Outcomes assessed included sociodemographic covariates, maternal prenatal morbidities and complications, birth outcomes, maternal postpartum health, child postpartum health, postpartum child welfare organization involvement, and children’s readiness for school at kindergarten entry. Descriptive statistics and logistic regression were used to examine differences in outcomes of interest based on IPV screen response (i.e., negative IPV screen, positive IPV screen, not screened for IPV). In the study population, 66.7% of the sample was screened for a history (past or current) of IPV between parenting partners. Among women who were screened, 2.1% screened positive for IPV. Findings indicated that a positive IPV screen was associated with increased maternal prenatal morbidities (e.g., mental health problems, hospitalizations), as well as more adverse birth outcomes (e.g., low birthweight, preterm birth). In the 5 years post-delivery, a positive screen for IPV at birth was associated with poorer maternal and child health, increased child and families services contact, and children being less ready for school at kindergarten entry relative to those with a negative IPV screen. Similar patterns of adverse outcomes were noted among women (and their children) who were not screened for IPV (vs. women screening negative for IPV) in the early postpartum period. Incorporating IPV screening into routine prenatal care, rather than assessing IPV experiences after birth, may help to better identify families in need of support and, ultimately, improve pregnancy outcomes and the longer-term trajectory of women and their children.
Intimate partner violence, Pregnancy violence, Families First screen, Maternal health, Child health, Birth outcomes, Pregnancy