Objective: Intimate partner violence (IPV) is a significant public health issue, with approximately 25% of women reporting lifetime violence. IPV 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 IPV and contraceptive patterns, contraceptive interruptions, and choice of contraceptive method among women seeking reproductive health services.

Design: The design was a 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 was extracted from a sample of 2,000 medical charts. Inclusion criteria were: (1) female, (2) reproductive age (menarche through menopause), (3) seeking reproductive health services. IRB approval was granted for the study.    

Results: Data analysis was performed with SPSS v.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 twelve months) predicted the use of a “hidden” method of contraception (injectables, implants, IUDs, 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 IPV among young women seeking reproductive health services. IPV impacts patterns of contraception use and may place women who experience IPV at greater risk for unintended pregnancy due to increased method changes and lack of contraception. Non-daily contraceptive methods may be one alternative to increasing adequate contraception.  Nurses who work with childbearing women need to assess for IPV when providing contraceptive counseling and discuss a wide range of contraceptive options that may increase the woman’s control of use. 

Keywords: Interpersonal violence, contraception