Constrained Choice, Perinatal Health, and Intimate Partner Victimization (IPV)

IPV research has been guided by the presumption that pregnancy increases women’s risk of victimization as well as their economic, social and legal ties to their partners, thereby narrowing their options for health and safety. More contextual understandings of how IPV originates and alters, before, during and after pregnancy, is largely missing from current literature. Our paper examines IPV throughout the perinatal period and expands notions of women’s well-being and health choices. Data come from qualitative semi-structured interviews with a subsample of 330 women who participated in a community based longitudinal study on maternal health in the USA. The study included IPV screening questions to which 64 (19%) answered positively for lifetime incidence. Forty of these women completed interviews with us, during which 27 reported IPV specifically during the perinatal period. It was here that we focused our phenomenological-based analysis.

Our findings affirm that the dynamics of IPV exist in relationships prior to pregnancy, whether or not the parties involved recognize the maltreatment as abuse. However how women perceive their relationships, as well as how visible they may be to others, are of relevance for identification and intervention. First, pregnancy may be a tangible precursor to IPV - abuse dynamics exist in the relationship prior to pregnancy, but are not overtly recognized by the victim until she becomes pregnant. Second, pregnancy may be an aggravator of already recognized IPV - women know they are in abusive relationships and pregnancy works to affirm this recognition. Third, pregnancy may serve as a temporary mitigator of IPV - women recognize they’re being abused but feel that the abuse stops or lessons during pregnancy. Such findings elucidate applications of constrained choice theory within high-risk perinatal contexts, and subsequent best practices with women with limited options within extreme health risk scenarios.