Populations at Risk Across the Lifespan: Case Studies: Psychological and Physical Abuse Among Pregnant Women in a Medicaid-Sponsored Prenatal Program

Abstract

OBJECTIVES: To document psychological and physical abuse during pregnancy among women enrolled in enhanced prenatal services (EPS); explore the associations between maternal risk factors and type of abuse; and examine the relationship between abuse and EPS participation. DESIGN AND SAMPLE: Cross-sectional study utilizing screening data collected between 2005 and 2008. Convenience sample of Medicaid-insured pregnant women enrolled in EPS selected from urban and rural providers. MEASURES: A prenatal screening tool that included measures such as Cohen's Perceived Stress Scale-4, Patient Health Questionnaire-2, and Abuse Assessment Screen was used. RESULTS: Logistic regressions showed that high perceived stress and lack of father support were associated with all types of abuse and abuse history. Women with risk factors, such as a positive depression screen (odds ratio [OR]=2.36), were associated with psychological abuse but not with physical abuse during pregnancy. Less than a 12th-grade education was associated with physical abuse (OR=1.64) but not psychological abuse during pregnancy. The amount or the timing of EPS participation was not significantly associated with abuse history or abuse during pregnancy. CONCLUSIONS: Risk factors, such as high perceived stress and lack of father support, may alert nurses to further explore abuse during pregnancy. Additional research is needed for understanding the relationship between abuse and EPS participation.

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