(282) State conservative ranking and prevalence of intimate partner violence before and during pregnancy

An estimated 2 to 9 percent of people who are pregnant experience intimate partner violence (IPV), increasing their risk of adverse pregnancy outcomes. We hypothesize that states with a more progressive political culture will have lower rates of IPV than more conservative states. We aimed to evaluate the association between state conservative ranking and state IPV rates before and during pregnancy.

Study Design:

We used 2016-20 data from the Pregnancy Risk Assessment Monitoring System, linked to published state conservative ranking scores based on the percent of total votes in a state legislature cast for conservative causes. States were grouped into tertiles of most to least conservative. Using multivariable Poisson regression, we assessed the association between state conservative ranking and the frequency of self-reported IPV before (within 12 months) and during pregnancy, controlling for individual-level sociodemographic variables.  

Results:

This analysis included 194,334 respondents representing a population of 9,785,771. In total, 3.1% of respondents reported experiencing IPV before or during pregnancy. Pearson correlation coefficients demonstrated a significant linear association (0.57, p< 0.001), with states that had a higher proportion of conservative votes associated with higher reported prevalence of IPV (Figure). In multivariate Poisson regression, there was a 14% lower likelihood of IPV in the 14 states with the least conservative (most liberal) state legislative voting records in comparison to a referent group of moderately conservative states (aIRR 0.86, 95% CI 0.79-0.95). However, the risk of IPV was not significantly different between those in highly versus moderately conservative states.

Conclusion:

Birthing individuals in states with the least conservative (most liberal) policy environment were significantly less likely to report IPV in the 12 months before or during pregnancy. While evaluation of individual-level factors dominates research about IPV, we advocate for a better understanding of how political environments influence the prevalence of IPV in order to reduce IPV rates.