(1092) State partisan divide and intimate partner violence before and during pregnancy

Objective: Pregnancy is a high-risk period for intimate partner violence (IPV), with greater risk for adverse pregnancy outcomes among people who experience IPV. Our objective was to evaluate the association between a state’s percent vote for Donald Trump in the 2020 presidential election and statewide IPV rates before and during pregnancy reported by birthing people.

Study Design: Data from 2016-2020 from 44 states using the Pregnancy Risk Assessment Monitoring System (PRAMS) were linked to the state percent vote for Trump in the 2020 election. PRAMS surveys postpartum people two to four months after delivery. The survey asks participants if their current or past husband/partner “push, hit, slap[ped], kick[ed], choke[d], or physically hurt [them] in any way” in the 12 months before pregnancy and/or during pregnancy. Respondents who answered “yes” to either question were defined as reporting IPV. Our main outcome was the mean state-reported prevalence of IPV in the 12 months before or during pregnancy. Multivariable Poisson regression estimated the association between the 2020 state percent vote for Trump and the mean IPV rate reported, controlling for individual-level sociodemographic variables. Sensitivity analysis with 2016 election data was performed.

Results: Among 190,800 respondents representing an estimated population of 9,762,956, 3.1% of respondents reported experiencing IPV before or during pregnancy. There was a significant positive association (r=0.62, p< 0.001) between mean state IPV rate and state percent vote for Trump in 2020 (Figure). After adjusting for respondent sociodemographic factors, each 10-point increase in the state percent vote for Trump was associated with a nine percent greater likelihood of reporting IPV before or during pregnancy (aIRR 1.09, 95% CI 1.05, 1.13; Table). Findings were similar for 2016 election data (aIRR 1.08, 95% CI 1.04, 1.13).

Conclusion: Political and cultural environments are potential contributing factors to IPV prevalence before and during pregnancy. The state percent vote for Trump may be a signal of a greater prevalence or toleration of abusive behavior.