(830) Targeted regulation of abortion providers and intimate partner violence before and during pregnancy

Targeted regulation of abortion providers (TRAP) laws have been associated with an increased rate of intimate partner violence (IPV)-related homicide. Pregnancy is a uniquely dangerous time for people who experience IPV, yet it is unclear whether abortion restriction on a state level is associated with IPV risk before or during pregnancy. Our objective was to evaluate the association between state-level TRAP laws and IPV before and during pregnancy. 

Study Design:

We performed a cross-sectional analysis using data from the Pregnancy Risk Assessment Monitoring System (PRAMS) from Phase 8, 2016-2021. PRAMS data were linked to Guttmacher Institute data about TRAP laws from 2016 to 2021. PRAMS asks participants if they were “push[ed], hit, slap[ped], kick[ed], choke[d], or physically hurt in any way?” by their current or ex-partner/husband either in the 12 months before or during pregnancy. IPV before and during pregnancy was defined as answering “yes” to that question. Multivariable Poisson regression analyzing the association between state-level TRAP laws and state percent IPV before and during pregnancy was performed, controlling for individual sociodemographic factors.

Results:

In this analysis of 196,451 participants representing a weighted population of 10,267,609 people, 2.5% and 1.7% reported experiencing IPV before and during pregnancy, respectively. Forty-five percent of PRAMS participants lived in states with at least one TRAP law during the study period (Figure). Multivariable Poisson regression found that participants living in states with TRAP laws had a 14% increased likelihood of IPV before pregnancy and 21% increased likelihood of IPV during pregnancy compared with participants living in states that do not have TRAP laws (aIRR 1.14, 95% CI 1.05, 1.25; aIRR 1.21, 95% CI 1.10, 1.35, respectively; Table).

Conclusion:

State restriction to abortion access through TRAP laws is associated with increased rates of reported IPV before and during pregnancy. Further research evaluating how state policies have the potential to both exacerbate and mitigate IPV and maternal health are warranted.