Research That Matters (January 17 - 20, 2008)

Background: Research on the relationship between Intimate Partner Violence (IPV) and Post Partum Depression (PPD) is limited. Numerous antecedents and consequences of both IPV and PPD are noted in the literature, however understanding the impacts of partner violence on the postpartum mood are not clearly understood. The specific aims of this exploratory study were to (1) describe the relationship between IPV and PPD while accounting for the presence of other psychosocial factors and (2) explore how prenatal depression influences the relationship between IPV and PPD among women living in an impoverished section of an urban community. Methods: This study utilized a concurrent nested mixed methods design and data was analyzed using both quantitative and qualitative procedures. Retrospective chart reviews were conducted from a pediatric/perinatal social work outreach program from a moderate size urban community. Convenience sampling was utilized; eligibility criteria included (1) women had been involved in the outreach program since 2002, but (2) were no longer receiving services. The final sample included 128. The sample was predominately minorities with 49% of women identifying themselves as black, 27% were Latina and 9% were white. The mean age was 21 with over 50% were 20 years of age or younger. Seventy three percent had less than a high school education, 53% were receiving Temporary Assistance to Needy Families (TANF) and 83% were receiving Women Infants and Children (WIC) and 86% were receiving Medicaid or Medicaid Managed Care insurance. Results: Individual logistic regressions on IPV and PPD were used to calculate odds ratios and confidence intervals for the factors considered in this study: socio-demographics, social support, stress, substance use/abuse, trauma and prenatal depression. Results indicate that the likelihood of PPD is reduced by 86% for those women who do not experience prenatal depression. Numerous significant relationships between factors and IPV, specifically: for every unit increase in age there was a 14% decrease in the likelihood of violence, women who had social support from family/friends were 4.3 times less likely to experience IPV; women who were not recently involved with child protection services demonstrated an 80% reduction in the experience IPV. Qualitative analysis revealed an indirect relationship between IPV and PPD resulting from childhood abuse trauma, social support and prenatal depression. Social support appears pivotal for women who have experienced childhood abuse trauma; those with deficits in family social support appear to have a higher likelihood of entering an abusive adult relationship and are at higher risk of developing and suffering more severe PPD. Prenatal depression was prominent in women who experience PPD and the incidence of prenatal depression appears influenced by IPV. Implications: The findings add to the limited research evidence surrounding the emerging complex relationship between IPV and PPD, and provide a framework that can guide social work practice and future policy development at various social service agencies. This research further informs a future research agenda and a conceptual model is proposed.