Mediating Effect of Material Hardship on the Mental Health of Pregnant Women Experiencing Economic Abuse

Background and Purpose: Economic abuse is a form of intimate partner violence (IPV) in which an individual controls their partner’s access to economic resources. Economic abuse tactics used by abusers include economic coercion, employment sabotage, and economic exploitation. The impact of economic abuse and financial insecurity can be devastating for IPV survivors. Not only does it serve as a barrier to leaving a violent relationship, but the effects of this financial damage can extend beyond the length of the relationship. Prior research has found that economic hardship partially mediated the relationship between economic abuse and mental health among a sample of female community college students. This study builds on this work by exploring whether material hardship mediates the relationship between economic abuse and mental health outcomes (PTSD; anxiety; depression) among a community sample of pregnant women.

Methods: The data used for this analysis were collected in January 2021 using Qualtrics panel, which distributes surveys to a pool of potential respondents. Individuals were eligible to participate if they were: age 18 or older, currently pregnant, and in a relationship. A total of 210 women completed the survey. Several sociodemographic characteristics (e.g., age, income under $20,000, race/ethnicity) were included in the models as covariates. First, logistic regression analyses were conducted to explore associations between economic abuse and mental health. Then, mediation analyses were conducted in SPSS using the PROCESS macro. Overall, 77% of the sample identified as white, non-Hispanic and had an average age of 28. One-third of the sample had an annual household income of $20,000 or less.

Results: Participants experienced an average of 2 forms of material hardship in the past 12 months; 31% met the cutoff for depression, 40% met the cutoff for anxiety, and 38% met the conservative cutoff for PTSD. A one-unit increase on the economic abuse scale was significantly associated with greater odds of anxiety (OR = 1.68), depression (OR = 1.78), and PTSD (OR = 1.94). Results from the mediation analysis showed that a one-unit increase on the economic abuse scale was associated with a 1.14 unit increase on the material hardship scale (a pathway) and a one-unit increase in material hardship was associated with 1.47 greater odds of PTSD (b pathway). Material hardship fully mediated the relationship between economic abuse and PTSD (indirect effect OR = 1.46). Material hardship did not mediate the relationship between economic abuse and anxiety nor economic abuse and depression in this sample.

Conclusions and Implications: Findings from this study highlight the significant impact that economic abuse and its consequences (e.g., material hardship) can have on the mental health of survivors of IPV. Over one-third of this sample of pregnant women met the conservative cutoff for PTSD. PTSD during pregnancy is associated with engagement in maternal risk behaviors (e.g., smoking during pregnancy), as well as adverse infant health outcomes. Prevention and intervention strategies for all women, including those experiencing economic abuse, include policies and programs that promote financial empowerment and increase access to tangible resources that can ameliorate material hardship.