Did domestic violence and unstable living conditions increase among pregnant women during the early days of the COVID-19 pandemic?


A new study offers insights into future guidelines for certain populations of pregnant women during a national pandemic.

Did social and economic fallout as a result of the COVID-19 pandemic result in an increase in violence and unstable living conditions for pregnant individuals? In a February 2023 study published in JAMA Network Open, investigators sought to find out if in fact safeguards need to be put in place to protect pregnant individuals from an increase in both unstable living conditions and partner violence during a pandemic.

For this study, a cross-sectional population-based interrupted time-series analysis was looked out from Kaiser Permanente Northern California, an integrated health care system with 21 hospital-based medical centers in the region. Records of women who were both pregnant and in unstable/unsafe living conditions as part of standard prenatal care screening between January 1, 2019 and December 31, 2020 were looked at, and 2 questions were asked during the screening.

Using data from electronic health records, researchers looked at 74,663 individuals, which included a cross-sampling of Asian/Pacific Islander (27.4%); Black (6.55), Hispanic (29%); nonHispanic White (32.3%); and other/unknown/multiracial (4.8%). The 2 questions from the prenatal IPV screening questionnaire were: “Is your living situation unsafe and/or unstable?” and “are you in a relationship with a person who threatens or physically hurts you?”

Across the 24-month study period, rates of unsafe/unstable living situations increased by 38% during the first month of the pandemic (April 2020), and partner violence increased by 101% during the first 2 months of the pandemic. The increase of unstable living conditions corresponded with the increase of shelter-in-place advisories that were put forth to control the spread of the COVID-19 virus. In some instances, these mandatory lockdowns, it appears, forced isolation with an abusive partner and could also have contributed to an increase in preexisting mental health problems or substance abuse on the part of the violent partner as well.

Investigators concluded that with these increases, even though temporary (overall increase trends, other than those noted, were not affected by the pandemic), measures to create safeguards for these adverse outcomes in pandemic emergency response plans could be beneficial.

Nearly a quarter of all women experience intimate partner violence at some point in their life, most common among women during their reproductive stage. Adverse effects from this violence include preterm birth, low birth weight, neonatal hospitalization and mental health problems for mothers, both before and after pregnancy.


Avalos LA, Ray GT, Alexeeff SE, et al. Association of the COVID-19 pandemic with unstable and/or unsafe living situations and intimate partner violence among pregnant individuals. JAMA Network Open. 2023;6(2):e230172. doi:10.1001/jamanetworkopen.2023

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