Disability, race, and risk of perinatal intimate partner violence: Findings from a nationally representative U.S. sample.

BACKGROUND

Intimate partner violence (IPV) during the perinatal period poses serious risks to maternal and infant health. Women with disabilities and those from racially and ethnically minoritized groups experience disproportionately high rates of IPV, yet little is known about how these identities intersect to shape risk.

OBJECTIVE

To examine the association between race, ethnicity, disability, and perinatal IPV in a nationally representative sample of U.S.

METHODS

This cross-sectional study analyzed 2018-2021 Pregnancy Risk Assessment Monitoring System data, including respondents with known IPV, race, ethnicity, and disability status. IPV was defined as self-reported violence in the 12 months prior to pregnancy and during pregnancy; given conceptual differences in timing, these periods were examined separately. Disability was assessed using the Washington Group Short Set. Logistic regression models estimated odds of IPV by race, ethnicity, and disability, with and without covariate adjustment for maternal age, insurance payer, and education.

RESULTS

Our analysis included 39,914 respondents, with 2744 (7.0%) respondents reporting a disability. In adjusted models, disability remained a strong predictor of IPV in the 12 months prior to pregnancy and during pregnancy across all racial and ethnic groups. In the 12 months prior to pregnancy, compared to non-disabled respondents, Non-Hispanic American Indian/Alaska Native (aOR = 3.35; 95% CI 1.85-6.08), non-Hispanic White (aOR = 3.04; 95% CI 2.19-4.23), Hispanic (aOR = 2.75; 95% CI 1.62-4.66), and non-Hispanic Black (aOR = 2.77; 95% CI 1.83-4.19) respondents with disabilities faced a higher risk of IPV. During pregnancy, compared to non-disabled respondents, Non-Hispanic American Indian/Alaska Native (aOR = 4.13; 95% CI 2.19-7.78), non-Hispanic White (aOR = 2.97; 95% CI 1.92-4.57), Hispanic (aOR = 2.52; 95% CI 1.29-4.93), and non-Hispanic Black (aOR = 3.51; 95% CI 2.34, 5.26) respondents with disabilities faced a higher risk of IPV.

CONCLUSIONS

Respondents with disabilities experienced substantially higher risk of IPV across all racial and ethnic groups. Findings highlight the need for accessible, trauma-informed IPV screening and intervention strategies that address both ableism and racism within perinatal care systems.