Increase in domestic violence seen early in COVID-19 pandemic among pregnant individuals

During the first months of the COVID-19 pandemic, there was a temporary increase in unstable or unsafe living situations and intimate partner violence for pregnant people in the U.S., according to an analysis published in JAMA Network Open.

“The social, behavioral and economic consequences of the COVID-19 pandemic and shelter-in-place orders enacted to slow the spread of the virus may have contributed to intimate partner violence and unstable and/or unsafe living situations,” Lyndsay A. Avalos, PhD, MPH, research scientist in the division of research at Kaiser Permanente Northern California, Oakland, and colleagues wrote. “Data suggest a worldwide increase in the prevalence of intimate partner violence during the COVID-19 pandemic, with the United Nations describing it as a shadow pandemic within the pandemic.”

This cross-sectional population-based interrupted time-series analysis included 77,310 pregnancies among 74,663 individuals (mean age, 30.9 years) who were Kaiser Permanente Northern California members. All participants were screened for unstable and/or unsafe living situations and intimate partner violence as part of standard prenatal care between January 2019 and March 2020 (pre-pandemic period) and April to December 2020 (during the COVID-19 pandemic).

Among the cohort, 27.4% of individuals were Asian/Pacific Islander, 6.5% were Black, 29% were Hispanic, 32.3% were non-Hispanic white and 4.8% were of another racial/ethnic group. During the 24-month study period, researchers observed a 2.2% increase in the standardized rate of unstable and/or unsafe living situations (RR = 1.022; 95% CI, 1.016-1.029 per month) and a 4.9% increase in reported intimate partner violence (RR = 1.049; 95% CI, 1.021-1.078 per month).

Researchers noted a 38% increase in unstable and/or unsafe living situations during the first month of the COVID-19 pandemic (RR = 1.38; 95% CI, 1.13-1.69) and a return to the overall trend afterward for the remaining study period. Researchers also observed a 101% increase in intimate partner violence during the first 2 months of the COVID-19 pandemic (RR = 2.01; 95% CI, 1.20-3.37).

“The mandatory lockdowns and shelter-in-place policies may have forced isolation at home with an abusive partner. The psychological toll of the pandemic may have exacerbated preexisting mental health or substance use conditions among perpetrators, leading to more violent or controlling behaviors. In addition, the pandemic led to the highest recorded US unemployment rate, leading to high rates of economic insecurity with potential for unstable and/or unsafe living situations,” the researchers wrote.

“The increasing prevalence rates highlight the need for universal prenatal screening for both unstable and/or unsafe living situations and intimate partner violence with referral to appropriate support services,” they wrote.