The Maternity Experiences Survey (MES) is a national survey of Canadian women’s experiences, perceptions, knowledge and practices before conception and during pregnancy, birth and the early months of parenthood. This is a project funded by the Public Health Agency of Canada’s Canadian Perinatal Surveillance System, with the goal of achieving a better understanding of the determinants of maternal, fetal and infant health. The MES questionnaire includes more than 300 questions covering a broad range of topics related to pregnancy, birth and the postpartum period.
A recent study analyzed data from the Canadian Maternity Experiences Survey to better understand how pregnancy and maternal outcomes are affected by the partner’s behavior. In this cross-sectional, nationally representative sample of 6,421 pregnant women, the researchers looked at three indicators of partner disengagement: (1) partner did not want the pregnancy, (2) partner argued more than usual in the year prior to the baby’s birth, and (3) partner was absent at the delivery.
Looking at all the respondents, 3.8% of the women who had partners who did not want the pregnancy, 16.1% argued more than usual with their partner in the year before the child’s birth, and 7.6% had partners who were absent at the time of delivery.
Women whose partner did not want the pregnancy were nearly four times as likely to report intimate partner violence (IPV) (adjusted odds ratio [AOR] 3.55) They were also more likely to experience depressive symptoms in the postpartum period (AOR 2.56) and were more likely to have nonroutine child health care visits after birth (AOR 1.54).
Women whose partner argued more during the past year were nearly five times as likely to report intimate partner violence (IPV) (AOR 4.82). In addition, they were more likely to experience elevated depressive symptoms during the postpartum period (AOR 3.63) and were more likely to have nonroutine child health care visits (AOR 1.49).
In general, women who had a partner who was not present at the time of delivery fared a little better. This form of disengagement did not significantly affect risk for IPV or depressive symptoms; however, these women were at greater risk for preterm delivery (aOR 2.27), pregnancy complications (aOR 1.82), and NICU admissions (aOR 1.89).
These findings are somewhat surprising to me. Based on the consistent finding that women with inadequate social supports are at increased risk for depression, I expected that women with no partner might fare worse than women with partners. However, this was not the case in this study. In fact, it seems that when there is disagreement or conflict with a partner, this has a robust effect on vulnerability to perinatal depression and risk for IPV.
When I screen for psychosocial risk factors for perinatal depression, I typically ask about marital status and social supports and history of trauma. I ask whether the pregnancy was planned or unplanned. This study indicates that we should, when assessing vulnerability to perinatal depression and IPV, delve a bit deeper into the quality of the woman’s relationship with her partner.
Ruta Nonacs, MD PhD
Urquia ML, Pulver A, Heaman MI, Ray JG, Daoud N, O’Campo P. Partner Disengagement from Pregnancy and Adverse Maternal and Infant Outcomes. J Womens Health (Larchmt). 2016 Nov 18. [Epub ahead of print]
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