Monash University researchers have uncovered compelling evidence linking early childhood trauma and depressive symptoms during pregnancy and early motherhood to a heightened risk of intimate partner violence (IPV). This study suggests that screening for both depression and childhood trauma during crucial antenatal and postnatal periods could identify women at risk of developing depression, anxiety, and PTSD.
The study, led by Professor Megan Galbally and published in the Archives of Women’s Mental Health, aimed to compare the prevalence of emotional and physical IPV across pregnancy and the first year postpartum in women with and without clinical depression.
Study Design and Findings
The researchers analyzed data from 505 pregnant women participating in the Mercy Pregnancy and Emotional Wellbeing Study, a longitudinal cohort study collecting data from pregnancy through 12 months postpartum.
Key findings of the study include:
Women experiencing IPV during the perinatal period were significantly more likely to report high levels of depressive symptoms.
A history of childhood trauma and current stressful life events were significantly associated with reporting IPV during the perinatal period.
There was a notable association between physical IPV and depressive disorders in early pregnancy.
Women subjected to IPV reported higher levels of depressive symptoms and more stressful life events throughout the perinatal period.
Those with a history of moderate to severe childhood trauma were more likely to experience both emotional and physical IPV, particularly postpartum.
Implications for Screening and Care
Professor Galbally highlighted the importance of these findings, noting that previous studies have linked IPV with poorer mental health during the perinatal period, including symptoms of depression and anxiety. However, few studies have used clinical diagnostic measures to examine clinical depression in this context.
“The perinatal period is a crucial time when women are in regular contact with healthcare providers,” said Professor Galbally. “This offers a unique opportunity to screen for both depression and IPV, potentially improving identification and support for those at risk.”
Currently, many maternity services routinely screen for perinatal depression and IPV. However, these screenings are often conducted separately, leading to fragmented care pathways. This study underscores the need for integrated screening practices that simultaneously address both issues.
In addition to clinical assessments for depression, participants completed the Stressful Life Events Questionnaire, which measures the incidence of common and pregnancy-specific life stressors such as major illness or injury, relationship changes, employment changes, unemployment, and financial strain.
Significant Findings
The study revealed several critical associations:
Physical IPV and depressive disorders were linked in early pregnancy.
Women experiencing IPV had higher depressive symptoms throughout the perinatal period and encountered more stressful events.
A history of childhood trauma increased the likelihood of experiencing both emotional and physical IPV, particularly after childbirth.
Future Directions
These findings raise important questions about current screening practices. Professor Galbally suggested that screening measures, such as the Antenatal Risk Questionnaire recommended in the National Perinatal Mental Health Guideline, should include questions about early childhood trauma experiences and be routinely integrated into maternity care.
“Women might find it easier to disclose childhood trauma than current IPV,” she noted. “Given the significant social and psychological transitions occurring during pregnancy and postpartum, as well as the development of early parenting relationships, understanding the unique support needs of these women is critical.”
This study highlights the importance of comprehensive, integrated screening and support systems for pregnant and postpartum women. By addressing the interconnected issues of childhood trauma, depression, and IPV, healthcare providers can better support the mental and physical well-being of mothers and their children.
