Facilitating disclosure of intimate partner violence during teen pregnancy

Background: One quarter of teen mothers experience intimate partner violence (IPV) before, during, or after pregnancy. Little research exists on health approaches targeting IPV in this vulnerable population. We attempt to identify barriers to disclosure and to explore effective approaches to help pregnant teens more comfortably disclose IPV. Methods: Participants were women who gave birth before age 24 and men who fathered children with women younger than 24, recruited via East Harlem parenting programs to participate in single-sex focus groups. Additionally, we interviewed counselors who regularly work with expectant teen parents. Focus groups were transcribed and analyzed for common themes. Results: Participants (n=14) were 7 women ages 18-26, 3 men ages 29-31, and 4 counselors. Multiple factors contributed to unwillingness to disclose IPV to providers including perceptions that providers are too hurried to listen properly and are “going down a checklist;” they use too much jargon; they cannot relate because they have not experienced IPV themselves; and they do not take teen relationships seriously. Participants had concerns that disclosure would lead to being viewed as unfit to parent, followed by drastic action such as police or ACS involvement. Suggestions for providers included developing ongoing relationships with patients, easing into discussions about IPV as casually as they approach other topics, providing written information about IPV, and offering concrete examples and advice about healthy relationships. Conclusions: A wide range of suggestions was elaborated. Ongoing patient-provider relationships based on trust and age-appropriate communication are key to facilitating pregnant teens' disclosure of IPV.