OBJECTIVE: To describe the daily lives of rural pregnant women who smoked during pregnancy, with a focus on their sources of stress and the compounding effects of intimate partner violence (IPV).

DESIGN: A qualitative study using content analysis of research nurse’s telephone logs from a large smoking cessation randomized controlled trial (N = 695) in which 33% of the sample (n = 227) experienced IPV in the past year.

PARTICIPANTS: Fifty pregnant women, 25 who had experienced IPV in the past year and 25 who had never experienced IPV, were randomly selected from those who received a nurse-delivered telephone intervention for smoking cessation (n = 345). The mean age of the sample was 22 years, and the majority were White and living in a married-like relationship.

RESULTS: Women experiencing IPV discussed certain stressors significantly more often than non-abused women. These stressors included finances, lack of social support, legal issues, transportation issues, and abuse by the intimate partner and others.

CONCLUSION: Health care providers need to recognize that intimate partner violence creates a stress which can compound the stressors of pregnancy and poverty in rural areas. Offering these women a chance to talk about their lives can help them not only to locate necessary resources, but also to break down the barriers of isolation.