Physical abuse of women before, during, and after pregnancy.

CONTEXT Clinicians who care for new mothers and infants need information concerning postpartum physical abuse of women as a foundation on which to develop appropriate clinical screening and intervention procedures. However, no previous population-based studies have been conducted of postpartum physical abuse. OBJECTIVES To examine patterns of physical abuse before, during, and after pregnancy in a representative statewide sample of North Carolina women. DESIGN, SETTING, AND PARTICIPANTS Survey of participants in the North Carolina Pregnancy Risk Assessment Monitoring System (NC PRAMS). Of the 3542 women invited to participate in NC PRAMS between July 1, 1997, and December 31, 1998, 75% (n = 2648) responded. MAIN OUTCOME MEASURES Prevalence of physical abuse during the 12 months before pregnancy, during pregnancy, and after infant delivery; injuries and medical interventions resulting from postpartum abuse; and patterns of abuse over time in relation to sociodemographic characteristics and use of well-baby care. RESULTS The prevalence of abuse before pregnancy was 6.9% (95% confidence interval [CI], 5.6%-8.2%) compared with 6.1% (95% CI, 4.8%-7.4%) during pregnancy and 3.2% (95% CI, 2.3%-4.1%) during a mean postpartum period of 3.6 months. Abuse during a previous period was strongly predictive of later abuse. Most women who were abused after pregnancy (77%) were injured, but only 23% received medical treatment for their injuries. Virtually all abused and nonabused women used well-baby care; private physicians were the most common source of care. The mean number of well-baby care visits did not differ significantly by maternal patterns of abuse. CONCLUSION Since well-baby care use is similar for abused and nonabused mothers, pediatric practices may be important settings for screening women for violence.

[1]  B Barnwell,et al.  SUDAAN User's Manual, Release 7.5, , 1997 .

[2]  Rosalind J Wright.  Identification of domestic violence in the community pediatric setting: need to protect mothers and children. , 2000, Archives of Pediatrics & Adolescent Medicine.

[3]  C. Rennison,et al.  Intimate Partner Violence: (378132004-001) , 2000 .

[4]  S. Killian.  Violence and substance use among north carolina pregnant women , 1997 .

[5]  Identification of violence in the home: Pediatric and parental reports , 2001 .

[6]  J. Belsky,et al.  Stability and Change in Marriage across the Transition to Parenthood. , 1983 .

[7]  J. Gazmararian,et al.  The Relationship Between Pregnancy Intendedness and Physical Violence in Mothers of Newborns , 1995, Obstetrics and gynecology.

[8]  D. Stewart,et al.  Physical abuse in pregnancy. , 1993, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[9]  D. Stewart,et al.  Incidence of postpartum abuse in women with a history of abuse during pregnancy. , 1994, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[10]  P. Tjaden,et al.  Extent, nature, and consequences of intimate partner violence , 2000 .

[11]  M. Karlan,et al.  Violence against women: Relevance for medical practitioners , 1992 .

[12]  B. Miller,et al.  Normal Stresses during the Transition to Parenthood. , 1980 .

[13]  J. Mcfarlane,et al.  Assessing for abuse during pregnancy: Severity and frequency of injuries and associated entry into prenatal care , 1993, JAMA.

[14]  L. Hedin.  Postpartum, also a risk period for domestic violence. , 2000, European journal of obstetrics, gynecology, and reproductive biology.

[15]  J. Mcfarlane,et al.  Battered and pregnant: a prevalence study. , 1987, American journal of public health.

[16]  J. Gazmararian,et al.  Prevalence of violence against pregnant women. , 1996, JAMA.

[17]  R. Petersen,et al.  Who gets screened during pregnancy for partner violence? , 2000, Archives of family medicine.

[18]  A. Gielen,et al.  Interpersonal conflict and physical violence during the childbearing year. , 1994, Social science & medicine.

[19]  R. Gelles.  Violence and pregnancy: Are pregnant women at greater risk of abuse? , 1988 .

[20]  R. J. Wright,et al.  Response to battered mothers in the pediatric emergency department: a call for an interdisciplinary approach to family violence. , 1997, Pediatrics.