Original Articles
Physical violence during pregnancy: maternal complications and birth outcomes

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Abstract

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women’s physical violence during pregnancy were based on self-reports of “partner-inflicted physical hurt and being involved in a physical fight.” Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence of physical violence was 11.1%. Among women who experienced physical violence, 54% reported having been involved in physical fights only and 46% had been hurt by husbands or partners. In the latter group, 70% also reported having been involved in fighting. Compared with those not reporting physical violence, women who did were more likely to deliver by cesarean and be hospitalized before delivery for maternal complications such as kidney infection, premature labor, and trauma due to falls or blows to the abdomen.

Conclusion: Physical violence during the 12 months before delivery is common and is associated with adverse maternal conditions. The findings support the need for research on how to screen for physical violence early in pregnancy and to prevent its consequences.

Section snippets

Materials and methods

We analyzed data from the South Carolina Pregnancy Risk Assessment Monitoring System,11 a population-based survey developed to monitor selected self-reported maternal behaviors and experiences occurring before, during, and after pregnancy among women who delivered live-born infants. A systematic birth weight–stratified random sample of new mothers (200–240 women) was drawn monthly from the South Carolina birth registry. Because of the low frequency of births of LBW infants in the population,

Results

Eleven percent of women reported physical violence (either “being physically hurt by husband or partner” or “being involved in a physical fight”) within the 12 months of delivering a live infant (Table 1). The prevalence of being involved in a physical fight during the year before delivery (9.6%) was twice as high as the prevalence of partner-perpetrated physical violence (5.1%). Also shown in Table 1 are the mutually exclusive categories of physical violence during pregnancy. Those data showed

Discussion

Violence against women is difficult to measure for various reasons, including the fact that a standardized definition is lacking, and the fact that some women are unwilling to disclose violence, because of social stigma or cultural sanctioning of violence.16 Thus, the best prevalence estimates are probably underestimates. Given this and the similar effects on maternal outcomes of being involved in a fight, we included data on women’s involvement in fights in our assessment of physical violence

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    This research was funded in part by Collaborative Agreement U50/CC407132 from the Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia.

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