Recorded presentation

Kenneth D. Rosenberg, MD, MPH, Office of Family Health, Oregon Department of Human Services, 800 NE Oregon Street, Suite 850, Portland, OR 97232, 503-731-4507, ken.d.rosenberg@state.or.us and Rebecca T Geller, Department of Maternal and Child Health, University of Alabama at Birmingham- student, 1530 3rd Avenue South, Birmingham, AL 35294.

Background: Physical abuse of women during pregnancy can cause preterm labor, depression, injury and death.

Methods: Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) asks postpartum women about physical abuse before and during pregnancy. A stratified random sample of women who delivered in Oregon in 2000 who were more than 19 years old at the time of delivery (n=1806; response rate=72.9%) were asked whether their husband or partner hit, slapped, kicked, choked or physically hurt them during their pregnancy [and during the 12 months before pregnancy]. Women were also asked about 13 stressful life events. (Young women were not asked about physical abuse in order to avoid mandatory reporting for child abuse.)

Results: 2.6% of Oregon women reported being physically abused by their husband or partner during pregnancy. [3.8% of Oregon women reported being physically abused by their husband or partner before pregnancy.] The women who had been physically abused were most likely to have experienced the following stressful life events (compared to women who had not been physically abused; multivariate analysis):

*Involved in a physical fight: ORa=6.45 (95% CI: 1.24, 33.56)

*Argued more than usual with husband or partner: ORa=8.43 (95% CI: 2.42, 29.38).

Conclusions: Women are more likely to be physically abused before pregnancy than during pregnancy. Fighting and arguing were the strongest risk factors for physical abuse during pregnancy. These findings reinforce the need for universal screening for abuse in prenatal care. The continuity of prenatal care may provide an opportunity for women to develop trust in their providers and disclose both past and present abuse. Providers should ask about abuse, fighting, and arguing several times during the course of prenatal care. Women who report having been abused before but not during pregnancy should be followed after pregnancy to be sure that the abuse does not recur. There is a need for further research to explore whether abuse recurs after pregnancy among women who were abused before but not during pregnancy.

Learning Objectives:

• Risk of physical abuse to women before and during pregnancy
• Importance of abuse counseling during prenatal care

Keywords: Domestic Violence,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation