Perinatal violence and perversion and a role for public health

Perinatal systems and agencies addressing violence and perversion are generally separate. A battered pregnant addict may be served by ten agencies, all separate. Public health can help connect systems. Topics include: 1) pregnancy with mothers who are: substance abusers, in jail or on probation, in domestic violence shelters, pregnant by incest or rape, developmentally disabled or mentally ill, murdered, HIV+, and pregnant juveniles in foster care or on probation. 2) neonates who are: effected by prenatal substance abuse, abandoned/abused/neglected, reported to child protective services and 3) infants who are victims of abuse/neglect including homicide victims. Models for multi-agency data collection and services include 1) The ICAN National Center on Child Fatality Review with: models from multiple states, Multi-agency data on infants, draft California protocols for review of severe nonfatal injuries, 2) LA County Projects; tracking infant homicide data across agencies and jurisdictions, neonatal reports to CPS after prenatal substance abuse, state law and local protocols, countywide public and private hospital data, and a multi-agency tracking system for an estimated 1500 neonates reported annually in the first year of life. Data will be included where it exists. Most systems will be described to demonstrate the lack of data particularly across themes, across professions and across jurisdictions. Existing data will be described that is generally unused for: preteen birth by adult males, HIV and HPV and child sexual abuse, STD in children under age 10, and inaccurate infant homicide data. Models will be presented that connect separate systems.