Domestic Violence Can Double Risk of Preterm Birth

A study out of the University of Iowa revealed what most of us could have already guessed—domestic violence during pregnancy puts both mom and baby at increased risk for serious health problems. Published this past March in BJOG: An International Journal of Obstetrics and Gynaecology, the results show intimate partner violence during pregnancy is “significantly associated with” preterm birth (before 38 weeks) and low birth weight, finding that women who endured abuse while pregnant were almost twice as likely to deliver their babies preterm.

Complications of Abuse During Pregnancy

Trauma to a woman’s abdomen, as well as sexual abuse, may increase the risk of spontaneous abortion, preterm delivery, low birth weight or neonatal death, say researchers, but the risks aren’t limited just to those abused physically. Adverse birth outcomes are also linked to increased stress, inadequate nutrition and prenatal care, and negative maternal behavior. This could include smoking, drinking or not sleeping, says family practice doctor and American Academy of Family Physicians Board Chair, Wanda Filer, MD.

“Different people cope differently with stress,” says Filer. Being stressed, drinking, smoking and not staying active can cause high blood pressure, which can have negative implications on the health of the placenta, she says. After 20 weeks, high blood pressure could lead to a condition called preeclampsia, which can cause serious damage to the mother-to-be’s organs, such as the brain and kidneys. While this condition is rare, roughly affecting only about 5 percent of pregnant women, it can lead to more serious complications such as seizures. This is classified as eclampsia, a condition which can be fatal.

Other complications of high blood pressure during pregnancy include placental abruption—an emergency condition in which the placenta detaches from the uterus prematurely—as well as low birth weight and an increased risk of C-section birth.

Screening for Abuse During Pregnancy Is Vital

The National Institutes of Health (NIH) estimates abusers target more than 300,000 pregnant women in the U.S. each year, adding that the number may be even higher than that given the reluctance of survivors to disclose abuse, especially during pregnancy.

This, combined with the fact that the NIH also lists homicide as one of the leading causes of death of pregnant women (Filer says she believes it is the leading cause of death, though research varies), means women with abusive partners who become pregnant should be aware that their lives are in danger in more ways than one.

“When a woman is pregnant, she is developing a relationship with, and focusing on, this new baby. And as we know, the abuser wants the focus on him,” says Filer. “My suspicion is the abuse escalates to turn the focus back on the abuser. It’s a way to exert control.”

Filer has been an outspoken advocate for more domestic violence training among medical professionals for the last 25 years. Luckily, she believes there have been significant improvements in the screening process of pregnant women by their medical staff to ask about domestic violence in the home.

“Twenty-five years ago, it [screening] was non-existent. Now, it’s routine. I have seen a better interface between domestic violence shelters and the medical community.” In Pennsylvania, where Filer practices, she says it’s not uncommon for domestic violence shelters to come into medical practices and do hour-long presentations on the victim services they offer.

What You Can Do

It is always your call whether or not to reach out for help, and when, as a survivor of abuse. Only you know when it’s safe to do so. However, if you’re looking for a window to reach out to an advocate, consider doing it during one of your prenatal appointments when your partner is either not with you, or not in the room, suggests The National Domestic Violence Hotline. You can ask your doctor or nurse if you can call a local shelter or national crisis hotline from the safety of their office.

Also make sure to inform your doctor of any injuries or health concerns you have as a result of the abuse. This includes physical injuries, high-stress levels or a lack of access to proper prenatal care, such as if your abuser is preventing you from eating healthy, sleeping or otherwise taking care of yourself. Full disclosure of any health concerns will give your baby the best chance for proper medical care.