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


OBJECTIVE
To examine patterns of physical abuse before, during, and after pregnancy in a representative statewide sample of North Carolina women.


METHODS
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.


METHODS
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.


CONCLUSIONS
Since well-baby care use is similar for abused and nonabused mothers, pediatric practices may be important settings for screening women for violence.
Department of Maternal and Child Health, School of Public Health, CB 7400, University of North Carolina, Chapel Hill, NC 27599-7400, USA. sandra_martin@unc.edu
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Martin
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Mackie
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Kupper
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Buescher
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Moracco
D000293:Adolescent; D000328:Adult; D002662:Child Health Services; D005260:Female; D006801:Humans; D007223:Infant; D007224:Infant Care; D009657:North Carolina / Q000453:epidemiology; D010372:Pediatrics; D049590:Postpartum Period; D011247:Pregnancy / Q000706:statistics & numerical data*; D015995:Prevalence; D012959:Socioeconomic Factors; D013179:Spouse Abuse / Q000517:prevention & control / Q000706:statistics & numerical data*