Homicide being the main cause of the mother’s death. Doctors have asked pregnant women to undergo domestic violence screening



CNN

The two researchers urge health care providers to educate and screen pregnant women about intimate partner violence, as women in the United States are more likely to die during pregnancy or postpartum than to die from common obstetric causes, such as sepsis.

Other studies suggest that they are at higher risk of homicide than non-pregnant women.

Pregnancy-related homicides are often linked to domestic violence and firearms, but are preventable, Rebecca Lawn and Karestan Koenen of the Harvard TH Chan School of Public Health wrote in an editorial published Wednesday in the medical journal BMJ.

“Women are likely to have more visits with health professionals during pregnancy, providing opportunities to identify and support women at risk of violence and prevent pregnancy-related homicides,” Lawn wrote in an email to CNN on Thursday. “However, recent US legislation that restricts women’s access to reproductive care and abortions reduces their opportunities for help and may put women at greater risk of violence.”

He also mentioned that the legislation on firearms increases the risk of women being subjected to violence by their partners.

“While many factors contribute to the high maternal mortality rate observed in the United States, the inextricable and deadly link between intimate partner violence and gun violence must be considered. Pregnancy is a high-risk time for intimate partner violence, and women are more likely to be killed by a partner who is shot by their partner.” if he’s got a weapon,” Lawn said. “Firearm laws are more lax in the US and rates of intimate partner violence and gun ownership are higher than in other high-income countries; this background likely contributes to the high pregnancy-related homicide rates we see in the US.”

Most people tend to think of clinical causes of maternal death (such as preeclampsia or gestational diabetes), but Law and Koen’s editorial offers insight into intimate partner violence as another cause, said Dr. Zenobia Brown, senior vice president of population health and associate chief medical officer. Health network officer at Northwell Health, New York.

“I applaud the article because I think it brings to light things that we don’t want to look at otherwise because they’re so difficult and traditionally health care hasn’t dealt with those issues well,” he said.

Brown added that intimate partner violence has been a part of maternal health discussions at the Northwell Center for Maternal Health, as well as assessing women’s risk of experiencing intimate partner violence.

“In general, there’s a lot of focus on assessment, asking the right questions and listening, and especially assessing these things that we haven’t traditionally assessed, like intimate partner violence, trauma history, behavioral health,” Brown. he said

“We tend to think of maternal mortality, or maternal issues, as a point in time or a moment for women and I think that’s what people need to understand more and more about the entire life cycle of a woman, her family, everyone who touches that family unit,” she said. “We shouldn’t wait until a woman is pregnant to ask these questions.”

A study published in August in the American Journal of Public Health found that pregnancy-related homicides in the United States have increased significantly in recent years, and that the risk of homicide was 35 percent higher for pregnant and postpartum women than for non-pregnant women. pregnant or postpartum.

Data on maternal deaths related to intimate partner violence are often lacking, but screening can help, said Kamila Alexander, an associate professor at the Johns Hopkins School of Nursing.

She also said that black women have a higher risk of maternal death than white women and that controlling for these racial disparities is important.

“There is no consistent screening in the clinical setting. So the documented violence that occurs during pregnancy is probably inconsistent, so it can be difficult to link it to a death,” Alexander said. “There are a lot of holes in the data we have.”