Domestic Violence and Maternal and Child Health

Abstract

a timely and comprehensive review of issues regarding the abuse of women during pregnancy. It is based on an extensive literature review as well as findings from the Stalking and Violence Project, a study conducted in the United States that draws on police records. A chapter on the psychosocial effects of violence was contributed by Mark Goldstein, who provides illustrative case studies from his practice in clinical psychology.In the first several chapters, Morewitz addresses the prevalence of abuse of women before, during, and after pregnancy and the causes and risk factors for such violence. Studies conducted in the United States have estimated that between 1 and 20 percent of pregnant women experience physical violence; the majority of estimates fall between 4 and 8 percent. International studies have produced estimates as high as 30 percent (Heise et al. 1999;Campbell et al. 2004) In the majority of studies, younger, less-educated, and poorer women are at a greater risk than other women of experiencing abuse during pregnancy. Women who report experiencing violence during pregnancy are more likely than others to report having witnessed domestic violence during their childhood, using alcohol and tobacco, and having an unintended pregnancy.Chapter 4 addresses parental child abductions, an issue that is often overlooked in discussions of domestic violence. The research cited by the author indicates, however, that an important link exists between these two issues: A large number of parental child-abduction cases are preceded by incidents of domestic violence.Chapters 5 through 7 discuss the physical and psychosocial effects of violence on the pregnant woman, neonatal outcomes, and effects on child development. Violence during pregnancy has been associated with a broad range of adverse pregnancy outcomes, including bleeding, miscarriages, infections, high-risk behaviors such as smoking and substance abuse, as well as low birth weight and child mortality. Moreover, many of the negative health consequences of violence for nonpregnant women, such as depression and physical injury, are often more severe when the abused woman is pregnant.The last third of the book deals with interventions undertaken to address domestic violence, primarily in the United States. Chapter 8 assesses police and court responses to domestic violence, particularly the effectiveness of restraining orders, and policies such as mandatory arrest for offenders. It describes differences in how services are used and in their outcomes.Chapters 9, 10, and 11 describe the social services that are available for abused women and, in particular, the challenges faced by health-care providers for screening and offering care to abused pregnant women. These three chapters present guidelines for screening victims of violence and for psychosocial treatment of women who have been abused. The last chapter discusses the challenges involved in identifying and treating offenders and different approaches to these efforts that have been used.This book is an ambitious ef...

The Dynamics of Intimate Partner Violence and the Risk of Pregnancy during the Transition to Adulthood

“…In general, women in violent relationships lack control over when they have sex (Heise, Moore, and Toubia 1995; Morewitz 2004). Men who are perpetrators of IPV may demand sex to demonstrate their power.…”

Relations Among Intimate Partner Violence, Maternal Depressive Symptoms, and Maternal Parenting Behaviors

“…It is important to emphasize that the linkages among IPV, maternal depressive symptoms, and maternal parenting behaviors may not be unidirectional but rather part of dynamic bidirectional relationships that change over time. For example, in addition to the rich literature that links IPV and depressive symptoms both concurrently and over time (Golding, 1999;Morewitz, 2004;Zlotnick, Johnson, & Kohn, 2006;Zlotnick, Kohn, Peterson, & Pearlstein, 1998), there also is evidence that depressive symptoms may contribute to conflict among couples (Beach, Sandeen, & O'Leary, 1990;Burke, 2003;Campbell, 2002). Similarly, just as depressive symptoms may influence parenting, the burden of caring for young children may be a risk factor for developing maternal depressive symptoms (Lyons-Ruth, Wolfe, & Lyubchik, 2000).…”

Intimate Partner Violence and Women's Contraceptive Use

“…Coercion and lack of negotiating power may also contribute to nonuse of contraception (Heise, Moore, & Toubia, 1995). Women in abusive relationships may also lack control over the timing of sexual intercourse, which would limit the effectiveness of some methods, particularly barrier methods (Heise et al, 1995;Morewitz, 2004). In another review, the authors hypothesize that abusive partners prevent women from using contraception as prescribed or refuse to pay for contraception (Branden, 1998).…”