Homicide found to be top cause of maternal death
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Pregnant women or those who've given birth in the past year are likelier to be murdered than die from medical causes like preeclampsia or hemorrhaging, a new study in JAMA Network Open concludes.
Why it matters: The findings show how maternal mortality can be influenced by state divorce laws and access to reproductive care, with individuals younger than 25 years and Black women at highest risk.
- Intimate partners account for the largest proportion of pregnancy-associated homicides.
What they found: Laws restricting access to abortion and divorce during pregnancy can raise the risk of intimate partner violence, University of South Carolina researchers wrote, pointing to the need for protective orders, safe housing and other resources for pregnant women in abusive relationships.
- Using violent death reports compiled by the Centers for Disease Control and Prevention from 2018 to 2021, the researchers found there was a significant risk ratio for being murdered by an intimate partner in states with barriers to finalizing divorce while pregnant. Arkansas, Missouri and Texas currently have such restrictions.
- The overall rate of pregnancy-associated homicide for white females under 25 was 0.03 per 100,000 women of reproductive age, but 0.43 for younger Black women and 0.10 for younger Hispanic women.
Rates were also higher in states that require a waiting period or parental consent and notification for an abortion. That's a particular concern since it's estimated that 18% of rape-related pregnancies are perpetrated by a family member, the researchers wrote.
Context: The available data didn't cover the period after Roe v. Wade was overturned, when states that already restricted access to reproductive care implemented total or near-total bans.
- "Research suggests this has led to increases in rape-related pregnancies and infant mortality, and it must be examined how these changes affect pregnancy-associated violence and homicide once data are available," lead author Kaitlin Boyle, a criminologist at the University of South Carolina, wrote by email.
Earlier research in BMJ found a combination of intimate partner violence and firearms made U.S. women likelier to to be murdered during pregnancy or soon after childbirth than to die from the three leading obstetric causes of maternal mortality.
- That study noted reports that the U.S. has a higher prevalence of intimate partner violence than other high-income countries, including most European countries and Australia.
