Women in the US are more likely to be murdered during pregnancy or shortly after childbirth than to die from the three leading obstetric causes of maternal death ( high blood pressure disorders, bleeding or sepsis ), say experts in The BMJ .
Rebecca Lawn of the Harvard School of Public Health and her colleagues say that most of these pregnancy-associated homicides are related to the lethal combination of intimate partner violence and firearms, and are completely preventable.
They argue that ending male violence, including gun violence, could save the lives of hundreds of women and their unborn children in the US each year, and is an urgent priority for women’s health and safety. Worldwide.
Intimate partner violence is common around the world, with one in three women reporting experiences of violence that includes physical, sexual or psychological abuse by a partner in their lifetime, they explain.
Reports suggest that the US has a higher prevalence of lifetime and past-year intimate partner violence than other high-income countries and that homicides by an intimate partner in the US are committed overwhelmingly. majority with firearms.
Recent estimates indicate that firearms were used in 68% of pregnancy-related homicides between 2008 and 2019, and that Black women are at substantially higher risk of being murdered than white or Hispanic women.
Cause-specific mortality ratios (deaths/100,000 live births) and 95% CIs among women during pregnancy and up to 42 days after the end of pregnancy, United States, 2018-2019 (obstetric causes of death are Organization World Health ICD-10 underlying cause of death code group categories for direct maternal deaths. Source: Obstet Gynecol. 2021 Nov 1;138(5):762–769. doi: 10.1097/AOG.00000000000004567
Domestic homicide rates are also associated with state-level rates of gun ownership and firearms legislation, however, the authors note that few perpetrators of intimate partner violence are ever convicted, and that many gaps remain that They allow access to firearms.
The recent dismantling of women’s reproductive rights in the US increases the urgency of these issues, they say.
For example, reproductive coercion , a common aspect of intimate partner violence, increases the risk of unwanted pregnancy, while restricting access to abortion endangers women as unwanted pregnancies can amplify the risks. in abusive relationships.
They note that pregnancy generally increases women’s interactions with health care providers, presenting opportunities for screening or other approaches to help women who experience or are at risk of violence.
Such interventions can help stop a pattern of abuse that could lead to homicides or adverse health outcomes, they say, but these efforts must be accompanied by urgent work to reduce all forms of violence against women.
Research to identify risk factors for homicide in pregnancy is also critical to prevention efforts, they add, but better quality data is needed for additional analyses.
All causes of maternal mortality are important, the tragedy is that homicide associated with pregnancy is one of the preventable causes of maternal mortality, they write. While the situation in the US is very serious and deteriorating, they note that intimate partner violence is one of the leading causes of homicide of women around the world.
Therefore, ending male violence, including gun violence, is an urgent priority for the health and safety of women everywhere, they conclude.
