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.
To examine patterns of physical abuse before, during, and after pregnancy
in a representative statewide sample of North Carolina women.
Design, Setting, and Participants
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.
Main Outcome Measures
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.
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.
Since well-baby care use is similar for abused and nonabused mothers,
pediatric practices may be important settings for screening women for violence.