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Pregnancy-related homicides a public health priority to reduce maternal mortality rates

Women in the US are more likely to be murdered during pregnancy or soon after childbirth than to die from the country’s top 3 leading causes of maternal death—high blood pressure disorders, hemorrhage, or sepsis—according to research in The BMJ.

Most of these pregnancy-related homicides—according to Harvard Medical School of Public Health’s Rebecca Lawn, PhD and colleagues—result from a combination of intimate partner violence and firearms.

They argue that society must address “male violence,” or the violence committed by men, could save the lives of hundreds of women in the US every year. While intimate partner violence is common worldwide, with 1 in 3 women reporting experiences of physical, sexual, or psychological abuse/violence by a partner in their lifetime, rates in the US are significantly higher than rates in other high-income countries.

The homicides committed by an intimate partner in the US are overwhelmingly tied to firearms, and homicides related to pregnancy are no different. Recent reports found that firearms were used in 68% of homicides around pregnancy between 2008 and 2019, with Black women at substantially higher risk of murder than White or Hispanic women.

These domestic homicides are also associated with state-level firearms legislation and gun ownership, and the plethora of loopholes allowing access to remain.

The recent decisions regarding women’s reproductive rights in the US place further emphasis on these issues, Lawn and her colleagues say. Specifically, reproductive coercion is a common aspect of intimate partner violence and increases the risk of unwanted pregnancy. Restricting access to abortion care further endangers women as unwanted pregnancies can often amplify risks in abusive relationships.

Lawn and her colleagues pointed out that pregnancy typically means more contact with health care providers, which can provide opportunities for screening and other approaches to help women at risk of intimate partner violence. These interventions—from doctors and health care teams—may help stop a pattern of abuse that could eventually lead to homicide or other negative health outcomes, the authors say.

All causes of maternal mortality are important, the authors say, but the tragedy here is that pregnancy-associated homicide is preventable. They concluded with an emphasis on the need to end male violence, including gun violence, for the health and safety of women everywhere.

Reference

Lawn RB, Koenen KC. Homicide is a leading cause of death for pregnant women in US. BMJ. Published online October 19, 2022:o2499. doi:10.1136/bmj.o2499