Physical Abuse in Pregnancy

Abstract

OBJECTIVES: To determine the prevalence of abuse during late pregnancy and to investigate how abused and nonabused pregnant women differ in demographic characteristics, health habits, psychologic distress and attitudes about fetal health. DESIGN: Survey of women attending for prenatal health care or admitted to hospital for delivery. The information was obtained on one occasion from self-report questionnaires, completed with the option of anonymity. SETTINGS: Community-based prenatal clinic, private obstetricians9 offices in a large city, private family physicians9 offices in a large city, family physicians9 offices in a small town, and a university teaching hospital. PATIENTS: English-speaking women at 20 weeks9 or more gestation attending or admitted consecutively. INTERVENTIONS: Three self-report questionnaires: the General Health Questionnaire (GHQ), the Fetal Health Locus of Control (FHLC) and the study questionnaire. RESULTS: Thirteen women (2.4%) refused to participate in the survey. Of the 548 women who completed the questionnaires 36 (6.6%) reported abuse during the current pregnancy and 60 (10.9%) before it. There were no significant differences in rates of abuse between settings. Of the women abused during the pregnancy 23 (63.9%) reported increased abuse during the pregnancy, and 28 (77.8%) remained with the abuser. Twenty-four pregnant women (66.7%) received medical treatment for abuse, but only 1 (2.8%) told her prenatal care provider of the abuse. Factor analysis revealed three factors associated with abuse in pregnancy: social instability (comprising low age, unmarried status, lower level of education, unemployment and unplanned pregnancy), unhealthy lifestyle (comprising poor diet, alcohol use, illicit drug use and emotional problems) and physical health (comprising health problems and prescription drug use). The GHQ scores showed that the abused women were significantly more emotionally distressed than the nonabused women (p