The spectrum of fetal abuse in pregnant women.

Abstract

Physical assault by a woman or her partner upon their unborn child has received minimal attention in the psychiatric or obstetric literature. The spectrum concept facilitates the application of knowledge about one type of fetal abuse (e.g., physical assault in response to fetal movements) to other types (e.g., neglect or failure to protect the fetus from chemical assault by alcohol, nicotine, or drugs). Three illustrative case histories are presented, including two cases of assault by the mother via the anterior abdominal wall. Fetal abuse may be one antecedent of child abuse, and this paper attempts to transpose the known correlates of child abuse into an antenatal time framework. The resultant preliminary etiological model also draws upon research findings from neonaticide, the psychology of pregnancy, and the psychology of aggression. In addition, recent research on the maternal-paternal-fetal triad is reviewed in an attempt to delineate under what circumstances ambivalence in the parental-fetal relationship may find expression as fetal abuse. The characteristics of individuals most at risk of perpetrating fetal abuse are outlined.