Maternal Intimate Partner Violence Research Articles

Maternal childhood trauma and prenatal stressors are associated with child behavioral health.

Maternal adversity and prenatal stress confer risk for child behavioral health problems. Few studies have examined this intergenerational process across multiple dimensions of stress; fewer have explored potential protective factors. Using a large, diverse sample of mother-child dyads, we examined associations between maternal childhood trauma, prenatal stressors, and offspring socioemotional-behavioral development, while also examining potential resilience-promoting factors. The Conditions Affecting Neurocognitive Development and Learning and Early Childhood (CANDLE) study prospectively followed 1503 mother-child dyads (65% Black, 32% White) from pregnancy. Exposures included maternal childhood trauma, socioeconomic risk, intimate partner violence, and geocode-linked neighborhood violent crime during pregnancy. Child socioemotional-behavioral functioning was measured via the Brief Infant Toddler Social Emotional Assessment (mean age = 1.1 years). Maternal social support and parenting knowledge during pregnancy were tested as potential moderators. Multiple linear regressions (N = 1127) revealed that maternal childhood trauma, socioeconomic risk, and intimate partner violence were independently, positively associated with child socioemotional-behavioral problems at age one in fully adjusted models. Maternal parenting knowledge moderated associations between both maternal childhood trauma and prenatal socioeconomic risk on child problems: greater knowledge was protective against the effects of socioeconomic risk and was promotive in the context of low maternal history of childhood trauma. Findings indicate that multiple dimensions of maternal stress and adversity are independently associated with child socioemotional-behavioral problems. Further, modifiable environmental factors, including knowledge regarding child development, can mitigate these risks. Both findings support the importance of parental screening and early intervention to promote child socioemotional-behavioral health.

Maternal emotional and physical intimate partner violence and early child development: investigating mediators in a cross-sectional study in a South African birth cohort

ObjectivesThis study investigated associations between recent maternal intimate partner violence (IPV) (emotional, physical and sexual) and child development at 2 years as well as whether maternal depression or alcohol use...

Two Pink Lines: An Exploratory, Comparative Study of Florida’s Pregnancy-associated and Nonpregnancy-associated Intimate Partner Homicides

Pregnancy-associated Intimate Partner Homicides (PAIPHs) are murders of pregnant women by a former or current intimate partner. This study uses aggregated public data from 2000 to 2019 to examine 33 Florida Pregnancy-associated Intimate Partner Homicides and a comparison group of 33 Nonpregnant Intimate Partner Homicides (NIPHs). Findings show that unwanted pregnancies or relationships, avoidance of prosecution, doubts concerning the unborn child’s paternity, infidelity accusations, and the victim’s drug use are risk factors for Florida’s Pregnancy-associated Intimate Partner Homicides. Moreover, findings suggest a need for Maternal Intimate Partner Violence programs, policies, and interventions targeted toward pregnant women and their intimate partners.

Intimate Partner Violence and Parenting: Examining the Roles of Parenting Stress, Timing, and Maternal Abuse History

Maternal intimate partner violence (IPV) exposure has been linked to negative parenting outcomes. Studies suggest that parenting stress is an intermediary between IPV exposure and parenting, though past work has relied on small, clinically- referred samples. Moreover, it is unclear if parenting is differentially affected by a mother’s recent versus past history of IPV exposure, or whether a mother’s childhood abuse history moderates the associations of IPV with parenting stress and parenting behaviors. The current study examines whether recent IPV, versus past IPV, has stronger associations with parenting stress and parenting behaviors and tests whether maternal abuse history moderates these associations. Using structural equation modeling, we tested relations between IPV (frequency and recency), parenting stress, and parenting behaviors cross-sectionally and longitudinally in a large community sample of IPV-exposed low-income Hispanic and African American mothers of children aged 0–14 years (N = 1159). We found that mothers who reported IPV exposure in the past year reported higher negative and lower positive parenting behaviors than mothers who reported less recent exposure. Further, we found that the frequency and timing of IPV exposure affected parenting indirectly through increased parenting stress. However, a childhood history of abuse did not appear to sensitize women to these effects. These findings suggest that psychological interventions aimed at reducing the subjective experience of parenting stress, as well as increased access to resources that reduce objective childcare burden, are important for promoting resilience among families exposed to violence.

Parenting Mediates Associations Between Intimate Partner Violence at Different Life Stages and Toddler Social-Emotional Problems.

Researchers have linked parent experiences of intimate partner violence (IPV) to engagement in more negative and less positive parenting behaviors with their own children. This parenting behavior is associated with more negative child social-emotional outcomes. There is little research examining the impact of exposure to IPV during childhood on subsequent parenting and child outcomes in the next generation. This study aimed to better understand the complex relationship between IPV, parenting, and child social-emotional development among mothers of toddler-aged children, using both mothers' self-reported and observed parenting. This study utilized longitudinal data from an economically disadvantaged, racially diverse sample of 120 women who participated in data collection across the perinatal period, until children were 2 years of age. Measures included self-reported and observed parenting, mother-reported IPV history, and mother-report of toddler social-emotional difficulties. Childhood exposure to IPV predicted observed parenting problems, which in turn predicted greater toddler social-emotional problems. Conversely, adult experiences of IPV predicted self-reported parenting difficulties, which predicted greater toddler social-emotional problems. Findings suggest that exposure to IPV at different time points may influence parenting in different ways, representing unique pathways between maternal IPV experiences and child social-emotional difficulties.

Cascades of Risk Linking Intimate Partner Violence and Adverse Childhood Experiences to Less Sensitive Caregiving During Infancy.

This study evaluated if maternal intimate partner violence (IPV) had indirect effects on sensitive parenting in infancy through prenatal depressive symptoms and postpartum parenting stress and if maternal adverse childhood experiences (ACEs) moderated these indirect effects. We hypothesized that: (a) IPV would be associated with greater prenatal depressive symptoms, which would predict greater postpartum parenting stress, and ultimately less sensitive parenting and (b) the link between IPV and depressive symptoms would be strongest for mothers with high ACEs. Participants included 295 mothers and their infants who were assessed prenatally and at 12 months postpartum. Path analyses indicated that mothers with higher IPV endorsed greater prenatal depressive symptoms, which was in turn associated with postpartum parenting stress, and ultimately less sensitive parenting behavior. Moderation analyses revealed that these indirect effects varied as a function of maternal ACEs, with the link between IPV and depressive symptoms only present for mothers who reported high ACEs. Because less sensitive caregiving is often an early indicator of child maltreatment risk, understanding precursors to sensitivity is critical to increase precision in parenting interventions designed to reduce risk for maltreatment. Results may inform evidence-based preventive interventions for mothers and infants at high-risk for child abuse and neglect.

Intimate partner violence and maternal health services utilization: evidence from 36 National Household Surveys

BackgroundHigh rates of maternal mortality and intimate partner violence (IPV) are both major worldwide health challenges. Evidence from single-country samples suggests that IPV may be an important risk factor for low utilization of maternal health services, but there is little large-scale evidence on this association. This paper evaluates whether IPV is a risk factor for low utilization of maternal health services in a large cross-country sample, and also compiles evidence on the relative effects of different forms of IPV.MethodsWe analyze the association between intimate partner violence and utilization of maternal health care, using a dataset compiling all Demographic and Health Surveys that report data on intimate partner violence. Using data on 166,685 women observed in 36 countries between 2005 and 2016, we estimate logistic regression models to analyze the relationship between lifetime experience of IPV and utilization of antenatal care (ANC), facility delivery care, and postnatal care. We estimate both unadjusted models and models adjusted for geographic and sociodemographic characteristics that are generally correlated with utilization of maternal health care (including age, education, number of children, wealth status, marital status, and urbanity).ResultsLifetime experience of any IPV is associated with decreased use of maternal health services in a broad sample of births observed in lower and middle-income countries: in particular, the utilization of four or more ANC visits, the number of ANC visits, and the utilization of facility care at birth. This association remains statistically significant even after adjusting for country of residence, subnational region of residence, and additional individual-level covariates; however, there is no statistically significant association between experience of any IPV and postnatal care. The only form of IPV significantly associated with care utilization is physical IPV.ConclusionsWomen experiencing physical intimate partner violence show lower levels of utilization of maternal health services in a large sample of developing and middle-income countries. Given that reduced utilization of maternal health services is correlated with maternal and neonatal health outcomes, this pattern suggests that IPV prevention may be an important component of interventions targeting enhanced maternal and neonatal health.

Intimate partner violence and exclusive breastfeeding of infants: analysis of the 2013 Nigeria demographic and health survey

BackgroundExisting knowledge on the relationship between intimate partner violence (IPV) and exclusive breastfeeding (EBF) in the context of Nigeria is minimal and limited to a lifelong measure of IPV experience. An abuse experienced a long time ago may not have as much negative effect as that encountered at a more proximal time to the breastfeeding phase. To this effect, we examined this relationship with maternal IPV experienced around the time of pregnancy and postpartum.MethodWe analyzed data from the 2013 Nigeria Demographic and Health Survey. The sample includes 2668 breastfeeding mothers having a child aged under 6 months. The outcome variable was EBF or mixed-feeding (24 h recall). The exposure variables were: the maternal experience of psychological, physical, and sexual intimate partner violence. Also, there was an experience of any form of IPV and frequency score of intimate partner violence. Analysis includes chi-square and t-test bivariates, complete case and imputed logistic regressions for binary outcome.ResultsIn the imputed analysis, compared to mothers who experienced no IPV, those who experienced IPV had a 26% reduced likelihood of EBF practice (AOR 0.74; 95% CI 0.55, 1.00). Also, a unit dose of maternal IPV experience was associated with a 5% reduced likelihood of EBF practice (AOR 0.69; 95% CI 0.49, 0.98). Among the three forms of IPV, physical IPV had the highest effect size. Physical IPV was associated with a 37% reduced likelihood of EBF practice (AOR 0.63; 95% CI 0.44, 0.90), while psychological IPV was associated with a 34% reduced likelihood of EBF practice (AOR 0.66; 95% CI 0.47, 0.92), when compared to the respective reference groups. On the other hand, those who reported sexual IPV were just as likely to breastfeed as those who did not (AOR 0.94; 95% CI 0.62, 1.41).ConclusionsIn this study, maternal IPV is associated with EBF practice. Policies aimed at promoting EBF should also be framed to combat IPV against pregnant women and nursing mothers.

A National Study on Child Abuse and Neglect in Rural China: Does Gender Matter?

Does gender affect the risk of child abuse and neglect (CAN) in rural China? This study aims to answer this question through a national gender-balanced survey. An empirical investigation of 4943 children (Mage = 12.08, 48.7% male) in eight provinces was finished in December 2019. The descriptive statistics, a mean analysis, and a linear regression are used to discuss the data. Two important findings can be summarized as follows. First, the risk of CAN in rural China differs across genders. The prevalence and severity of the physical and emotional abuse are higher among boys than among girls, while girls are more likely to suffer emotional neglect. Second, the risk factors for CAN also differ across genders. Girls are more likely than boys to be affected deeply by factors such as the experience of maternal intimate partner violence (IPV), parental educational attainment, children’s age and academic performance, while boys are more associated with parental alcohol dependence than girls. The findings indicate that the prevalence of, severity of and risk factors for CAN differ significantly across genders, primarily because of gender inequality and the residual child welfare system.

Adverse Childhood Experiences (ACEs) in English Electronic Health Records of Linked Mothers and Children: Validation Study Using a Multistage Risk-Prediction Model

Background: Electronic health records (EHRs) are readily available and increasingly used for identifying adverse childhood experience (ACEs), yet well-developed indicators for ACEs remain limited. We aimed to develop clinically relevant indicators of ACEs for routine EHRs of mothers and children using multi-stage risk prediction models of child maltreatment (CM) and maternal intimate partner violence (mIPV). Methods: We developed a representative population-based birth cohort of 211 ·393 linked mother-child pairs (422·786 total patients) followed from 2-years pre-birth up to 5-years post-birth (2002-2018) across the Clinical Practice Research Datalink (primary care), Hospital Episode Statistics (secondary care), and the Office for National Statistics mortality register. We randomly assigned the cohort into a derivation cohort (2/3 of sample) and a validation cohort by GP practice. The primary outcome (reference standard) was any CM or mIPV in the mother's or child's record from 2-years pre-birth (mIPV only) up to 5-years post-birth. We used 8 prediction models combined with expert ratings to systematically developed indicators. We validated the final indicators by integrating results from machine learning models, survival analyses and clustering analyses in the validation cohort. Findings: We included 63 indicators in six ACE domains: maternal mental health problems (mMHPs), maternal substance misuse (MSM), adverse family environments (AFE), CM, mIPV, and high-risk presentations for CM (HRP-CM) . Excluding the 7 indicators in the reference standard, 56 indicators showed high discriminative validity for family violence (validation cohort, area under the receiver operating characteristic curve: 0·85, 95% CI: 0·84-0·86). The prevalence over the 2-year period before and after birth were 39·1% for any of the 63 ACE indicators, 22·2% for mMHPs, 15·7% for AFE, 8·1% for HRP-CM, 6·9% for MSM, and 3·0% for any CM (2·4%) and mIPV (1·0%). 74·1% of ACEs were recorded only in primary care. Interpretation: We developed and quantified clinically relevant indicators for identifying ACEs using EHRs of mothers and children presenting to health care during pregnancy and early childhood. Details of all ACEs and indicators are publicly available for further evaluation (https:/ACEsinEHRs.com). Funding: None to declare. Declaration of Interest: None to declare. Ethical Approval: The study was approved by the MHRA (UK) Independent Scientific Advisory Committee

Adverse Childhood Experiences and Child Development Outcomes in Ceará, Brazil: A Population-based Study

More than 200 million children fail to reach their full developmental potential in low- and middle-income countries. Adverse childhood experiences, maternal mental health, and intimate partner violence are negatively associated with child development outcomes. The relationship of these risk factors with child communication, gross motor, fine motor, problem-solving, and personal-social development scores in Brazil are assessed. A population-based, cross-sectional study of preschool children living in the state of Ceará, Brazil, in 2017 was conducted. Child development was assessed with the Ages and Stages Questionnaire. Adverse childhood experiences for children were self-reported by the participants' mothers using the Centers for Disease Control and Prevention Adverse Childhood Experiences Study‒adapted metric. Maternal mental health and intimate partner violence were evaluated using validated questionnaires. Sample-adjusted multivariable generalized linear models with interaction terms were used to determine the association of intimate partner violence, maternal mental health, and adverse childhood experiences with developmental outcomes and identify possible moderators. Data were analyzed between 2019 and 2020. Children exposed to ≥3 adverse childhood experiences had -0.12 (95% CI= -0.24, 0) lower communication, -0.25 (95% CI= -0.46, -0.03) lower gross motor, -0.27 (95% CI= -0.47, -0.07) lower fine motor, and -0.17 (95% CI= -0.3, -0.03) lower personal-social domain scores than children with no adverse childhood experiences. Furthermore, the greater number of adverse childhood experiences was linearly associated with lower developmental scores. Maternal mental health and intimate partner violence were also associated with lower development scores. Adverse childhood experiences were independently associated with developmental outcomes in Brazilian children. Community-based interventions to reduce the impact of adverse childhood experiences, intimate partner violence, and maternal mental health may benefits child development outcomes.

Intimate Partner Violence During Pregnancy: Effects of Maternal Depression Symptoms and Parenting on Teen Depression Symptoms.

Past studies have indicated that mothers who are victims of intimate partner violence (IPV) have a greater risk of developing depression symptoms. Furthermore, existing literature provides evidence that children's mental health can be affected by their mother's mental health well past infancy and early childhood. Given this, children of IPV victims are particularly at risk of developing depression symptoms. Guided by trauma theory, the ecobiodevelopmental (EBD) framework, and social learning theory, this study investigates the long-term relationship between maternal IPV victimization during pregnancy and teen depression symptoms. This study utilizes longitudinal data from the Fragile Families and Child Wellbeing Study to examine the relationship between IPV during pregnancy and maternal depression symptoms at early childhood, as well as the mechanism by which maternal depression symptoms affect child depression symptoms in the adolescent stage of development. The findings indicate that mothers who were victims of IPV during pregnancy were more likely to have depression symptoms when children turned 3 and that maternal depression symptoms could directly predict children's depression symptoms at age 15. Meanwhile, maternal depression symptoms could indirectly increase adolescent depression symptoms via physical punishment at age 5 and bullying victimization at age 9. While extensive evidence has shown that IPV during pregnancy has detrimental effects on mothers and children, our study adds to the literature that such detriments can last as long as a decade. Given that depression symptoms can be detrimental to later development, the findings call for universal and comprehensive IPV screening tools and swift service referrals for pregnant women who are experiencing IPV. At the same time, trauma-informed parenting education for women, along with school- and community-based interventions for children, may also mitigate these harmful associations.

Longitudinal Correlates of Maternal Involvement and Spanking in Spanish-speaking Latinas Who Have Experienced Intimate Partner Violence.

Mothers experiencing intimate partner violence (IPV) have been found to have negative long-term parenting outcomes, such as reduced maternal involvement and greater use of physical punishment, which represent potential pathways by which IPV negatively affects children. Factors influencing these parenting practices have not been examined in IPV-exposed Latinas. The aim of this study is to understand the factors that affect maternal involvement and spanking by Latinas to contribute to culturally-informed intervention development and refinement. A total of 93 Spanish-speaking Latinas who had experienced IPV completed standardized measures of maternal involvement, spanking, IPV, depression, and posttraumatic stress (PTS) and provided demographic information. Slightly over half of the women participated in an intervention program. Longitudinal multilevel modeling (MLM) demonstrated that higher levels of maternal depression predicted lower levels of involvement over time. PTS reexperiencing symptoms were positively related to involvement, such that mothers with higher levels of reexperiencing reported higher levels of involvement. An independent longitudinal MLM revealed that higher amounts of IPV exposure and higher levels of PTS arousal symptoms were associated with higher levels of spanking, while maternal employment was associated with lower levels of this same parenting behavior. Maternal involvement increased over time, where there was no significant change in spanking over time, and no effect of the intervention program on either parenting practice. Results suggest clinical interventions should target reductions in depression and specific PTS symptom subdomains as pathways to improving parenting in IPV-exposed Latinas. Continued study is needed to understand the relationship between reexperiencing and maternal involvement.

Association of maternal depression and home adversities with infant hypothalamic-pituitary-adrenal (HPA) axis biomarkers in rural Pakistan

BackgroundEach year, almost 35% of children are exposed to maternal depression and more grow up in persistent poverty, increasing the risk for stress-related disease and other socio-developmental deficits later in life. These impacts are likely related to chronic stress via the hypothalamic-pituitary-adrenal (HPA) axis. However, there is little evidence relating early windows of child HPA axis activity to multiple exposures. MethodsWe investigated chronic measures of hair-derived HPA axis hormones (cortisol and dehydroepiandrosterone (DHEA)) in 104 one-year old infants from rural Pakistan and longitudinal measures of maternal depression, intimate partner violence (IPV), socio-economic status (SES), and the home environment. ResultsEstimates from adjusted linear mixed effects models did not reveal consistent significant associations between infant cortisol and maternal depression or home adversities. By contrast, infants exposed to maternal depression during pregnancy had lower DHEA levels (ß= -0.18 95% confidence interval [CI]: -0.34, -0.02) as did those whose mothers experienced multiple types of IPV (ß=-4.14 95% CI: -7.42, -0.79) within one year postpartum. Higher SES had a significant positive association with infant DHEA levels (ß= 0.77 95% CI: 0.08, 1.47). Depression severity and chronicity at one year postpartum had near significant associations with infant DHEA. Measures of home environment had no observable impacts on infant HPA axis activity. LimitationsLimitations include the modest sample size and aggregation of hair samples for analysis. ConclusionResults point to possible early HPA axis dysregulation driven by changes in DHEA activity, but not cortisol at one year of age. Findings contribute to growing research examining intergenerational transmissions of maternal depression, IPV, and household environment on infant stress-response systems.

Children emotional and behavioural problems and its association with maternal depression in Jimma town, southwest Ethiopia

BackgroundIn sub-Saharan countries, one in five children and one in three women experiences emotional and behavioural problems (EBPs) and depression, respectively. While various factors were reported to affect the mental...

Maternal Intimate Partner Violence Exposure and Autonomic Reactivity: Associations With Positive Parenting.

Intimate partner violence (IPV) can negatively impact parenting, posing a threat both to the wellbeing of mothers and their young children. Parenting may also be influenced by emotion regulation (ER), which can support parents' ability to navigate relational challenges or buffer against the influence of adverse experiences on parenting. Changes in maternal respiratory sinus arrhythmia (RSA) during parent-child interactions have been conceptualized as a psychophysiological index of ER. Competing theoretical models posit that RSA response may mediate or moderate the relation between IPV and parenting or may be independently associated with parenting, however, there is little prior evidence concerning these hypothesized associations. This study examined these associations in a sample of 125 low-income maltreating and comparison mothers and their 3- to 5-year-old children. Dyads completed a moderately challenging laboratory task, and positive parenting and maternal RSA were measured during the task. Maternal verbal IPV exposure, but not physical IPV, was associated with less positive parenting, while greater maternal RSA activation over the task was associated with more positive parenting. Maternal RSA activation did not mediate or moderate the relationship between IPV exposure and parenting, and this association did not differ by whether or not the mother had perpetrated child maltreatment. Consequently, verbal IPV exposure and greater RSA activation independently predicted positive parenting. Results suggest that interventions for IPV-exposed mothers of young children may benefit from ensuring psychological safety and improving maternal ER to promote positive parenting for at-risk children.

Children Exposed to Intimate Partner Violence from Fragile Families: The Moderating Role of Social Support

Intimate partner violence (IPV) from male to female is prevalent among the US population, alongside extensive studies showing the negative associations between maternal IPV victimization and child’s developmental outcomes. Using data from the Fragile Families and Child Wellbeing Study, we endeavored to examine the consequences of exposure to maternal IPV on child’s internalizing functioning, as well as the moderating effect of mother’s perceived social support in this current study. We employed both cross-sectional and longitudinal modeling strategies and found that 1) approximately one in four mothers had experienced emotional violence from their intimate partners at least once, and over 10% mothers had encountered physical or sexual violence; 2) There were significant adverse maternal IPV victimization effects from both cross-sectional and longitudinal analyses and 3) the mother’s perceived social support played a moderating role in buffering the impact of IPV exposure on children’s internalizing functioning under a physical or sexual violence setting, although the effect was not robust using more rigorous longitudinal analysis. An intensive intervention facilitating mother’s social support was thus suggested to protect children under such risks.

The effects of Intimate Partner Violence and a history of Childhood Abuse on Mental Health and Stress during Pregnancy.

Maternal adverse childhood experiences (ACEs) and intimate partner violence (IPV) are temporally distinct risk factors that negatively impact mothers and their offspring. Risk associated with ACEs and IPV begin during pregnancy, a period of increased physical and psychological demands. The current study examined a person-centered method to empirically identify profiles of pregnant women based on type and severity of ACEs and past-year IPV. Profiles were then differentiated on psychosocial functioning indicators. A primarily Latinx, low socioeconomic sample of women (n = 225) completed measures assessing ACEs and past-year IPV, perceived and experienced stress, emotion regulation, and trauma-related symptoms during their third trimester. Latent profile analysis (LPA) was used to identify unique profiles of women based on seven dimensional indicators reflecting threat- and deprivation-based ACEs and IPV. A 4-class solution best fit the data: (1) low probability of ACEs or IPV (64.9%), (2) childhood neglect-only (20.4%), (3) childhood abuse/neglect (10.2%), and (4) polytrauma characterized by a combination of childhood abuse, neglect, and IPV (4.4%). Women with the "childhood abuse/neglect" or "polytrauma" profiles reported more stress and symptoms than women with the "low exposure" profile. Women in the "childhood neglect-only" profile were generally similar to women in the "low exposure" profile, but did report greater difficulties in emotion regulation. These results suggest that childhood abuse and IPV, exposure types involving threat, are potent correlates of stress, emotion regulation, and mental health difficulties during pregnancy. However, exposure characterized by deprivation alone generally did not increase difficulties.

The Impact of Paid Maternity Leave on the Mental and Physical Health of Mothers and Children: A Review of the Literature and Policy Implications.

For decades, national paid maternity leave policies of 12 weeks or more have been established in every industrialized country except the United States. Despite women representing 47% of the current U.S. labor force, only 16% of all employed American workers have access to paid parental leave through their workplace. As many as 23% of employed mothers return to work within ten days of giving birth, because of their inability to pay living expenses without income. We reviewed recent studies on the possible effects of paid maternity leave on the mental and physical health of mothers and children. We found that paid maternity leave is associated with beneficial effects on (1) the mental health of mothers and children, including a decrease in postpartum maternal depression and intimate partner violence, and improved infant attachment and child development, (2) the physical health of mothers and children, including a decrease in infant mortality and in mother and infant rehospitalizations, and an increase in pediatric visit attendance and timely administration of infant immunizations, and (3) breastfeeding, with an increase in its initiation and duration. Given the substantial mental and physical health benefits associated with paid leave, as well as favorable results from studies on its economic impact, the United States is facing a clear, evidence-based mandate to create a national paid maternity leave policy. We recommend a national paid maternity leave policy of at least 12 weeks.

The Role of Maternal Intimate Partner Violence Victimization on Neonatal Mortality in Ethiopia.

Previous studies have suggested that when intimate partner violence (IPV) tends to be persistent across a woman's life span, her newborn offspring have a higher risk of ill health and mortality. There is a high prevalence of both IPV and neonatal mortality in Ethiopia, but the issue of IPV has remained largely outside the focus of child survival programs in this country. One of the noticeable reasons is a lack of evidence regarding the effect of IPV on neonatal mortality. Therefore, this study investigated the effect of maternal IPV on neonatal mortality in Ethiopia. This study used nationally representative data from the 2016 Ethiopian Demographic and Health Survey. A total of 2,863 currently married women of reproductive age who gave birth in the preceding 5 years were included in analysis. Regression models using propensity scores were used. The prevalence of physical, emotional, and sexual IPV were 24.5%, 22.9%, and 12.0%, respectively. About 56% of women had also experienced at least one act of partner controlling behavior. Maternal IPV experience (a composite measure of physical, sexual, and emotional abuse) was associated with increased neonatal mortality (adjusted odds ratio [AOR] = 2.58, 95% confidence interval [CI] = [1.03, 6.45]). In addition, the odds of neonatal mortality were 2.75 times (AOR = 2.75; 95% CI = [1.05, 7.2]) higher among women who had experienced three or more partner controlling behaviors than women who had experienced less than three or none. Maternal IPV is significantly associated with risk of neonatal mortality in Ethiopia. There is a clear need for IPV interventions in child survival programs. Therefore, existing neonatal survival strategies should focus beyond the direct causes of neonatal mortality, and they need to target IPV as an underlying factor to neonatal morbidities and mortality.