Domestic Violence in Pregnancy and Term Paper

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In light of the evidence in this literature review then it is of great import that monitoring of the health of pregnant women is vital in reference to LBW infants not only in the sense of present terms but as well to lifelong health considerations for the LBW infant which is probably why stated further is: "Given the relative neglect that mothers and newborns have suffered, their centrality to the Millennium Development Goals, and the cost-effectiveness of maternal and newborn health interventions, a greater emphasis on safe motherhood and newborn health is clearly needed within many health sectors." (JHPIEGO, 2003)

Literature Review

Stated in the publication "Shaping Policy for Maternal and Newborn Health: A Compendium of Case Studies (2003) is that: "The health of a newborn is inextricably linked to the health of the mother; the majority of newborn deaths are caused by the poor health of the mother during pregnancy, or by the poor care she and her newborn receive during and immediately after childbirth." (JHPIEGO, 2003) Bohn, et al. (2004) reports the conduction of a study that makes an examination of the influence of socioeconomic factors such as "status, education, ethnicity, and age" in the area of spousal abuse or "intimate partner abuse" before/during/after pregnancy.

The design in this study was through "respective correlational analysis. Data was collected at post-partum maternity meetings with 1.004 women of six different ethnicities with the measure being the commonplaceness of partner abuse and violence. Results were reported as "15.9% reported physical abuse by their partner and 5.2% reported abuse during the course of pregnancy." Findings in the study state that "decreased income, not having a high school education and ethnicity were significantly related to current abuse as well as abuse during the course of the pregnancy performed through use of bivariate analyses. Furthermore, the findings in this study point toward the abuse of women who are disadvantaged as being more prevalent than in those who are not considered to be disadvantaged. There is a great lack of information of a comprehensive nature on the relationship that exists between domestic abuse, both physical and emotional violence, and pregnancy outcomes. This study was a systematic review of available literature in examination of the evidence in relation to the connection between physical and emotional type abuse and outcomes in pregnancy. In this case study 296 articles were located, case reports and articles that did not satisfy the study inclusion criteria were removed from the study and results were stated finding that: "Overall, adverse pregnancy outcomes, including low birth weight, maternal mortality and infant mortality are significantly more likely among abused than non-abused" individuals. (Salihu, 2004)

The study reported by Salihu (2004) informs of the fact that pregnant mothers who suffered abuse were more likely to suffer "kidney infections, gain less weight during pregnancy, and are more likely to undergo operation delivery." Further stated is that: "Fetal morbidity, such as low birth weight, pre-term delivery, and small size for gestational age are more frequent among abused expectant mothers than those who are not abused. Abused mothers of the black race are three to four times more likely to suffer death, as are white abused mothers.

This study concluded that violence by an intimate partner is many times an event that is 'life-threatening' both to the fetus and the mother. Implications are stated that for further research based on the fact that 'the heightened level of fetal -- maternal morbidity and mortality as well as providing justification for further and routine systemic screening for the abuse present during pregnancy. (Salihu, 2004)

In a separate study that was conducted by University Texas School of Public health the cross-sectional study investigates the associations between physical violence and/or emotional abuse and the pregnancy outcomes including the factors of low birth weight, pre-term delivery as well as perinatal death."(Coker, 2004) 755 women who had reported a live birth or late fetal death were surveyed. Of those 14.7% gave indication that an intimate partner was violent or abusive to them while they were in the course of pregnancy equaling 274 of 1862 pregnancies. Findings were that abuse during pregnancy was associated in a significant way with increased risks of perinatal death among live births with low birth-weight both term and pre-term.

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Finally that frequency of abuse being accelerated was associated with perinatal death and low birth weight in newborn infants. (Coker, et al., 2004)

In another study entitled "Effects of Domestic Violence on Pre-term Birth and Low Birth Weight" stated is the recognition that domestic violence has the potential to be a "modifiable risk factor" in adverse outcomes of pregnancy. The study was conducted in or to evaluate that existing relationship between the abuses suffered in a pregnancy or within the last year and low weight and pre-term birth." Methods used in the study were those of a screening tool for the assessment of emotional, physical and/or sexual abuse. Injury due to physical abuse. There were 3,013 reports of abuse in the index pregnancy and of these women emotional abuse was reported by 26.6% with 18.87% reporting physical abuse. In the past 12 months while 10.3% of the women stated they had been beaten, bruised, threatened with a weapon or being permanently injured. Conclusions of the study state that indications are that injuries due to abuse of an emotional greatly enhanced the chances of low birth-weight as well as re were enhanced greatly by 5.9% of the women. (Neggers, et al., 2004)

In the study entitled, "Health Behaviors as Mediators for the Effect of Partner Abuse on Infant birth-weight" stated is that there is a link, which has been identified by low birth-weight and abuse of the mother during the course of pregnancy. Furthermore women who are abused tend to report more instances of substance abuse, poor nutrition, and as well as demographic risks for factors for poor outcomes of birth. Factors identified in this subject are inclusive of recent and/or psychological abuse as to the effects on birth-weight in this sample. Conclusions state it is warranted to perform prospective studies in relation to nursing care and in improvement of bit outcomes as well as in the promotion of maternal well being. (Kearney, et al., 2004)

The study entitled "Physical, Psychological, Emotional and Sexual Violence during Pregnancy as a Reproductive-Risk Predictor of low Birth-weight in Costa Rica" states that the objective of the study was to make determination as to the prevalent nature of physical, psychological, emotional, and sexual violence experience during the course of a pregnancy as to the links that violence and low birth-weight have. In this study 118 women who delivered between September 1998 and November 1998 were examined through a questionnaire as to the violence suffered during their pregnancy. A validated questionnaire with closed questions, as well as a multiple linear regression model was used in adjusting the average (weights of the newborns in alignment with the mother's characteristics in terms of age, years of schooling, marital status, desire for the pregnancy, habits of smoking, and drinking alcohol, number of prior pregnancies or childbirths as well as birth interval, physical stature, total weight increases during pregnancy and gestational illnesses. Stated is that "a logistic regression model was used to measure the direct effect of violence on low birth-weight." Results indicate the need for investigations of this subject more thoroughly and implications for training of health workers in the area of violence to women as being that of a 'reproductive-risk' factor as well as formation of groups on this subject in development of" specialized protocols for the early identification of pregnant women subject to violence." (Nunez-Rivas, et al., 2003)

2003 study in relation to the impact of police-reported intimate partner violence during the course of pregnancy. The method of the study was through conduction of a population-based, retrospective, cohort study in Seattle, Washington through use of Seattle police data and Washington State birth certificate files for the period of January 1995 through September 1999. The conclusion of this study is stated to be a 'critical need' for identification of pregnancy among women with reported incidents of abuse. This study concluded that Increased risks of birth outcomes are associated with partner violence during pregnancy. The need is one which is critical in the provisions of "women health, social services. (Lipsky, et al., 2003) study performed by Altarac and Strobino entitled "Abuse During Pregnancy and Stress Because of Abuse During Pregnancy and Birth-weight the stated objective is the.....

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