The Intersection of Maternal Morbidity and Mortality and Intimate Partner Violence in the United States

Abstract

Background: In the United States, rates of maternal morbidity and mortality (MMM) are high compared with other high-income countries and are characterized by significant racial/ethnic disparities. Typically, research on MMM focuses on obstetrical problems. Less research examines the role of intimate partner violence (IPV). Maternal health, IPV, and their intersection are linked with the impacts of social determinants of health. Objective: We sought to understand the intersection of MMM and IPV in the United States, particularly data issues that hinder research in this area and the resulting knowledge gaps. Methods: We identified major articles of interest regarding maternal morbidity and mortality and IPV in the United States and drafted a mini review based on relevant information. Results: Despite the prevalence of IPV during pregnancy, the intersection of maternal health and IPV has not been widely reviewed or discussed. Conclusion: There are a number of limitations in surveillance activities and data collection that underestimate the impact of IPV on MMM. Importantly, women who die by homicide or suicide— which in many cases is linked with IPV—are not counted as pregnancy-related deaths in the United States under the current definition. Establishing separate panels of local experts in maternal health or maternal mortality review committees (MMRCs) that are dedicated to examining violent deaths and use of the Maternal Mortality Review Information Application system would likely improve data accuracy of pregnancy-associated deaths. Based on the literature reviewed and limitations of current data, there are significant knowledge gaps on the effects of IPV and maternal health.