Violence can lead to injury and death among women of all ages. CDC continues a history of seeking insights into how to protect women of reproductive age from preventable causes of injury that can lead to excess morbidity and mortality. In 1997, the first meeting on pregnancy related violence was held to obtain expert advice on the key scientific issues related to research on violence around the time of pregnancy. This meeting one of the first formal collaborations between the CDC's Division of Reproductive Health and CDC’s National Center for Injury Prevention and Control (NCIPC). In 2001, this effort was one the highlights of the first national Summit on Safe Motherhood, as scientists, health professionals and program managers noted that violence may play a key role in women’s health before, during and after pregnancy. We continue this collaboration to gain a greater understanding of the role of violence in the lives of women of reproductive age.

This page provides background information on key activities related to violence and reproductive health. Federal and other programs are highlighted as they may be important to public health professionals concerned about preventing violence that is associated with pregnancy-related illness, injury, and death.

This is a nationwide service offering crisis intervention, information about domestic violence and referrals to local service providers to victims of domestic violence and those calling on their behalf. Highly qualified and trained Hotline Advocates to are available to answer every call. Assistance is available in both English and Spanish. Hotline Advocates and volunteers also have access to translators in 139 languages.

• Assistance through e-mail at ndvh@ndvh.org;
• Crisis intervention and referrals to the Deaf through the TTY line and e-mail at deafhelp@ndvh.org);
• Informational materials on such topics as domestic violence, sexual assault, battering intervention and prevention programs

Scientific Evidence on Violence and Reproductive Health

Homicide: A Leading Cause of Injury Deaths among Pregnant and Postpartum Women in the United States, 1991–1999.

This article highlights an analysis conducted used data from CDC’s Pregnancy Mortality Surveillance System. Risk factors for pregnancy-associated homicide were examined. (Pregnancy-associated homicide was defined as a death during or within one year of pregnancy). Homicide was found to be a leading cause of pregnancy-associated injury deaths among women from 1991–1999. The pregnancy-associated homicide ratio was 1.7 per 100,000 live births. Risk factors included age younger than 20 years, Black race, and late or no prenatal care. Source: Am J Public Health 2005;95:471–477.

Pregancy Risk Monitoring System (PRAMS)
This system obtains information from women who recently delivered a live birth. One of the core questions in the survey seeks information about women’s perception of the threat of violence during their pregnancy. To view information about the survey and how results have been used, see prams surveillance report and prams questionnaire.

The National Criminal Justice Reference Service (NCJRS) (http://www.ncjrs.gov)
This government clearinghouse provides technical assistance, publications and other services to public health professionals seeking insights about the relationship between criminal justice and public health programs. 

National Violent Death Reporting System (NVDRS)
This is CDC’s effort to develop nationwide, state-based monitoring system for violent deaths.  The NVDRS  is a linked dataset  that provides law enforcement officials and death investigators a clearer picture of violent activity in their jurisdictions and will aid program managers design and implement potentially successful prevention plans.

Organizations offering services for clinicians and others involved in preventing violence against women of reproductive age: 

Physician’s for a Violence-Free Society* (http://www.pvs.org)

Family Violence Prevention Council*

American Nurses Association*

American College of Obstetricians and Gynecologists*

American College of Nurse Midwives*

Family and Intimate Violence Prevention

National Women's Health Information Center

National Violence Against Women Survey
This second Research in Brief from the National Institute of Justice and CDC provides data on the prevalence and incidence of rape, physical assault, and stalking; the prevalence of male-to-female and female-to-male intimate partner violence; the prevalence of rape and physical assault among women of different racial and ethnic backgrounds; the rate of injury among rape and physical assault victims; and injured victims' use of medical services

Maternal and Child Health Journal special issue; Violence and Reproductive Health Abstracts
This special edition of the Maternal and Child Health Journal grew out of a major conference, the National Conference on Violence and Reproductive Health: Science, Prevention, and Action. Source: Maternal and Child Health Journal, Vol. 4, No. 2, June 2000.

Strategies to Reduce Pregnancy-Related Deaths
This 2001 manual describes strategies for conducting pregnancy-related or maternal mortality surveillance in the United States. PDF 29.73MB

Search PubMed for articles on Pregnancy and Domestic Violence
This search is being conducted on the PubMed an NLM/NIH service.

Search PubMed for articles on Intimate Partner Violence
This search is being conducted on PubMed an NLM/NIH service.

The following is a list of pregnancy and violence related publications authored by CDC's Division of Reproductive Health. These publications are only a few of the scientific and technical materials available. We recommend that you review abstracts of our reports and other publications by using the resources of the National Library of Medicine's PubMed service. PubMed is a searchable database that provides abstracts of biomedical articles and reports. You may also be able to obtain full text articles (some services may require subscriptions to view full text articles). If you are seeking less technical information, please use the National Library of Medicine's MedlinePlus, which offers a wide range of information on diseases, disorders, treatments, drugs and preventive services.

Chang J, Berg CJ, Saltzman LE, Herndon J. Homicide: a leading cause of injury deaths among pregnant and postpartum women in the United States, 1991–1999. Am J Public Health 2005;95(3):471–7.

Goodwin MM, Petersen R, Kowal D, Koenig L, Saltzman LE, Spitz AM. Highlights of national conference on violence and reproductive health: science, prevention, and action. American Journal of Preventive Medicine 2000;18:186–187.

Moore M. Reproductive health and intimate partner violence. Family Planning Perspectives 1999;31(6):302–306,312.

Gazmararian JA, Adams, MM, Saltzman LE, Johnson CH, Bruce FC, Marks JS, Zahniser SC. The Relationship Between Pregnancy Intendedness and Physical Violence in Mothers of Newborns. Obstetrics and Gynecology 1995;85:1031–1038.

Gazmararian JA, Lazorick S, Spitz AM, Ballard TJ, Saltzman LE, Marks JS. Prevalence of Violence Against Pregnant Women: A Review of the Literature. JAMA 1996;275:1915–1920.

Petersen R, Gazmararian JA, Spitz AM, Rowley DL, Goodwin MM, Saltzman LE, Marks JS. Violence and Adverse Pregnancy Outcomes: A Review of the Literature and Directions for Future Research. American Journal of Preventive Medicine 1997;13:366–373. 

Dietz PM, Gazmararian JA, Goodwin MM, Bruce FC, Johnson CH, Rochat RW, and PRAMS Working Group. Delayed Entry to Prenatal Care: Impact of Physical Violence. Obstetrics and Gynecology 1997;90:221–224.

Ballard TJ, Saltzman LE, Gazmararian JA, Spitz AM, Lazorick S, Marks JS. Violence During Pregnancy: Measurement Issues. AJPH 1998;88:274–276.

Saltzman, Linda E. "Battering During Pregnancy: A Role For Physicians." Atlanta Medicine 1990;64(3):45–47,49.

Dietz PM, Spitz AM, Anda RF, Williamson DF, McMahon PM, Santelli JS, Nordenberg D, Felitti VJ, Kendrick JS. Unintended Pregnancy Among Adult Women Exposed to Abuse and Household Dysfunction During Their Childhood. JAMA 1999;282:1359–1364.

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Date last reviewed: 04/17/2006
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion