by Improving Maternal Health
October 14, 2020
In May and June 2020, at least two Houston area women were killed – a 15 week pregnant woman was shot by her husband and a 7 month pregnant woman was shot by her boyfriend. And in late September 2020, a pregnant woman was beaten to death by her boyfriend. We’ve heard a lot over the past couple of years about the unacceptably high rate of women who die during pregnancy or experience life-threatening complications that can have life-long impact on their health and well-being.
To our great benefit, state and local leaders are taking steps to improve the quality of medical care pregnant women receive. While we applaud the efforts of our community and state allies, improving medical care is only part of the answer to reducing maternal deaths. Homicide is among the top four causes of maternal death, and we must do more to curb violence endured by expectant and new mothers.
Recent data from the Texas Council on Family Violence found that 151 women in Texas were killed by their current or former intimate partners in 2019. Yet death is just the tip of the iceberg: thousands more women and their children must leave their lives to seek safety.
As the COVID-19 pandemic continues, an increased number of domestic violence hotline calls and requests for emergency housing continue to be made. According to the Harris County Sheriff’s Office, in March through June, they responded to 1,128 reports of family violence assaults and aggravated family violence assaults, a 19 percent increase compared to those months last year.
This number does not begin to address the need. According to Emilee Whitehurst, CEO of Houston Area Women’s Center, “it’s rare that the people ultimately killed by their intimate partners ever contacted the women’s center for shelter or assistance.” Many women are trapped in relationships they cannot leave. If not killed, staying in these abusive relationships has untold health and mental health impacts on these women and their children. We also know, in 2019, 48 percent of emergency shelter requests statewide were unmet due to capacity issues.
If the health of mothers is a reflection of the cultural, political and economic values of a community, then the incidence of violence against women is a worrisome indicator for ours. State lawmakers are doing their part to hold perpetrators accountable by increasing the penalty for assaults against pregnant women, from a class A misdemeanor to a third-degree felony. Instead of up to a year in county jail, abusers can serve anywhere from two to 10 years in prison. However, putting more emphasis on prevention holds greater promise to reduce maternal deaths and the many other negative impacts of violence.
One way to predict whether a woman is experiencing violence while pregnant is through routine screenings. While the U.S. Preventive Services Task Force recommends screening all expectant mothers for intimate partner violence, 2013 data suggests that only 39% of women of reproductive age are screened. This means a majority of doctors are not utilizing the various screening tools available to detect intimate partner violence.
We know the medical community is critical in identifying, treating and supporting those who are suffering abuse. We encourage all doctors to screen for domestic violence during obstetric and postpartum visits. Screening has long received support from groups like the American Medical Association and American College of Obstetricians and Gynecologists. The repeated contact with a health care provider and the trust that builds between an expectant mother and physician offer a unique opportunity to screen, identify and counsel those experiencing intimate partner violence. Exam rooms are one of the few places a pregnant woman may be alone and feel safe. Service providers can also train their staff on how to recognize, respond and refer survivors of domestic violence for services. Conversations over checklists and relational medicine are what we strongly advocate.
While any act of violence is reprehensible, causing harm to an expectant or new mother is unconscionable. Domestic violence is a serious yet preventable public health problem, and even one maternal death that is preventable is too many. Because we know that pregnancy and new babies are risk factors for domestic violence, let’s do everything we can to intervene and assist expecting women, new mothers and their children to have a real chance at a life free from violence.
If you or someone you know is a survivor of domestic or sexual violence help is available 24/7. We believe you. You are not alone. Contact the National Domestic Violence Hotline at 800.799.SAFE or the Houston Area Women’s Center at 713.528.2121 or TTY 713.528.3625. Spanish and over 200 languages are available.