Violence and Pregnancy

Key points

  • Experiencing violence before, during, or after pregnancy can have long-term effects on the health and well-being of the pregnant person and their baby.
  • Violence around the time of pregnancy often involves an intimate partner and may be severe.

Overview

Violence can take place before, during, and after pregnancy. It may be from an intimate partner, and can include physical violence, stalking, psychological aggression, reproductive coercion, or sexual violence. It may also occur as a consequence of community violence, or violence that happens outside the home between people who may or may not know each other.

Terms to know

  • Physical violence is when a person hurts or tries to hurt another person by using physical force.
  • Stalking is when someone repeatedly harasses or threatens someone else causing fear or concerns for the safety of that person or someone close to them.
  • Psychological aggression is the use of verbal and non-verbal communication with the intent to harm someone mentally or emotionally or to exert control over someone.
  • Reproductive coercion is when a person exerts power and control over reproduction through interference with contraception use and pregnancy pressure.
  • Sexual violence is forcing or attempting to force someone to take part in a sex act, sexual touching, or a non-physical sexual event (e.g., sexting) when the person does not or cannot consent.
  • Sexual coercion is a type of sexual violence defined as unwanted sexual penetration that occurs after a person is pressured in a nonphysical way.

Facts

Violence around the time of pregnancy often involves an intimate partner and can be severe. In the United States:

  • About 6% of people with a recent live birth experienced emotional, physical, or sexual violence during pregnancy by a current intimate partner.1
  • Over two thirds of people who experienced violence by a current intimate partner during pregnancy also experienced it before pregnancy.1
  • In 2018 to 2019, the homicide rate for women ages 15-44 was 16% higher among those who were pregnant or within one year of pregnancy compared to those who were not.2
  • Almost half (45.3%) of homicides to women who were pregnant or within one year of pregnancy have been found to involve intimate partner violence.3
  • Depression, smoking, and using marijuana or other illegal drugs during pregnancy was more than twice as common among those who experienced intimate partner violence during pregnancy compared with those who did not.4

Outcomes

In the most severe cases, violence around the time of pregnancy can result in the loss of life. It can also increase risk for substance use, depression and other mental health issues for the pregnant person.156 It can lead to poor health outcomes for the baby as well. 67There are negative impacts that correspond to the time the violence happens — before, during, and after pregnancy.

Before pregnancy

Violence before pregnancy can include reproductive coercion, sexual coercion, and rape. This violence can lead to unintended or unwanted pregnancy, injury, emotional or psychological distress, fear for safety, challenges using contraception, and sexually transmitted infections.8910

Keep Reading: Pregnancy Resulting from Rape

During pregnancy

Physical violence during pregnancy affects both the pregnant person and the baby. Violence can result in bodily injury, head trauma, pregnancy complications, premature birth, low birth weight, and other adverse outcomes. 6111213 Physical, emotional, and sexual intimate partner violence are all associated with depression, smoking, and substance use during pregnancy4. People who experience violence during pregnancy may be less likely to attend prenatal care visits or may delay beginning care.144

After pregnancy

Experiencing violence after pregnancy, or postpartum, carries the same risks as experiencing violence before pregnancy, but with potential added concerns for the new baby. Postpartum victims of violence may face challenges caring for their own health while also caring for the baby. They may experience postpartum depression, issues breastfeeding, and miss postpartum checkups.151617

Violence around the time of pregnancy can create a cycle of trauma that affects multiple generations. This puts the baby and other children in the home at risk for injury, neglect, or other adverse childhood experiences as they grow.1819

Prevention

Pregnancy is often a time of frequent health care visits for prenatal and postpartum care. There are clinical recommendations to screen for violence during health care encounters, including prenatal care visits and postpartum care visits. Screening can be the first step in connecting individuals with assistance and services to reduce violence exposure and prevent further harms.2021

Violence can be prevented. Strategies to prevent intimate partner violence, sexual violence, and community violence can also prevent violence around the time of pregnancy. The key is to stop violence before it happens and address the norms, structures, and policies that contribute to violence against girls, women, and people who may become pregnant.

Resource‎

CDC has developed Prevention Resources for Action to help states and communities focus their prevention efforts on what works to address violence and risk and protective factors for violence.

Resources

  • National Domestic Violence Hotline: Call 1−800−799−7233 or TTY 1−800−787−3224 or visit online to chat one-on-one with a support specialist.
  • Rape, Abuse and Incest National Network's (RAINN) National Sexual Assault Hotline: Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.
  • National Maternal Mental Health Hotline: This service offers free, confidential, 24/7 emotional support, resources, and referrals to pregnant and postpartum individuals facing mental health challenges. Counselors offer support by phone and text in English and Spanish. Interpreter services are available in 60 additional languages. Call or text 1-833-943-5746 (1-833-9-HELP4M(oms)). TTY users can use a preferred relay service or dial 711 and then 1-833-943-5746.
  • Crisis Text Line: Text HOME to 741741 to receive free, 24/7, confidential text-based mental health support in English and Spanish.
  • Love is Respect National Teen Dating Abuse Helpline: Call 1-866-331-9474 or TTY 1-866-331-8453 or visit online to chat one-on-one with a support specialist.
  • Text4baby: This is a free mobile information service designed to promote healthy birth outcomes and to reduce infant mortality among underserved populations. Women who sign up for the service by texting BABY to 511411 (or BEBE for Spanish) will receive free SMS text messages each week, timed to their due date or baby’s date of birth.
  • ZERO TO THREE | Early Connections Last a Lifetime: This organization supports the healthy development and well-being of infants, toddlers and their families by educating and supporting adults who influence the lives of infants and toddlers.
Keep Reading: Resources
Print
Content Source:
National Center for Injury Prevention and Control
  1. D’Angelo, D. V., Bombard, J. M., Lee, R. D., Kortsmit, K., Kapaya, M., & Fasula, A. (2022). Prevalence of experiencing physical, emotional, and sexual violence by a current intimate partner during pregnancy: population-based estimates from the pregnancy risk assessment monitoring system. Journal of family violence, 38(1), 117-126.
  2. Wallace, M., Gillispie-Bell, V., Cruz, K., Davis, K., & Vilda, D. (2021). Homicide During Pregnancy and the Postpartum Period in the United States, 2018-2019. Obstetrics and gynecology, 138(5), 762–769.
  3. Palladino, C. L., Singh, V., Campbell, J., Flynn, H., & Gold, K. (2011). Homicide and suicide during the perinatal period: findings from the National Violent Death Reporting System. Obstetrics and gynecology, 118(5), 1056.
  4. Steele-Baser M, Brown AL, D'Angelo DV, et al. Intimate Partner Violence and Pregnancy and Infant Health Outcomes — Pregnancy Risk Assessment Monitoring System, Nine U.S. Jurisdictions, 2016–2022. MMWR Morb Mortal Wkly Rep 2024;73:1093–1098.
  5. Paulson, J. L. (2022). Intimate partner violence and perinatal post-traumatic stress and depression symptoms: a systematic review of findings in longitudinal studies. Trauma, Violence, & Abuse, 23(3), 733-747.
  6. Agarwal, S., Prasad, R., Mantri, S., Chandrakar, R., Gupta, S., Babhulkar, V., Srivastav, S., Jaiswal, A., & Wanjari, M. B. (2023). A Comprehensive Review of Intimate Partner Violence During Pregnancy and Its Adverse Effects on Maternal and Fetal Health. Cureus, 15(5), e39262.
  7. Hill, A., Pallitto, C., McCleary-Sills, J., & Garcia-Moreno, C. (2016). A systematic review and meta-analysis of intimate partner violence during pregnancy and selected birth outcomes. International Journal of Gynecology & Obstetrics, 133(3), 269-276.
  8. Basile, K.C., Smith, S.G., Kresnow, M., Khatiwada S., & Leemis, R.W. (2022). The National Intimate Partner and Sexual Violence Survey: 2016/2017 Report on Sexual Violence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
  9. D'Angelo, D. V., Liu, Y., Basile, K. C., Smith, S. G., Chen, J., Friar, N. W., & Stevens, M. (2024). Rape and sexual coercion related pregnancy in the United States. American Journal of Preventive Medicine, 66(3), 389-398.
  10. Bergmann, J. N., & Stockman, J. K. (2015). How does intimate partner violence affect condom and oral contraceptive use in the United States?: a systematic review of the literature. Contraception, 91(6), 438-455.
  11. Chisholm, C. A., Bullock, L., & Ferguson II, J. E. J. (2017). Intimate partner violence and pregnancy: epidemiology and impact. American journal of obstetrics and gynecology, 217(2), 141-144.
  12. Currie, J., Mueller-Smith, M., & Rossin-Slater, M. (2022). Violence while in utero: The impact of assaults during pregnancy on birth outcomes. The Review of Economics and Statistics, 104(3), 525-540.
  13. Auger, N., Low, N., Lee, G. E., Ayoub, A., & Luu, T. M. (2022). Pregnancy outcomes of women hospitalized for physical assault, sexual assault, and intimate partner violence. Journal of interpersonal violence, 37(13-14), NP11135-NP11135.
  14. Jamieson, B. (2020). Exposure to interpersonal violence during pregnancy and its association with women's prenatal care utilization: a meta-analytic review. Trauma, Violence, & Abuse, 21(5), 904-921.
  15. Danilack, V. A., Brousseau, E. C., Paulo, B. A., Matteson, K. A., & Clark, M. A. (2019). Characteristics of women without a postpartum checkup among PRAMS participants, 2009–2011. Maternal and child health journal, 23, 903-909.
  16. Ankerstjerne, L. B. S., Laizer, S. N., Andreasen, K., Normann, A. K., Wu, C., Linde, D. S., & Rasch, V. (2022). Landscaping the evidence of intimate partner violence and postpartum depression: a systematic review. BMJ open, 12(5), e051426.
  17. Normann, A. K., Bakiewicz, A., Madsen, F. K., Khan, K. S., Rasch, V., & Linde, D. S. (2020). Intimate partner violence and breastfeeding: a systematic review. BMJ open, 10(10), e034153.
  18. Centers for Disease Control and Prevention (2019). Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
  19. Swedo, E. A., D'Angelo, D. V., Fasula, A. M., Clayton, H. B., & Ports, K. A. (2023). Associations of Adverse Childhood Experiences With Pregnancy and Infant Health. American journal of preventive medicine, 64(4), 512-524.
  20. ACOG Committee Opinion No. 518: Intimate partner violence. (2012). Obstetrics and gynecology, 119 (2 Pt 1), 412–417. https://doi.org/10.1097/AOG.0b013e318249ff74.
  21. US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: US Preventive Services Task Force Final Recommendation Statement. JAMA. 2018;320(16):1678-1687.