Battering during pregnancy: tip of an iceberg revealed.

Physical abuse of women is pervasive with one in three women experiencing battering. Battering occurs during pregnancy with women reporting blows to the pregnant abdomen, injuries to the breast and genitals, and sexual assault. A recent study in a large metropolitan area documented one in twelve pregnant women to have been physically battered during the present pregnancy. Among the women battered, 87% had been physically abused prior to pregnancy and 29% reported the abuse increased after becoming pregnant. Health care providers did not assess any of the women for abuse. When pregnancy outcome was analyzed in another study of 589 postpartum women, battered women were four times more likely to deliver a low-birthweight infant. This paper discusses the etiology of battering, prevalence of battering during pregnancy and pregnancy outcomes of battered women. A community-wide primary prevention program is presented that has linked the health care provider with law enforcement and shelters for battered women to interrupt the cycle of violence and promote the health and safety of pregnant women.