Physical Abuse Around the Time of Pregnancy Among Women With Disabilities
Women with disabilities are at greater risk for physical abuse than women without disabilities. However, no previous population-based studies have examined physical abuse against women with disabilities around the time of pregnancy, a critical period for mother and child. The objective of this study was to describe the prevalence of physical abuse before and during pregnancy among a representative sample of Massachusetts women with and without disabilities. Data from the 2007–2008 Massachusetts Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed in 2010. Disability prevalence was 4.9% (95% CI = 3.9–6.2) among Massachusetts women giving birth during 2007–2008. The prevalence of physical abuse during the 12-months before pregnancy among women with disabilities was 13.6% (95% CI = 7.2–24.0) compared to 2.8% for women without disabilities (95% CI = 2.1–3.7). Similarly, 8.1% (95% CI = 4.0–15.7) of women with disabilities compared to 2.3% (95% CI = 1.7–3.1) of women without disabilities experienced physical abuse during pregnancy. Multivariate analyses indicated that women with disabilities were more likely to report physical abuse before pregnancy (OR = 4.3, 95% CI = 1.9–9.7), during pregnancy (OR = 2.8, 95% CI = 1.1–7.1), or during either time period (OR = 3.2, 95% CI = 1.4–7.1) than women without disabilities while controlling for maternal age, education, race/Hispanic ethnicity, marital status and household poverty status. No difference was observed by disability status in the likelihood of prenatal-care providers talking to women about physical abuse. These analyses reveal disproportionate prevalence of physical abuse before and during pregnancy among women with disabilities. Screening for physical abuse and timely referral of women in need of assistance are critical to optimize health outcomes for both mother and child.
KeywordsPhysical abuse Violence Disabilities Women Pregnancy
Monika Mitra is supported by the Massachusetts Medicaid Infrastructure and Comprehensive Employment Opportunities Grant which is funded by Centers for Medicare and Medicaid Services (CFDA No. 93.768). Emily Lu is supported by the Massachusetts PRAMS project which is supported in part by grant No. 1 UR6 DP000513-01 from the Centers for Disease Control and Prevention. The authors thank the Maternal and Child Health Epidemiology Program, Applied Sciences Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Public Health Promotion, Centers for Disease Control and Prevention and the Health Services and Resources Administration for scientific guidance on this analysis and manuscript.
- 5.Grossman, S. F., & Lundy, M. Double jeopardy: A comparison of persons with and without disabilities who were victims of sexual abuse and/or sexual assault. Journal of Social Work Disability Rehabilitation, 7(1), 19–46.Google Scholar
- 6.Milberger, S., Israel, N., LeRoy, B., Martin, A., Potter, L., & Patchak-Schuster, P. (2003). Violence against women with physical disabilities. Violence Victims, 18, 581–591.Google Scholar
- 9.Wacker, J., Macy, R., Barger, E., & Parish, S. (2009). Sexual assault prevention for women with intellectual disabilities: a critical review of the evidence. Intellect Dev Disabil, 47(4), 249–262. [Review, Erratum in Intellect Dev Disabil, 47(5), ii].Google Scholar
- 12.Brownridge, D. A., Ristock, J., & Hiebert-Murphy, D. (2008). The high risk of IPV against Canadian women with disabilities. Medical Science Monitoring, 14(5), PH27–PH32.Google Scholar
- 13.Massachusetts Department of Public Health. Massachusetts. (2009). Pregnancy risk assessment monitoring system (PRAMS) 2007. Surveillance Report.Google Scholar
- 14.Department of Health and Human Services Federal Poverty Guidelines. (2007). 2007 HHS Poverty Guidelines [online]. Cited 2011 Apr 7. Available from http://aspe.hhs.gov/POVERTY/07poverty.shtml.
- 15.Silverman, J. G., Decker, M. R., Reed, E., & Raj, A. (2006). Intimate partner violence victimization prior to and during pregnancy among women residing in 26 U.S. states: Association with maternal and neonatal health. American Journal of Obstetrics and Gynecology, 195, 140–148.PubMedCrossRefGoogle Scholar
- 17.Chevarley, F. M., Thierry, J. M., Gill, C. J., Ryerson, A. B., & Nosek, M. A. (2007). Health, preventive health care, and health care access among women with disabilities in the 1994–1995 National Health Interview Survey, Supplement on Disability. Womens Health Issues, 16(6), 297–312.CrossRefGoogle Scholar