Rural-Urban Differences in Domestic Violence as a Contributor to Maternal Morbidity and Mortality

Research center:
Lead researcher:
Project funded:
September 2022
Anticipated completion date:
April 2024

Rural residents who give birth face unique health risks – from declining access to obstetric services to elevated risks of maternal morbidity and mortality. Another important risk that birthing people face is domestic violence. Both exposure to and recognition of domestic violence may differ for rural vs. urban residents, as may the consequences. Among people who give birth, domestic violence is associated with higher rates of preterm birth, lower birth weights, and lower rates of breastfeeding. The most extreme risk is homicide perpetrated by intimate partners, and this risk is heightened around pregnancy and childbirth as well; approximately 60% of homicides that occur around the time of pregnancy are related to domestic violence. Understanding the extent to which birthing people report experiences of physical abuse and whether they are screened before, during, and after pregnancy will provide critical insight for health care clinicians, domestic violence service providers, policymakers, and other stakeholders into the current state of domestic violence and screening. Such knowledge is needed to inform rural-relevant policies and practices that ensure that efforts to improve maternal health do not ignore the needs of rural people or exacerbate rural-urban inequities.

Using 2016-2020 data from the CDC's Pregnancy Risk Assessment Monitoring System, this project will assess the prevalence of domestic violence among rural and urban residents who give birth. We will also analyze how screening and support services could be improved to support rural families that experience domestic violence, including during pregnancy and the postpartum period.