The impact of physical and verbal abuse on delivery outcomes among pregnant women

Purpose This five-year prospective cohort study examined the relationship between physical and verbal abuse of pregnant women and subsequent delivery by cesarean section. Methods Data were compiled on 506 pregnant women from two counties in Alabama followed for the duration of their pregnancies. Inclusion criteria included age (12–34), ethnicity (black, white), Medicaid eligible status, and the gestational age of the infant at the first prenatal visit (1–20 weeks). Women were interviewed twice during pregnancy (first and third trimesters) and asked whether they experienced physical and verbal abuse prior to pregnancy and throughout their pregnancy. Cesarean section was determined through a medical chart review of each participant after childbirth. Results Eighteen percent of the women in the sample underwent cesarean section during childbirth, and 43% stated they had been physically and verbally abused. Adjusted logistic regression analysis indicated that women who were physically and verbally abused were more than two times more likely to require a cesarean section during childbirth than women who had no history of abuse (odds ratio = 2.05; 95% confidence interval = 1.16–3.66). Conclusion Findings indicate that women who have a history of physical and/or verbal abuse are at a higher risk of cesarean section during childbirth. Recommendations include identifying pregnant women experiencing abuse, possible intervention during the course of the pregnancy to eliminate the physical stressor of abuse and subsequent risk of cesarean section, and close monitoring of this group of higher risk women during the third trimester of pregnancy to avoid delivery complications.