Despite research documenting high rates of violence during pregnancy, few studies have examined the impact of physical abuse, psychological abuse, and posttraumatic stress disorder (PTSD) on miscarriage. Secondary analysis of data collected by the Chicago Women's Health Risk Study permitted an exploration of the relationships among physical abuse, psychological abuse, PTSD, and miscarriage among 118 primarily ethnic minority women. The interaction between maximum severity of abuse and age provided the best multivariate predictor of miscarriage rate, accounting for 26.9% of the variance between live birth and miscarriage outcome. Mean scores of psychological abuse, physical violence, forced sex, and PTSD were significantly higher in the miscarriage group than in the live birth group. Women who experience physical violence and psychological abuse during pregnancy may be at greater risk for miscarriage. Prospective studies can confirm findings and determine underlying mechanisms. Routine screening for traumatic stress and PTSD may reduce rates of miscarriage.
Astin, M.C., Ogland-Hand, S.M., Coleman, E.M., & Foy, D.S. (1995). Posttraumatic stress disorder and childhood abuse in battered women: Comparisons with marital distressed women. Journal of Consulting and Clinical Psychology, 63, 308-312.
2.
Berenson A.B., Wiemann, C.M., Wilkinson, G.S., Jones, W.A., & Anderson, G.D. (1994). Perinatal morbidity associated with violence experienced by pregnant women. American Journal of Obstetrics and Gynecology, 170, 1760-1769.
3.
Block, C.R. (with Devitt, C.O., Fonda, D., Engel, B., Fugate, M., Martin, C., McFarlane, J., et al.). (2000). The Chicago women's health risk study: Risk of serious injury or death in intimate violence: A collaborative research project. Washington, DC: U.S. Department of Justice, National Institute of Justice.
4.
Block, C.R., Engel, B., Naureckas, S.M., & Riordan, K.A. (1999a). The Chicago women's health risk study: Lessons in collaboration. Violence Against Women, 5, 1157-1176.
5.
Block, C.R., Engel, B., Naureckas, S.M., & Riordan, K.A. (1999b). Collaboration in the Chicago women's health risk study. Chicago: Illinois Criminal Justice Information Authority.
6.
Boyles, S.H., Ness, R.B., Grisso, J.A., Markovic, N., Bromberger, J., & CiFelli, D. (2000). Life event stress and the association with spontaneous abortion in gravid women at the urban emergency department. Health Psychology, 19, 510-514.
7.
Brockmeyer, D.M., & Sheridan, D.J. (1998). Domestic violence: A practical guide to the use of forensic evaluation in clinical examination and documentation of injuries. In J. C. Campbell (Ed.), Empowering survivors of abuse: Health care for battered women and their children (pp. 214-226). Thousand Oaks, CA: Sage.
8.
Bullock, L.F., & McFarlane, J. (1989). The birth-weight/battering connection. American Journal of Nursing, 89, 1153-1155.
9.
Campbell, J.C. (1995). Prediction of homicide of and by battered women . In J. C. Campbell (Ed.), Assessing dangerousness. Violence by sexual offenders, batterers, and child abusers (pp. 85-104). Thousand Oaks, CA: Sage.
10.
Campbell, J.C., Kub, J., Belkap, R.A., & Templin, T. (1997). Predictors of depression in battered women. Violence Against Women, 3, 276-293.
11.
Campbell, J.C., Poland, M.L., Waller, J.B., & Ager, J. (1992). Correlates of battering during pregnancy. Research in Nursing and Health, 15, 219-226.
12.
Cascardi, M., O'Leary, K.D., Lawrence, E.E., & Schlee, K.A. (1995). Characteristics of women physically abused by their spouses and who seek treatment regarding marital conflict. Journal of Consulting and Clinical Psychology, 63, 616-623.
13.
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (1997). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Arlington, VA: American Psychiatric.
14.
Foa, E.B., & Tolin, D.F. (2000). Comparison of the PTSD Symptom Scale-Interview Version and the Clinician-Administered PTSD Scale. Journal of Traumatic Stress, 13, 181-191.
15.
Follingstad, D.R., Hause, E.S., Rutledge, L.L., & Polek, D.S. (1992). Effects of battered women's early responses on later abuse patterns. Violence and Victims, 7, 109-128.
16.
Friedman, M.J., & McEwan, B.S. (2003). PTSD, allostatic load and medical illness. In P. P. Schnurr & B. L. Green (Eds.), Trauma and health: Physical health consequences of exposure to extreme stress (pp. 157-188). Washington, DC: American Psychological Association .
17.
Gabbe, S.G., Niebyl, J.R., & Simpson, J.L. (1996). Obstetrics: Normal and problem pregnancies. New York: Churchill Livingstone.
18.
Gazmararian, J.A., Lazorick, S.M., Spitz, A.M., Ballard, T.J., Saltzman, L.E., & Marks, J.S. (1996). Prevalence of violence against pregnant women . Journal of the American Medical Association, 275, 1915-1920.
19.
Humphreys, J.C., & Campbell, J.C. (2003). Family violence in nursing practice. Philadelphia: Lippincott, Williams & Wilkins.
20.
Johnson, H. (1996). Dangerous domains: Violence against women in Canada . Toronto, Ontario, Canada: Nelson Canada.
21.
Johnson, H., & Sacco, V.F. (1995). Researching violence again women: Statistics Canada's national survey. Canadian Journal of Criminology, 37, 281-304.
22.
Kubany, E.S., McKenzie, W.F., Owens, J.A., Leisen, M.B., Kaplan, A.S., & Pavich, E. (1996). PTSD among women survivors of domestic violence in Hawaii. Hawaii Medical Journal, 55, 164-165.
23.
Martin, S.L., Kilgallen, B., Dee, D.L., Dawson, S., & Campbell, J.C. (1998). Women in prenatal care/substance abuse treatment program: Links between domestic violence and mental health . Maternal and Child Health Journal, 2, 85-94.
24.
McFarlane, J., Campbell, J., Sharp, P., & Watson, K. (2002). Abuse during pregnancy and Femicide: Urgent implications for women's health. Obstetrics & Gynecology, 100, 27-36.
25.
McFarlane, J., & Parker, B. (1994). Preventing abuse during pregnancy: An assessment and intervention protocol. MCN: American Journal of Maternal/Child Nursing, 19, 321-324.
26.
McFarlane, J., Soeken, K., Campbell, J., Parker, B., Reel, S., & Silva, C. (1998). Severity of abuse to pregnant women and associated gun access of the perpetrator. Public Health Nursing, 15, 201-206.
27.
Murphy, C.C., Schei, B., Myhr, T.L., & Du Mont, J. (2001). Abuse: A risk factor for low birth rate? A systemic review and meta-analysis. Canadian Medical Association Journal , 164, 1567-1572.
28.
O'Hare, T., & Creed, F. (1995). Life events and miscarriage. British Journal of Psychiatry, 167, 799-805.
29.
Petersen, R., Gazmararian, J.A., Spitz, A.M., Rowley, D.L., Goodwin, M.M., Saltzman, L.E., et al. (1997). Violence and adverse pregnancy outcomes: A review of the literature and directions for future research. American Journal of Preventive Medicine, 13, 366-373.
30.
Regan, L., Braude, P.R., & Trembath, P.L. (1989). Influence of past reproductive performance on risk of spontaneous abortion. British Medical Journal, 299, 541-545.
31.
Sackett, L.S., & Saunders, D.G. (1999). The impact of different forms of psychological abuse on battered women. Violence and Victims, 14, 105-117.
32.
Saltzman, L.E. (1990). Battering during pregnancy: A role for physicians . Atlanta Med, 64, 45-48.
33.
Schei, B., Samuelsen, S.O., & Bakketeig, L.S. (1991). Does spousal physical abuse affect the outcome of pregnancy? Scandanavian Journal of Social Medicine, 19, 26-31.
34.
Schnurr, P.P., & Jankowski, M.K. (1999). Physical health and post-traumatic stress disorder: Review and synthesis. Seminars and Clinical Neuropsychiatry, 4, 295-304.
35.
Seng, J.S., Oakley, D.J., Sampsell, C.M., Killion, C., Graham-Bermann, S., & Liberzon, I. (2001). Posttraumatic stress disorder and pregnancy complications . Obstetrics and Gynecology, 97, 17-22.
36.
Sheridan, D.J. (1998). Measuring harassment of abused women: A nursing concern. Unpublished doctoral dissertation, Oregon Health and Science University, Portland.
37.
Sheridan, D.J. (2001). Treating survivors of intimate partner abuse: Forensic identification and documentation. In J. S. Olshaker, M. C. Jackson, & W. S. Smock (Eds.), Forensic emergency medicine (pp. 203-228). Philadelphia: Lippincott Williams & Wilkins.
38.
Statistics Canada. (1993). Violence Against Women Survey [Public use data file]. Ottawa, Ontario , Canada: Author.
39.
Street, A.E., & Arias, I. (2001). Psychological abuse and posttraumatic stress disorder in battered women: Examining the roles of shame and guilt. Violence and Victims, 16, 65-78.
40.
Stuart, E.P., & Campbell, J.C. (1989). Assessment of patterns of dangerousness with battered women. Issues Mental Health Nursing, 10, 245-260.
