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Pregnancy and Homicide

Metro Series

Jacquelyn Campbell, Ph.D.
Professor, School of Nursing, Johns Hopkins University
Monday, December 20, 2004; 3:00 PM

Several statewide studies show that pregnant women and new mothers are more likely to be victims of homicide than to die of any single natural cause. Records show more than 1,367 maternal killings have occurred since 1990.

The Washington Post's Pregnancy and Homicide series takes a look into how often this happens, why, how victim's families cope and the social implications of the cases.

Jacquelyn Campbell, Ph.D., professor at the School of Nursing at Johns Hopkins University, was online Monday, Dec. 20, at 3 p.m. ET to answer questions about domestic violence and homicide cases involving pregnant women.

Campbell's teaching and research focuses on domestic violence and intimate partner homicide.

The transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.


Jacquelyn Campbell, Ph.D.: I am pleased that people have emailed questions about the groundbreaking story in the Washington Post on Maternal Mortality and Homicide of Women. I will be posting my responses over the next hour.

Jacquelyn Campbell, PhD, RN
Johns Hopkins University School of Nursing


Rockville, Md.: Dear Dr. Campbell,
Though the articles published in the Post are very timely and important, they neglect the one factor often overlooked in our discussions of domestic violence -- the MEN and the cultural socialization that leads them to believe that women are essentially property to be used or abused as it suits them. In a culture hostile to women, the result will be males hostile to women. How else can we explain this phenomenon? Certainly, attributing it to individual deviance on the part of abusers is not adequate.
Thanks for your comments.

Jacquelyn Campbell, Ph.D.: I absolutely agree. Unfortunately, many aspects of our culture do still tolerate if not encourage violence against women. We need to educate our young men that it is never acceptable to be violent toward women, nor for men to control women.


Washington D.C: It is tragic to think that we do not 'think' about this type of crime until someone brings it to our attention like the Lacey Peterson story. When I first read about police suspecting her husband of murdering his pregnant wife, I honestly thought that this situation was not on that grande of a scale....until today. It breaks my heart to think that a human being can have such callous in his heart to murder another;my heart aches even more to think that he takes his anger one step further to take away the life of his child. It is shameful that these men found it okay to lay down with a woman, yet when the time comes for them to step up to the plate and assume responsiblity for their actions (like an unplanned pregnancy), they choose to snuff out what they deem to be a problem. The article quoted one young man who is the father of two other children that only did he not want the expected child, he did not want the two children he already has. Heck I would rather they run from their responsibility than to commit murder!; Is there any data out there looking into what types of background these men have? Are they from broken homes? Do they have any type of substance abuse? Did they suffer from child abuse?

Jacquelyn Campbell, Ph.D.: It is a tragedy - I agree. We have done research on men who kill their wivees or girlfriends, (pregnant or not) and major risk factors include them being unemployed, being gun owners, being extremely controlling of their partners. From research on men who abuse their wives, we know that many of them do come from homes where the were exposed to their father beating their mother or were abused. But the majority of men exposed to violence in their homes growing up do not hit or kill their wives. We also know that men who are substance abusers are more at risk to abuse their wives or girlfriends, but again the majority of men who abuse substances do not abuse their partners so substance abuse does not CAUSE domestic violence but it does increase the risk.

Jacquelyn Campbell, Ph.D.:


Washington, D.C.: Too bad better records weren't kept regarding the murdered women's pregnancy status. Too bad there is no way of knowing if the pregnancies were unplanned to begin with. Too bad there is no way of knowing if these women got pregnant against their husband's/boyfriend's wishes.

Too bad that these men felt they had no other recourse.

Jacquelyn Campbell, Ph.D.: We absoulutely do need to start doing a better job keeping track of what is happening in these cases in order to identify what can be done to prevent these tragedies. Our police homicide records, homicide autopsy reports and our public health data on maternal mortality need to be combined in each state. If the public starts to ask for that, the states will start to keep this data.


Baltimore, Md.: While the Post series is disheartening, this is nothing new in America. Folklorists say that the most common subject in Anglo-American balladry is women being killed by their lovers: Tom Dooley, Omie Wise, and The Banks of the Ohio are 3 traditional ballads that come to mind. So there is perhaps something cultural at work here.

washingtonpost.com: Violence Intersects Lives of Promise (Post, Dec. 20)

Jacquelyn Campbell, Ph.D.: I agree. The American culture is much too tolerant of violence against women and encouraging of violence in general in many ways. We need to all work on changing those aspects of our culture.


Washington, D.C.: Hello,

I am in no way trying to defend these men who have committed such crimes...they truly deserve double life sentences for such brutal murders.

However, there is a bit of understanding in the "shock affect"...of having something in your life permently and when indicating you are not ready....it builds incredible stress and pressure. Also, the treatment towards "mostly men"...when they go into a child support office is awful...despite there being good fathers who pay child support...most all men that enter that office are treated like "dead beat dads"(sterotype)...which is unfair.
Also, the amount of money taken from the father...and how its taken...plus healthcare cost are placed on the father...there is no tax break at all..absolutely none. The mother gets all tax credits etc. Then there is jail time that can be served.

And lastly, just as when these women were manipulating welfare...this system is not all fool proof...there should be a monitoring system with the money that goes toward the child, is it being spent on the child or is the mother using it for personal gain. I personally have seen crack head mothers getting child support money for their habits. There are many stories of manipulation regarding wrongful use of these monies that are suppose to be for the child.

To men who are going through it...learn to deal with it. But, for those young men that sit back and hear the horror stories mentioned above...it throws them into some kind of mental dis-order of desperation.

Hopefully, the future of Child Support will be more user-friendly (pun). Thanks

Jacquelyn Campbell, Ph.D.: There are inequities in the child support system and certainly stereotypes that all men are "dead beat dads" need to end. However, we all need to think carefully and talk to each other about the possibility of pregnancy when we become intimate with partners. No matter how desperate the situation looks, there are ways to get help without resorting to murder.


Fairfax, Va.: It seems that the crux of most of these killings is the feeling among the men that they are trapped by the woman's pregnancy. Is there any legal avenue for men who want to "disown" custody of child they do not want? Is there a way for the mother and father to mutually codify that the father will have no responsibility for the child? It doesn't make the crime any less horrific, but it is hypocritical that our society allows women to opt out of parenthood and all its responsibilities through abortion, but men have no recourse if they don't want the child (or if they DO want the child and the mother does not.)

Aside from existing domestic abuse prevention/escape programs, what do you see as the main course of prevention?

Jacquelyn Campbell, Ph.D.: Actually, the crux of most of the killings are prior domestic violence against the woman. But there definitely are issues around unwanted pregnancies for men as well as women. Perhaps the best way to prevent difficulties around pregnancy is for all couples to sit down and talk together about the possibilities of babies before they become intimate.


Chicago, Ill.: Thought provoking problem... how to get males to be men.

I can see where women that are in solid pre-natal situations would be able to be screened for the potential domestic violence they face as they carry a child. Is there much hope for the population that doesn't have such care?

A suburban clinic in Chicago pays about half of its operating budget for malpractice insurance -- and even then the insurance company doesn't permit obstetrics. If the clinic did obstetrics, it couldn't get insurance.

Are the women that are at most danger receiving the least protection?

Jacquelyn Campbell, Ph.D.: Actually, most women in this country do get at least some prenatal care. This is one of the things we have done well and has contributed to the decrease in maternal mortality from other causes. However, not all women get assessed for domestic violence in their prenatal care, and we all need to start insisting that every clinic and every private obstetrician do so. There is an increasing issue in regards to malpractice and obstetrical care that also needs to be addressed so that all women can access good prenatal care and that all of the programs include an assessment for domestic violence.


Montross, Va.: I was a victim of a very bad domestic assault back in 2002. I was 7 months pregnant. The guy that I was with at the time never would have thought of doing something like this to me. My questions are. Why do they aim for the stomach? I know that, that is the most vulnerable spot on you at that particular time, but what possesses them to do something like that? Why do they turn out to be more violent when you are pregnant? Is it because they second guess the situation of being a father? Why was it that if I did not pretend my water broke, he would have killed me? I actually peed my pants, but I did not know it. I thought that my water really did break.

Jacquelyn Campbell, Ph.D.: That must have been an absolutely horrible experience for you and I am so glad to hear how resourceful you were in getting away. It is very difficult to know why men can do this - other women have reported their partners "aiming for the stomach" as if they were trying to harm or kill the unborn child, so you are not alone in that experience. Some have theorized that men are threatened by the existence of baby who will take their woman's attention away from him, others that he imagines that the baby is not his and becomes jealous.


New York, N.Y.: Is there anything public health officials can do to protect pregnant women--especially when the women don't seem to have understood they were in danger?

Jacquelyn Campbell, Ph.D.: We have found that if knowledgeable and caring nurses or physicians ask women about domestic violence during prenatal care that they can start a conversation with her about the possible dangers and help her begin to see her risk. They can then refer her to domestic violence advocates and programs who are good at helping women understand the dangers. Public health officials need to encourage the entire health care system to become more informed about domestic violence and ensure there is funding for domestic violence programs in health care systems.


Laytonsville, Md.: Is there any evidence that live-in partners pose less of a risk?

Jacquelyn Campbell, Ph.D.: We do not have clear evidence around this issue; if anything, live in partners pose more risk than married partners for domestic violence and intimate partner homicide - at least according to Canadian data. However, what we DO know is that women are more at risk when she is leaving an abusive partner. We as a society need to do a better job of keeping abused women safe during the time immediately after she leaves.


Washington, D.C.: Thank you for the excellent article on a neglected topic. I cried after reading today's segment. It is just so unbearably sad that these men felt violence was a solution. My condolences to all of the families involved in these senseless tragedies.

Jacquelyn Campbell, Ph.D.: Yes, all of us feel the same way. The individual stories are incredibly powerful and sad. I pay tribute to the families for being willing to share these stories so that hopefully fewer women will be killed this way.


Washington, D.C.: Something that occured to me as I read these stories is that in many of these cases, Laci Peterson being a notable exception, many of these men and women did not have terribly stable lives to begin with. At least two of these girls (and boys) were young teenagers; many more, both men and women, had multiple children and no college education by the time they were 22 or 23. It seems to me that in these kinds of volatile relationships, women -and- men are more likely to be hurt or killed. In the cases that have been examined here, pregnancy was just the trigger.

Jacquelyn Campbell, Ph.D.: Your reading is very insightful! It is often true that the pregnancy is just the trigger in an already abusive, volatile relationship, often between two people that are too young or unprepared to have a family. And one of the keys that often gets lost is that the man was already abusive before the pregnancy in the majority of cases.


Lexington, Ky.: Earlier, Dr. Campbell said "Perhaps the best way to prevent difficulties around pregnancy is for all couples to sit down and talk together about the possibilities of babies before they become intimate."
This does not account for the women in these relationships who may have been forced into "intimacy" and became pregnant as a result. Doesn't violence usually build over time in a relationship, sometimes resulting in homicide?
Also, I am distressed at the tone of some of the questions I'm reading. Yes, there's blame to be placed at the men's feet, but if a lot of us could do just one little thing--volunteer or write a check to a daycare center for low income families,
create a safe haven in our churches for young women who have nowhere else to turn when they find out they're pregnant, or offer a friendly ear to our neighbor or friend in this situation--maybe women in an abusive relationship would feel there is a way out. I wish we wouldn't be so quick to think it's not our problem, just because we don't know anyone personally who's a victim. Believe me, with statistics like those mentioned in the articles--it's ALL of our problem.

Jacquelyn Campbell, Ph.D.: You are absolutely right to bring up this point. Forced sex is all too often part of abusive relationships. And way too many adolescents are forced into sex as their first sexual experience. And yes, violence does often build up over time, the violence escalating into a homicide. And your last point is absolutely right on - if we all made it our problem - reached out to an abused woman, gave a donation to our local domestic violence shelter, said something to a young man who was being disrespectful to a young woman or about women in general - we need to all "make it our business" and coach boys into nonviolent young men. Go to www.endabuse.org for ideas on how to get involved.


Washington, D.C.: I would like to add that anyone looking for help with a
violent relationship can call the National Domestic
Violence Hotline at 1-800-799 SAFE.

Jacquelyn Campbell, Ph.D.: Fabulous - I was going to end with exactly that resource!!


Alexandria, Va.: It is a tragedy that lives are destroyed because of domestic violence. I have to ask one question, which by no means justifies any of the heinous crimes committed. Why are these young women not taking precautions to prevent pregnancies? With all the information available on birth control, safe sex and teen pregnancy, it is sad that so many young women have children that not planned for.

Jacquelyn Campbell, Ph.D.: We often find that abusive men force their partners into sex or insist that she not use birth control. They often seem to want the baby until she is actually pregnant. Sometimes the young woman will get pregnant in order to please him, thinking it will end the violence. And unfortunately, many young people are not getting the information about birth control and safe sex that they need.


Frederick, Md.: It seems many of these men kill the pregnant women to avoid responsibilities of fatherhood. Um, how did they think 25+ years was going to impact their life? Pregnant women have access to public health care and counseling. Are there programs for unwilling fathers to help them cope? Could programs for women include a session on this hazard and help target potential violent men?

Jacquelyn Campbell, Ph.D.: Actually many of our Healthy Start programs do provide programming for young fathers. We do need more of those programs but there is often insufficient funding to support them. Such programs need to be explicit about addressing issues of abuse also and unfortunately, many do not. Check out the programs in your area - are they doing what they need to?


Anonymous: I'm 68 years old and was raised in a poor section of San Antonio, Texas. Growing up, in my neighborhood, any boy who hit, pushed, or even verbally assaulted a girl or anyone smaller than himself, was looked down on and ostrasized by his peers. Boys, young men and old alike looked on themselves as protectors of women. A pregnant woman was practically idolized for the precious gift she was carrying. What in the world has happened?

Jacquelyn Campbell, Ph.D.: This is the kind of neighborhood, community action that we all need to start promoting in our neighborhoods. All of our neighborhoods and schools need to teach those kinds of lessons about nonviolence.


Washington, D.C.: There should be no exception or reasoning to excuse abuse against a woman, especially a pregnant woman. None of these women deserve to die or get killed by the husbands/boyfriends.

Jacquelyn Campbell, Ph.D.: I couldn't agree more!


Washington, D.C.: I knew one of the victims that were murdered. Although her children are alright how do I assist in helping other children of murdered mothers who have no where to go. what happens to them? I'm also thinking about bearing a child what are my chances of my relationship becoming violent, how can i prevent it?

Jacquelyn Campbell, Ph.D.: I am so glad you are reaching out to these children - this is incredibly important work and more need to do so. Remember that most men are not violent so don't be overly scared about this. However, get to know him well before you have a child with him. Be sure he has not been violent toward other women and that he is not controlling toward you in any way or overly suspicious and jealous. Be sure that the two of you are able to talk about your problems and not let issues build up. If he was abused as a child or witnessed his father beat his mother, some counseling is in order to make sure that trauma has really healed.


Laurel, Md.: The 1,367 you found (yes-big caveat there) since 1990 amounts to about 100 per year, or about 0.5% of all murders in the United States.

Women are much less likely to be murdered than men; but the age range of pregnancy pretty much mirrors the age range of the most likely homicide victims.

Is there any reason to think pregnancy increases the risk of homicide?

Jacquelyn Campbell, Ph.D.: This is a good observation - the age of pregnancy and the age of the greatest risk for domestic violence and homicide for women is close to the same. In most cases, pregnancy does not increase the risk of homicide but in some cases, it does seem to be a trigger.


Washington, D.C.: Thank you for participating in this forum.
It is very sad that many of the young mothers profiled already had kids, some of whom witnessed either the violence or the emergency response/police aftermath. This can be traumatic for young children, and they can also experience something called traumatic grief reactions in response to the violent nature of the death. Traumatic stress can impact children's development for years. More information is available at www.NCTSNet.org.
Patrick Cody
communications consultant

Jacquelyn Campbell, Ph.D.: This is an excellent point and I am glad you brought out this resource. We have found that often the other children do not get the counseling and services they need.


Washington, D.C.: Is parenting education included in the general curricula of any local school districts? (e.g. actually part of health or social studies, not elective). Nothing excuses what these men and boys have done-- they deserve the worst--, but a recurring theme in the article seemed to be young fathers terrified of fatherhood and seeking to erase their babies. I would bet many of them grew up fatherless themselves, and really have no idea how a father should behave.

Jacquelyn Campbell, Ph.D.: Parenting education is in the general curricula of some school districts but not all and it certainly should be. I agree that fatherhood needs to be learned, especially when one was not fathered well oneself. But ironically, that is why many pregnant women stay with abusive husbands - they fear the consequences if their baby grows up without a father.


Southern Maryland: Two comments -- I worked as a volunteer advocate for a shelter for battered women and was surprised to learn in many abusive relationships, the most dangerous time for the woman was during her pregnancy. The male somehow seems threatened and jealous of the fetus/newborn/toddler and will not hesitate to beat the daylights out of the mother.

#2 -- what about the flip side of the coin...women who are abusive to men? I had contact with some "button pushers" who knew just the right soft spots to dig when they wanted to control their men, i.e., flirting when they know the man is jealous, or taunting him for some past slight in front of others. I began to believe that some of these battered women deserved it when they started their button-pushing. The men, in some cases, knowing the gentleman's rules about beating up women, had no choice but to take it in silence.

Ain't love grand?

Jacquelyn Campbell, Ph.D.: I am so glad to read that you volunteered in a shelter for battered women - they all need volunteers desperately and it is such important work! And of course, women are not angels,and we all know how to "push buttons" in the one we love and live with. But no matter how much a woman flirts or taunts - it does not warrant physical violence in return. When couples are verbally ugly to each other they need to get counseling to become mutually loving and supportive, but nothing excuses physical violence, no matter how much one is provoked.


Jacquelyn Campbell, Ph.D.: I was pleased to take part in this forum. Thank you all for the excellent questions. For people who need help with an abusive relationship or want the location of a domestic violence shelter in your area, please call 800-799-SAFE. If you are interested in getting more information about how to help in your community or how to work on making the health care system more responsive, go to www.endabuse.org -the Family Violence Prevention Fund. If you are interested in the risk factors for homicide in abusive relationships, go to www.dangerassessment.com If you are interested in reading about or conducting research in domestic violence or in becoming a forensic nurse go to www.son.jhmi.edu

Again thank you all!


Rosslyn, Va.: It is sad to see that many of the victims are young mothers. Would older women be better able to cope (mentally and emotionally) with the situation and perhaps better equipped to leave an abusive partner?

Jacquelyn Campbell, Ph.D.: Perhaps, although women up until their late 30's are highly at risk for domestic violence and intimate partner homicide.


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