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CDC Explores Pregnancy-Homicide Link

Killings Cited Among Top Causes of Trauma Death for New, Expectant Mothers

By Donna St. George
Washington Post Staff Writer
Wednesday, February 23, 2005; Page A05

The U.S. Centers for Disease Control and Prevention has reported that homicide is a leading cause of traumatic death among new and expectant mothers, with higher risks for women who are younger than 20 or black. It was the CDC's first national look at pregnancy and homicide.

The study, which was released yesterday and appears in the March issue of the American Journal of Public Health, documents 617 slayings from 1991 to 1999. That number significantly understates the actual toll because many states do not have reliable methods for tracking such deaths, researchers said.

_____About This Series_____

The Toll: Researchers are just beginning to discover what has been a hidden risk of pregnancy: Pregnant women and new mothers are more likely to be victims of homicide than to die of any single natural cause, several statewide studies have shown.

The Victims: As public health experts focus new attention on homicide during pregnancy, the Washington region has become a focal point. Research rarely casts light on the lives of those who were slain or how violence entered their lives at such a pivotal time.

The Legacy: The tragedy of maternal homicide lingers in the lives of children left behind, some of them born as their mothers were dying. Older siblings sometimes witnessed the violence. The children often must be raised by their grandparents.

Video: Recovering at Ceeatta's House
Photo Gallery: The Missing Stories
Photo Gallery: Caring for a Lost Daughter's Son
Maternal Homicide in D.C. Area
_____From The Post_____
Mending Shattered Childhoods (The Washington Post, Dec 21, 2004)
Bittersweet Childhoods of Love and Loss (The Washington Post, Dec 21, 2004)
Violence Intersects Lives of Promise (The Washington Post, Dec 20, 2004)
States Add Penalties For Death of Unborn (The Washington Post, Dec 20, 2004)
Many New or Expectant Mothers Die Violent Deaths (The Washington Post, Dec 19, 2004)
Researchers Stunned By Scope of Slayings (The Washington Post, Dec 19, 2004)
How the Series Was Reported (The Washington Post, Dec 19, 2004)
_____For Information or Help_____
National Domestic Violence Hotline, 1-800-799-SAFE
D.C. Coalition Against Domestic Violence, 202-299-1181
Maryland Network Against Domestic Violence, 301-352-4574
Virginians Against Domestic Violence, 804-377-0335

The CDC study was lauded by several public health experts for recognizing an overlooked phenomenon. Using data from more than 30 states, the CDC found that homicide ranked second, after auto accidents, among trauma deaths of pregnant women and new mothers. The study looked only at "injury deaths" and drew no comparison to deaths from medical causes.

"I think it's a very important first step," said Jacquelyn Campbell, who studies domestic homicide at the Johns Hopkins University School of Nursing. She said more research is needed "to really understand how widespread it is and . . . how to best intervene to prevent these deaths."

In the CDC report, researchers recommended that state and local health officials take ambitious steps to improve the way they identify maternal homicides, linking information from autopsy records, police reports and birth and death records, for example, to develop a clearer portrait of victims and offenders. Few states do this.

"Homicide is an important cause of death for women during pregnancy or within one year of pregnancy," said Jeani Chang, lead author of the CDC study.

Many of the CDC's findings were comparable to those produced by The Washington Post in a year-long examination of homicide and pregnancy, published in December. After culling cases from death certificate data, medical examiner records, news reports and interviews, the paper identified 1,367 maternal homicides since 1990, a total that also falls short because so many cases are missed.

The CDC study found that homicide accounted for 31 percent of maternal injury deaths. Auto accidents accounted for 44 percent, other unintentional injuries for 13 percent and suicide for 10 percent.

The analysis showed black women had a maternal homicide risk about seven times that of white women. The disparity was even more striking at ages 25 to 29, with black women in that age group about 11 times as likely as white women to be killed.

The authors reported that age stood out more than race, with the highest homicide risk for women younger than 20 when all races were combined.

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