Among other differences noted, married women were found at less risk than unmarried women. Women who received no prenatal care had a higher risk of homicide than those who did.
The study found that 57 percent of maternal homicides were caused by gunfire; stabbings ranked second, with nearly 18 percent.
_____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 said it was "important but difficult to assess" whether women in general are at an increased risk of homicide during pregnancy and the postpartum period, which covers 12 months under the public health definition of "pregnancy-associated" deaths. It noted that homicide is a leading cause of death among black and young women, regardless of maternal status.
Using its 617 cases, the CDC calculated a ratio of 1.7 homicides per 100,000 live births, but Chang, the lead author, acknowledged the ratio is understated because homicides are so poorly tracked.
In Maryland, researchers found 11.5 homicides per 100,000 live births. In two other state studies, the figures were much higher than the CDC number, said Isabelle Horon, co-author of a Maryland study published in the Journal of the American Medical Association in 2001.
Horon said the CDC study "may call attention to the problem, but I think that it also does a disservice to the problem because it suggests the magnitude of the problem is less than what it is."
The CDC report pointed out that several studies, including Horon's, showed pregnant and postpartum women faced an increased risk of homicide. In Maryland, researchers found that new and expectant mothers were nearly twice as likely as other women to be victims of homicide, even after adjusting for race and age.
Cara Krulewitch, a researcher at the University of Maryland at Baltimore School of Nursing, called the CDC findings significant.
"Homicide was second on the list of injuries," she said. "It wasn't falls. It wasn't suicides. It wasn't anything else." This does not mean that most pregnant women are in peril, she said, "but that there is a phenomenon going on out there and we don't understand it yet."