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Pregnant women risk murder in US

WASHINGTON - February 27, 2005 - Murder is a surprisingly common cause of death among pregnant women in the United States, US government researchers reported on Wednesday.

Black women are especially vulnerable to being killed while pregnant, the team at the Centers for Disease Control and Prevention found.

“Homicide is a leading cause of pregnancy-associated injury deaths,” Jeani Chang and colleagues wrote in the latest issue of the American Journal of Public Health. They investigated the deaths of women who died while pregnant or within a year of being pregnant between 1991 and 1999 and found 1,993 that were caused by injury, compared with 4,200 that were directly related to pregnancy complications. Of the injury-related deaths, 617 or 31 percent were ruled homicide, making murder the second most common cause of injury-related death for pregnant women after car accidents. The homicide rate for pregnant black women was more than triple that for white women, the researchers said.

Most of the murdered women, 56 percent, were shot to death while the rest were either stabbed or strangled. On Tuesday, a Texas man was charged with murdering his pregnant lover and her 7-year-old son after he led police to a makeshift grave. Stephen Barbee, 37, told police he murdered Lisa Underwood, 34, and her son Jayden because she was pregnant with his child and wanted him to leave his wife for her, according to court documents quoted by the Dallas Morning News.

A second report suggests that pregnancy-related deaths may be underreported. Isabelle Horon of the Maryland Department of Health and Mental Hygiene collected data on maternal deaths from death certificates and other records.

March 2005, Vol 95, No. 3 | American Journal of Public Health 471-477
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2003.029868


Homicide: A Leading Cause of Injury Deaths Among Pregnant and Postpartum Women in the United States, 1991–1999

Jeani Chang, MPH, Cynthia J. Berg, MD, MPH, Linda E. Saltzman, PhD and Joy Herndon, MS

Jeani Chang, Cynthia J. Berg, and Joy Herndon are with the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga. Linda E. Saltzman is with the Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Correspondence: Requests for reprints should be sent to Jeani Chang, MPH, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, NE, Mail Stop K-21, Atlanta, GA 30341–3724 (e-mail:

Objectives. We identified risk factors for pregnancy-associated homicide (women who died as a result of homicide during or within 1 year of pregnancy) in the United States from 1991 to 1999.

Methods. Pregnancy-associated homicides were analyzed with data from the Pregnancy Mortality Surveillance System at the Centers for Disease Control and Prevention.

Results. Six hundred seventeen (8.4%) homicide deaths were reported to the Pregnancy Mortality Surveillance System. The pregnancy-associated homicide ratio was 1.7 per 100000 live births. Risk factors included age younger than 20 years, Black race, and late or no prenatal care. Firearms were the leading mechanism for homicide (56.6%).

Conclusions. Homicide is a leading cause of pregnancy-associated injury deaths.

Homicide still a leading cause of death among pregnant and postpartum women

Homicide is a leading injury-related cause of death among pregnant and postpartum women, second only to motor-vehicle accidents, according to a review of death certificates for U.S. women.
The study found that for every 100,000 live births in the United States from 1991-1999, at least two women were homicide victims during pregnancy or within one year of being pregnant. Being black, under age 20 and receiving late or no prenatal care increased a woman's chance of being a homicide victim while pregnant. And for 57 percent of pregnant homicide victims, the gun was their assailant's weapon of choice, followed by 17 percent of assailants who cut or stab victims.

Using a new CDC surveillance system called the National Violent Death Reporting System (NVDRS), timely data can be better captured about the scope and nature of pregnancy-related deaths. NVDRS can capture information about pregnancy status, victim-perpetrator relationship and the presence of an intimate partner. This information makes it an important information tool to better understand the scope and nature of pregnancy-associated violent deaths. [From: "Homicide: a Leading Cause of Injury and Deaths Among Pregnant and Postpartum Women in the United States, 1991-1999." Contact: Office of Communication, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, 770-488-5131.]


Homicide, cause of death in 617 pregnant mothers: APJH report

Author : Thomas Blythe
News Category : Health

2005-02-23 - A team from a government funded researcher agency, who studied the causes of death among pregnant women, has reported homicide as one of the major causes. The report featured in the latest issue of the American Journal of Public Health.

According to the report, in 1999, homicide accounted for one-third of injury related deaths among all women, whether pregnant or not, who were of reproductive age, i.e. 15 to 44 years. This was followed by motor vehicle accidents and suicide as the causes for deaths.

The report also stated that homicide was the second leading cause of injury-related death among women aged 15 to 24 years. The risk is noticeably higher for women who are under the age of 35 or black. The homicide rate for Black women (15.8 per 100 000) was more than 3 times higher than that for White women (4.3 per 100 000).

In the technical terminology used by the researchers, ‘pregnancy-associated homicide’ is defined as a pregnancy-associated death that was attributed to homicide as the manner of death or immediate cause of death. That means these pregnant women died due to extreme trauma caused by violence or assault.

The report is the first instance of the U.S. Centers for Disease Control and Prevention (CDC) studying pregnancy and homicide at a nationwide level. Each year, health departments in the 50 states provide the agency with de-identified copies of death certificates and, for those deaths following a live birth or stillbirth, matching birth or fetal death certificates.

Additional data is collated from reports by state maternal mortality review committees, the media, and individuals. Each death is reviewed and confirmed by medical epidemiologists at the CDC. Their report then categorizes them according to cause of death, associated conditions, and the outcome of the pregnancy.

In this report the CDC has reported 617 cases of death due to homicide from 1991 to 1999. It must be noted here that the actual number could be much higher because many states do not have reliable methods for keeping track of such deaths.

However, pregnancy-related mortality ratio, defined as the number of deaths caused by pregnancy complications per 100 000 live births, remained relatively unchanged.

The 617 pregnancy-associated homicide cases represent 8.4% of the total 7342 reported deaths.


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