The American College of Obstetrics and Gynecology and the American Medical Association have both recognized interpersonal physical violence (IPV) during pregnancy as a significant public health problem (Petersen et al., 1997). Physical violence against pregnant women has been associated with adverse birth outcomes such as low birthweight and preterm delivery due to placental dysfunction (Berenson et al., 1991, Parker et al., 1994) as well as increased risk of neonatal death (Webster, 1996). Primary care is a logical setting within which to study this problem given the family focused, preventative medicine orientation of primary care practitioners. Previous research into intimate partner violence in primary care found that 1 in 5 women had experienced domestic violence in her lifetime (McCauley et al., 1995). However, the prevalence of intimate partner violence during pregnancy in a primary care population remains unknown. Moreover, the factors that may contribute to an increased risk of violence during pregnancy are also unknown. The proposed research will fill this gap and is intended to provide primary care practitioners with easily detectable markers of an increased risk of abuse during pregnancy. Using an interdisciplinary theoretical model, it is hypothesized that the batterer's paternity certainty plays a pivotal role in the expression of physical abuse during pregnancy. This study will use a cross-sectional survey methodology. An anonymous, self-administered survey, developed from the investigator's pilot project will be distributed to a cross-section of pregnant women who present for care within a primary care practice based research network. Approximately 1600 women will be surveyed over a six month period. During the Health Services Dissertation Research Grant, the following aims will be accomplished: 1.Determine the prevalence of IPV around the time of pregnancy in a primary care population. 2.Identify changes in the perceived frequency and severity of battery and the risk factors of these changes around the time of pregnancy in a primary care population.
