Prevention of Pregnancy-Associated Violent Death


If you, or someone you know, is experiencing abuse, seek help from a trusted friend, family member, or healthcare provider.

For more information and resources, visit Virginia Sexual & Domestic Violence Action Alliance, Virginia Victim Assistance Network, and 2020 Mom.

Trained advocates can provide resources and help make a safety plan to keep the mother and baby safe.

During your medical appointments, your doctor may ask personal questions about your relationship. It is important that you feel comfortable being open and honest with your doctor. Your answers are confidential and will not be shared with your partner, or family members.

Your doctor may screen you at many appointments to track changes.

If you are experiencing abuse, your doctor can connect you to support resources.

Pregnancy-Associated Deaths related to Violence

The leading causes of pregnancy-associated deaths (PADs), as defined by the Centers for Disease Control and Prevention (CDC), are homicide, suicide, and drug overdose.

PADs resulting from homicide and suicide-related violence are a significant public health issue in Virginia as a leading cause of maternal and infant mortality, leaving behind immeasurable burdens for families and communities, in addition to long-term exposure to violence-related health consequences.

Despite the burden and the challenge of addressing this complex issue, maternal homicide and suicide are largely preventable, and require the public health model of defining and monitoring the problem, identifying risk factors, testing prevention factors, and assuring widespread adoption of efforts to address the issue.

Pregnancy-Associated Death due to Domestic and Intimate Partner Violence

Domestic violence is a pattern of abusive behavior. It involves an imbalance of power and control. An abuser uses hurtful words and actions to control a partner. Abuse, or threats of abuse, can be physical, sexual, financial, or psychological. This includes any behaviors that manipulate, embarrass, isolate, coerce, blame, or injure someone. Most often, the perpetrator of domestic violence is a current or former spouse or partner.

Domestic violence can happen to anyone of any race, age, economic class, religion, or gender. It can happen to married couples, couples that are living together, or couples who are dating. Domestic violence can occur in heterosexual and same-sex relationships.

Certain risk factors can contribute to domestic violence but may not be direct causes.

Risk Factors for Domestic Violence

Heavy alcohol and drug use Lack of nonviolent problem-solving skills
Poor behavioral control Having few friends and isolation from other people
Emotional dependence and insecurity Desire for power and control in relationships
Hostility towards women Witnessing violence between parents as a child
History of experiencing physical discipline or poor parenting as a child Communities with high rates of poverty and unemployment
Communities with limited educational opportunities Communities with high rates of violence and crime and low community involvement
Cultural norms that support aggression toward others Weak community sanctions against domestic violence

Domestic Violence During and After Pregnancy or Pregnancy Loss

Domestic violence may begin or intensify during pregnancy. Sometimes partners become upset or jealous if a new mom is focusing more on the baby. Even if a partner is stressed or unhappy, domestic violence is never the victim’s fault.

Exposure to abuse can increase the mother's risk of physical and mental health issues. This includes substance misuse, depressive or suicidal thoughts, eating disorders, and chronic illnesses. Domestic violence also creates an economic burden due to increased medical costs.

Abuse can affect the unborn baby too. Pregnancy complications include preterm delivery, low birth weight, or death of the newborn. An abuser may not stop being abusive once the baby is born.

The following are potential warnings signs of abuse during and after pregnancy

Prevents you from going to pre-natal appointments or visiting the doctor Prevents you from seeing family or friends
Act jealous of the baby Threaten to take the baby away after they are born
Attempt to harm the baby by hitting, pushing, or twisting the stomach of the pregnant woman Question the paternity of the baby
Continual criticism and insults of one’s parenting abilities Withhold money for basic needs and baby essentials

Protective Factors for Domestic Violence

Protective factors are conditions or characteristics that support healthy relationships.

Strong social support networks and stable, positive relationships with others Neighborhood involvement and connection
Coordination of resources and services among community agencies Communities with access to safe, stable housing
Communities with access to medical care and mental health services Communities with access to economic and financial help


What We are Doing to Address this Burden

Click on the flyer to learn more about our program. 

MMG flyer (3)

The Surgeon General’s Call to Action to Improve Maternal Health outlines strategies for states and localities to take to improve women’s health before, during, and after pregnancy as it relates to prevention of violence.

Public Health Approach VDH Program Efforts
Define and Monitor the Problem


Continued monitoring of existing data sources to track indicators
Identify Risk and Protective Factors


Expand and develop public/private partnerships based on connections of risk and protective factors between different forms of violence
Develop and Test Prevention Factors Fund sub-recipients to implement CDC Technical Package community-level strategies and implement state evaluation plans
Assure Widespread Dissemination Implement a State Action Plan with goals that align with CDC strategies, provide technical assistance and support capacity building to organizations to implement effective prevention strategies, and promote and adopt CDC policies and practices at state and local levels

Our work encompasses:

1) promoting social and physical environments that promote good health,

2) ensuring a broad set of options for women to access culturally and literacy appropriate quality care and trauma informed services through a more stigma and bias free diverse health care workforce.

3) supporting evidence-based programs to address health risks before, during, and after pregnancy, and improving identification of pregnant/postpartum women in the first year (or longer) after delivery who go to the emergency department or hospital and may be at risk for homicide, suicide, or drug overdose

4) improving integrated care systems with obstetricians, primary care, pediatricians and behavioral health providers

5) improving the quality and availability of data on maternal morbidity and mortality,

6) educating the public on risk, and

7) lessening harms.

Hotline connections/resources are listed at the top of this webpage. 

If you, or someone you know, is experiencing abuse, seek help from a trusted friend, family member, or healthcare provider.

For more information and resources, visit Virginia Sexual & Domestic Violence Action Alliance, Virginia Victim Assistance Network, and 2020 Mom.


1. Office on Women’s Health Awards $4.1 Million to Reduce Maternal Deaths Due to Violence | Office on Women's Health (
2. Alhusen JL, Ray E, Sharps P, Bullock L. Intimate partner violence during pregnancy: maternal and neonatal outcomes. J Womens Health (Larchmt). 2015 Jan;24(1):100-6. doi: 10.1089/jwh.2014.4872. Epub 2014 Sep 29. PMID: 25265285; PMCID: PMC4361157.
3. National Center for Injury Prevention and Control, Division of Violence Prevention. Adverse Childhood Experiences. Apr 2022.