Homicide in Pregnant and Postpartum Women: A Review of the Literature

Access to better care and advances in obstetric medicine have led to a global reduction in maternal mortality rate. Although obstetric-related causes of death have decreased, the numbers of deaths relating to injuries have remained static. Suicide has been recognised as a significant cause of overall perinatal mortality. However there has been less consideration of the role of maternal homicide as a contributor to pregnancy-associated mortality. This review reports on international literature on maternal homicide. Rates were reported from 0.97 to 10.6 per 100 000 live births. Pregnancy-associated homicide rates were higher in the United States compared with other countries; it is unclear whether this is due to better case identification or represents an actual difference in risk. Women murdered in the perinatal period constituted a highly vulnerable group: they were younger, more likely to be from minority ethnic groups and unmarried. Domestic violence was a significant risk factor for attempted and completed homicide. This review demonstrates pregnancy–associated homicide is an important contributor to maternal mortality with rates comparable to suicide. Central to any strategy will be the identification of those at risk and these findings add to the importance of screening for current and previous domestic violence.