Physical Assault During the Perinatal Period by Disability Status and Racial/Ethnic Background.

Abstract

Physical assault of women at the intersection of race/ethnicity and physical disability is not well studied. This study seeks to assess the prevalence of physical assault-related emergency department or hospital visits among women with physical disabilities during different stages of the perinatal period, stratified by racial/ethnic background. This study used 1998-2020 data from the Massachusetts Pregnancy to Early Life Longitudinal Data System. Unique singleton deliveries were classified into 10 cohorts by combining maternal physical disability status (yes/no) and racial/ethnic background (White, Black, Latinx, Asian/Pacific Islander [API], and American Indian/Alaska Native [AIAN]); nondisabled White mothers served as referent. Outcomes assessed were the presence of assaults up to 1 year before conception, during pregnancy, and up to 1 year postpartum. Compared to nondisabled White mothers, Black, Latinx, and AIAN mothers with physical disabilities were at the highest risk and experienced 16.0, 12.0, and 12.0 times the risk, respectively, of preconception assault; 15.3, 12.7, and 11.6 times the risk of prenatal assault; and 9.0, 8.2, and 9.3 times the risk of postpartum assault (p < .001 for all risk ratios). Adjusting for sociodemographic differences between groups reduced the magnitude of disparities, but Black, Latinx, and AIAN mothers with physical disabilities remained at greatest risk among all cohorts. Women with physical disabilities from minoritized racial/ethnic backgrounds experienced compounded risk of perinatal violence, with risks exceeding those of nondisabled women in the same racial/ethnic groups as well as White women with physical disabilities. Violence against women with physical disabilities, especially during pregnancy, is a major and ongoing public health crisis. Urgent needs include screening and outreach efforts to Black, Latinx, and AIAN mothers with physical disabilities.