Severe physical violence among intimate partners: a risk factor for vaginal bleeding during gestation in less privileged women?

Objectives. To evaluate the role of severe physical violence within intimate partners on the occurrence of vaginal bleeding during gestation in less privileged women. Design . Health service survey. Setting. Three large public maternities in the city of Rio de Janeiro, Brazil. Sample. Five hundred and twenty‐eight women who gave birth to full‐term newborn infants were selected at random among the births that took place during the six months of fieldwork. Methods. Information on vaginal bleeding during gestation was obtained from medical records, pre‐natal cards, and by means of a questionnaire addressed to the women giving birth. To collect severe physical violence data, use was made of the Portuguese version of the instrument Revised Conflict Tactics Scales, formally adapted for use in Brazil. Main outcome measures. Vaginal bleeding during gestation. Results. After accounting for socio‐economic, demographic, reproductive, and pregnant women's life‐style variables, women who had been victims of two or more acts of severe physical violence were 2.74 (95% CI: 1.37–5.48) times more liable to present with vaginal bleeding during pregnancy than those who did not. Conclusion. Our findings suggest that physical violence increases the risk of vaginal bleeding in pregnancy. This result should encourage studies on whether intervention in violent relationships can reduce the risk of vaginal bleeding and other pregnancy complications.