Women in the US are more likely to be murdered during pregnancy or soon after childbirth than to die from the three leading obstetric causes of maternal death - high blood pressure disorders, hemorrhage, or sepsis.
Writing in the British Medical Journal, experts say the majority of these pregnancy-associated homicides are linked to the lethal combination of intimate partner violence and firearms, and are entirely preventable.
They argue that ending male violence, including gun violence, could save the lives of hundreds of women and their unborn children in the US every year.
While the situation in the US is very serious and deteriorating, they point out that intimate partner violence is a leading cause of homicide for women globally.
Intimate partner violence
And they say this is an urgent priority for the health and safety of women everywhere.
Intimate partner violence is common worldwide, with one in three women reporting experiences of violence including physical, sexual, or psychological abuse by a partner in their lifetime, the experts explain.
Reports suggest the US has a higher prevalence of lifetime and past-year intimate partner violence than other high-income countries.
Murders by an intimate partner in the US are overwhelmingly committed using firearms.
Risk factors
Recent estimates indicate that firearms were used in 68% of killings around pregnancy between 2008 and 2019, with black women at substantially higher risk of being killed than White or Hispanic women.
Few perpetrators of intimate partner violence are ever convicted, the authors say.
They point out that pregnancy typically increases women's interactions with healthcare providers, presenting opportunities for screening or other approaches to help women experiencing or at risk of violence.
Such interventions may help stop a pattern of abuse that could lead to murder or adverse health outcomes, they say, but these efforts must sit alongside urgent work to reduce all forms of violence against women.