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Fetal abuse and neglect is the often overlooked form of maltreatment. A child’s development begins in the womb, and the possibility of a suboptimal environment causing serious and irreversible harm begins in the womb as well. A baby’s wellbeing is attached to the physiology of his or her mother for the first 9 months of life, and if a mother neglects herself, she is also being neglectful of her baby.

“We pass more biological milestones before we’re born than at any other time in our lives,” says Peter Nathanielsz, director of the center for Pregnancy and Newborn Research at the University of Texas Health Service Center at San Antonio. “If we do not pass them correctly, there is a price to pay.” (Laber-Warren, 2009) The CDC cautions that prenatal factors can “have a lifetime impact on infants.” (CDC, 12-14-07) As many as one in ten women have had a poor birth outcome, often from causes attributable to prenatal abuse or neglect. Yet this area is often overlooked, in part because the effects of it aren’t always visible right away. The most extreme consequences are seen only in a minority of cases. Not all mothers who drink during pregnancy will end up with a baby who has fetal alcohol syndrome. Yet if only 5 percent of mothers who drink heavily end up with babies with FAS, that’s still hundreds of thousands of children out there walking around with severe handicaps and mental retardation because of their mother’s substance use.

Women who experience an unintended pregnancy are more likely than those with an intended pregnancy to have poor maternal nutrition, to use alcohol during pregnancy, and to have adverse maternal and infant outcomes. (Hellerstedt et al., 1998) Lack of health care has also been cited as a major culprit. (CDC, 12-14-07) We’ve also included things like stress, depression, and maternal weight problems. Even though not all of these issues are within the mother’s conscious control, and they are not typically classified as fetal abuse, they nontheless impact the baby. As always, our focus should be on working together to solve these problems. Nothing of substance is accomplished by persecuting or condemning expectant mother.

Types of fetal abuse/neglect & its prevalence in the U.S.

There are numerous things that are known to cause problems and complications during pregnancy, many of which have life-long implications for the child. Some of these conditions are more preventable than others, and some are more socially accepted than others. It is not our intent to start a heated debate about what should be labeled abuse versus what is merely a suboptimal environment. Each of these situations listed below is in some way related to behavior on the part of parents and/or others that can jeopardize the welfare of the baby, which is why we’ve included them in this discussion. They are:

1. Smoking during pregnancy: Around 14% of expectant mothers have a smoking habit and approximately half are exposed to second- or third-hand smoke during pregnancy, which is also dangerous.

2. Drinking alcohol during pregnancy: Between 15% and 20% of expectant mothers will drink sometime during pregnancy, and around 6% will abuse alcohol.

3. Drug or substance use/abuse during pregnancy: Approximately 10% of pregnant women use illicit drugs.

4. Excessive stress during pregnancy: Prevalence varies by circumstance.

5. Depression during pregnancy: Approximately 8% to 15% of expectant mothers are depressed during pregnancy, which impacts their baby.

6. Maternal obesity during pregnancy: Around 22% to 35% of babies are born to obese mothers, which affects their development.

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