Maternal and Child Health Journal, Vol. 4, No. 2, 2000 Commentary Violence and Reproductive Health: Current Knowledge and Future Research Directions Julie A. Gazmararian, 1,5 Ruth Petersen, 2 Alison M. Spitz, 3 Mary M. Goodwin, 3 Linda E. Saltzman, 4 and James S. Marks 3 Objectives: Despite the scope of violence against women and its importance for reproductive health, very few scientific data about the relationship between violence and reproductive health issues are available. Methods: The current knowledge base for several issues specific to violence and reproductive health, including association of violence with pregnancy, pregnancy intention, contraception use, pregnancy terminations, and pregnancy outcomes, are reviewed and suggestions are provided for future research. Results: Despite the limitations of current research and some inconclusive results, the existing research base clearly documents several important points: (1) violence occurs commonly during pregnancy (an estimated 4%–8% of pregnancies); (2) violence is associated with unintended pregnancies and may be related to inconsistent contraceptive use; and (3) the research is inconclusive about the relationship between violence and pregnancy outcomes. Conclusions: Improved knowledge of the risk factors for violence is critical for effective intervention design and implementation. Four areas that need improvement for development of new research studies examining violence and reproductive-related issues include (1) broadening of study populations, (2) refining data collection methodologies, (3) obtaining additional information about violence and other factors, and (4) developing and evaluating screening and intervention programs. The research and health care communities should act collaboratively to improve our understanding of why violence against women occurs, how it specifically affects reproductive health status, and what prevention strategies may be effective. KEY WORDS: Domestic violence; reproductive health; women. INTRODUCTION An estimated 1.5 million women are physically assaulted or raped by an intimate partner in the United States annually (1). Over the past decade, 1 USQA Center for Health Care Research, Atlanta, Georgia. 2 Cecil Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina. 3 National Center for Chronic Disease Prevention and Health Pro- motion, Centers for Disease Control and Prevention, Atlanta, Georgia. 4 National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. 5 Correspondence should be addressed to Dr. Julie Gazmararian, Vice-President, USQA Center for Health Care Research, 2859 Paces Ferry Road, Suite 820, Atlanta, Georgia 30339; e-mail: julie.gazmararian@phc.aetna.com. 79 1092-7875/00/0600-0079$18.00/0  2000 Plenum Publishing Corporation violence against women has become increasingly rec- ognized as an issue of clinical and public health im- portance (2). Healthy People 2010 objectives (3) sup- port working toward a decrease in violence against women. Additionally, health care providers and pro- fessional groups such as the American Medical Asso- ciation (4) and American College of Obstetricians and Gynecologists (5) acknowledge violence against women as a major problem that needs to be ad- dressed in clinical practice. Increasingly, health pro- fessionals are expected to screen for and intervene in intimate partner violence in their patient popula- tions (4–10). Because women in their reproductive years make many visits to health care providers, an impor- tant opportunity to screen for and intervene in vio-