Child abuse: Definitions, prevalence, and considerations in assessment

This chapter discusses the wide variability in conceptualizations and definitions of child abuse over time and cross-culturally. Commonly recognized forms of child abuse are physical and sexual; psychological and emotional abuse are less recognized, with variability in the relatedness of these types. Examinations of child abuse and maltreatment more broadly show that survivors may be more likely to experience adverse perinatal outcomes. However, a key limitation of the research is a failure to examine differential associations and a focus on child sexual abuse. Given the distinct characteristics of abuse types, understanding their potential differential impact on perinatal women is important for providing evidence-based care. The assessment of abuse also differs, with child abuse not always a single event but rather an ongoing pattern of victimization. Multitype maltreatment recognizes this and also the interconnectedness of maltreatment experiences. The adverse childhood experiences (ACEs) approach is commonly used, recognizing a range of adversity (abuse and dysfunction); however, it is criticized as a simplistic representation of adverse experiences, particularly given the equivalent risk it assumes for each experience. For pregnant/postpartum women, research into the abuse subtypes provides a more detailed understanding of the challenges and opportunities in perinatal care. Given the prevalence of abuse worldwide, the likelihood that an expectant mother will be a child abuse survivor is high. Child abuse can have serious and wide-ranging implications for perinatal women; therefore, understanding their needs is essential to working toward optimal outcomes for both mother and child.