Source
Labora Rounds Special Report, Domain 18 — Social Systems & Intimacy Crisis
Data Through
March 2026
Active crisis. No federal screening mandate exists. Reporting infrastructure unchanged.
For OB Providers
Maternal homicide now exceeds all obstetric causes combined. Rate: 5.33 per 100,000. 77% involve firearms. Screen for intimate partner violence at every prenatal visit — document as part of social history. Post-Dobbs data shows 7–10% increase in DV in abortion ban states. Each additional abortion restriction correlates with +3.4% increase in intimate partner homicide.
For Midwives
CNMs: You have prescriptive authority — use screening protocols and DV documentation in your charts. CPMs: Out-of-hospital birth carries additional risk if IPV is present. Screen clients at intake and first visit. Partner with local DV agencies for warm referrals. Homicide is now the leading pregnancy-related cause of death.
For Birth Workers & Doulas
Homicide is the #1 killer of pregnant people. 77% involve firearms. You are often the trusted person clients talk to first. Know how to listen without judgment. Have local DV hotlines, shelters, and legal aid numbers ready. If a client discloses abuse, believe her. Connect her to someone who can help.
For Institutional Leaders
Maternal homicide is the leading cause of pregnancy-related death (5.33 per 100,000 live births). Post-Dobbs abortion restrictions correlate with 7–10% increases in intimate partner violence in ban states. Develop mandatory IPV screening protocols, staff training, social work integration, and trauma-informed care standards.
For Everyone
If you are pregnant or know someone who is: homicide is now the #1 cause of death during pregnancy and the year after birth. Most of these deaths involve abuse in a relationship. If you feel unsafe, tell a doctor, nurse, midwife, or doula. There are free hotlines (1-800-799-7233) and shelters. You deserve to be safe.
Source
Labora Rounds Report, Domain 01 — Maternal Health & Birth Outcomes
Data Through
February 2026
Active crisis. Bicillin L-A remains in shortage. CDC STI surveillance team eliminated.
For OB Providers
Congenital syphilis cases: 335 (2012) → 4,000 (2024). 282 infants dead or permanently disabled in 2022 alone. One-time treatment: benzathine penicillin G (Bicillin L-A) — $440–$1,037 per syringe. Bicillin is in shortage. The CDC team tracking this epidemic was fired. Check maternal RPR/VDRL at first prenatal visit and third trimester. Treat empirically if positive.
For Midwives
Syphilis screening is standard prenatal care. CNMs: You have access to penicillin protocols in hospital settings. CPMs: Out-of-hospital births should include routine serologic screening at first visit and late pregnancy. Partner with OBs on all positive cases. Bicillin L-A shortage means treatment delays.
For Birth Workers & Doulas
Syphilis is treatable but catastrophic if missed. The cure is one shot of penicillin. Encourage all pregnant clients to get prenatal care early. If someone can't access care, help them find a community health center or hospital clinic.
For Institutional Leaders
Congenital syphilis is a preventable catastrophe. Tenfold surge (335 → 4,000 cases). 282 infants died or were permanently disabled in 2022. Bicillin L-A shortages are delaying treatment. CDC surveillance team was eliminated. Ensure robust prenatal screening protocols and secure Bicillin supply chain.
For Everyone
Syphilis in pregnancy is completely preventable and treatable — one shot stops it. But if it's missed, it can kill your baby or cause permanent disability. 282 babies were harmed in 2022. The treatment has existed for 70 years. If you're pregnant, ask your doctor about syphilis screening.
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