The bruised and battered elephant in the emergency room.

There is a new study in Pediatrics by Dr. John Leventhal of Yale University on child abuse in the U.S.; it’s not a comprehensive study of all abused children, only the cases that end up requiring hospitalization due to severity of injuries. Cassie Murdoch at Jezebel rounds up coverage of the study, and shares with us that such injuries include, but are not limited to:

For the most part, children arrived with abusive head trauma, fractures, burns, abdominal injuries and bruises. Their hospitalizations cost the U.S. about $73.8 million and lasted almost twice as long compared to children who were hospitalized with other kinds of injuries.

Dr. Leventhal offers us further insight into the context of abuse:

Based on data from the 2006 Kids’ Inpatient Database, the last such numbers available, Leventhal’s team found that six out of every 100,000 children under 18 were hospitalized with injuries ranging from burns to wounds to brain injuries and bone fractures.

The children spent an average of one week in the hospital; 300 of them died.

The rate of abuse was highest among children under one, particularly if they were covered by Medicaid, the government’s health insurance for the poor. One out of every 752 of those infants landed in the hospital due to maltreatment.

“Medicaid is just a marker of poverty, and poverty leads to stress,” said Leventhal, who is the medical director of the Yale-New Haven Children’s Hospital Child Abuse Program.

Last year, a study from four U.S. states showed a clear spike in abusive brain injuries following the financial crash in late 2007, a finding researchers chalked up to the added pressure on parents.

In that study, too, toddlers appeared to be at higher risk. That led researchers to suggest the maltreatment might have been triggered by crying.

Brain injuries in children do not spike following a financial crash for no reason. One may conclude from Dr. Leventhal’s data that child abuse is for the most part not a matter of parents being horrible inhuman monsters, but of parents being overwhelmed. What might be done about this?

So Dr. Leventhal proposes we act to stop abuse in the same way we’ve worked to stop SIDS: “We need a national campaign related to child abuse where every parent is reminded that kids can get injured.” Another probably even more effective option would be to send public health workers to do home visits with new parents to offer support and advice, a practice that is already common in a lot of European countries.

I don’t disagree with either of those ideas, but I have something else to suggest.

It makes me really angry to know that there are so many parents who are so unprepared and stressed out that they can’t deal with a crying infant without pummeling the poor baby, and yet we still have to fight so hard for our right to control our fertility. There is something seriously fucked up about a widespread cultural movement that says our nation really needs more babies born to people who aren’t ready for babies but has nothing to offer in how to take better care of the kids we have.

Want to prevent child abuse? There’s no substitute for family planning.