(CNN) — Strangling someone is seen by medical experts and victim advocates as a predictor of more serious violence — even homicide. While almost all US states consider choking someone as a felony, a few jurisdictions still treat it as a misdemeanor.

A number of bills recently proposed by lawmakers in Maryland, Washington D.C. and Ohio could change that.

In Maryland, a bipartisan group of lawmakers introduced bills in the state House and Senate last week that would make intentionally suffocating or strangling someone a felony punishable by up to 25 years in prison.

Supporters of the bills, including Attorney General Brian Frosh and Prince George’s County State’s Attorney Aisha Braveboy, plan to hold a news conference about the legislation on Tuesday.

In Washington DC, Mayor Muriel Bowser proposed a bill to the DC Council in December that would make strangulation that doesn’t end in death a felony offense, with increased penalties if the victim was seriously injured or if the perpetrator was subject to supervised release.

And in Ohio, state Senate lawmakers introduced a bill last year that would expand the definition of domestic violence to include strangling, also making it a felony.

“We owe it to every victim and survivor of domestic violence to strengthen our laws to enhance their safety and protection,” Bowser said in a news release. “By enacting this legislation, the District will be better able to hold offenders accountable and provide a sense of security for those who need these protections most.”

Strangling is a misdemeanor in a few states
Strangling is typically prosecuted as a misdemeanor in those jurisdictions. Even though it’s one of the most lethal forms of domestic violence, strangling has gotten overlooked by some state policies because it does not always produce visible signs of assault, according to the Training Institute on Strangulation Prevention.

Under current Maryland law, a person who strangles someone else can be charged with a first-degree assault, defined as causing serious physical injury, but the charge can also be reduced to second-degree assault, a misdemeanor.

DC law treats it as a misdemeanor simple assault, unless the attack caused serious injury or an object was used to strangle the victim.

Current Ohio law treats strangling as a misdemeanor domestic violence charge.

Along with Maryland, Washington D.C. and Ohio, South Carolina is the only other jurisdiction that does not specifically treat strangling as a felony.

Strangling is a risk factor for other violence
Symptoms of strangulation can include a sore throat, difficulty swallowing, bruising, fainting or unconsciousness. But even in the most serious cases, victims might not have any visible injuries.

A 2008 study published in the Journal of Emergency Medicine found that strangling was a significant risk factor for future lethal violence. The researchers found that women who experienced nonfatal strangulation by an intimate partner were six times more likely to be the victim of an attempted murder and seven times more likely to be killed.

A study published by the National Institute of Justice in 2003 found that women who had been strangled by their partners were 10 times more likely to be killed by them.

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