Reproductive coercion

Reproductive coercion (also called coerced reproduction) is threats or acts of violence against a partner's reproductive health or reproductive decision-making and is a collection of behaviors intended to pressure or coerce a partner into initiating, keeping, or terminating a pregnancy.[1] Reproductive coercion is a form of domestic violence, also known as intimate partner violence, where behavior concerning reproductive health is used to maintain power, control, and domination within a relationship and over a partner through an unwanted pregnancy. It is considered a serious public health issue.[1][2] This reproductive control is highly correlated to unintended pregnancy.[3]

The most common forms of reproductive coercion are pregnancy pressure, pregnancy coercion, and birth control sabotage; they can exist independently or occur simultaneously. Not complying with the partner's wishes may result in the partner acting out violently.[1]

Pregnancy pressure

Pregnancy pressure is enacted by a woman's sexual partner when he pressures her into having unprotected sex in order to become pregnant, or into continuing or terminating the pregnancy.[1] It might involve pregnancy coercion, which are threats or acts of violence if the woman does not comply with the perpetrator's demands or wishes.[2][4] [5]

Reproductive pressure behaviors may result in several unintended pregnancies that are then followed by multiple coerced abortions. Women who seek abortions are nearly three times as likely to have experienced reproductive pressure by a partner in the past year, compared to women continuing their pregnancies.[2] A Guttmacher Institute policy analysis states that forcing a woman to terminate a pregnancy she wants or to continue a pregnancy she does not want violates the basic human right of her reproductive health.[6]

Birth control sabotage

Reproductive coercion can take the form of birth control sabotage, either as verbal sabotage, behavioral sabotage, and/or acts as an active interference with contraceptive methods. Direct actions are taken to ensure the failure of birth control (such as poking holes in or breaking condoms) or complete removal of contraception (such as flushing birth control pills down the toilet or removing contraceptive rings or patches from the body). Partners can also forbid women from using family planning or force them to have sex without protection.[1][2]

Birth control sabotage is frequently associated with physical or sexual violence, and is a contributor to high pregnancy rates—especially teenage pregnancy rates—among abused, disadvantaged women and teenagers.[2]

Studies on the birth control sabotage performed by males against female partners have indicated a strong correlation between domestic violence and birth control sabotage. These studies have identified two main classes of the phenomenon:[7]

  • Verbal sabotage—verbal or emotional pressure not to use birth control or to become pregnant.
  • Behavioral sabotage—the use of force to have unprotected sexual intercourse or not to use birth control.

14% of surveyed young mothers reported undergoing birth control sabotage.[7] A separate study found that 66% of teen mothers on public assistance who had recently experienced intimate partner violence disclosed birth control sabotage by a dating partner. When women did try to negotiate condom use with their abusive partners, 32% said they were verbally threatened, 21% reported physical abuse, and 14% said their partners threatened abandonment.[2]

Gender and sexual power dynamics and coercion associated with sexual power dynamics are both linked to condom nonuse.[8] Even women with high STI knowledge are more likely to use condoms inconsistently than women with low STI knowledge when there is a high level of fear for abuse.[2]

Teen pregnancy

Teenage girls in physically violent relationships are 3.5 times more likely to become pregnant and are 2.8 times more likely to fear the possible consequences of negotiating condom use than non-abused girls. They are also half as likely to use condoms consistently compared to non-abused girls, and teenage boys perpetrating dating violence are also less likely to use condoms.[2] There are actions girls and women can take if their contraception has been stealthed or sabotaged:[9] In the US, Plan B (the morning after pill) can be acquired by girls 15 years or older. When taken within 72 hours, it can help prevent an unwanted pregnancy. It is approximately 95% effective when taken within 24 hours and is approximately 89% effective when taken within 72 hours.

Teenage mothers are nearly twice as likely to have a repeat pregnancy within 2 years if they experienced abuse within three months after delivery.[2]

26% of abused teenage girls reported that their boyfriends were trying to get them pregnant.[10]

Prevalence

Domestic violence, also called "intimate partner violence", is monitored by the US Centers for Disease Control and Prevention (CDC). Their survey on domestic violence measures five types of domestic violence, including control of reproductive health, citing pregnancy pressure and birth control sabotage specifically.[11] While research remains fragmentary, women in abusive relationships appear to be at higher risk of reproductive coercion and unintended pregnancies.[12]

The Center for Disease Control found that:[11]

  • approximately 8.6% (or an estimated 10.3 million) of women in the United States reported ever having an intimate partner who tried to get them pregnant when they did not want to, or refused to use a condom, with 4.8% having had an intimate partner who tried to get them pregnant when they did not want to, and 6.7% having had an intimate partner who refused to wear a condom;
  • approximately 10.4% (or an estimated 11.7 million) of men in the United States reported ever having an intimate partner who tried to get pregnant when they did not want to or tried to stop them from using birth control, with 8.7% having had an intimate partner who tried to get pregnant when they did not want to or tried to stop them from using birth control and 3.8% having had an intimate partner who refused to wear a condom.

Assessment and intervention

A typical assessment of women's reproductive health includes the following questions:[2]

  • Has a current or former partner not let you use birth control, destroyed your birth control, or refused to wear a condom?
  • Has your partner ever tried to get you pregnant when you didn't want to be?
  • Has your partner ever forced you to have an abortion or caused you to have a miscarriage?
  • Has your partner ever purposely given you an STD?
  • Are you worried you might be pregnant?[2]

Due to the findings related to reproductive coercion and its prevalence, the American College of Obstetricians and Gynecologists has called for its members to be vigilant for reproductive coercion.[1] Clinical implications discovered through case studies are the following: to assess for reproductive coercion as a part of a routine family planning care; to assess reproductive coercion before discussing contraceptive options; to offer discreet birth control methods; and to assess safety.[2] Some believe that all reproductive health care settings should have a written protocol for identifying and responding to domestic violence that includes reproductive coercion, and agencies that already have a protocol should be reviewed and expanded to address reproductive coercion.[2]

Law

In Mexico, the government permits abortion, which is otherwise illegal, for women who have been coerced into pregnancy.[13]

See also

References

  1. 1 2 3 4 5 6 "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. LWW. 121 (2 Pt 1): 411–5. February 2013. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 13 Chamberlain L, Levenson R (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). San Francisco: Family Violence Prevention Fund.
  3. ↑ Coker AL (April 2007). "Does physical intimate partner violence affect sexual health? A systematic review". Trauma, Violence & Abuse. Sage. 8 (2): 149–77. doi:10.1177/1524838007301162. PMID 17545572.
  4. ↑ Sueda A. "Contraceptive Coercion" (PDF). Department of Ob/Gyn, Kaiser Permanente. Archived from the original (PDF) on 3 January 2012.
  5. ↑ Miller E, Silverman JG (September 2010). "Reproductive coercion and partner violence: implications for clinical assessment of unintended pregnancy". Expert Review of Obstetrics & Gynecology. 5 (5): 511–515. doi:10.1586/eog.10.44. PMC 3282154. PMID 22355296.
  6. ↑ Barot S (Fall 2012). "Governmental coercion in reproductive decision making: see it both ways". Guttmacher Policy Review. Guttmacher Institute. 15 (4).
  7. 1 2 Domestic Violence and Birth Control Sabotage: A Report from the Teen Parent Project. Chicago: Center for Impact Research, 2000.
  8. ↑ Hendriksen ES, Pettifor A, Lee SJ, Coates TJ, Rees HV (July 2007). "Predictors of condom use among young adults in South Africa: the Reproductive Health and HIV Research Unit National Youth Survey". American Journal of Public Health. 97 (7): 1241–8. doi:10.2105/AJPH.2006.086009. PMC 1913066. PMID 17538062.
  9. ↑ Brocail M (10 May 2017). "Stealthing & Sabotaging Condoms: What You Need To Know". STDcheck. Retrieved 21 May 2017.
  10. ↑ Futures Without Violence. Feb 27, 2012 Teen Dating Violence and Reproductive Coercion: Innovative Opportunities for Programs and Partnerships
  11. 1 2 Black MC, Basile KC, Breiding MJ, Smith SG, Walters ML, Merrick MT, Chen J, Stevens MR (2011). The National Intimate Partner and Sexual Violence Survey (NISVS) (PDF). Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention: 48.
  12. ↑ Paterno MT, Jordan ET (March 2012). "A review of factors associated with unprotected sex among adult women in the United States". Journal of Obstetric, Gynecologic, and Neonatal Nursing. 41 (2): 258–74. doi:10.1111/j.1552-6909.2011.01334.x. PMID 22376055.
  13. ↑ Cusack CM (2011). "Consensual Insemination, An Analysis of Social Deviance within Gender, Family, or the Home" (PDF). Journal of Law & Social Deviance. 2: 158.
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