Reproductive coercion

Reproductive coercion is defined as 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 woman into becoming pregnant or ending a pregnancy. 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 the woman's body. It is considered a serious public health issue and has great psychological and social consequences including drug dependence, suicide attempts, and post-traumatic stress disorder. This reproductive control, or a (commonly male) partner's attempt to control a woman's reproductive choices, is highly correlated to unintended pregnancy. Victims and survivors are significantly more likely to describe their pregnancy as unplanned and unwanted than women without these violent experiences.

Women report that their partners engage in reproductive coercion because they want to leave a legacy with the woman or have the woman in their life forever as a few of the reasons they perpetrate the coercion. As stated by the National Domestic Violence Hotline, “Survivors of domestic violence don’t always recognize reproductive coercion as part of the power and control their partner is exerting over them in their relationship.”

The three forms of reproductive coercion are pregnancy pressure, birth control sabotage, and pregnancy coercion; they can exist independently or occur simultaneously. There are also three periods in which reproductive coercion can take place: preintercourse, during intercourse, and postintercourse. Preintercourse may involve pregnancy pressure, during intercourse may involve birth control sabotage, and postintercourse may involve pregnancy coercion. If a woman does not comply with her partner's wishes, her partner may act out violently against her, which is a common response.

Men can also be victims of reproductive coercion, although the majority of victims - 86% - are women. Reproductive coercion can happen to men if their partner lies about or misrepresents their contraception usage or need, also known as contraceptive fraud.

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. Ways in which this occurs are through verbal demands, verbal threats, and physical violence. The behaviors are intended to pressure the partner into becoming pregnant, in order to maintain control over the woman and keep her from pursuing other romantic relationships.

Examples of verbal pressure are:

• If you have a baby, you will never have to worry about me leaving you. I will always be around.
• You would have my baby if you really loved me.
• I'll leave you if you don't get pregnant.
• I'll hurt you if you don't agree to become pregnant.
• I'll have a baby with someone else if you don't become pregnant.
• Let's have beautiful babies together.

In a survey of 474 young mothers, aged 11 to 21, in Chicago, 48% reported experiencing pregnancy pressure.

Birth control sabotage

Main article: Birth control sabotage

Reproductive coercion can take the form of birth control sabotage, either as verbal sabotage or behavioral sabotage, and 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.

14% of surveyed young mothers reported undergoing birth control sabotage. 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.

Gender and sexual power dynamics and coercion associated with sexual power dynamics are both linked to condom nonuse. Studies also link condom nonuse to patriarchal attitudes and intimate partner violence. 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.

The most common forms of birth control sabotage are when the partner refused to wear a condom and when the partner ejaculated before withdrawal, although it was the agreed-upon contraceptive method.

In Canada, a man was convicted of sexual assault for poking holes in his girlfriend's condoms. She expressed that she did not want to become pregnant, and when she did, he confessed to the birth control sabotage.

Pregnancy coercion

Pregnancy coercion is the act of controlling the outcome of a pregnancy - to either force the continuation or termination of the pregnancy - by threats or acts of violence if the woman does not comply with the perpetrator's demands or wishes. Reproductive coercion behaviors may result in several unintended pregnancies that are then followed by multiple coerced abortions.

Women who seek abortions are nearly 3 times as likely to have experienced reproductive coercion by a partner in the past year, compared to women continuing their pregnancies.

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.

Role in domestic violence

A strong association between domestic violence and reproductive coercion exists. Women in abusive relationships are more likely to fear the consequences of resisting their partner's reproductive coercive tactics.

The National Intimate Partner and Sexual Violence Survey defines intimate partner violence by measuring five types of domestic violence, including control of reproductive health, citing pregnancy pressure and birth control sabotage specifically.

85-93% of women who experienced pregnancy pressure or birth control sabotage also reported physical or sexual partner violence. In a separate survey of 1,319 women, about one-third of all participants who experienced domestic violence also experienced reproductive coercion, but only about 15% of women reported reproductive coercion in the absence of other forms of domestic violence. And, as many as 75% of abused women between the ages of 18 and 49 also reported some form of reproductive coercion. Thus, women who are in abusive relationships are at a higher risk of reproductive coercion and unintended pregnancy regarding family planning decision making due to their compromised position within the relationship .

Domestic violence interferes with a woman's ability to manage her health. It causes pain and can expose her to irreversible conditions, such as STIs, miscarriages, and premature delivery. This violence also interferes with a woman's control over her sexuality and autonomy and can cause financial, physical, and emotional harm, such as depression, financial strain, and continued abuse. Regarding pregnancy, domestic violence is associated with increased rates of low birth weight, chorioamnionitis, fetal injury, and fetal death.

Women who are abused by male partners and men who are abusive to female partners are 3 times as likely to have an STI or contract HIV. 40% of abused women reported that their pregnancy was unintended, as compared to 8% of non-abused women. Between 4% and 17% of women report domestic violence during their current pregnancy. Some women experience increased domestic violence during pregnancy, with violence more focused on the abdomen.

Teen pregnancy

Teen dating violence, and specifically reproductive coercion, may be a factor in the United States' increasing teen-pregnancy rate. As the increase in teen pregnancy rate has occurred, both birth rate and abortion rate have increased, pointing to reproductive coercion within teen dating relationships as a possible explanation. 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.

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

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

Prevalence and law

In a study conducted at family planning clinics in Northern California, 1,278 16- to 29-year-old women reported 19.1% of the participants had experienced pregnancy pressure and 15% had experienced birth control sabotage. Of these women, 25.7% reported an experience of reproductive coercion by a partner. Among 474 teenage mothers in Chicago, 51% reported experiencing at least one form of reproductive coercion by their boyfriends.

Reproductive coercion is criminalized in Sweden, such as in the case of Julian Assange. Nonconsensual insemination is considered to be a type of "sex by surprise," with emphasis in the law being that all acts in a sexual activity must be fully consensual. According to Swedish law, a woman has the right to have unprotected sex, but that does not equate to her having consented to be inseminated.

Within Latin America, reproductive coercion is widespread and often correlated with intimate partner violence. In Mexico, the government permits abortion for women specifically who have been coerced into pregnancy - but it is argued that women have to take it upon themselves to reverse the abuse, instead of the law punishing the perpetrator of the coercion.

Men as victims of contraceptive fraud

Contraceptive fraud is the conversion of a man's semen for a purpose that he does not consent to; in this case, pregnancy. Conversion is seen as the civil equivalent of theft, but because the crime was committed by the mother and not a third party, such as the resulting child, the father is obligated to pay child support. If he attempts to avoid or lessen the child support, it is seen as seeking a remedy from the wrong person.

Assessment and intervention

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

• 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?

Due to the findings related to reproductive coercion and its prevalence, many women's groups and hotlines have begun to train their advocates on how to identify and support callers who disclose reproductive coercion. Clinical implications discovered through case studies are 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. 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 that already have a protocol should be reviewed and expanded to address reproductive coercion.

In order to overcome reproductive coercion, and domestic violence in general, there needs to be greater awareness, improved identification techniques, and education about available social and legal interventions available for victims and survivors.

See also

• Domestic violence
• Domestic violence and pregnancy
• Contraceptive security
• Reproductive rights
• Birth control
• Timeline of reproductive rights legislation
• Family planning
• Teen dating violence
• Teenage pregnancy

External links

• National Domestic Violence Hotline
• Futures Without Violence
• Houston Area Women's Center