Young women and teenage girls often face efforts by male partners to sabotage birth control or coerce pregnancy according to a study from UC Davis.
This “reproductive coercion,” includes damaging condoms and destroying contraceptives and is frequently associated with physical or sexual violence.
The study, “Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy,” was published in the January issue of the journal Contraception. About 1,300 English- and Spanish-speaking 16- to 29-year-old women responded to a computerized survey about their relationships and pregnancy experiences..
This is believed to be the first quantitative examination of the relationship between intimate partner violence, reproductive coercion and unintended pregnancy. The study was conducted between August 2008 and March 2009 at five reproductive health clinics in Northern California.
Women who experienced both reproductive coercion and partner violence, the risk of unintended pregnancy doubled.
“This study highlights an under-recognized phenomenon where male partners actively attempt to promote pregnancy against the will of their female partners,” said lead study author professor of pediatrics Elizabeth Miller, from the UC Davis School of Medicine.
“Not only is reproductive coercion associated with violence from male partners, but when women report experiencing both reproductive coercion and partner violence, the risk for unintended pregnancy increases significantly.”
Study participants were asked questions about birth-control sabotage, pregnancy coercion and intimate partner violence to assess their experience of pregnancy coercion and birth control sabotage.
Questions included:
- “Has someone you were dating or going out with ever told you not to use any birth control” or “… said he would leave you if you would not get pregnant?”
- “Has someone you were dating or going out with ever taken off the condom while you were having sex so that you would get pregnant?”
Approximately 20% experienced pregnancy coercion and 15% experienced birth control sabotage.
Sadly, 53% reported physical or sexual violence from an intimate partner. 35% of the women who reported partner violence also reported either pregnancy coercion or birth control sabotage.
“We have known about the association between partner violence and unintended pregnancy for many years,” said associate professor at Harvard School of Public Health Jay Silverman, a senior author of the study.
“What this study shows is that reproductive coercion likely explains why unintended pregnancies are far more common among abused women and teens.”
“This study confirms that women experiencing partner violence are more likely to have greater need for sexual and reproductive health services,” said Miller.
Comprehensive assessment in clinical settings for pregnancy coercion, birth control sabotage and intimate partner violence should be a priority concluded the study.
The study emphasizes the importance of educating women seeking care about reproductive coercion. Women who are seeking reproductive health services need offered counseling on ways to prevent pregnancy that are less vulnerable to partner interference.
“Clinical settings that offer reproductive health services likely offer the greatest opportunity to identify women experiencing partner violence and to ensure that women receive the counseling and support they may need” said Miller.
The study highlights the need of women to have access to service assisting with domestic violence. It also stresses the importance of working with young men to prevent both violence against female partners and coercion around pregnancy.
Moreover, public health efforts to reduce unintended pregnancy should ensure that discussions of reproductive coercion are included in pregnancy prevention programs, she said.
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A later commentary in Newsweek made the folowing observations:
“According to Newsweek, the study is “particularly relevant” given new data on teen pregnancy released Tuesday by the Guttmacher Institute. The Guttmacher research showed that the teen pregnancy rate increased from 2005 to 2006, the first increase since 1990. Newsweek reports that reproductive coercion could be an “overlooked factor” in the U.S. teen pregnancy rate. Leslie Walker, chief of adolescent medicine at Seattle Children’s Hospital, who is not affiliated with either study, said, “I think (reproductive coercion) is underreported and not thought about as often as it should be,” adding, “Just like violence, it’s a power thing.”
Miller said she is hesitant to categorize reproductive coercion as a form of partner violence because doing so would require providers to report such incidents to authorities under many states’ laws. She added that clinicians should focus on either offering birth control that could be hidden from a partner — such as Depo-Provera shots — and building a relationship with the patient to help her consider ending the relationship. If a patient reports that she does not wish to become pregnant, “[i]t really behooves clinicians to offer her methods where she can control the outcome, whether her partner agrees or not,” Miller said (Kliff, Newsweek, 1/26)”.