Greetings all! It’s been over a year since I last wrote so I thought it fitting to take things back to the beginning – the fundamentals, if you will – by expanding more on the topics of consent, autonomy, recognizing abusive behaviours in intimate relationships, you name it. Today’s topic is reproductive & sexual coercion/abuse.
The American College of Obstetrics and Gynecologists (ACOG) defines reproductive and sexual coercion as “behaviour intended to maintain power and control in a relationship related to reproductive health by someone who is, was, or wishes to be involved in an intimate relationship with an adult or adolescent”. This is referred to as “the hidden form of violence against women” by Marie Stopes and it may be isolated or part of a larger pattern of abusive behaviour in a relationship.
Reproductive coercion is related to behaviour that interferes with contraception use and pregnancy. The most common forms of reproductive coercion are: contraceptive method/birth control sabotage, pregnancy coercion, and pregnancy pressure.
Contraceptive method/birth control sabotage. This is the active interference with a partner’s contraceptive in an attempt to promote pregnancy (but may also occur in isolation to intention to cause pregnancy). Examples include:
- Hiding, withholding or destroying a partner’s contraceptive
- Poking holes or rupturing a condom on purpose
- Removing a condom during sex without your partner’s consent/knowledge (stealthing)
- Condom refusal – claiming that condom use brings displeasure/“doesn’t feel natural”, completely disregarding a partner and ignoring them when condom use is requested, or women being accused of not trusting their partners/of cheating
- Not withdrawing when that was the agreed upon method of contraception
- Removing vaginal rings, contraceptive patches, or intrauterine devices (IUDs)
- Ensuring a partner misses their family planning appointment
- Exaggerating side effects with the intent of discouraging a partner from using contraception
- Male deception regarding (in)fertility – lying about taking medication that makes him sterile, having a vasectomy done, or claiming that they’re unable to have children
Pregnancy coercion. Coercive behaviour such as acts or threats of violence if the partner doesn’t comply with the perpetrators wishes regarding the decision to terminate or continue a pregnancy.
Pregnancy pressure. Pressuring a partner to become pregnant when they don’t wish to do so. Some examples of pregnancy coercion and pressure include:
- Threatening to hurt a partner or end the relationship if they don’t agree to becoming pregnant
- Forcing a partner to continue with a pregnancy against their wishes
- Forcing a partner to terminate a pregnancy against their wishes or injuring a partner in a way that may cause a miscarriage
- Forcing a partner into more permanent forms of contraception such as sterilization (tubal ligation)
- Raping a partner with the intention of causing pregnancy
Sexual coercion is unwanted sexual activity that happens when a partner is pressured, tricked, threatened or forced without using physical violence. Examples of this include:
- Forcing a partner to not use contraception
- Intentionally exposing a partner to a sexually transmitted infection (STI) or threatening retaliation if notified of a positive STI result
- Threatening to leave a partner if they don’t have sex with you
- Pressuring/forcing a partner to have sex with you when they don’t want to
I am currently doing my third month in Obstetrics & Gynaecology and as a hub for women’s health concerns, it comes as no surprise that I have come across some forms of reproductive coercion. It is therefore important for us as clinicians to be on high alert and always consider the possibility of such abuse when we see patients for pregnancy testing, STI screening, emergency contraception, unplanned & unwanted pregnancies. The young girl lying in a pool of blood because she’s having a miscarriage – is it truly her body’s natural way of aborting the fetus or there’s a more sinister explanation for the miscarriage?
Some women have expressed their preference for a boy over a girl child. They’ll be on baby number five and refuse contraception because they don’t have a boy yet. Sure that could be what they want but I sometimes wonder how much of that stems from the partner’s pressure & desire to have sons.
This type of abuse can occur in the most subtle ways that people going through it might not even be aware. If you suspect that you or someone you know is being subjected to reproductive coercion/abuse, you may want to contact a domestic violence advocate/organization such as People Opposing Women Abuse (POWA), TEARS foundation, etc. In addition, your healthcare provider may advise you to:
- Buy birth control or condoms yourself and keeping them in a hidden/private location
- Inspecting contraceptive pills to make sure they’re the correct pills
- Inspecting condoms for any signs of tampering
- Switch to long-acting contraceptive methods that are less detectable to partners such as IUDs (with strings cut very short), contraceptive implant or injection
Of course these aren’t permanent solutions but covert contraceptive use is a common response to reproductive coercion according to Women’s perceptions and experiences of reproductive coercion and abuse: a qualitative evidence synthesis.
This brings us to the end of today’s post, all my love and prayers to anyone who found themselves relating to it ❤. To my returning and new faves, welcome to the upgraded website. I realize it doesn’t have the subscribe button, that will be fixed soon so you don’t miss a thing. Thank you for your time, take care, until next time!
Resources:
Reproductive Abuse: The Hidden Form of Violence Against Women (Marie Stopes, SA)
Reproductive Abuse and Coercion (WomensLaw.org)