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Grace KT, Glass NE, Miller E, Alexander KA, Holliday CN, Decker MR. Birth Control Sabotage Motivation and Measurement: A Mixed-Methods Analysis among Latina Women. Violence Against Women 2024; 30:1634-1655. [PMID: 36567608 PMCID: PMC10290727 DOI: 10.1177/10778012221145292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Reproductive coercion (RC) is a type of intimate partner violence that includes birth control sabotage (BCS). We explored the perceived intent behind BCS to refine RC measurement, using a mixed-methods design with a clinic-based sample of Latina women (13 interviews; 482 surveys). Women perceived partners used BCS for reasons beyond pregnancy promotion. Specifically, 16.8% of participants reported any past-year RC; this decreased to 9.5% when asked if their partner used BCS with the sole intent of getting them pregnant. RC measures and assessment should separate behavior from intent in BCS questions to not underestimate the prevalence and to guide clinical response.
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Affiliation(s)
- Karen Trister Grace
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nancy E Glass
- Johns Hopkins University, School of Nursing, Baltimore, MD, USA
| | - Elizabeth Miller
- Division of Adolescent Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | | | | | - Michele R Decker
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
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Frank R, Wildsmith E, Kroeger RA, Williams CE, Beltran AT. What's Behind the Dramatic Pre-2020 Declines in Hispanic/Latina Adolescent Childbearing? Decomposing Change by Age, Origin, and Nativity. J Adolesc Health 2024:S1054-139X(24)00068-5. [PMID: 38520431 DOI: 10.1016/j.jadohealth.2024.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/21/2023] [Accepted: 01/21/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To assess whether the large declines in adolescent childbearing among Hispanic adolescents over the period 2000-2019 have been driven by co-occurring changes in the composition of the Hispanic population and, if so, whether they have done so differentially by Hispanic subgroup. METHODS We use birth counts from the United States vital statistics system and population denominators from the United States decennial census long form 5-percent Public Use Microdata and the American Community Survey to conduct a decomposition analysis apportioning observed declines in Hispanic adolescent childbearing to: (1) compositional shifts in nativity, age, and region-of-origin and (2) subgroup changes in childbearing rates. RESULTS The Hispanic adolescent fertility rate fell by over 71% from 2000 to 2019, with Mexican-Origin, United States-born, and younger adolescents exhibiting the steepest declines (79%, 70%, and 80% declines, respectively). Results from the decomposition analysis show that almost 90% of the decline is due to within-group rate change, with some variability by subgroup and by decade. Only 10% of the decline was due to compositional changes, with shifts in nativity driving much of the effect. DISCUSSION Declines in Hispanic adolescent childbearing over the last decades have occurred in spite of substantial shifts in the composition of the Hispanic population, not because of them. These findings set the stage for a more detailed examination of the drivers of change in sexual activity, contraceptive use, and abortion, all of which are proximate determinants of adolescent pregnancy and childbearing. Additionally, a focus on more distal factors is needed, including the role that changing political, societal, and economic conditions in the United States have for early fertility patterns.
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Affiliation(s)
- Reanne Frank
- Department of Sociology, Ohio State University, Columbus, Ohio.
| | | | - Rhiannon A Kroeger
- Department of Sociology, Louisiana State University, Baton Rouge, Louisiana
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Carrandi A, Bull C, Hu Y, Grzeskowiak LE, Teede H, Black K, Callander E. Patterns in the provision of government-subsidised hormonal postpartum contraception in Queensland, Australia between 2012 and 2018: a population-based cohort study. BMJ Sex Reprod Health 2024; 50:13-20. [PMID: 37353310 DOI: 10.1136/bmjsrh-2023-201830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/07/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Short birth intervals and unintended pregnancy are associated with poorer maternal and infant outcomes. There is a risk of pregnancy during the immediate postpartum period unless contraception is initiated. This retrospective cohort study aimed to capture the current patterns of hormonal contraceptive provision within 12 months postpartum in a high-income country. METHODS We used a linked administrative dataset comprising all women who gave birth in Queensland, Australia between 1 July 2012 and 30 June 2018 (n=339 265 pregnancies). We described our cohort by whether they were provided with government-subsidised hormonal contraception within 12 months postpartum. The associations between hormonal postpartum contraceptive provision and demographic and clinical characteristics were examined using univariate and multivariate logistic regression and presented in terms of crude and adjusted odds ratios with 95% confidence intervals. RESULTS A majority of women (60.2%) were not provided with government-subsidised hormonal postpartum contraception within 12 months postpartum. Women who were younger (<25 years), were overweight or obese, smoked, were born in Australia, were non-Indigenous, gave birth in a public hospital, or were in the lowest socioeconomic status group were more likely to be provided with postpartum contraception after adjusting for other covariates, compared with their counterparts. CONCLUSIONS Strategies to increase the provision and uptake of contraception in the immediate postpartum period are needed to prevent short birth intervals and unintended pregnancy and ensure women's fertility intentions are enacted. Ongoing research is needed to examine the factors influencing women's access to contraceptive services and, further, the types of contraception provided.
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Affiliation(s)
- Alayna Carrandi
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Claudia Bull
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Yanan Hu
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Luke E Grzeskowiak
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Monash University Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Clayton, Victoria, Australia
| | - Kirsten Black
- Faculty of Medicine and Health, The University of Sydney School of Medicine, Sydney, New South Wales, Australia
| | - Emily Callander
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
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Huber-Krum S, Bornstein M, D'Angelo D, Narasimhan S, Zapata LB, Tsukerman K, Ruvalcaba Y. Contraceptive Sabotage and Contraceptive Use at the Time of Pregnancy: An Analysis of People with a Recent Live Birth in the United States. J Interpers Violence 2023; 38:11954-11979. [PMID: 37515538 PMCID: PMC10989733 DOI: 10.1177/08862605231190346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
Contraceptive sabotage and other forms of intimate partner violence (IPV) can interfere with contraceptive use. We used 2012 to 2015 Pregnancy Risk Assessment Monitoring System data from 8,981 people residing in five states who reported that when they became pregnant, they were not trying to get pregnant. We assessed the relationships between ever experiencing contraceptive sabotage and physical IPV 12 months before pregnancy (both by the current partner) and contraceptive use at the time of pregnancy using multivariable logistic regression. We also assessed the joint associations between physical IPV 12 months before pregnancy and ever experienced contraceptive sabotage with contraceptive use at the time of pregnancy. Few people ever experienced contraceptive sabotage (1.8%; 95% confidence interval [CI]: 1.4, 2.3) or physical IPV 12 months before pregnancy (2.8%; 95% CI: 2.3, 3.3). In models adjusted for age, race/ethnicity, marital status, education, and state of residence, ever experiencing contraceptive sabotage was associated with contraceptive use at the time of pregnancy (adjusted odds ratio [aOR]: 1.73; 95% CI: 1.06, 2.82), but not with physical IPV 12 months before pregnancy (aOR: 0.69; 95% CI: 0.46, 1.02). When examining the joint association, compared to not ever experiencing contraceptive sabotage or physical IPV 12 months before pregnancy, ever experiencing contraceptive sabotage was significantly related to contraceptive use at the time of pregnancy (aOR: 1.72; 95% CI: 1.00, 2.95). However, it was not associated with experiencing physical IPV 12 months before pregnancy (aOR: 0.68; 95% CI: 0.45, 1.04) or with experiencing both contraceptive sabotage and physical IPV 12 months before pregnancy (aOR: 1.21; 95% CI: 0.42, 3.50), compared to not ever experiencing contraceptive sabotage or physical IPV 12 months before pregnancy. Our study highlights that current partner contraceptive sabotage may motivate those not trying to get pregnant to use contraception; however, all people in our sample still experienced a pregnancy.
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Affiliation(s)
- Sarah Huber-Krum
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Denise D'Angelo
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Lauren B Zapata
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kara Tsukerman
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Yanet Ruvalcaba
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
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Lévesque S, Rousseau C, Jean-Thorn A, Lapierre S, Fernet M, Cousineau MM. Reproductive Coercion by Intimate Partners: Prevalence and Correlates in Canadian Individuals with the Capacity to be Pregnant. PLoS One 2023; 18:e0283240. [PMID: 37535635 PMCID: PMC10399814 DOI: 10.1371/journal.pone.0283240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 03/03/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVES Despite the large body of research on violence against women, violence that specifically targets women's reproductive autonomy and control over their reproductive health, called reproductive coercion (RC), is poorly documented in Canada. The purpose of this study is to determine the prevalence of RC behaviors in an adult Canadian community sample and to explore associated factors. STUDY DESIGN A self-report online questionnaire was administered from September 2020 to April 2021 in Quebec and Ontario, Canada. Participants were recruited via social media, sexual and reproductive health clinics, community-based anti-violence organizations, and the project's partner organizations. The questionnaire contained validated RC questionnaire items and new items drawn from previous qualitative work. The sample comprised 427 participants, mostly self-identified as women (92%), aged 18 to 55 years (M = 29.01; SD = 6.64). Descriptive analyses and binary logistic regressions were conducted using SPSS 27. RESULTS The results of this study show that 63.9% of participants reported at least one lifetime experience of RC. According to our data, contraceptive sabotage was the most common form (62.8%). Of the participants who had been pregnant, 9.8% reported control of pregnancy outcomes. Each RC category shows a different pattern of correlates. The findings also reveal that intimate partner violence (IPV) increases the likelihood of contraceptive sabotage. Moreover, the study suggests that low education level and IPV increase the risk for control of pregnancy outcomes. CONCLUSION These findings underscore the importance of RC in the lives of many Canadian individuals with the capacity to be pregnant, and they highlight certain factors that place individuals at greater risk for RC. This knowledge can inform the development of prevention efforts and clinical interventions.
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Affiliation(s)
- Sylvie Lévesque
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Catherine Rousseau
- Interdisciplinary School of Health Sciences, Ottawa University, Ottawa, Ontario, Canada
| | - Arianne Jean-Thorn
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Simon Lapierre
- School of Social Work, Ottawa University, Ottawa, Ontario, Canada
| | - Mylène Fernet
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada
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Graham M, Haintz GL, Bugden M, de Moel-Mandel C, Donnelly A, McKenzie H. Re-defining reproductive coercion using a socio-ecological lens: a scoping review. BMC Public Health 2023; 23:1371. [PMID: 37461078 DOI: 10.1186/s12889-023-16281-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Reproductive coercion is a significant public health issue in Australia which has mainly been conceptualised as a form of violence at the interpersonal level. This limited scope ignores the role of the gendered drivers of violence and fails to encompass a socio-ecological lens which is necessary to consider the multiple interacting layers that create the context in which reproductive coercion occurs. The aim of the scoping review was to explore how the reproductive coercion is defined by international research. Specifically, how is reproductive coercion defined at the social-cultural-systems-structural levels, and are the definitions of reproductive coercion inclusive of the conditions and contexts in which reproductive coercion occurs? METHODS A scoping review was undertaken to explore existing definitions of reproductive coercion. Searches were conducted on Embase, Cochrane Library, Informit Health Collection, and the EBSCOHost platform. Google was also searched for relevant grey literature. Articles were included if they were: theoretical research, reviews, empirical primary research, grey literature or books; published between January 2018 and May 2022; written in English; and focused on females aged 18-50 years. Data from eligible articles were deductively extracted and inductively thematically analysed to identify themes describing how reproductive coercion is defined. RESULTS A total of 24 articles were included in the scoping review. Most research defined reproductive coercion at the interpersonal level with only eight articles partially considering and four articles fully considering the socio-cultural-systems-structural level. Thematic analysis identified four main themes in reproductive coercion definitions: Individual external exertion of control over a woman's reproductive autonomy; Systems and structures; Social and cultural determinants; and Freedom from external forces to achieve reproductive autonomy. CONCLUSIONS We argue for and propose a more inclusive definition of reproductive coercion that considers the gendered nature of reproductive coercion, and is linked to power, oppression and inequality, which is and can be perpetrated and/or facilitated at the interpersonal, community, organisational, institutional, systems, and societal levels as well as by the state.
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Affiliation(s)
- Melissa Graham
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia.
| | - Greer Lamaro Haintz
- School of Health and Social Development, Deakin University, Locked Bag 20, Geelong, 000, 3220, Australia
| | - Megan Bugden
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Caroline de Moel-Mandel
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Arielle Donnelly
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Hayley McKenzie
- School of Health and Social Development, Deakin University, 221 Burwood Highway, Burwood, 3125, VIC, Australia
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Pike GK. Coerced Abortion - The Neglected Face of Reproductive Coercion. New Bioeth 2023; 29:85-107. [PMID: 36260375 DOI: 10.1080/20502877.2022.2136026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Reproductive coercion encompasses a collection of pregnancy promoting and pregnancy avoiding behaviours. Coercion may vary in severity and be perpetrated by intimate partners or others. Research is complicated by the inclusion of behaviours that do not necessarily involve an intention to influence reproduction, such as contraceptive sabotage. These behaviours are the most common, but are not always included in survey instruments. This may explain why the prevalence of reproductive coercion varies widely. Prevalence also varies when coerced abortion is included in survey instruments. When it is, it seems roughly comparable in prevalence to coercion intended to impregnate. The extent and nature of coerced abortion can also be derived from studies that explore the reasons why women access abortion, the relationship between abortion and intimate partner violence, and online blogs and forums. This narrative review of reproductive coercion examines the evidence and attempts to comprehend why coerced abortion has been neglected.
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St Clair S, Dearden S, Clark L, Simonsen SE. Some key questions: Pregnancy intention screening by community health workers. Womens Health (Lond) 2023; 19:17455057231213735. [PMID: 38105749 PMCID: PMC10729636 DOI: 10.1177/17455057231213735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Unintended pregnancy contributes to a high burden of maternal and fetal morbidity in the United States, and pregnancy intention screening offers a key strategy to improve preconception health and reproductive health equity. The One Key Question© is a pregnancy intention screening tool that asks a single question, "Would you like to become pregnant in the next year?" to all reproductive-age women. This study explored the perspectives of community health workers on using One Key Question in community-based settings. OBJECTIVES This study aimed to identify barriers and facilitators to the use of the One Key Question pregnancy intention screening tool by community health workers who serve reproductive-age women in Salt Lake City, Utah. DESIGN Using reproductive justice as a guiding conceptual framework, this study employed a qualitative descriptive design. Participants were asked to identify barriers and facilitators to the One Key Question, with open-ended discussion to explore community health workers' knowledge and perceptions about pregnancy intention screening. METHODS We conducted focus groups with 43 community health workers in Salt Lake City, Utah, from December 2017 through January 2018. Participants were trained on the One Key Question algorithm and asked to identify barriers and facilitators to implementation. All focus groups occurred face-to-face in community settings and used a semi-structured facilitation guide developed by the study Principal Investigator with input from community partners. RESULTS Pregnancy intention screening is perceived positively by community health workers. Barriers identified include traditional cultural beliefs about modesty and sex, lack of trust in health care providers, and female bias in the One Key Question algorithm. Facilitators include the simplicity of the One Key Question algorithm and the flexibility of One Key Question responses. CONCLUSION One Key Question is an effective pregnancy intention screening tool in primary care settings but is limited in its capacity to reach those outside the health system. Community-based pregnancy intention screening offers an alternative avenue for implementation of One Key Question that could address many of these barriers and reduce disparities for underserved populations.
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Affiliation(s)
| | - Susan Dearden
- Strategic Marketing Analyst, bioMérieux, Salt Lake City, UT, USA
| | - Lauren Clark
- University of California Los Angeles (UCLA) School of Nursing, Los Angeles, CA, USA
| | - Sara E Simonsen
- University of Utah College of Nursing, Salt Lake City, UT, USA
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Grace KT, Decker MR, Alexander KA, Campbell J, Miller E, Perrin N, Glass N. Reproductive Coercion, Intimate Partner Violence, and Unintended Pregnancy Among Latina Women. J Interpers Violence 2022; 37:1604-1636. [PMID: 32486886 PMCID: PMC8162928 DOI: 10.1177/0886260520922363] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Reproductive coercion (RC) describes a range of behaviors that restrict reproductive autonomy including pregnancy coercion, birth control sabotage, and controlling the outcome of a pregnancy. RC is associated with pregnancies that are mistimed and unwanted (i.e., unintended). Past research demonstrates that Latina women have higher risk for RC and for unintended pregnancy. This cross-sectional descriptive study with Latina women (n = 482) examined prevalence and risk factors for RC, evaluated the association of RC and unintended pregnancy among women with a past-year pregnancy, and explored use of safety and harm reduction strategies. A tablet survey was administered to women attending a community health center, between the ages of 15 and 45, who self-identified as Latina and who had a dating or sexual partner in the past year. Approximately one in six (16.8%) experienced past-year RC and risk factors included younger age (adjusted odds ratio [AOR] = 0.95, 95% confidence interval [CI] = [0.91, 1.00], p = .038) and concurrent intimate partner violence (IPV; AOR = 4.47, 95% CI = [2.06, 9.70], p < .001). IPV questions were specific to the partner involved with RC behaviors. For the 185 participants who reported a past-year pregnancy, RC was associated with lower pregnancy planning scores (β = -.27, 95% CI = [-0.41, -0.13], p < .001). The combination of experiencing RC and IPV appeared particularly potent in lowering pregnancy planning scores (β = -.15, 95% CI = [-0.29, 0.00], p = .052). Approximately 10.6% of participants engaged in harm reduction strategies, most commonly ending an unhealthy or abusive relationship (6.1%) and using less detectable methods of contraception so that partners would not find out (3.4%). The study articulates the risk of RC and its intersection with IPV and unintended pregnancy for Latina women. Providers working with racially and ethnically marginalized women have an important role in promoting safety and harm reduction strategies that include offering less detectable methods of contraception and support in leaving unhealthy and abusive relationships.
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Affiliation(s)
| | - Michele R Decker
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Nancy Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Nancy Glass
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
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Moulton JE, Corona MIV, Vaughan C, Bohren MA. Women's perceptions and experiences of reproductive coercion and abuse: a qualitative evidence synthesis. PLoS One 2021; 16:e0261551. [PMID: 34932570 PMCID: PMC8691598 DOI: 10.1371/journal.pone.0261551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Reproductive coercion and abuse is a major public health issue, with significant effects on the health and well-being of women. Reproductive coercion and abuse includes any form of behaviour that intentionally controls another person's reproductive choices. The aim of this qualitative evidence synthesis is to explore women's experiences of reproductive coercion and abuse globally, to broaden understanding of the different ways reproductive coercion and abuse is perpetrated, perceived and experienced across settings and socio-cultural contexts. METHOD We searched Medline, CINAHL and Embase for eligible studies from inception to 25th February 2021. Primary studies with a qualitative study design that focused on the experiences and perceptions of women who have encountered reproductive coercion and abuse were eligible for inclusion. Titles and abstracts, and full texts were screened by independent reviewers. We extracted data from included studies using a form designed for this synthesis and assessed methodological limitations using CASP. We used Thomas and Harden's thematic analysis approach to analyse and synthesise the evidence, and the GRADE-CERQual approach to assess confidence in review findings. RESULTS We included 33 studies from twelve countries in South Asia, the Asia Pacific, North America, South America, Africa and Europe. Most studies used in-depth interviews and focus group discussions to discuss women's experiences of reproductive coercion and abuse. Reproductive coercion and abuse manifested in a range of behaviours including control of pregnancy outcome, pregnancy pressure or contraceptive sabotage. There were a range of reasons cited for reproductive coercion and abuse, including control of women, rigid gender roles, social inequalities and family pressure. Women's different responses to reproductive coercion and abuse included using covert contraception and feelings of distress, anger and trauma. Across contexts, perpetration and experiences of reproductive coercion and abuse were influenced by different factors including son preferences and social exclusion. CONCLUSIONS We reflect on the importance of socio-cultural factors in understanding the phenomenon of reproductive coercion and abuse and how it affects women, as well as how the mechanisms of power and control at both individual and societal levels work to perpetuate the incidence of reproductive coercion and abuse against women.
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Affiliation(s)
- Jessica E. Moulton
- Gender and Women’s Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Martha Isela Vazquez Corona
- Gender and Women’s Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Cathy Vaughan
- Gender and Women’s Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Meghan A. Bohren
- Gender and Women’s Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
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Abstract
BACKGROUND Reproductive coercion and abuse (RCA) is a hidden form of violence against women. It includes behaviours intended to control or dictate a woman's reproductive autonomy, for the purpose of either preventing or promoting pregnancy. MAIN TEXT In this commentary, we argue that there is a lack of conceptual clarity around RCA that is a barrier to developing a robust evidence base. Furthermore, we suggest that there is a poor understanding of the way that RCA intersects with other types of violence (intimate partner violence; sexual violence) and-as a result-inconsistent definition and measurement in research and healthcare practice. To address this, we propose a new way of understanding RCA that centres perpetrator intent and the presence of fear and/or control. Recommendations for future research are also discussed. CONCLUSION We suggest that IPV and SV are the mechanisms through which RCA is perpetrated. In other words, RCA cannot exist without some other form of co-occurring violence in a relationship. This has important implications for research, policy and healthcare practice including for screening and identification of women in reproductive healthcare settings.
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Affiliation(s)
- Laura Tarzia
- Department of General Practice, The University of Melbourne, Level 2, 780 Elizabeth Street, Melbourne, VIC, 3010, Australia.
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, VIC, Australia.
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Level 2, 780 Elizabeth Street, Melbourne, VIC, 3010, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, VIC, Australia
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Sansone A, Limoncin E, Colonnello E, Mollaioli D, Ciocca G, Corona G, Jannini EA. Harm Reduction in Sexual Medicine. Sex Med Rev 2021; 10:3-22. [DOI: 10.1016/j.sxmr.2021.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/21/2021] [Accepted: 01/24/2021] [Indexed: 12/22/2022]
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