September 9, 2015 — Health care providers must learn to recognize and screen for acts of reproductive coercion, such as sabotaging a woman's birth control or controlling a woman's reproductive choices, according to a review published last month in the American Journal of Obstetrics and Gynecology, Reuters reports.
Forms of Reproductive Coercion
According to Reuters, there are several different types of reproductive coercion. For example, a perpetrator of reproductive coercion could sabotage a woman's birth control by hiding or destroying contraceptive pills, removing contraceptive devices such as vaginal rings, patches or intrauterine devices without their partner's consent, removing or damaging condoms or failing to withdraw when that was the mutually agreed upon method of contraception.
Reproductive coercion also can occur when a perpetrator threatens to leave or harm a woman if she either does or does not carry a pregnancy to term, depending on the perpetrator's desires.
Victims of Reproductive Coercion
According to Rebekah Gee, associate professor of health policy and management and obstetrics and gynecology at Louisiana State University, women who are most vulnerable to reproductive coercion tend to have little education, be low-income or rely on partners for financial support.
However, Gee, who was not part of the review, noted, "Intimate partner violence happens (to women in) all races, socioeconomic classes, all levels of education." She added, "It doesn't spare anyone, and I ask every single patient."
While women most commonly are victims of reproductive coercion, the authors noted that men also can experience reproductive coercion. They said future studies should look into how men and lesbian, gay, transgender or bisexual individuals can be affected by reproductive coercion.
Identifying Reproductive Coercion
The researchers noted that health care providers and victims often do not recognize reproductive coercion.
Lead author Jeanna Park of the University of Illinois in Chicago said providers must be aware of the signs. "Providers may suspect (reproductive coercion) when a patient has a known history of intimate partner violence, expresses a desire to obtain contraception but repeatedly loses her prescription or changes her contraceptive method frequently, presents with frequent unintended pregnancies or sexually transmitted infections, or appears apprehensive of her partner discovering her contraceptive or pregnancy choices," she said.
Park added, "Screening can be performed in conjunction with, or independent of, intimate partner violence screening with an open ended question like, 'what challenges have you had with your current or previous contraceptive methods?'"
She also noted that the National Health Resource Center on Domestic Violence in partnership with the American College of Obstetricians and Gynecologists offers a comprehensive screening and assessment script for providers. Park recommended that providers discuss discrete methods of birth control with women who choose to stay with perpetrators of reproductive coercion (Doyle, Reuters, 9/4).