Attacks on women's reproductive freedom don't just come from our courts and politicians. They also come from our bedrooms and partners. Reproductive coercion is abuse. And it happens any time a man tries to control a woman's decision about pregnancy.
An American College of Obstetricians and Gynecologists committee wants to help stop it, according to an opinion they published today in the latest issue of Obstetrics & Gynecology. The committee wrote that it doesn't know just how common reproductive coercion is in general, but that "birth control sabotage" was reported by 25% of teen girls with abusive partners and by 15% of women who were physically abused. Some women had their IUD or vaginal contraceptive ring pulled out. Other cases range from rape, to removing a condom during sex, to hiding a woman's birth control. Reproductive coercion often includes trying to impregnate a woman against her will and can include using threats to pressure a woman to continue an unwanted pregnancy or, on the other hand, terminate a desired pregnancy.
"Often, it's about taking away choices, taking away freedom, control and self-esteem," says Rebekah Gee, an obstetrician and gynecologist in New Orleans and assistant professor at Louisiana State University, who has studied the problem but did not work on the opinion.
The committee wants to raise awareness about reproductive abuse: "We want to make sure that health care providers are aware that this is something that does go on and that it's a form of abuse," says Veronica Gillispie, an obstetrician and gynecologist at Ochsner Health System, New Orleans.
But they are also encouraging OB/GYNs to ask their patients questions to assess whether reproductive abuse is occurring, educate patients that it does indeed exist, and help patients fight it. OB/GYNs can help by directing their patients to agencies and hotlines like the National Domestic Violence Hotline at 1-800-799-SAFE (7233). But they can also take more direct approaches by providing women with contraception that is hard to detect, like IUDs with the removal strings cut or emergency contraceptive pills in unlabeled envelopes.
There is evidence that these measures help reduce the rates of abuse, according to Rebecca Levenson, senior policy analyst at Futures Without Violence, a non-profit advocacy group based in San Francisco. In one small study, reports of reproductive coercion dropped 71% among women who got information and questionnaires about it.
This is a very important step in fighting reproductive coercion and one that deals in the reality of the here and now. Just as important, though, is prevention. Anne Teitelman, an associate professor of nursing at the University of Pennsylvania, and a nurse practitioner, who often hears about sexual and reproductive coercion from her patients agrees. She thinks talking about reproductive coercion is extremely important because, "if we don't ask the questions, often patients don't realize that there's something they can do to change the situation." But she sees prevention programs as the next step that help "both young girls and young boys" avoid abusive relationships.