Brown Medicine asked Associate Professor of Medicine (Clinical) and Obstetrics and Gynecology (Clinical) Amy S. Gottlieb, MD, and Assistant Professor of Obstetrics and Gynecology Rebecca H. Allen, MD, MPH, to explain the issue and describe their study published in the American Journal of Obstetrics and Gynecology.
Reproductive coercion—or RC—is male behavior to control contraception and pregnancy outcomes of female
partners. It can include pregnancy coercion, such as threatening to harm a woman physically or end the relationship if she does not become pregnant; and birth control sabotage, such as flushing oral contraceptive pills down the toilet, intentionally breaking or removing condoms, or inhibiting a woman’s ability to obtain contraception. Since RC is about fertility control and not a particular reproductive outcome, it can also involve pressuring a female partner to terminate a pregnancy.
Nationwide, at least 9 percent of women in the US have experienced RC. Recently at Women & Infants Hospital’s Women’s Primary Care Center, we and our colleagues asked 632 women presenting for routine obstetrics and gynecology care about experiencing RC. Our study was the first to assess RC among a general obstetrics and gynecology population and affirmed findings of previous investigations done in more specialized settings like family planning clinics. We found that 16 percent of women reported experiencing RC currently or in the past. Among these women, almost one-third said RC occurred within a physically abusive relationship.
Health professionals who care for reproductive-aged, heterosexual women should address RC in the clinical setting. RC impacts a woman’s ability to use contraception and/or plan her own pregnancies. It has significant implications for providers’ efforts to promote reproductive health and family planning. Furthermore, when RC is identified, a female patient who desires contraception can be offered hidden forms of birth control like a contraceptive injection or intrauterine device.
Physicians and allied health professionals are well placed to identify reproductive coercion and lessen its impact on the health and well-being of our patients and their families.