Doctors, Just Ask

Reproduction coercion, a term used to describe tactics men use to control the reproductive lives of their partners, is very common in relationships that involve violence. Coercive tactics can include forcing women to have sex or perform sex acts they find distasteful, refusing to use or interfering with the use of contraceptives, forcing women to carry unwanted pregnancies to term, or forcing women who would choose to carry a pregnancy to term to have an abortion. Reproductive coercion is present in the lives of many teenage girls who become pregnant.

A new study reveals that all doctors and other health professionals need to do to reduce the prevalence of reproduction coercion is to ask women about it.

In two of the clinics, women patients were asked whether their boyfriends had pressured them to get pregnant (for instance, by threatening to dump them if they didn’t get knocked up). Clinic workers also asked patients whether their boyfriends had sabotaged their birth control (such as by breaking condoms on purpose or hiding birth control pills).

In the two comparison clinics, patients were treated as usual.

Three to six months later, researchers followed up with all of the patients to see if they had been coerced into getting pregnant. Among women who were recent victims of intimate partner violence, the patients who were asked about pregnancy coercion and birth control sabotage were 71% less likely to become pregnant against their will, according to the study. They were also more likely to break up with their boyfriends – 52% of them did, compared with 45% of their counterparts who were treated at the clinic where pregnancy coercion and birth control sabotage weren’t discussed.

The results were published online this week in the journal Contraception.

The researchers speculated that the higher rate of break-ups contributed to the lower rate of unwanted pregnancies. The findings suggest that educating women about pregnancy coercion and birth control sabotage can empower women to get out of unsafe relationships.

If all it takes to reduce the rate of reproductive coercion is talking about it, please talk about it! Talk about it with your doctor or other healthcare providers and encourage them to contact their local domestic violence agency for tips on discussing it with their patients. Or, if you are a healthcare provider, please begin asking the question and have the phone number or pamphlet of your local domestic violence advocacy agency close at hand for those who need it. How could you justify not doing something so simple that can have such an impact on a woman's life?