What women and men need to know about reproductive coercion

January 14, 2020

Shivani Patel, M.D. Obstetrics and Gynecology

Kathryn O'Donnell, Ph.D. Associate Professor of Molecular Biology

Woman holding contraceptive pills in her hands. — Tampering with, hiding, or destroying someone’s birth control method is a form of intimate partner violence.

Replacing a partner’s birth control pills with sugar pills or poking holes in a condom sounds like a plotline from a TV drama. But these scenarios don’t just play out on the screen. It's reality for some patients and is known as reproductive coercion.

This type of abuse occurs when a person exerts power and control over another person's reproductive health and decisions. The term may be unfamiliar, but the situation is much more common than people realize. An August 2019 study found that of 550 sexually active high school females, one in eight had experienced reproductive coercion in the past three months.

If you or a loved one suspect you are being coerced, your Ob/Gyn can help identify the signs and connect you with resources to help navigate the situation.

“Reproductive coercion comprises a range of behaviors, but regardless of which are used, it’s important to understand that it is abuse.”

Shivani Patel, M.D.

Types of reproductive coercion

As with any type of intimate partner violence, reproductive coercion is primarily focused on gaining power in a relationship.

The partner might do this by:

Refusing to use a condom or other form of contraception
Lying about using a method of birth control, such as getting a vasectomy
Sabotaging birth control methods, such as tampering with birth control pills or poking a hole in a condom
Hiding or destroying contraception
Withholding money to purchase birth control
Failing to use an agreed-upon pull-out method
Physically removing contraception, such as a vaginal ring
Purposely trying to give a partner a sexually transmitted infection
Pressuring, guilting, or shaming a partner about their decision whether to have children
Forcing a woman to get an abortion, or preventing her from getting one

Reproductive coercion can, at times, even be a form of physical abuse.

If a woman becomes pregnant, the abuser might use the child to maintain power and control. For example, the abuser might say they will take the child away if the other parent doesn’t do as they're told. However, the abuser isn’t always an intimate partner. They can be family members as well.

It’s also important to note that reproductive coercion is often not the only form of abuse a victim is experiencing. In the study of high school females, those who experienced reproductive coercion were also more likely to experience physical and sexual abuse.

Women who experience intimate partner violence often receive little or no prenatal care. Because of this, they are at higher risk of adverse pregnancy outcomes, such as low birth weight, preterm birth, or stillbirth. This is just one of the reasons we screen for intimate partner violence during prenatal exams.

Pregnant woman in a hijab talking to a doctor.

More resources

National organizations recommended by ACOG include:

Rape Abuse & Incest National Network (RAINN) Hotline: 1-800-656-HOPE (4673)Futures Without Violence (previously known as Family Violence Prevention Fund)National Coalition Against Domestic Violence National Network to End Domestic Violence National Resource Center on Domestic Violence Office on Violence Against Women (U.S. Department of Justice)

Get help from your provider

We encourage women (and men) to confide in their health care providers if they are experiencing any form of intimate partner violence. We are here to provide support and resources.

During annual health maintenance exams or prenatal exams, we ask questions related to mental health and intimate partner violence. The American College of Obstetricians and Gynecologists (ACOG) recommends these screening questions related to reproductive coercion:

Has your partner ever forced you to do something sexually that you did not want to do?
Has your partner ever refused your request to use condoms?
Has your partner ever tried to get you pregnant when you did not want to be?
Are you worried your partner will hurt you if you don't follow their wishes regarding the pregnancy?
Does your partner support your decisions about when or whether you want to become pregnant?

Along with providing support and resources, we also can talk about discreet and confidential methods of contraception, such as IUDs with shorter strings, birth control injections or implants, emergency contraception, or birth control pills in anonymous packaging.

Above all, know that you are not alone. We are ready to provide support and assistance.

If you feel the need for anonymity, additional resources are available. The National Domestic Violence Hotline at 1-800-799-SAFE (7233) provides highly trained advocates 24/7 to talk confidentially with anyone experiencing domestic violence, seeking resources or information, or questioning unhealthy aspects of their relationship.