The nation's leading group of women's reproductive health experts says health providers should screen women and girls for "reproductive coercion" in a new report.
In a committee opinion, the American College of Obstetricians and Gynecologists defined reproductive coercion as an "explicit [attempt]" to:
– "impregnate a partner against her will,"
– "control outcomes of a pregnancy,"
– "coerce a partner to have unprotected sex,"
– "and interfere with contraceptive methods."
A man's hiding or sabotaging his partner's birth control would be an example, wrote the college, whether that means poking holes in condoms or intentionally not pulling out on time. It also mentioned "pregnancy pressure," which includes:
– "coercive behavior such as threats or acts of violence if a partner does not" agree with a man on whether to become pregnant or get an abortion,
– "forcing a partner to carry a pregnancy to term" or, conversely, forcing her to have an abortion under threat of violence,
– and "injuring a female partner in a way that may cause a miscarriage."
The opinion says coercion like this is an indicator of physical or sexual violence, which have been strongly linked to "poor reproductive heath outcomes." One of those outcomes is unintended pregnancies; another is exposure to sexually-transmitted diseases.
Among the college's recommendations:
– Health providers should get up-to-speed on what it means for a woman to be reproductively coerced.
– Women and teen girls should be screened routinely for signs of coercion.
– Health providers should offer patients birth control that are "less detectable" to partners – intrauterine devices (IUDs) or the contraceptive implant or injection, for example.
– Health providers should be particularly aware of the possibility of reproductive coercion when they see patients for pregnancy testing, STD testing, emergency contraception (the morning-after pill) or unintended pregnancies.
In the opinion, the group also described "sexual coercion," which refers to nonphysical methods of pressuring someone to have sex, whether or not that person wants to. That may mean threatening to end a relationship or repeatedly pressuring someone to have sex.
Photo by outcast104 via Flickr Creative Commons.