It is time to talk about Reproductive Coercion
We are letting thousands of women down by failing to acknowledge reproductive coercion, and the issue is likely even greater for society’s most vulnerable women.
The front page of the October Issue of the British Medical Journal highlighted the issue of reproductive coercion (RC) to medical professionals. Reproductive coercion refers to actions taken by a person’s partner or family member to prevent or promote pregnancy despite the person’s wishes.
It is often part of other forms of intimate partner violence, most commonly coercive control. Coercive control occurs when an abuser isolates their victim and prevents them from accessing support or having any form of independence, and may make it impossible for the victim to access healthcare, including reproductive health services, without surveillance or under duress. Whilst Section 76 of the Serious Crime Act 2015 made coercive behaviour a criminal offence, reproductive coercion can be much more difficult for the victim to acknowledge and professionals to spot.
It can be displayed through a wide range of behaviours from applying pressure to an individual to conceive, sabotaging contraception and preventing use of contraception, threating an individual to conceive/not conceive, administering abortion medication and physically abusing an individual to induce miscarriage. Whilst it is most often seen the context of heterosexual relationships, with a male perpetrator, this is not always the case. Significantly, it can also be perpetrated by a family member.
As those experiencing reproductive coercion can find the abuse difficult to disclose, or even struggle to recognise it as abuse themselves, the scale of the problem is difficult to ascertain. However, research that has been undertaken globally illustrates that some women may be at greater risk than others, including those that who do not speak English as their first language, those experiencing mental health problems, those who are unemployed / economically disadvantaged or those with substance misuse problems. Those from cultural backgrounds where having a large family or having a male child is a priority may find themselves at particular risk.
It is vital that we start to ensure that those in contact with those most at risk of reproductive coercion are more aware.
Those from cultural backgrounds where having a large family or having a male child is a priority may find themselves at particular risk
As Dr Rebecca Holdsworth, one of the co-authors of the British Medical Journal article, says: “It’s vital that GPs recognise and discuss the signs of RC with patients and know how to support patients with relevant and holistic resources and care. Normalising the conversation about RC will ensure it becomes integrated into day-to-day practice and patients will become more aware and empowered to understand RC and its impact”
Earlier this year, the BBC undertook a large survey of 1000 women for an episode of their File on 4 documentary series, Controlling my Birth Control. The survey revealed that 50 per cent had experienced a form of reproductive coercion at some point. One in 10 revealed that their contraception had been tampered with or they had experienced ‘stealthing’ – removing the condom without consent during sex – which is classed as a form of sexual assault under UK law. This survey reveals the magnitude of the problem is much greater than many think.
This is also not just an issue for health providers. It is imperative that we incorporate discussions on reproductive coercion within education on sexual consent. Our failure to acknowledge the scale of this problem is leaving many open to abuse and devastating consequences in its wake.
Dr Annabel Sowemimo is a community sexual and reproductive health registrar and the founder and co-director of Decolonising Contraception
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