As many as one in four women attending sexual health clinics in the United States reported they don’t have control over their own reproductive lives, British researchers say.
The patients' partners were controlling contraceptive use and/or whether they conceived or continued with a pregnancy, a medical and social science database review published today in BMJ Sexual & Reproductive Health concluded.
"The behaviours are about trying to get her pregnant one way or another, so either encouraging her to have a family, to discontinue contraception, and if that doesn't work, influencing condom use," the study's coauthor, professor Sam Rowlands of Bournemouth University, told BuzzFeed News.
"This could involve 'stealthing' – actually taking a condom off during sex when this has not been the agreement or actually puncturing the condom – or it could involve confiscating her [contraceptive] pills, tearing off her [contraceptive] patch or, most violently, pulling out [an intrauterine device].
"What was surprising was that it was so very common."
The documented rate of reproductive coercion varied between studies, but Rowlands said an average of 1 in 4 women in the United States have experienced it.
Rowlands, who has worked as a clinician in sexual and reproductive health for decades, said doctors need to be aware of why their patients might be requesting emergency contraception or abortion repeatedly.
"Some women will come in and request contraception that 'he won't know about', so the classic one is a contraceptive injection because you can't see where the needle went in, or having an [intrauterine device] with the threads cut very short so he can't feel it."
There is a positive correlation between controlling and violent relationships and the likelihood of an unwanted pregnancy, he said.
Rowlands said while coercing a woman into a pregnancy was the most prevalent theme in the examined literature, there were also cases of women being coerced into having an abortion and even having her drink spiked with abortifacient pills.
"The research we looked at is mainly in America, a few Asian countries, and in Africa, but we think it is important that more research is carried out so Europe is represented."
The report concludes that reproductive control infringes on women's reproductive rights and erodes their reproductive autonomy.
In November, national not-for-profit sexual and reproductive health service provider Marie Stopes Australia released a policy white paper on reproductive coercion. The paper is the culmination of a 20-month consultation process with key stakeholders from across the health, academic, legal, media, and political sectors.
"The findings of the [research released today] are in line with what we found when researching the reproductive coercion white paper," Marie Stopes Australia chief executive Michelle Thompson told BuzzFeed News.
"We suspect that the rate of coercion, i.e., 1 in 4 women experiencing some form of coercion, is about the same in Australia."
Thompson said further research is needed into what drives reproductive coercion on both an interpersonal and structural level.