Why We Need To Talk About Reproductive Coercion

Birth control sabotage. Forced pregnancy and abortion. Emotional manipulation. Reproductive coercion is a form of domestic violence, stripping women of their bodily autonomy.

“I recall a patient who came to see us at one of our Melbourne clinics. She had flown from Sydney because she did not want her partner to know she was pregnant and having a termination. Her partner had hidden her contraceptive pills and refused to use contraception himself. She was in the process of leaving this quite controlling and abusive relationship. She knew that if she continued this pregnancy, her chances of leaving and regaining control of her life were quite slim.”

This is what Michelle Thompson, CEO of Marie Stopes Australia, said when I asked her why her organisation had released a draft white paper on reproductive coercion.

You may have heard the term ‘reproductive coercion’ being talked about a bit in the media lately. The term was coined in 2010, but it hasn’t been until recently that researchers have started taking a hard look into what causes it, and its serious health implications for women and wider communities. Usually, it is used in reference to intimate partner violence, or domestic violence -- any situation where a partner forces a woman into continuing or terminating a pregnancy against her will.

While there hasn't been a significant amount of research done in Australia, Queensland organisation ‘Children by Choice’ estimates that reproductive coercion from a male partner is a factor in one in seven of the women they have contact with. That figure rises to one in five for women from culturally and linguistically diverse backgrounds. And this is only women who are looking into, or being forced into, accessing abortions.

Another form of reproductive coercion is when a partner forces the other to continue with an unwanted pregnancy. This is even harder to research, as many of these women will not present to medical professionals seeking an abortion.

However, there is evidence that we need to be looking at reproductive coercion through a much broader lens if we are going to understand just how truly widespread and insidious it may be. The recently released draft white paper from Marie Stopes Australia revealed that there are many more forces at play that can coerce a woman into falling (or not falling),  or staying (or not staying) pregnant.

What is reproductive coercion?

This may seem like a simple question, but it’s actually hard to answer. Because the area is so under-researched, there is no single definition.

“As a sexual and reproductive health provider, we see first-hand what happens when someone is not in control of their reproductive decisions,” Marie Stopes Australia CEO Michelle Thompson said.

“While the instances of coercion we see are generally intimate partners or families coercing a woman, we know that the issue is much broader than this. It gets back to the pressures that are on women when it comes to their reproductive decisions. That can be driven by workplace culture, practice, media, law and even our tax system.”

Reproductive coercion may most simply be defined as anything that affects if, when and how a woman decides to have children.

What causes reproductive coercion?

Usually, domestic and intimate partner violence are listed as the main causes of reproductive coercion, and a study by the Association of Reproductive Health Professionals 2010 found that women in abusive relationships were more likely to be affected.

A 2014 study by California health researchers indicated that women in an abusive relationship were twice as likely to have a male partner refuse contraception.

In Australia, the rates of domestic and intimate partner violence are high. According to research from Our Watch, a quarter of Australian women have experienced sexual or physical violence by an intimate partner in their lifetime.

Given the prevalence of domestic violence, it is absurd that reproductive coercion has not been a bigger part of the national conversation.

(Image: Getty Images)

While reproductive coercion from a violent or abusive partner poses the most serious health and well-being risks to a woman and any children she may bear, evidence shows there are a number of societal factors that influence reproductive autonomy, that women simply may not be aware of.

The laws around abortion in Australia (fact: it’s still a criminal offence in three states, although Queensland is moving to decriminalise it), the ability of a woman to access an abortion, her ability to pay for and procure contraception or an abortion, the media, maternity leave, workplace culture, familial influences, religious influences and Australia’s political landscape are all examples of things that may consciously or unconsciously influence if, when and how a woman decides to have children, and should be acknowledged as such.

It is also important to acknowledge that there is very little research that looks at how reproductive coercion may affect people in the LGBTQI community, women with a disability or people who are not in heterosexual, cisgender relationships.

“The little research there is about reproductive coercion shows that women are disproportionately affected. However reproductive coercion can affect men and is not exclusive to people in heterosexual, cisgender relationships. We really want to explore the different experiences of reproductive coercion through this white paper.” Thompson said.

What are the consequences of reproductive coercion?

That’s an area where more research needs to be done. In instances where reproductive coercion is a product of intimate partner violence, however, studies show when a woman experiences an unplanned or unintended pregnancy, both her health outcomes and those of the child are worse.

Research indicates the negative impacts of reproductive coercion on women include:

  • Poor mental health, including anxiety, depression, self-harm and PTSD
  • Higher rates of abortion and miscarriage, as well as higher rates of pregnancy complications
  • Higher rates of unsafe abortions
  • Higher rates of sexually transmitted infections

Evidence also suggests women who are victims of reproductive coercion are more likely to be suffering from alcohol and drug dependencies and other physical injuries from an abusive partner.

WHAT ABOUT MEDIA INFLUENCE?

Researchers are keen to investigate whether the narrative of ‘engaged, married, pregnant, baby,’ -- often played out in movies, TV and in news media (currently being played out with Harry and Meghan this year) -- could in fact be a more subtle form of reproductive coercion.

“The way couples and particularly women in couples are portrayed in the media can drive reproductive coercion. For instance, when Prince Harry and Meghan Markle were married, the very next day media were covering stories about their children. The couple hadn’t even gone on their honeymoon yet there was this assumption that she would bear children,” Thompson said.

Image: Getty.
“Now it may well be that the Royal couple will choose to have children, but it is the mass society-wide assumption that a woman is newly married, therefore she will go on to have children. That can be a dangerous, coercive assumption.”
What can we do about it?

Reproductive coercion is yet another example of a serious health and well-being issue predominantly affecting women that is just not being taken seriously, and that needs to change. Particularly for women from culturally and linguistically diverse backgrounds, women with a disability and the LGBTQI community, there is little to no research about how reproductive coercion affects them.

Without proper research, we will never be able to gauge the true scope of the problem, or combat it.

We must be aware of conscious and unconscious influences, talk about them, and call on policy makers to fund research so we can make real change, if we ever want to ensure women are able to exercise their rights to full reproductive autonomy.

If you or someone you know is in immediate danger, dial 000. If you need help and advice, call 1800Respect on 1800 737 732, or Lifeline on 13 11 14. A range of domestic and family violence resources based around the country can be found here.