By Sonia Elks
LONDON, Jan 7 (Thomson Reuters Foundation) - Up to three in 10 women seeking family planning healthcare in the United States have suffered coercive control over their reproductive choices, researchers said on Monday.
Women experienced abuse ranging from pressure over reproductive choices to deliberate sabotage of contraception to threats of violence if they did not comply, a review of studies in the journal "BMJ Sexual & Reproductive Health" found.
"It's something that I think is still a bit unrecognised," lead author Professor Sam Rowlands told the Thomson Reuters Foundation.
"Reproductive control does not necessarily have any violence in it but there's obviously quite an overlap with intimate partner violence."
Control over family planning is widely recognised as a human right and experts say being able to prevent unwanted childbirth can improve women's access to education and work, helping to break cycles of poverty.
However, the review found that coercion of women – usually by a male partner – appears to be common.
The authors defined reproductive coercion as including a wide range of behaviours that have an impact on a woman's ability to take charge of her body and family planning choices.
It ranged from emotional blackmail to sabotage such as piercing condoms or throwing out contraceptive pills and so-called "stealthing" where a man secretly removes a condom during sex without consent.
It also included women who were coerced either to continue a pregnancy or have an abortion against their will.
A review of nine U.S. studies of women seeking family planning or other healthcare found between 8 percent and 30 percent reported some form of reproductive control being held over them.
Young women and those from minority backgrounds appeared to be more vulnerable, the research found.
The extent of pressure ranges from mild to extreme: some women might not realise they are being subjected to unhealthy or abusive behaviour, especially if it is not accompanied by threats or violence, the authors said.
They called on healthcare experts to question women who were seeking reproductive care services about their family planning with their partner to identify those at risk and offer advice.
The issue is not limited to the United States, Ann Moore of the Guttmacher Institute, a research organisation focusing on sexual and reproductive issues, said.
Moore said she had heard "harrowing" stories of reproductive coercion from India to Zambia.
"Once you start looking for it, it is very universal, unfortunately," she said.
"It is no doubt leading to unhealthy reproductive health outcomes where women are deprived of the ability to use the contraceptive method that they feel is best for them."
She added the study highlighted a lack of high quality data on the subject outside the United States and called for more research. (Reporting by Sonia Elks @soniaelks; Editing by Jason Fields. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women's and LGBT+ rights, human trafficking, property rights, and climate change. Visit http://news.trust.org)
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