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Lévesque S, Jean-Thorn A, Rousseau C. A Latent Class Analysis of Reproductive Coercion Experiences Based on Victim-Survivors' Acknowledgment and Disclosure Patterns. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241259409. [PMID: 38898711 DOI: 10.1177/08862605241259409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
Reproductive coercion (RC) is a form of violence involving behavior that interferes with an individual's contraceptive and reproductive decisions. Like other forms of violence perpetrated by intimate partners, victims of RC do not necessarily identify it as such. Similarly, victim-survivors do not readily disclose their experiences or seek support and treatment. This study identifies patterns of acknowledgment and formal and informal disclosure of RC experiences in a community sample of 317 participants. Latent classes are then compared with respect to characteristics of victims/survivors, RC consequences, and associated contexts. Participants completed measures to assess experiences of RC and violence perpetuated by intimate partners as well as social support, posttraumatic stress symptoms, and consequences for psychological and sexual health. Latent class analysis was performed to identify acknowledgment and disclosure patterns. An optimal three-class solution was selected: High unacknowledgment with ambivalence, High disclosure (41%); High acknowledgment, High disclosure (30%); and Hesitant acknowledgment, No disclosure (29%). Classes were identified according to the presence of social support, living with a disability, victimization experiences, and mental and sexual health consequences. Future studies should explore the relationship between RC acknowledgment and disclosure, which can influence victims' search trajectories for support and services.
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Thomas HL, Bell SO, Karp C, Omoluabi E, Kibira SP, Makumbi F, Galadanci H, Shiferaw S, Seme A, Moreau C, Wood SN. A qualitative exploration of reproductive coercion experiences and perceptions in four geo-culturally diverse sub-Saharan African settings. SSM. QUALITATIVE RESEARCH IN HEALTH 2024; 5:100383. [PMID: 38911288 PMCID: PMC11190838 DOI: 10.1016/j.ssmqr.2023.100383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/22/2023] [Accepted: 12/13/2023] [Indexed: 06/25/2024]
Abstract
Reproductive coercion (RC) is any intentional behavior that interferes with another's reproductive decision-making or pregnancy outcome. This study aims to qualitatively examine RC experiences and perceptions among women and men in Ethiopia, Nigeria (Kano and Anambra States), and Uganda. This is a secondary analysis utilizing qualitative data from the Women's and Girls' Empowerment in Sexual and Reproductive Health study. Across sites, focus group discussions (38 groups; n=320 participants) and in-depth interviews (n=120) were conducted, recorded, and transcribed. Transcripts were loaded into Atlas.ti, and quotes describing experiences of reproductive control or abuse were coded as "reproductive coercion." RC quotes were input into a matrix for thematic analysis. Emergent RC themes included indirect reproductive pressures, direct family planning interference, concurrent experiences of violence, and responses to RC. Indirect reproductive pressures included tactics to both promote and prevent pregnancy, while direct interference centered on pregnancy promotion. Women who were not compliant with their partners' reproductive demands were often subjected to violence from multiple actors (i.e., parents, in-laws, community members) in addition to their partners. Despite concurrent forms of violence, women across sites resisted RC by using contraceptives covertly, choosing to abort, or leaving their abusive partnerships. Women and men across sites indicated that men were highly influential in fertility. RC behaviors were a mechanism of control over desired reproductive outcomes, which were often rooted in perceptions of childbearing as social status. Findings indicate a need for more nuanced community interventions targeting social norms, as well as improved RC screening and response within health services.
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Affiliation(s)
- Haley L. Thomas
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Suzanne O. Bell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Celia Karp
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | | | | | - Hadiza Galadanci
- Center for Advanced Medical Research and Training, Bayero University Kano, Nigeria
| | - Solomon Shiferaw
- Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Ethiopia
| | - Assefa Seme
- Department of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Ethiopia
| | - Caroline Moreau
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Soins Primaires et Prévention, CESP Centre for Research in Epidemiology and Population Health, U1018, Inserm, F-94800, Villejuif, France
| | - Shannon N. Wood
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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Tarzia L, McKenzie M. Reproductive coercion and abuse in intimate relationships: Women's perceptions of perpetrator motivations. PLoS One 2024; 19:e0299069. [PMID: 38626011 PMCID: PMC11020648 DOI: 10.1371/journal.pone.0299069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/03/2024] [Indexed: 04/18/2024] Open
Abstract
Reproductive coercion and abuse is a hidden and poorly recognised form of violence against women. It refers broadly to behaviours that interfere with or undermine a person's reproductive autonomy, specifically to promote or prevent pregnancy. Reproductive coercion and abuse can involve physical, sexual, financial or psychological abuse in order to achieve these aims, and is overwhelmingly perpetrated by men against women. As an emerging field of scholarship, conceptual understanding of reproductive coercion and abuse is still in its infancy; however, it is often described as being linked to coercive control. In this article, we seek to highlight the complexity of this relationship through qualitative analysis of in-depth interviews with 30 victim/survivors in Australia recruited from the community, focusing on their perceptions of the perpetrator's motivations. We developed four themes from our analysis: 1) His needs came first; 2) The illusion of a perfect father; 3) Creating a weapon of control; and 4) My body was his. Perceived perpetrator motivations ranged from entitlement and self-interest to a deep desire for domination and entrapment. Pregnancy preventing behaviour was more likely to be linked with entitlement and self-interest, whereas pregnancy promoting behaviour tended to be described by participants in relationships where there was a broader pattern of ongoing control and entrapment. Thus, we suggest that coercive control is a motivating factor for some, but not all men who perpetrate reproductive coercion and abuse. A greater understanding perpetrator motivations may be important for practitioners, particularly those working in sexual and reproductive health services, since it could be relevant to women's level of risk for coercive controlling behaviour or more extreme forms of physical or sexual violence.
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Affiliation(s)
- Laura Tarzia
- Department of General Practice & Primary Care, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Mandy McKenzie
- Department of General Practice & Primary Care, The University of Melbourne, Carlton, Victoria, Australia
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Ibrahimi S, Youssouf B, Potts C, Dumouza A, Duff R, Malaba LS, Brunner B. United States Government-Supported Family Planning and Reproductive Health Outreach in the Democratic Republic of the Congo: Lessons Learned and Recommendations. Open Access J Contracept 2024; 15:13-21. [PMID: 38476860 PMCID: PMC10929168 DOI: 10.2147/oajc.s446263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Background In response to limited contraception availability and a lack of knowledge about family planning (FP) in the Democratic Republic of the Congo (DRC), the United States Agency for International Development (USAID) Integrated Health Program (IHP) in the DRC has been providing FP services, including outreach programs in the DRC. Our study aims to assess the FP outreach program by understanding the participants' perception of the campaign, its impact on their behavior, and their feedback regarding the campaign. Additionally, we draw insights from lessons learned and provide recommendations. Methods Between July and August 2022, we conducted 47 in-person participant interviews with women of reproductive age who used the outreach services provided by USAID IHP. Participants were randomly selected from Sud-Kivu, Kasai-Oriental, Haut-Katanga, and Tanganyika provinces. Consent and confidentiality were assured, and responses were recorded and transcribed in a Word document. We used Excel for data coding and analysis. Results The campaign reached 95.7% of women interviewed; however, some participants could not recall specific message details. Most respondents (89.3%) reported that the campaign motivated them to make FP decisions and change their behaviors. While 14.8% of women reported making FP decisions independently, 85.1% reported making the decision jointly with their partners. Our analysis resulted in three emerging themes: 1) Increased FP outreach and improved perception of FP, 2) Improved perceived behavioral changes due to FP outreach, and 3) The need for program improvement by including men and providing additional information about possible FP side effects. Implications Our study provides insights into how women receive information and whether they find it useful and share it with other women in their community. In particular, women's feedback about the FP outreach program and our recommendations can inform future policies and interventions.
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Affiliation(s)
- Sahra Ibrahimi
- International Development Division, Abt Associates, Rockville, MD, USA
- Department of Global Health, Denison University, Granville, OH, USA
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, USA
| | - Bamba Youssouf
- Matchboxology, Johannesburg, Gauteng, province, South Africa
| | - Christine Potts
- International Development Division, Abt Associates, Rockville, MD, USA
| | - Alexandre Dumouza
- International Development Division, Abt Associates, Rockville, MD, USA
| | - Rani Duff
- International Development Division, Abt Associates, Rockville, MD, USA
| | | | - Bettina Brunner
- International Development Division, Abt Associates, Rockville, MD, USA
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Bodin M. 'It wasn't what I was suited for': regretful mothers negotiating their reproductive decision and mother role. MEDICAL HUMANITIES 2024; 50:70-76. [PMID: 37977805 DOI: 10.1136/medhum-2023-012717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 11/19/2023]
Abstract
This study contributes to our understanding of why women without a longing to have children and who, in theory, have the possibility of refraining from parenthood still become mothers. The article is based on in-depth interviews with six Swedish mothers who never longed to have children in the first place. It illustrates how they make sense of their reproductive decision-making process and their current role as a mother. The analysis shows how reproductive decision-making is highly influenced by cultural perceptions of proper womanhood and the idea that every woman has an innate longing to have children, as well as other people's wishes and pressure. Although the mothers did their best to align with motherhood expectations, their narratives show that they are still oriented towards non-motherhood on an emotional level. This manifests through their experiences of existential regret about having children. Hence, the mothers' understandings of their path to motherhood reveal a complex conflict between outer expectations and inner wishes, which destabilises the idea of reproduction as a promise of happiness.
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Affiliation(s)
- Maja Bodin
- Centre for Medical Humanities, Uppsala University Department of History of Science and Ideas, Uppsala, Sweden
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Baritwa MS, Joho AA. Intimate partner violence influences modern family planning use among married women in Tanzania: cross-sectional study. BMC Public Health 2024; 24:421. [PMID: 38336740 PMCID: PMC10858459 DOI: 10.1186/s12889-024-17666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/04/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Married women who experience intimate partner violence (IPV) are less likely to negotiate with their partners on modern family planning (FP) use. This study aimed to determine the influence of intimate partner violence and sociodemographics on modern family planning use. METHODS A community-based cross-sectional study was conducted in the Mara region, Tanzania from April to July 2020. A total of 366 married women were interviewed. Data were collected using a structured interviewer-administered questionnaire. Analysis was done using SPSS version 25, and a binary logistic regression model was used to determine the predictors of modern FP use. The significance level was set at a p-value less than 0.05. RESULTS The overall prevalence of IPV was 73% with 54.1% physical, 36.3% psychological, and 25.4%, sexual violence. The prevalence of modern FP use was 62%, and the most (49.1%) common method practiced by married women was injection (Depo Provera). Physical violence (AOR = 0.32, p = 0.0056), and psychological violence (AOR = 0.22, p = 0.0022) had significantly reduced odds of modern FP use. Religion (AOR = 4.6, p = 0.0085), and availability of preferred modern FP methods (AOR = 9.27, p < 0.0001) had significantly increased odds of modern FP use. CONCLUSION In this study, there is a positive association between the use of modern FP methods and IPV. To prevent IPV and its negative health consequences, it is crucial to involve community leaders and primary healthcare workers. They can help in identifying the best strategies to prevent IPV and promote the use of modern FP methods. It is equally important to involve male partners in reproductive health decisions, including the use of modern FP methods. This approach will help reduce reproductive coercion.
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Affiliation(s)
- Mrimi S Baritwa
- Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Angelina A Joho
- Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania.
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Sheikh J, Allotey J, Kew T, Khalil H, Galadanci H, Hofmeyr GJ, Abalos E, Vogel JP, Lavin T, Souza JP, Kaur I, Ram U, Betran AP, Bohren MA, Oladapo OT, Thangaratinam S. Vulnerabilities and reparative strategies during pregnancy, childbirth, and the postpartum period: moving from rhetoric to action. EClinicalMedicine 2024; 67:102264. [PMID: 38314056 PMCID: PMC10837549 DOI: 10.1016/j.eclinm.2023.102264] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 02/06/2024] Open
Abstract
Maternal outcomes throughout pregnancy, childbirth, and the postnatal period are influenced by interlinked and interdependent vulnerabilities. A comprehensive understanding of how various threats and barriers affect maternal and perinatal health is critical to plan, evaluate and improve maternal health programmes. This paper builds on the introductory paper of the Series on the determinants of maternal health by assessing vulnerabilities during pregnancy, childbirth, and the postnatal period. We synthesise and present the concept of vulnerability in pregnancy and childbirth, and map vulnerability attributes and their dynamic influence on maternal outcomes in early and late pregnancy and during childbirth and the postnatal period, with a particular focus on low-income and middle-income countries (LMICs). We summarise existing literature and present the evidence on the effects of various reparative strategies to improve pregnancy and childbirth outcomes. Lastly, we discuss the implications of the identified vulnerability attributes and reparative strategies for the efforts of policymakers, healthcare professionals, and researchers working towards improving outcomes for women and birthing people in LMICs.
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Affiliation(s)
- Jameela Sheikh
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - John Allotey
- WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- National Institute of Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, United Kingdom
| | - Tania Kew
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Halimah Khalil
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Hadiza Galadanci
- Africa Center of Excellence for Population Health and Policy, College of Health Sciences, Bayero University, Kano, Nigeria
| | - G Justus Hofmeyr
- Department of Obstetrics and Gynaecology, University of Botswana, Gaborone, Botswana
- University of the Witwatersrand and Walter Sisulu University, East London, South Africa
| | - Edgardo Abalos
- Centro de Estudios de Estado y Sociedad (CEDES), Buenos Aires, Argentina
| | - Joshua P. Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Tina Lavin
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - João Paulo Souza
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- BIREME, Evidence and Intelligence for Action in Health Department, Pan America Health Organization/World Health Organization, São Paulo, Brazil
| | - Inderjeet Kaur
- Fernandez Hospital Educational & Research Foundation, Hyderabad, India
| | - Uma Ram
- Seethapathy Clinic & Hospital, Chennai, India
| | - Ana Pilar Betran
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Meghan A. Bohren
- Gender and Women’s Health Unit, Nossal Institute for Global Health, School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Olufemi T. Oladapo
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Shakila Thangaratinam
- WHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- National Institute of Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, United Kingdom
- Birmingham Women’s Hospital, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, United Kingdom
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Saldanha S, LaGrappe D, Botfield JR, Mazza D. Risk factors and health consequences of experiencing reproductive coercion: a scoping review protocol. BMJ Open 2023; 13:e073326. [PMID: 37857548 PMCID: PMC10603526 DOI: 10.1136/bmjopen-2023-073326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/16/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Reproductive coercion (RC) describes behaviours that interfere with an individual's reproductive autonomy and decision-making. RC can be a form of intimate partner violence and overlaps with other forms of gender-based violence, such as sexual violence. Health settings are well placed to identify and intervene to support patients experiencing RC, however, the lack of conceptual clarity on RC means that health providers are not easily able to identify those at risk of experiencing RC. To facilitate appropriate identification and development of interventions, there is a need to understand the risk factors related to experiencing RC and associated health consequences. AIM To assess the current scope of evidence in relation to risk factors and health consequences of experiencing RC. METHODS AND ANALYSIS Eligible articles for inclusion in the scoping review will be original peer-reviewed literature that describe risk factors and health consequences of any type of RC. Studies on humans published in English since 2010 will be included. The proposed scoping review will be conducted in accordance with the JBI Methodology. This protocol is reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Five electronic databases, OVID Medline, CINAHL, Scopus, PsychINFO and Embase, will be searched for relevant literature from 1 January 2010 to 23 January 2023. Two reviewers will individually screen and review articles for eligibility, and conflicts will be resolved by a third reviewer. Data will be charted and reported using a tool developed for the purpose of this review. ETHICS AND DISSEMINATION Findings will be disseminated in publications and presentations to relevant stakeholders. Ethical approval is not required as data from publicly available literature sources will be used. Available evidence will be mapped across the breadth of eligible studies to identify associated risk factors and health consequences of RC.
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Affiliation(s)
- Susan Saldanha
- Department of General Practice, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Judith Lumley Centre, NHMRC Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE), Melbourne, Victoria, Australia
| | - Desireé LaGrappe
- Judith Lumley Centre, NHMRC Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE), Melbourne, Victoria, Australia
- La Trobe University School of Nursing and Midwifery, Bundoora, Victoria, Australia
| | - Jessica R Botfield
- Department of General Practice, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Judith Lumley Centre, NHMRC Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE), Melbourne, Victoria, Australia
| | - Danielle Mazza
- Department of General Practice, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Judith Lumley Centre, NHMRC Centre of Research Excellence in Sexual and Reproductive Health for Women in Primary Care (SPHERE), Melbourne, Victoria, Australia
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Lévesque S, Rousseau C, Jean-Thorn A, Lapierre S, Fernet M, Cousineau MM. Reproductive Coercion by Intimate Partners: Prevalence and Correlates in Canadian Individuals with the Capacity to be Pregnant. PLoS One 2023; 18:e0283240. [PMID: 37535635 PMCID: PMC10399814 DOI: 10.1371/journal.pone.0283240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 03/03/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVES Despite the large body of research on violence against women, violence that specifically targets women's reproductive autonomy and control over their reproductive health, called reproductive coercion (RC), is poorly documented in Canada. The purpose of this study is to determine the prevalence of RC behaviors in an adult Canadian community sample and to explore associated factors. STUDY DESIGN A self-report online questionnaire was administered from September 2020 to April 2021 in Quebec and Ontario, Canada. Participants were recruited via social media, sexual and reproductive health clinics, community-based anti-violence organizations, and the project's partner organizations. The questionnaire contained validated RC questionnaire items and new items drawn from previous qualitative work. The sample comprised 427 participants, mostly self-identified as women (92%), aged 18 to 55 years (M = 29.01; SD = 6.64). Descriptive analyses and binary logistic regressions were conducted using SPSS 27. RESULTS The results of this study show that 63.9% of participants reported at least one lifetime experience of RC. According to our data, contraceptive sabotage was the most common form (62.8%). Of the participants who had been pregnant, 9.8% reported control of pregnancy outcomes. Each RC category shows a different pattern of correlates. The findings also reveal that intimate partner violence (IPV) increases the likelihood of contraceptive sabotage. Moreover, the study suggests that low education level and IPV increase the risk for control of pregnancy outcomes. CONCLUSION These findings underscore the importance of RC in the lives of many Canadian individuals with the capacity to be pregnant, and they highlight certain factors that place individuals at greater risk for RC. This knowledge can inform the development of prevention efforts and clinical interventions.
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Affiliation(s)
- Sylvie Lévesque
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Catherine Rousseau
- Interdisciplinary School of Health Sciences, Ottawa University, Ottawa, Ontario, Canada
| | - Arianne Jean-Thorn
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Simon Lapierre
- School of Social Work, Ottawa University, Ottawa, Ontario, Canada
| | - Mylène Fernet
- Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada
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Graham M, Haintz GL, Bugden M, de Moel-Mandel C, Donnelly A, McKenzie H. Re-defining reproductive coercion using a socio-ecological lens: a scoping review. BMC Public Health 2023; 23:1371. [PMID: 37461078 DOI: 10.1186/s12889-023-16281-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/10/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Reproductive coercion is a significant public health issue in Australia which has mainly been conceptualised as a form of violence at the interpersonal level. This limited scope ignores the role of the gendered drivers of violence and fails to encompass a socio-ecological lens which is necessary to consider the multiple interacting layers that create the context in which reproductive coercion occurs. The aim of the scoping review was to explore how the reproductive coercion is defined by international research. Specifically, how is reproductive coercion defined at the social-cultural-systems-structural levels, and are the definitions of reproductive coercion inclusive of the conditions and contexts in which reproductive coercion occurs? METHODS A scoping review was undertaken to explore existing definitions of reproductive coercion. Searches were conducted on Embase, Cochrane Library, Informit Health Collection, and the EBSCOHost platform. Google was also searched for relevant grey literature. Articles were included if they were: theoretical research, reviews, empirical primary research, grey literature or books; published between January 2018 and May 2022; written in English; and focused on females aged 18-50 years. Data from eligible articles were deductively extracted and inductively thematically analysed to identify themes describing how reproductive coercion is defined. RESULTS A total of 24 articles were included in the scoping review. Most research defined reproductive coercion at the interpersonal level with only eight articles partially considering and four articles fully considering the socio-cultural-systems-structural level. Thematic analysis identified four main themes in reproductive coercion definitions: Individual external exertion of control over a woman's reproductive autonomy; Systems and structures; Social and cultural determinants; and Freedom from external forces to achieve reproductive autonomy. CONCLUSIONS We argue for and propose a more inclusive definition of reproductive coercion that considers the gendered nature of reproductive coercion, and is linked to power, oppression and inequality, which is and can be perpetrated and/or facilitated at the interpersonal, community, organisational, institutional, systems, and societal levels as well as by the state.
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Affiliation(s)
- Melissa Graham
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia.
| | - Greer Lamaro Haintz
- School of Health and Social Development, Deakin University, Locked Bag 20, Geelong, 000, 3220, Australia
| | - Megan Bugden
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Caroline de Moel-Mandel
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Arielle Donnelly
- Department of Public Health, School of Psychology and Public Health, La Trobe University, 3086, Bundoora, VIC, Australia
| | - Hayley McKenzie
- School of Health and Social Development, Deakin University, 221 Burwood Highway, Burwood, 3125, VIC, Australia
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Lévesque S, Rousseau C, Raynault-Rioux L, Laforest J. Canadian service providers' perspectives on reproductive coercion and abuse: a participatory action research to address their needs and support their actions. Reprod Health 2023; 20:100. [PMID: 37391776 PMCID: PMC10311789 DOI: 10.1186/s12978-023-01640-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 06/16/2023] [Indexed: 07/02/2023] Open
Abstract
Reproductive coercion and abuse (RCA) is a form of violence that affects sexual and reproductive health. Women and individuals who experienced RCA in an intimate relationship frequently consult service providers (SPs), such as health professionals or violence counselors. The objective of this article, which is the result of a participative action research project targeting RCA perpetrated by in an intimate partner, is twofold: (1) to better understand the practices as well as the barriers and facilitators encountered by SPs and (2) to develop information and awareness tools with them that meet their needs. To this end, we first held focus groups with 31 SPs. The use of thematic analysis revealed intervention strategies that focus on caring and listening, identifying signs of RCA, and creating a safe environment for disclosure. Their practices also focused on harm-reduction strategies and effective referrals. Despite the importance they gave to this issue, lack of time, inappropriate settings, and inadequate training hindered them from intervening effectively with individuals who were victims of RCA. They also indicated the need for easy-to-follow practice guidelines and patient education tools. Based on these findings and the best practices identified in the grey and scientific literature, we developed a practice guide for SPs and a booklet on RCA. The development of these guide and booklets involved a lot of back and forth to meet the needs expressed by the community and health professionals.
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Affiliation(s)
- Sylvie Lévesque
- Sexology Department, Université du Québec à Montréal, CP 8888, Succ. Centre-Ville, Montréal, QC, H3C 3P8, Canada.
| | - Catherine Rousseau
- Population Health, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Julie Laforest
- Population Health and Well-Being, Institut National de Santé Publique du Québec, Montréal, Canada
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Pike GK. Coerced Abortion - The Neglected Face of Reproductive Coercion. New Bioeth 2023; 29:85-107. [PMID: 36260375 DOI: 10.1080/20502877.2022.2136026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Reproductive coercion encompasses a collection of pregnancy promoting and pregnancy avoiding behaviours. Coercion may vary in severity and be perpetrated by intimate partners or others. Research is complicated by the inclusion of behaviours that do not necessarily involve an intention to influence reproduction, such as contraceptive sabotage. These behaviours are the most common, but are not always included in survey instruments. This may explain why the prevalence of reproductive coercion varies widely. Prevalence also varies when coerced abortion is included in survey instruments. When it is, it seems roughly comparable in prevalence to coercion intended to impregnate. The extent and nature of coerced abortion can also be derived from studies that explore the reasons why women access abortion, the relationship between abortion and intimate partner violence, and online blogs and forums. This narrative review of reproductive coercion examines the evidence and attempts to comprehend why coerced abortion has been neglected.
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Zheng A, Nelson HN, McCall-Hosenfeld JS, Lehman EB, Chuang CH. Recent Intimate Partner Violence and Oral Contraceptive Pill Adherence in a Cohort of Reproductive-Aged Women. J Womens Health (Larchmt) 2022; 31:1703-1709. [PMID: 36126298 PMCID: PMC9805850 DOI: 10.1089/jwh.2021.0622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective: Intimate partner violence (IPV) is an important public health problem that impacts reproductive decision-making. Although previous literature has reported a negative impact on contraceptive adherence overall, this study specifically aims to investigate the association between IPV and oral contraceptive pill (OCP) adherence. Methods: We analyzed baseline survey data from 373 OCP users participating in the MyNewOptions study. Recent IPV was defined as any positive response to HARK, a 4-question tool assessing emotional, sexual, and physical abuse in the past year, or self-report of sexual coercion in the past 6 months. High OCP adherence was defined by self-report of missing ≤1 pill per month, which was then corroborated by pharmacy claims data. Multivariable regression analyses were performed to assess the influence of recent IPV history and patient-level variables on OCP adherence. Results: Just over half of our participants were highly adherent to OCPs (53.6%), and approximately one-quarter reported recent IPV exposure (25.2%). Women with recent IPV were significantly less likely to be OCP adherent than those without IPV (adjusted odds ratio (AOR) 0.54, 95% confidence interval (CI): 0.32-0.92). Protestant religion was also associated with high OCP adherence (AOR 2.41, 95% CI: 1.24-4.65, compared with no religious affiliation), while younger age groups (18-25 and 26-33 years) were less likely to have high OCP adherence compared with the 34-40 age group (AOR 0.45, 95% CI: 0.20-1.00 and AOR 0.40, 95% CI: 0.18-0.91, respectively). Conclusion: Recent IPV exposure is associated with low OCP adherence among women of reproductive age. ClinicalTrials.gov identifier: NCT02100124.
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Affiliation(s)
- Amy Zheng
- Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Hallie N. Nelson
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York, USA
| | - Jennifer S. McCall-Hosenfeld
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Erik B. Lehman
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Cynthia H. Chuang
- Division of General Internal Medicine and Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
- Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Tumlinson K, Britton LE, Williams CR, Wambua DM, Onyango DO, Senderowicz L. Contraceptive method denial as downward contraceptive coercion: A mixed-methods mystery client study in Western Kenya. Contraception 2022; 115:53-58. [PMID: 35779578 PMCID: PMC9672661 DOI: 10.1016/j.contraception.2022.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study uses mixed methods to quantify the frequency of method denial in Western Kenya and describe how this barrier impacts contraceptive access. STUDY DESIGN We estimate the frequency of method denial using data from mystery clients deployed to 57 randomly selected public-sector facilities located in Western Kenya. These quantitative data are triangulated with data from 8 focus group discussions, 19 key informant interviews, and 2 journey mapping workshops with contraception clients and providers. RESULTS In 21% of mystery client visits, the client was denied their preferred contraceptive method. In 13% of visits, mystery clients were unable to procure any method. Method denial was primarily motivated by provider-imposed requirements for HIV or pregnancy testing, or by provider bias against young, unmarried, or nulliparous women. Method denial also occurred because of provider reluctance to offer certain methods. Focus group discussion participants and interviewees confirmed the frequency and reasons for method denial and identified this practice as a substantial barrier to reproductive autonomy. CONCLUSION Method denial disrupts contraceptive access among women who have already overcome financial and logistical barriers to arrive at a health care facility. Further attention to this barrier is required to promote reproductive autonomy among women in Western Kenya. IMPLICATIONS Providers may impose unnecessary restrictions on contraceptive access that limit the ability of women to achieve their desired family size. Unwarranted method denial occurs in approximately one out of every 5 visits to public-sector facilities in Western Kenya and presents a major impediment to reproductive autonomy and justice.
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Affiliation(s)
- Katherine Tumlinson
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, United States.
| | - Laura E Britton
- Columbia University School of Nursing, New York City, New York, United States
| | - Caitlin R Williams
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States; Department of Mother and Child Health, Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | | | - Dickens Otieno Onyango
- Kisumu County Department of Health, Kisumu, Kenya; Julius Global Health, Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, Netherlands
| | - Leigh Senderowicz
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, United States
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Rowlands S, Holdsworth R, Sowemimo A. How to recognise and respond to reproductive coercion. BMJ 2022; 378:e069043. [PMID: 36126969 DOI: 10.1136/bmj-2021-069043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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