Reproductive coercion is behavior that interferes with the autonomous decision-making of a woman, with regards to reproductive health. It may take the form of birth control sabotage, pregnancy coercion, or controlling the outcome of a pregnancy. The objectives of this article are to address the questions: 1. What is known about reproductive coercion, its prevalence and correlates? 2. What strategies do women use to preserve their reproductive autonomy when experiencing reproductive coercion? 3. What interventions are effective to decrease reproductive coercion? In this review of 27 research studies, 12 contained findings regarding the general phenomenon of reproductive coercion, and 19 contained findings about at least one component of reproductive coercion. Additionally, 11 studies contained findings related to the intersection of IPV and reproductive coercion, 6 presented data on strategies women use to resist reproductive coercion, and 3 included intervention data. Variation in measurement makes synthesis of prevalence and correlate data challenging. The reviewed literature presents reproductive coercion as a phenomenon that disproportionately affects women experiencing concurrent IPV, women of lower socioeconomic status, single women, and African American and multiracial women. Women who experience reproductive coercion were found to present frequently for certain health services. Most data on reproductive coercion are descriptive; there is need for further research to examine the co-occurrence with related phenomena such as IPV and unintended pregnancy. More research is also needed on the strategies women use to resist reproductive coercion as well as interventions aimed at survivors and perpetrators of reproductive coercion and healthcare providers who encounter them.

Introduction: Intimate partner violence is a serious public health concern in the United States. Despite recommendations that physicians should routinely screen their patients, research has shown that lack of specific training has resulted in many health care professionals feeling unable to adequately perform this difficult but vital task. Though many educational resources exist to teach intimate partner violence screening, they often lack specific guidance on how to navigate this difficult conversation. In addition, they often lack formal teaching on how to counsel and refer patients who are victims of intimate partner violence. Methods: This unique module, intended for a small-group setting of four to eight students, contains an intimate partner violence checklist with sample language that covers both screening and counseling using a motivational interviewing framework. Additional materials include a checklist companion for tips on how to navigate the conversation, two cases for role-play, a facilitator guide, and an objective structured clinical encounter case and assessment rubric. Results: This module was given to 260 second-year medical students at the Warren Alpert Medical School between 2015 and 2017 and was rated highly by almost 90% of students. Discussion: After completing this module, learners will be able to appropriately screen for intimate partner violence as well as counsel and refer patients who have screened positive. By implementing this module, educators can increase the number of health care professionals able to broach this difficult conversation with patients who may be in need of help and may otherwise go unaided.

The objective of this study was to examine differences in change over time in health and safety outcomes among female college students randomized to myPlan, a tailored safety planning app, or usual web-based safety planning resources. Three hundred forty-six women (175 intervention, 171 control) from 41 colleges/universities in Oregon and Maryland completed surveys at baseline, 6- and 12-months from July 2015 to October 2017. Generalized estimating equations were used to test group differences across time. Both groups improved on four measure of intimate partner violence (IPV; Composite Abuse Scale [CAS], TBI-related IPV, digital abuse, reproductive coercion [RC]) and depression. Reduction in RC and improvement in suicide risk were significantly greater in the myPlan group relative to controls ( p = .019 and p = .46, respectively). Increases in the percent of safety behaviors tried that were helpful significantly reduced CAS scores, indicating a reduction in IPV over time in the myPlan group compared to controls ( p = .006). Findings support the feasibility and importance of technology-based IPV safety planning for college women. myPlan achieved a number of its objectives related to safety planning and decision-making, the use of helpful safety behaviors, mental health, and reductions in some forms of IPV.

BackgroundResearch demonstrates high rates of physical and sexual victimization of women by intimate partners on college campuses (Black et al. 2001). College women in abusive relationships must weigh complex factors (health, academics, economics, and social stigma) during critical decision-making regarding the relationship. Rather than access formal support systems (e.g., campus security, administrators, counselors), research indicates abused college women most often turn to informal networks; specifically friends (Perspect Psychiatr Care 41:162–171, 2005), who often lack the knowledge or resources to provide effective support (Nurs Res 54(4):235–242, 2005). Decision aids have been shown to assist with health-related decisions by improving knowledge, creating realistic expectations, and resolving decisional conflict (Cochrane Database Syst Rev 1:1–332, 2014).Methods/DesignThis study is a randomized controlled trial testing the effectiveness of an interactive safety decision aid web-based and smartphone application (App) for abused college women and their friends. Three hundred female college students experiencing abuse and three hundred friends of female college students experiencing abuse will be recruited in Maryland and Oregon and randomized to either the intervention safety decision aid, accessible by website or smartphone App, or a usual safety planning control website/App. The intervention App allows users to enter information on: a) relationship health; b) safety priorities; and c) severity of violence/danger in relationship. The App uses this information to provide personalized safety planning information and resources. Self-reported outcome measures for abused college women on safety seeking behaviors, decisional conflict, IPV exposure and mental health will be collected at baseline, six, and 12-months post-baseline via the study App/website. Outcomes measured for friends are IPV awareness, confidence to intervene, supportive behaviors and decisional conflict. Protocols for safely recruiting, retaining and collecting data from abused women via web/App are discussed.DiscussionThis trial may provide important information on the impact of an App and web-based safety planning tool on college women’s decisional conflict and safety behavior use when making difficult safety decisions. This study is the first, to our knowledge, to test an intervention that engages friends of abused college women. The trial may also inform researchers on the feasibility of safely conducting research with abused women using online recruitment and enrollment methods and collecting data via an App or website.Trial registrationClinicaltrials.gov ID: NCT02236663