Experiences of Reproductive Coercion Among Latina Women and Strategies for Minimizing Harm: “The Path Makes Us Strong”

Abstract

Introduction Latina women disproportionately report experiencing reproductive coercion (RC), a set of behaviors that interfere with autonomous reproductive decision making. Given RC's associations with intimate partner violence (IPV) and unintended pregnancy, it is critical to identify and address RC to assist women to achieve safety, autonomy, and reproductive life plans. The purpose of this study was to describe and understand the context of RC and the use of RC safety strategies among Latina women receiving services at an urban clinic, through listening to the experiences of the women in their own words. Methods Qualitative descriptive methodology was used. Semistructured interviews were conducted with a purposive sample of 13 Latina women recruited from a Federally Qualified Health Center in the Washington, DC, area. Results Data were organized into 3 a priori categories: (1) RC behaviors, (2) co‐occurrence of RC and IPV, and (3) RC harm reduction strategies. New RC behaviors emerged, and immigration status was used as a method of coercive control. From these a priori categories emerged 4 themes: impact of immigrant and citizenship status, machismo, strength and bravery, and importance of family. Harm reduction strategies included less detectable contraception; some sought community services, but others resorted to deception and stalling as the only tools available to them. Discussion Less detectable methods of contraception remained useful harm reduction strategies for women experiencing RC. Midwives should inquire about method fit and be mindful of honoring the request when patients ask to change methods. Women's strength and resilience emerged as a vital source of power and endurance. This diverse sample and the powerful voices of the women who participated make a significant contribution to the understanding of RC experienced by Latina women in the United States.

Women’s perceptions and experiences of reproductive coercion and abuse: a qualitative evidence synthesis

“…Nine studies specifically explored experiences of low-income women [ 30 , 33 , 36 , 37 , 40 , 41 , 43 , 51 , 52 ]. Two studies explored the experiences of Indigenous women in Australia [ 48 , 49 ], two studies explored perspectives of rural Hindu women in India [ 51 , 52 ], and three explored experiences of migrant women in Australia and USA [ 38 , 42 , 48 ]. Fifteen studies from the USA explored the experiences of women from different racial and ethnic backgrounds, particularly White, African American and Latina women [ 3 , 29 – 37 , 39 , 40 , 42 , 43 ].…”

“…Reproductive coercion and abuse was the primary phenomena of interest in 13 studies [ 3 , 5 , 29 , 40 – 42 , 44 , 47 , 48 , 50 , 54 , 58 ]. Reproductive coercion and abuse was a secondary phenomena of interest in the other studies, which focused on women’s experiences with intimate partner violence (IPV) particularly sexual violence [ 31 , 53 , 57 ], the effects of abuse or IPV on women’s reproduction [ 32 – 35 , 39 , 43 , 45 , 46 , 51 , 55 , 56 ], factors affecting women’s pregnancy intentions [ 30 , 36 , 49 , 52 ], barriers to contraception use [ 37 ] and son preferences [ 38 ].…”

“…Thirty two studies described women’s experiences of reproductive coercion and abuse within the three domains of pregnancy coercion, contraceptive control or control of pregnancy outcome [ 3 , 5 , 29 – 59 ]. Eighteen studies included perceived and experienced consequences of reproductive coercion and abuse [ 3 , 5 , 29 , 32 – 36 , 38 , 39 , 41 , 43 , 47 – 50 , 56 , 59 ] and 16 studies explored women’s responses [ 3 , 29 , 30 , 32 , 33 , 35 – 37 , 42 , 44 , 45 – 49 , 51 ].…”

“…Thirteen studies explored societal and cultural factors [ 3 , 29 , 33 , 38 , 42 – 44 , 46 , 48 , 50 – 52 , 55 ] and eight studies described men’s contradictory behaviours after perpetrating reproductive coercion and abuse [ 3 , 5 , 29 , 34 , 35 , 40 , 56 , 58 ]. Most studies focused on reproductive coercion and abuse by an intimate partner, and 10 studies described reproductive coercion and abuse perpetrated by family members or in-laws sometimes in conjunction with intimate partners [ 33 , 38 , 40 , 43 , 44 , 46 , 50 – 52 , 55 ].…”

A conceptual re-evaluation of reproductive coercion: centring intent, fear and control

“…Lastly, we argue that referring to “reproductive coercion” obscures the fact that perpetrator tactics—such as the use of physical violence to induce miscarriage or threats to kill or harm existing children if a woman has an abortion—venture well beyond the realms of “coercion” and into abuse and violence. Consider for example the below quote from a recent study by Grace and colleagues [ 34 ] with Latina women in the US: He made me abort by kicking me. After he hit me, the very next minute I started to have contractions in my spine.…”