Reproductive coercion and abuse among pregnancy counselling clients in Australia: trends and directions

Abstract

Background Reproductive coercion and abuse (RCA) interferes with a person’s reproductive autonomy and can be classified into behaviours that are pregnancy promoting or pregnancy preventing (including coerced abortion). However, prevalence data are lacking, and little is known about whether particular forms of RCA are more or less common. The aims of our study were to explore how frequently people seeking pregnancy counselling reported RCA, the proportions reporting the different forms of RCA, and whether there were different trends based on a range of demographic factors. Methods Data were collected from 5107 clients seeking counselling support for their pregnancy between January 2018 and December 2020 from two leading providers of pregnancy counselling and sexual and reproductive health services in Australia, Marie Stopes Australia and Children by Choice. Counsellors identified and recorded the presence of RCA and whether the behaviour was pregnancy promoting and/or pregnancy preventing. Demographic factors included age, and whether the person identified as being from a migrant or refugee community or as an Aboriginal and/or Torres Strait Islander person. Results RCA was identified in 15.4% of clients, with similar proportions disclosing RCA towards pregnancy (6%) and towards pregnancy prevention or abortion (7.5%), and 1.9% experiencing RCA towards pregnancy and abortion concurrently. There were no differences based on age or whether the person identified as being from a migrant or refugee background, though people who identified as Aboriginal and/or Torres Strait Islander experienced RCA that was significantly more likely to be pregnancy promoting. Conclusions RCA is commonly disclosed by people seeking support in a pregnancy counselling context, and coercion and abuse is equally likely to be towards pregnancy promotion or pregnancy prevention/abortion. Given the prevalence and negative impacts of RCA, regardless of age and background, we recommend sensitive and culturally respectful enquiry around experiences of RCA be embedded in healthcare, health education, and health research.

Reproductive Coercion and Intimate Partner Violence Perpetration Among Young Adult Males

“…Initial research on reproductive coercion shows that approximately 0.1–0.5% of women have experienced abortion coercion, in which their partner attempts to control the outcome of a pregnancy by pressuring them into terminating it (Chibber et al, 2014; Finer et al, 2005). More recent research has identified that victimization rates of pregnancy-preventing forms of reproductive coercion are equivalent to pregnancy-promoting forms of reproductive coercion (Sheeran et al, 2022). This study reported that approximately 7.5% of their sample had experienced abortion coercion or physical violence that was meant to induce miscarriage.…”

Re-defining reproductive coercion using a socio-ecological lens: a scoping review

“…Research exploring the prevalence of violence against women in Australia demonstrates that one in five women over the age of 15 will experience violence in their lifetime [ 8 ]. Further, a recent study found 15% of women attending two family planning clinics had experienced reproductive control and abuse, which included pregnancy prevention and abortion [ 9 ]. Public health practice widely accepts that gender inequality is the underlying cause of all forms of violence against women [ 10 – 14 ].…”