As many as one in four women attending sexual healthcare services are not allowed to take control of their own reproductive lives, reveals a review published in BMJ Sexual & Reproductive Health.
As well as not being able to actively choose whether to use contraceptives, or start or continue with a pregnancy, this “reproductive control” also takes the form of “contraceptive sabotage”, which includes covert removal of a condom during sex, which the authors say invalidates consent.
Reproductive coercion is primarily carried out by intimate partners, but is also perpetrated by the wider family and in organised criminal activity. The perpetrators’ focus of control may vary, at times coercing pregnancy and at other times coercing abortion, the review found. In some cultures, the wider family, and older female relatives in particular, may have control over reproductive decision-making that is endorsed by society.
The authors say healthcare professionals should be alert to the issue of reproductive coercion in consultations with women who are displaying behavioural patterns such as persistent lack of use of contraception despite not wishing to become pregnant, frequent requests for emergency contraception, frequent attendances for pregnancy or sexually-transmitted disease testing, and requests for more than one abortion.