Factors Related to Reproductive Coercion and Pregnancy Avoidance Among Women Experiencing Intimate Partner Violence

Approximately 5% of US women have experienced reproductive coercion – an intimate partner trying to get them pregnant when they did not want to be (Black et al., 2011). Reported prevalence is higher (14-74%) in smaller community samples of women receiving services (Miller et al., 2010; Moore, Frohwirth, & Miller, 2010; Raphael, 2005). Associations with physical/sexual violence have been mixed (Messing & Thaller, 2012; Miller et al., 2010), though reproductive coercion was related to unintended pregnancy when physical violence was present (Miller et al., 2010). Reproductive coercion has also been associated with compromised sexual health decision-making (fear of refusing sex or asking a partner to use a condom; Messing & Thaller, 2012). There is need to investigate other factors associated with reproductive coercion and pregnancy avoidance among women experiencing intimate partner violence (IPV) to inform development of screening tools and targeted interventions.

This study’s objective was to examine factors associated with reproductive coercion and pregnancy avoidance. IPV survivors (n=154) residing in shelters in a Southwestern US county were surveyed about reproductive coercion, birth control methods, and IPV (using the SVAWS). Logistic regression was utilized to examine the association of sociocultural factors, types of violence/abuse, and homicide risk factors related to reproductive coercion and pregnancy avoidance.

Women in the sample ranged in age from 18-61 (M=35.77, sd=10.7) and identified as being from the following racial/ethnic groups: 36% Latina, 35% White, 14% African American, 11% multiracial, and 4% Native American. Nearly 1/3 of the sample was born outside the US, and 77% of women had children. Approximately 37% (n=57) reported their partner tried to get them pregnant when they did not want to be; nearly half (n=30) of these women reported that their partner physically hurt them or threatened to leave if they did not get pregnant. Reproductive coercion was related to physical violence (OR=3.21, p<.05), being younger (OR=0.94, p<.005), and identifying as Latina (OR=1.01, p<.05). Being foreign born led to a significant increase in reproductive coercion for women (OR=1.99, p<.05), but partners’ immigration status was not associated. A partner’s use of religious teachings as a reason to abuse (OR=6.59, p<.0005) and risk of homicide as measured by Danger Assessment score (OR=1.08, p<.05) were both associated with an increase in reproductive coercion. Approximately 20% (n=31) of women reported using birth control without their partner’s knowledge and 8.4% (n=13) using emergency contraception or ending a pregnancy without their partner’s knowledge. Pregnancy avoidance was associated with being younger (OR=0.95, p<.05), and was more likely to occur in association with moderate violence (OR=2.8, p<.05).

Results demonstrate a high prevalence of reproductive coercion among IPV survivors seeking shelter services and a relationship with physical violence. Findings lend insight into sociocultural factors associated with reproductive coercion and help seeking behaviors, which can inform targeted screening and intervention. Future research is needed to examine sociocultural factors more closely. The association between reproductive coercion and homicide risk highlights the importance for screening and intervention and may explain why some women practice pregnancy avoidance while others do not (e.g., fear).