Reproductive Coercion and Pregnancy Avoidance Among Women Receiving Shelter Services for Intimate Partner Violence

Reported prevalence of reproductive coercion—attempting to get an intimate partner pregnant when she does not want to be—is particularly high (14-74%) in samples of women receiving shelter or reproductive health services. Associations with intimate partner violence (IPV) have been mixed, though reproductive coercion was related to unintended pregnancy when physical violence was present. Reproductive coercion has also been associated with fear of refusing sex or asking a partner to use a condom, as well as request for pregnancy testing and/or emergency contraception. Moreover, studies have found an association between reproductive coercion and race (the victim being non-white).

This study examined factors associated with reproductive coercion and pregnancy avoidance. IPV survivors (n=660) residing in shelters in the Southwestern US were surveyed about reproductive coercion, birth control methods, and risk for intimate partner homicide (using the Danger Assessment). Logistic regression was used to examine the association of reproductive coercion and pregnancy avoidance with sociocultural factors, intimate partner sexual violence, and risk factors for homicide.

Women in the sample ranged from 18-71 years (M=37, SD=11) and identified as White (37%), Latina (24%), African American (19%), multiracial (11%), and Native American (6%). Approximately 31% (n=207) reported their partner tried to get them pregnant when they did not want to be; over half (n=114; 55%) reported that their partner physically hurt them or threatened to leave if they did not get pregnant. Reproductive coercion was related to being younger (OR=0.94, p<.01) and identifying as African American (OR = 2.06, p<.01) and Latina (OR=3.27, p <.01). A partner’s use of religious teachings as a type of abuse (OR=4.11, p<.01), intimate partner sexual violence (OR=2.73, p<.01), and women’s risk for homicide (OR=1.07, p<.01) were each associated with increased likelihood of reproductive coercion. Pregnancy avoidance strategies were also associated with reproductive coercion (X²(1, 591)=113.64, p<.01). Approximately 20% of the sample (n=130) reported using birth control without their partner’s knowledge, and 9.4% (n=62) reported using emergency contraception or ending a pregnancy without their partner’s knowledge.

Of the 40% of the sample (n=262) who had a child in common with an abusive partner, 43.5% (n=114) had experienced reproductive coercion, and 31.3% (n=82) had used pregnancy avoidance strategies. The odds of having a child in common with an abusive partner were 1.9 times greater for women who had experienced reproductive coercion (X²(1, 579)=7.88, p=.005) and 1.8 times greater among women who reported pregnancy avoidance (X²(1, 584)=8.91, p=.003). These results may indicate that pregnancy avoidance strategies were unhelpful; however, lack of time sequencing hinders clear conclusions.

Results demonstrate a high prevalence of reproductive coercion among IPV survivors seeking shelter services. The association with homicide risk highlights the importance of risk-informed intervention and findings regarding race, children-in-common, and religious abuse can inform prevention and intervention strategies. It is unknown whether women may decide to employ pregnancy avoidance strategies after having had a child with an abusive partner to avoid subsequent pregnancies. More research is needed to clarify the usefulness of women’s attempts to avoid pregnancy in the context of reproductive coercion.