Reproductive Coercion in a Diverse US Sample: Risk in Minoritized Communities and Associations with Psychological Distress

Background and Purpose: A growing body of research has explored partner-perpetrated reproductive coercion, which occurs when a partner interferes with contraception or reproductive decision-making. However, most reproductive coercion studies rely on clinical samples and/or samples that lack diversity in terms of race/ethnicity, sexual orientation, and gender identity. As a result, little is known about the frequency, manifestations, and impact of reproductive coercion in diverse samples. In this study, we set out to advance the field by examining the frequency and associates of reproductive coercion among a diverse sample.

Methods: We used Prolific, a national panel of thousands of vetted participants, to recruit a diverse sample of 1,500 reproductive-aged people assigned female at birth for an online survey about health and contraceptive care. We used validated measures of reproductive coercion (the Reproductive Coercion Scale) and psychological distress (the Kessler Psychological Distress Scale). Items from the Reproductive Coercion Scale were modified slightly to improve their relevance for sexual minority respondents (e.g., removing “so you would get pregnant” after several items because many individuals engage in sexual activity that cannot lead to pregnancy and/or use contraception for reasons other than pregnancy prevention). Cronbach’s alpha indicated that the modified version of the Reproductive Coercion Scale had good internal consistency (α=0.810). After reviewing descriptive statistics to evaluate the frequency of reproductive coercion in this sample and among subgroups, we conducted chi-square tests and t-tests to investigate risk factors for reproductive coercion and associations with psychological distress.

Results: Among our sample as a whole, 7% had experienced partner-perpetrated reproductive coercion in the past three months. Racial/ethnic minorities (χ2[3]=15.159, p=0.002) and sexual minorities (χ2[3]=14.574, p=0.002) were at increased risk of experiencing reproductive coercion compared to white participants and heterosexual participants, respectively. Reproductive coercion was most common among Black participants (12% compared to 5% for whites, 6% for Asians, and 9% for mixed/others) and among bisexual participants (11% compared to 7% for heterosexuals, 3% for gay/lesbian participants, and 2% for others). Gender minorities were not at increased risk compared to cisgender participants. Participants who experienced reproductive coercion reported higher levels of psychological distress (M=16.06) than those who did not experience reproductive coercion (M=14.58; t[1441]=-2.244, p=0.013).

Conclusions and Implications: These findings indicate a need for continued research on reproductive coercion with diverse samples, particularly among racial/ethnic minorities and sexual minorities who may be at an increased risk of experiencing reproductive coercion. Findings also link experiences of reproductive coercion to psychological distress, speaking to the potential deleterious effects of reproductive coercion. Finally, this study has implications for future measurement of reproductive coercion as it provides critical insight on modifications to the established Reproductive Coercion Scale in order to make it more appropriate for research with non-heterosexual participants.