“At Least I Didn’t Get Raped”: A Qualitative Exploration of IPV and Reproductive Coercion among Adolescent Girls Seeking Family Planning in Mexico

Abstract

Adolescent girls who report intimate partner violence (IPV) are at an increased risk of experiencing reproductive coercion (RC); both these forms of gender-based violence (GBV) are associated with unintended pregnancy. Yet little is known about these experiences among adolescent girls in Mexico. Qualitative data were collected as part of formative research for the adaptation of an evidence-based intervention to address RC and IPV in community health centers in Tijuana, Mexico. From September, 2017 to January, 2018, adolescent girls aged 16 to 20 years old ( n = 20) seeking voluntary family planning (FP) services were identified and recruited from two publicly funded community health centers. We conducted semi-structured, in-depth interviews and analyzed the transcripts using inductive and deductive techniques. Participants in this sample commonly described experiencing IPV and RC (including pregnancy coercion and contraceptive sabotage), which many girls reported resulted in unintended pregnancy. Further, participants’ narratives and general lack of knowledge on how to cope with IPV or RC illuminated the acceptability of offering GBV prevention intervention within FP clinics serving this population. Findings highlight an urgent need to prevent IPV and RC, and reduce risk for unintended pregnancy among adolescent girls in this region and the potential of FP clinics to serve as a safe space for intervention delivery. Findings contribute to the limited qualitative evidence from Mexico, describing adolescent girl’s experiences of IPV and RC, strategies for preventing pregnancy in the context of RC, and opportunities for support from FP providers.

Women’s perceptions and experiences of reproductive coercion and abuse: a qualitative evidence synthesis

“…All studies included the perspectives of women, four studies were mixed methods and 29 were qualitative studies. Of the 33 studies, 16 were from USA [ 3 , 29 – 43 ], four from Kenya [ 44 – 47 ], three from Australia [ 48 – 50 ], two from India [ 51 , 52 ], and one each from Brazil [ 53 ], Fiji [ 54 ], Iran [ 55 ], England [ 56 ], Sweden [ 57 ], Mexico [ 58 ], Ecuador [ 59 ] and Canada [ 5 ]. Nine studies specifically explored experiences of low-income women [ 30 , 33 , 36 , 37 , 40 , 41 , 43 , 51 , 52 ].…”

“…Reproductive coercion and abuse was the primary phenomena of interest in 13 studies [ 3 , 5 , 29 , 40 – 42 , 44 , 47 , 48 , 50 , 54 , 58 ]. Reproductive coercion and abuse was a secondary phenomena of interest in the other studies, which focused on women’s experiences with intimate partner violence (IPV) particularly sexual violence [ 31 , 53 , 57 ], the effects of abuse or IPV on women’s reproduction [ 32 – 35 , 39 , 43 , 45 , 46 , 51 , 55 , 56 ], factors affecting women’s pregnancy intentions [ 30 , 36 , 49 , 52 ], barriers to contraception use [ 37 ] and son preferences [ 38 ].…”

“…Thirteen studies explored societal and cultural factors [ 3 , 29 , 33 , 38 , 42 – 44 , 46 , 48 , 50 – 52 , 55 ] and eight studies described men’s contradictory behaviours after perpetrating reproductive coercion and abuse [ 3 , 5 , 29 , 34 , 35 , 40 , 56 , 58 ]. Most studies focused on reproductive coercion and abuse by an intimate partner, and 10 studies described reproductive coercion and abuse perpetrated by family members or in-laws sometimes in conjunction with intimate partners [ 33 , 38 , 40 , 43 , 44 , 46 , 50 – 52 , 55 ].…”

“…Partners interfered with condom durability by poking holes in the condom [ 35 , 37 , 58 ], and hid or disposed of contraception, for example by flushing pills down the toilet [ 3 , 29 , 30 , 32 , 33 , 35 – 37 , 42 , 44 , 47 , 48 ]. While some partners used physical or verbal abuse to overtly sabotage contraceptive use [ 56 , 57 ], some forms were more subtle, such as pressuring a woman to get an implant removed to have their partner’s baby [ 42 , 44 , 49 ].…”

“…Partners also used condom refusal as a way of asserting their reproductive intentions. Tactics included the partner stating his displeasure in, and preference against, using a condom [ 29 , 35 , 48 , 58 , 59 ]. Men also refused more subtly, with one woman noting that her partner would ‘disregard her’ and not respond when she requested a condom, and continue with physical sexual advances [ 40 ].…”