Mental health impacts of reproductive coercion among women in Côte d'Ivoire

Abstract

Objective To assess the independent associations of partner-perpetrated reproductive coercion, intimate partner violence (IPV), in-law reproductive coercion, and in-law abuse with recent probable post-traumatic stress disorder (PTSD), and to test their relationship with PTSD symptoms when controlling for the other types of abuse among partnered women in rural Côte d’Ivoire. Methods Cross-sectional analyses were conducted using logistic generalized estimating equations, which accounted for village-level clustering. Data were drawn from baseline data from a randomized controlled trial among 24 villages in rural Côte d’Ivoire (n = 953 partnered women). Three adjusted models were used to test associations of reproductive coercion and abuse with probable PTSD. Results Partner-perpetrated reproductive coercion was experienced by 176 (18.5%) women. In model 3, which accounted for the co-occurrence of abuses, partner-perpetrated reproductive coercion (odds ratio [OR] 2.3; 95% confidence interval [CI], 1.4–3.9) and partner-perpetrated IPV (OR 1.7; 95% CI, 1.1–2.7) were the most significant predictors of past-week probable PTSD (P < 0.05). Conclusion Reproductive coercion may be a significant contributor to poor mental health. The mental health impacts of reproductive coercion and IPV should be considered within psychosocial programming for rural Ivorian communities to address the full range of traumatic experiences that may have been experienced by women.

Psychometric properties and refinement of the Reproductive Coercion Scale

“…The version that achieved our goals of identifying women along the continuum of RC severity and having the best face validity given previous research on RC included three items for pregnancy coercion and two items for condom manipulation. “Told you not to use birth control” was the most commonly reported item in this study, a finding that is similar across most of the studies that have used the RCS [16–18]. Retaining this item allows us to capture women who may be experiencing less severe forms of RC.…”

“…Moreover, emerging evidence from samples in the United States and other countries indicate that RC may impact women’s mental health (e.g. PTSD symptoms, anxiety, stress symptoms), extending the literature on the health impacts of RC [18, 20]. …”

“…Another clinic-based study by Clark and colleagues found that 16% of women seeking routine care at obstetrics and gynecology clinics had experienced RC [16], while a recent study found that 8% of almost 6,000 college students reported RC, providing evidence beyond the clinical setting [17]. RC has also been assessed in global settings using items modified from the RCS, with evidence that RC may be perpetrated both by partners and extended family [18, 19]. Moreover, emerging evidence from samples in the United States and other countries indicate that RC may impact women’s mental health (e.g.…”

Intimate Partner Violence and PrEP Acceptability Among Low-Income, Young Black Women: Exploring the Mediating Role of Reproductive Coercion

“…Specifically, reproductive coercion is distinct from IPV because reproductive coercion such as birth control sabotage and pregnancy coercion describe behaviors that interfere with women’s ability to make decisions about their reproductive health [9,10]. Also, reproductive coercion can occur in relationships where IPV is absent and these strategies can be enacted by family members [9,11]. Although few studies have examined the relationship between reproductive coercion and women’s HIV risk, a growing body of research demonstrates a significant co-occurrence of IPV and HIV [12].…”

Reproductive coercion among women living with HIV

“…36 This finding is not surprising, given the previously identified links between reproductive coercion and both IPV and unintended pregnancy which have well documented correlations with increased mental health symptoms. 37–39 While the degree of overlap in these traumatic life events makes pinpointing specific causes difficult, these findings highlight the need for trauma-informed care practices more broadly.…”