Relationships of Reproductive Coercion and Intimate Partner Violence to Unintended Pregnancy

Samankasikorn, Wilaiporn; Alhusen, Jeanne L.; Gao, Yan; Schminkey, Donna; Bullock, Linda

doi:10.1016/j.jogn.2018.09.009

Cited by 44 publications

(47 citation statements)

References 29 publications

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“…Though our study was cross-sectional, which limits our ability to draw conclusions regarding causality, the effect of IPV on unintended pregnancy was both direct and indirect. The direct effect could be through coerced pregnancy (coercion by husband to become pregnant) or coerced unprotected sex (coercion by partner to have sex against her will) [41,42]. This study further revealed that IPV might influence unintended pregnancy indirectly by reducing women's autonomy.…”

Section: Discussionmentioning

confidence: 64%

“…However, there is evidence that partner controlling behaviour is a reflection of power dynamics in an intimate relationship and indicates imminent risk of other forms of abuse [27,39]. Studies have also revealed that partners' control influences women's decision-making power [27], health service access and utilization [27,40], and fertility control [15,41,42]. Therefore, we have adopted the World Health Organization (WHO) definition of IPV (1 p89) and included partner control as a form of IPV in our analysis.…”

Section: Introductionmentioning

confidence: 99%

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The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia

et al. 2020

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Background Intimate partner violence (IPV) affects one in every three women globally. Previous studies have revealed that women’s experiences of different forms of IPV are significantly associated with a higher rate of unintended pregnancy, reduced uptake of contraception, and reduced ability to make decisions regarding their fertility. The aim of this study was to investigate whether previously observed relationships between IPV and unintended pregnancy in Ethiopia are mediated by contraceptive use and women’s autonomy. Methods This study was performed using nationally representative data from the 2016 Ethiopian Demographic and Health Survey (EDHS). A subsample of married women of reproductive age reporting a pregnancy within the 5 years preceding 2016 and who participated in the domestic violence sub-study of the survey were included in analyses. Logistic regression models, together with the product of coefficients method, were used to estimate direct and mediated effects. Results Twenty six percent of participants reported an unintended pregnancy in the 5 years preceding the survey. Sixty-four percent reported having ever experienced IPV (a composite measure of physical, sexual, emotional abuse, and partner controlling behaviour). After adjusting for potential confounding factors, unintended pregnancy was significantly positively associated with reporting sexual IPV, emotional IPV, IPV (a composite measure of physical, sexual, or emotional abuse), and multiple partner controlling behaviour. However, IPV (as a composite of all four forms), physical IPV, and partner control (single act) were not significantly associated with unintended pregnancy. Women’s autonomy, but not contraception use, had a significant partial mediation effect in the relationships between some forms of IPV and unintended pregnancy. Women’s autonomy mediated about 35, 35, and 43% of the total effect of emotional IPV, IPV (physical, sexual, and/or emotional), and multiple partner control on unintended pregnancy respectively. Conclusion Women’s autonomy appears to play a significant role in mediating the effect of IPV on unintended pregnancy in Ethiopia. Maternal health service interventions in Ethiopia could incorporate measures to improve women’s decision-making power to reduce the negative reproductive health effects of IPV.

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Section: Discussionmentioning

confidence: 64%

Section: Introductionmentioning

confidence: 99%

The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia

et al. 2020

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“…IPV may be linked to unintended pregnancy via another form of gender-based violence, reproductive coercion (RC), which has been shown in the United States to be independently associated with risk for unintended pregnancy, above and beyond the risk associated with IPV [6]. Research in many global settings have found that women's experiences of IPV and RC are positively associated with one another [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Women’s and girls’ experiences of reproductive coercion and opportunities for intervention in family planning clinics in Nairobi, Kenya: a qualitative study

et al. 2020

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Background: Reproductive coercion (RC), which includes contraceptive sabotage and pregnancy coercion, may help explain known associations between intimate partner violence (IPV) and poor reproductive health outcomes, such as unintended pregnancy. In Kenya, where 40% of ever-married women report IPV and 35% of ever-pregnant women report unintended pregnancy, these experiences are pervasive and co-occurring, yet little research exists on RC experiences among women and adolescent girls. This study seeks to qualitatively describe women's and girls' experiences of RC in Nairobi, Kenya and opportunities for clinical intervention. Methods: Qualitative data were collected as part of the formative research for the adaptation of an evidence-based intervention to address reproductive coercion and IPV in clinical family planning counselling and provision in Nairobi, Kenya in April 2017. Focus group discussions (n = 4, 30 total participants) and in-depth interviews (n = 10) with family planning clients (ages 15-49) were conducted to identify specific forms of reproductive coercion, other partner-specific barriers to successful contraception use, and perceived opportunities for family planning providers to address RC among women and girls seeking family planning services. Additionally, data were collected via semistructured interviews with family planning providers (n = 8) and clinic managers (n = 3) from family planning clinics. Data were coded according to structural and emergent themes, summarized, and illustrative quotes were identified to demonstrate sub-themes. Kenyan family planning providers and administrators informed interpretation. Results: The results of this study identified specific forms of pregnancy coercion and contraceptive sabotage to be common, and often severe, impeding the use of contraceptives among female family planning clients. This study offers important examples of women's strategies for preventing pregnancy despite experiencing reproductive coercion, as well as opportunities for family planning providers to support clients experiencing reproductive coercion in clinical settings.

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“…Women and girls of reproductive age who seek contraceptives in health settings report higher rates of IPV than their same age peers [2][3][4], and those experiencing this form of genderbased violence (GBV) are significantly more likely to report unintended pregnancies and other poor sexual and reproductive health (SRH) outcomes [5][6][7][8]. Women and girls experiencing such abuse also report higher incidence of male partner opposition to their use of contraceptives [2,[9][10][11]. In 2018, the Lancet Commission on Sexual and Reproductive Health and Rights found that GBV was a significant contributor to global unmet need for contraception and unintended pregnancy, with the greatest proportion and relative impacts of GBV experienced by women and girls in low and middle-income countries (LMICs) [12].…”

Section: Introductionmentioning

confidence: 99%

Protocol for a matched-pair cluster control trial of ARCHES (Addressing Reproductive Coercion in Health Settings) among women and girls seeking contraceptive services from community-based clinics in Nairobi, Kenya

et al. 2020

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Background: Reproductive coercion (RC) and intimate partner violence (IPV) are prevalent forms of gender-based violence (GBV) associated with reduced female control over contraceptive use and subsequent unintended pregnancy. Although the World Health Organization has recommended the identification and support of GBV survivors within health services, few clinic-based models have been shown to reduce IPV or RC, particularly in low or middle-income countries (LMICs). To date, clinic-based GBV interventions have not been shown to reduce RC or unintended pregnancy in LMIC settings. Intervention: ARCHES (Addressing Reproductive Coercion in Health Settings) is a single-session, clinic-based model delivered within routine contraceptive counseling that has been demonstrated to reduce RC in the United States. ARCHES was adapted to the Kenyan context via a participatory process to reduce GBV and unintended pregnancy among women and girls seeking contraceptive services in this setting. Core elements of ARCHES include enhanced contraceptive counseling that addresses RC, opportunity for patient disclosure of RC and IPV (and subsequent warm referral to local services), and provision of a palm-sized educational booklet.

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Relationships of Reproductive Coercion and Intimate Partner Violence to Unintended Pregnancy

Cited by 44 publications

References 29 publications

The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia

The mediation effect of contraceptive use and women’s autonomy on the relationship between intimate partner violence and unintended pregnancy in Ethiopia

Women’s and girls’ experiences of reproductive coercion and opportunities for intervention in family planning clinics in Nairobi, Kenya: a qualitative study

Protocol for a matched-pair cluster control trial of ARCHES (Addressing Reproductive Coercion in Health Settings) among women and girls seeking contraceptive services from community-based clinics in Nairobi, Kenya

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