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In 2019, the possibility of the government gaining control over women’s reproductive health often feels too close for comfort. But as people across the United States fight to maintain the right to legal birth control and abortions, many women are already suffering the loss of reproductive autonomy within their intimate relationships as victims of reproductive coercion.
This type of abuse involves an abuser exerting power and control over a victim’s reproductive health and reproductive decisions, according to The American College of Obstetricians and Gynecologists (ACOG). While it’s not a particularly mainstream term at this point, it’s actually quite common — particularly among young women. A study conducted by researchers at University of Pittsburgh and Michigan State University (MSU) and published this year in the journal Obstetrics & Gynecology, found that nearly one in eight sexually active females between the ages of 14 and 19 had experienced reproductive coercion in the last three months alone. A 2011 survey of more than 3,000 people conducted by The National Domestic Violence Hotline found that 25% of participants had experienced this type of abuse in some form. But what exactly is reproductive coercion — and what are the long-term impacts? Here’s what you should know.
It can take many forms.
Reproductive coercion is an umbrella term that encompasses a wide range of abuses, all meant to “maintain power and control in a relationship,” according to the ACOG. It commonly takes the form of active birth control sabotage — like hiding, destroying, or withholding contraception (or, according to The National Domestic Violence Hotline (The Hotline), withholding finances for purchasing birth control); poking holes in a condom or removing a condom during sex without consent (an act known as “stealthing”); failing to carry out the agreed-upon pull out method; and even physically removing contraception like IUDs, vaginal rings, and patches.
The abuse can also take the form of pregnancy pressure and coercion. “The most common form of reproductive coercion we see in study after study is a partner telling a young person not to use birth control,” Heather McCauley, an assistant professor at MSU’s School of Social Work and one of the researchers of the MSU study, tells Teen Vogue. Per the ACOG, it can also mean forcing a person get pregnant against their wishes by threatening or carrying out acts of violence; and according to The Hotline, reproductive coercion may also be exerted by monitoring the victim’s menstrual cycles or purposefully trying to pass on a sexually transmitted disease.
If a victim does get pregnant, reproductive coercion can take the form of controlling that person’s decision about how to move forward. “We see that young women who...have experienced reproductive coercion are also more likely to report pressure once they're diagnosed with a pregnancy,” McCauley says. “And we see that in both directions. Partners will pressure them to carry the pregnancy to term, or they'll exert pressure to terminate the pregnancy. The fact that we're seeing it both ways...shows that this is another form of power and control, just using a young person's health and sexuality to do so.”
It’s not necessarily about wanting to have a baby.
While someone exerting reproductive coercion may want a child, that’s not always the driving force behind it. Rather, it’s “another way to control someone in a relationship and to make decisions for them,” Ebony Tucker, Advocacy Director at the National Alliance to End Sexual Violence, tells Teen Vogue, later adding, “it’s very different from having a legitimate, actual conversation with your partner about whether or not now is the time to have children, what the process for that should be, and what your plans are. [...] Someone trying to control how you have sex, [the] contraception you use during sex, trying to make you doubt what your thoughts are about it, [and] talking you into the possibility of children or becoming pregnant when you're not ready for that [are red flags]. It...follows a lot of the typical indicators of relationships that are abusive, of pushing someone more toward something that they don't want and going past the line of having a conversation into directing or very, very heavily suggesting.”
With reproductive coercion, Tucker explains, the abuser uses a future child (or the possibility of one) to gain power, such as the power to keep the victim in the relationship. “Often what we see abusers think is, ‘This child will keep us locked into this relationship together. It will make it easier for me to maintain control over this person and know what they do all the time,’” she says.
And regardless of the exact methods used or whether or not it happens within an established relationship, reproductive coercion is abuse — despite the fact that, Tucker says, many people don’t see it that way. “People have a very narrow view of what abuse is in a relationship,” she says. “Abuse in a relationship goes much further than just physically abusing someone. The ability to control someone's emotions, to control their station in life, to control their jobs...all of those...are examples [of abuse]. Reproductive abuse and coercion really gets to controlling someone's body in a way that is extremely harmful. [...] We never see a situation, or at least I haven't, where reproductive coercion is something that is being done for a good or altruistic purpose, because that just doesn't really exist.”
The abuse and its impacts don’t stop at pregnancy.
Indeed, one of the reasons reproductive coercion is so harmful is because of the impacts it has on so many aspects of the victim’s life. “The trauma, particularly when you've been forced to have children, is long term,” Ruth Glenn, President and CEO of the National Coalition Against Domestic Violence, tells Teen Vogue. There’s “lack of awareness of your own space, your own body and what you can and cannot do with it.” In a separate study examining the mental health impacts of reproductive coercion, McCauley found an association between the abuse and post-traumatic stress disorder.
And then there are the emotional, logistical, and financial implications that can prevent a victim from leaving and becoming independent from their abuser. “One of the tactics that abusers use when there's domestic violence present is the threat of the victim not having access to their children, and/or threatening to take their children from them,” Glenn says. “It's also very difficult, the more children that you have to be able to find safety. So if you have three, four, or five children — even if you have one, quite frankly — and you're seeking a way to escape the violence, the more children you have, the more difficult it is.”
And part of that also comes down to the cost of taking care of those children, whether because a victim is financially dependent on their abuser, they don’t have the means to start a new life with those kids, or parenting keeps them away from their job. Reproductive coercion “changes how often they’ll be able to work in the future,” Tucker says. “They’ll have to take off time for maternity leave — what does that look like on their jobs? That is a piece of the puzzle that is significant in our country, when there is such a poor response [from] a lot of employers to pregnant women.”
Anyone can be a victim of reproductive coercion.
Reproductive coercion doesn’t only happen in heterosexual relationships; and while it primarily occurs at the hands of male partners, that’s not always the case. According to a report published in BMJ Sexual & Reproductive Health, in some cultures, people outside the intimate relationship — such as older relatives — exert control over a victim’s reproductive decisions.
And the victims aren’t always women, either. Men “absolutely” experience reproductive coercion, “but that is the dominant narrative that has been in our society for a very long time — that women interfere with contraceptive use or lie to their partners about using birth control in order to get pregnant and trap a man in a relationship,” McCauley says. That said, females are more likely to be victims than males — particularly young women and women of color, according to the BMJ report.
It’s often accompanied by other forms of abuse
For victims of reproductive coercion, that particular abuse rarely stands alone. The aforementioned MSU study found that females who experienced reproductive coercion were four times more likely to experience other forms of relationship abuse; and according to study results examined by the ACOG, many victims of reproductive coercion also experience physical or sexual violence — and males who perpetrate intimate partner violence are more likely to perpetrate forced sexual intercourse without a condom. “I think that the idea that someone is being abused in one way is false,” Tucker says. “Abusers don’t choose one way to abuse. They choose many, and as many as possible, and...we see this is as one of those ways.”
Because of that, other abusive or controlling behaviors in a relationship can serve as red flags signaling reproductive coercion. “If you are with someone who is controlling this aspect of your relationship, they are probably controlling a lot of different aspects of your relationship as well,” Tucker says. If you think you may be victim of reproductive coercion, Tucker says look out for “constant control” and “constant jealousy.”
It may not be completely obvious, and that’s okay. With domestic violence, “you sometimes don’t know what’s happening to you because it’s been so consistent and so prevalent in the situation that you’re in,” Glenn says. “So the first thing is to recognize...do you feel like you’re being forced to have children? Do you feel like you’re being forced to be pregnant? Do you feel like there has been violence, particularly when your partner says, ‘I’d love to have children with you,’ and you have to take control of your body and say, ‘I don’t think I’m ready,’ and there’s this subtle pressure to have children.”
Victims can get help and get out.
If, after asking yourself those questions, you do feel that you’re experiencing reproductive coercion, Tucker recommends talking to a family member (if possible), or turning to an advocate who can discuss it with you further and help you make a safety plan. This could be a domestic violence shelter or hotline like The National Domestic Violence Hotline, or your doctor. Your doctor, according to the ACOG and The Hotline, may be able to help you conceal contraceptive methods (such as giving you birth control pills without indicative packaging) or determine if an IUD (with a shortened string that makes it more difficult to be removed) is a good option.
If you’re concerned that a loved one may be a victim, you can help — but it’s important to tread carefully. Glenn suggests reaching out to that person and saying, “I think I know what’s happening to you. If you need to talk at any time, let me know,” and have a resource available — such as a hotline or support group — that you can provide. But, she notes, be careful to not explicitly say what you believe the abuse to be (“We encourage and want to empower people to understand what’s happened to them,” she says) and never direct the person to leave the relationship. “When we say, ‘leave,’ and we put that pressure on, we’re...taking their power away from them,” Glenn says. “Somebody else is already doing that, right? [...] Letting them know somebody is out there, but that person is available to them when they know it’s safe or when they know it’s okay to leave is what is helpful."
And equally important is to not judge people — whether it’s strangers or people you know — about their reproductive choices and circumstances, something Glenn says occurs with people who don’t understand reproductive coercion and its implications. “You see somebody with three children and you don’t understand the subtle coercion or outright violence that they may have experienced to have those three children,” she says. “Let’s not stand in judgment. Let’s try to understand what's happening to that person, particularly when we see someone when we know that there might be something else going on. It may be that she hasn't had a lot of choice in the amount of children that she has.”
