Reproductive coercion: what it is and how to protect yourself

What comes to mind when you hear the words “intimate partner violence”? Perhaps you imagine a bruised woman hunched in the corner as her partner hovers over her. Maybe she has a child, who is scared and clinging to her.

These sorts of vivid images—of physical harm and fear—are synonymous with intimate partner violence.

Rarely do we think of hidden birth control pills, holes poked in condoms, missed prenatal care appointments, and condoms secretly removed during sex. But, these are also tactics of intimate partner violence—specifically, of reproductive coercion.

Reproductive coercion is a collection of tactics aimed at controlling someone’s reproductive decisions. About 20% of US women experience it, most commonly before the age of 25.¹ Estimates in the UK are as high as one in four.²

Reproductive coercion is, above all, about power. It can happen to people of any gender and not only at the hands of a partner. Family members can also be to blame.

However, because reproductive coercion looks very different from other forms of intimate partner violence and abuse, many do not realise they are experiencing it.³

“Controlling every aspect of your life, from small things like where you place things in the house to what you wear, are signs that things may eventually escalate”

“Sometimes it’s not apparent to patients, but they’ll express feelings about power and control over their circumstances being in the hands of their partner,” says Erin Pollitt, a forensic nurse and executive director of the non-profit District of Columbia Forensic Nurse Examiners (DCFNE), which provides free medical forensic exams and trauma-informed care for survivors of intimate partner violence.

The warning signs are not always obvious. “Controlling every aspect of your life, from small things like where you place things in the house to what you wear, are signs that things may eventually escalate,” explains Charlene Reid, a sexual assault nurse examiner with the Bergen County Prosecutor’s Office in Hackensack, NJ.

Other red flags Reid describes are isolating you from loved ones, refusing to wear protection early in the relationship, excessive calling and texting, and gaslighting to make abusive behaviour seem insignificant.

Reid recalls an incident of stealthing—when barrier protection is secretly removed during sex—shared by a female patient. “[Her abusive partner] knew she needed him financially, so during consensual sex, initially with the agreement to wear protection, he secretly took off the condom before penetration. He knew getting her pregnant again would keep her from leaving.”

“Forcing pregnancy on someone for the sake of control has consequences for everyone, especially the child”

And the repercussions of reproductive coercion extend beyond its survivors.

Along with the spread of infections and lifelong mental health struggles, this abuse is linked to both unwanted pregnancies and abortions.⁴ “I’ve had patients fearing for the safety of their unborn child, debating whether they should even keep it,” Reid says. “Forcing pregnancy on someone for the sake of control has consequences for everyone, especially the child.”

Protecting yourself from reproductive coercion can be difficult. If you’re experiencing it, first consider how you can safely get some time away from your abuser.

Try to have a moment alone with your healthcare provider, says Pollitt. “As nurses, we assess for abuse in our patients away from other people, which I know is sometimes easier said than done.” Pollitt emphasises that providers uphold patient confidentiality, which means they’ll never share your information with anyone (including family and partners) unless you give them permission.

Choosing birth control that’s tamper-proof, like the contraceptive injection, IUDs, and implants that are inserted under the skin can also help. However, for those in the US, there’s always the risk that these may be billed to an abusive partner’s insurance, explains Pollitt.

“If you get a confidential moment with your provider, you can mention this. There are resources in place to help with this issue, too.”

“We can’t tell them what their experiences are, but we can tell them that this was not their fault”

But what’s perhaps most important is validating people’s experiences, and educating them about what’s happening.

“Patients might present not believing [that they’re experiencing coercion] or it hasn’t become apparent to them that what they are telling us is part of the abuse,” says Pollitt. “They disregard the coercive acts as [being] what they are used to experiencing. They feel shame at ‘letting’ it happen.”

Reid adds, “Because we ask about their experience and what the abuser told them, we can point out the specific subtle abuses to the patient. We can’t tell them what their experiences are, but we can tell them that this was not their fault. Whether or not they said ‘no’ or fought back, they didn’t deserve what happened to them and it was abuse.”

Reproductive coercion affects the survivors and the communities in which it is allowed to persist. As bodily autonomy and reproductive rights are under constant attack, it is imperative to know the warning signs and, more importantly, how to stay safe.

If you’re experiencing reproductive coercion and are in the UK, you can call the Freephone National Domestic Abuse Helpline on 0808 2000 247. This line is run by the charity Refuge.

It’s also important to know your reproductive rights. As of 1st February 2023, abortion is illegal in 13 states, while five others have gestational limits. Know your state’s laws so you can seek help from the right place.

Featured image is an illustration of a figure draped in shadow, who is stealing someone’s birth control pills. They’re tucking the pill packet into the front pocket of their shirt

Page last updated February 2023