Understanding the risk factors of experiencing reproductive coercion

Saldanha S¹, Botfield JR², LaGrappe D³, Moradi M⁴, Mazza D¹ ²
¹ SPHERE, NHMRC Centre of Research Excellence
² Department of General Practice, Monash University, Australia
³ Judith Lumley Centre, La Trobe University, Australia
⁴ Global Women’s Health Unit, Monash University, Australia

Background

• Reproductive coercion (RC) refers to a range of behaviours that interfere with individual reproductive autonomy and decision-making.

• Can be imposed by intimate partners, family members, health providers, coercive structures, and social systems.

• Currently, there is limited understanding of the risk factors of experiencing RC across interpersonal and structural domains, limiting efforts to inform future prevention and intervention.

Aims

• To explore the scope of evidence on the risk factors of experiencing reproductive coercion.

• To contextualise identified risk factors from the perspective of health and social providers within the Australian setting.

Methods

1. Scoping review

• Five databases searched: MEDLINE, Embase, Scopus, CINAHL, PsycINFO

• English language, peer-reviewed articles searched from 1 Jan 2010 to 2 June 2024

2. Qualitative interviews

• Semi-structured interviews conducted with Australian health and social service providers

• Reflexive thematic analysis* within a narrative constructivist approach

Results

Scoping review

• 101 included articles reviewed across 27 countries

• Most were cross-sectional surveys (n = 67)

• Most focused on pregnancy coercion (n = 79) and contraceptive sabotage (n = 73)

• Common perpetrators identified were male partners (n = 61)

• Risk factors for experiencing RC identified based on an adapted socio-ecological model

Qualitative interviews

• 25 interviews conducted:

  • 10 general practitioners

  • 6 nurses

  • 6 social workers/domestic violence workers

  • 2 obstetrician/gynaecologists

  • 1 specialist women’s health professional

• Qualitative analyses contextualised the interplay between interpersonal and structural risk factors of experiencing RC

• Findings revealed three mechanisms of RC influence:

  • Explicit RC: Overt threats or violence impacting reproductive decisions

  • Implicit RC: Subtle pressures like manipulation or emotional control

  • Tacit RC: Stemming from deeply internalised societal norms restricting reproductive autonomy

Conclusion and recommendations

• Findings illustrate how interpersonal RC risk factors are rooted in broader societal and structural conditions that enable its occurrence

• RC spans a spectrum—from explicit acts to implicit pressures and tacit RC shaped by societal norms

• Strengthening understanding of covert and structural RC is key to improving recognition and fostering informed, respectful responses

• Future research should focus on victim-survivor experiences to further refine this conceptualisation and explore the intersection of RC with systems of oppression

References

1. Tarzia L, Hegarty K. Reprod Health. 2021;18(1):87.

2. Grace KT, Anderson JC. TVA. 2018;19(4):371–390.

3. Sheeran et al. Reprod Health. 2022;19(1):170.

4. Graham et al. BMC Public Health. 2023;23(1):1371.

5. Warling et al. J Midwifery Womens Health. 2023;68(6):697–701.

6. Coleman et al. J Trauma Dissociation. 2023;24(4):471–488.

7. Braun et al. Springer. 2023:19–38.

8. Creswell J, Poth CN. Sage Publications. 2018.