How to recognise and respond to reproductive coercionBMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2021-069043 (Published 20 September 2022) Cite this as: BMJ 2022;378:e069043
- Sam Rowlands, visiting professor1,
- Rebecca Holdsworth, academic general practice trainee, academic clinical fellow23,
- Annabel Sowemimo, PhD candidate, community sexual and reproductive health registrar45
- 1Bournemouth University, Bournemouth, UK
- 2Newcastle University, Newcastle-upon-Tyne, UK
- 3National Institute for Health and Care Research, UK
- 4King’s College, London, UK
- 5Haymarket Health, Leicester, UK
- Correspondence to S Rowlands
What you need to know
Reproductive coercion refers to actions taken by a person’s partner or family member to prevent or promote pregnancy, irrespective of the person’s wishes
Steps taken to promote pregnancy without a sexual partner’s knowledge invalidate sexual consent in many countries, including the UK
People exposed to reproductive coercion may resort to covert use of contraception
Those at risk of reproductive coercion are often also at risk of intimate partner violence
Samantha, a 19 year old mother to a 7 month old boy, is well known to you. She has booked a telephone consultation, but when she answers she sounds panicked and states that she hasn’t got long as she needs to get back home. She wants the subdermal implant you fitted one month ago removed, as she’s changed her mind and wishes to try for another baby. She agrees to the face-to-face appointment you offer and hangs up.
She arrives for the appointment with her 30 year old partner, Steven. Samantha appears withdrawn and Steven answers questions on her behalf. You feel uncomfortable about the relationship dynamic and ask to see Samantha on her own. When her partner leaves the room, you inquire further about her wish to have her contraceptive implant removed. She pauses, looking visibly upset, then starts to cry.
This article offers an overview of reproductive coercion for clinicians. It focuses on reproductive coercion perpetrated against women who are heterosexual and cisgender (gender identity matching sex assigned at birth),1 although the discussion applies to any person who has female reproductive capacity.
Reproductive coercion is any deliberate attempt to dictate a woman’s reproductive choices or interfere with her reproductive autonomy. It comprises a range of behaviours, from psychological pressure through to threats of (and actual) physical and sexual violence (table 1). These are all forms of abuse. Note …