Reproductive Coercion in the Perinatal Context [11F]

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Abstract

INTRODUCTION:

Reproductive coercion (RC), or behavior that interferes with contraception use and/or pregnancy autonomy, has been poorly assessed in the perinatal context. Our objective was to determine patient factors associated with RC and to explore associations between RC and pregnancy engagement.

METHODS:

This was a cross-sectional study utilizing an anonymous, self-administered, Spanish or English survey among women with at least one prior pregnancy. The RC questionnaire queried participants’ experience of birth control sabotage and/or pressure to become pregnant by a partner at the time of their most recent pregnancy. Surveys were distributed at a tertiary care center during routine outpatient visits. Descriptive and bivariable analyses were performed.

RESULTS:

In this sample of 93 women, 6.5% screened positive for RC. In the overall cohort, the mean age was 36.8 years, 79.6% were racial or ethnic minorities, and 41.9% were college graduates. Women reporting RC were younger (27.6vs.37.4 years, p=0.036) and reported more limited prenatal care (66.7%vs.25.3% with late/no prenatal care, p=0.049). There were trends demonstrating greater work insecurity, younger age at first pregnancy, poorer self-perception of health, and increased frequency of intimate partner violence (p<0.075). Race/ethnicity and education did not differ by experience of RC. Women were significantly more likely to have had an undesired pregnancy or pregnancy ambivalence if they had experienced RC (p=0.004).

CONCLUSION:

In this unselected population, RC was present in a distinct minority of women without discrimination along racial, ethnic, education and economic lines. These data suggest that RC experience is associated with pregnancy ambivalence/unintendedness and poorer engagement in perinatal care.

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