There are numerous types of abuse from physical and verbal to emotional, spiritual, financial, and technological. While abusers use a variety of tactics to exert power in these different spheres, many of these tactics boil down to the same thing: coercive control. Coercion is when the abuser attempts to persuade the victim to do or not do something using force or threats. As coercive control expert Kate Amber puts it, “When fear is present, consent cannot be present.” This can be expressed in diverse ways. April is Sexual Assault Awareness Month (SAAM), a ripe opportunity to explore one of these lesser-known abuse tactics that is more common than one might think: reproductive coercion.

What is Reproductive Coercion?

A term first coined by Dr. Elizabeth Miller in 2010, reproductive coercion is when one person controls the reproductive system and/or timeline of another. There are various ways this can happen. It is ultimately not about pregnancy or children, but the power the abuser can exert over their victim’s body and life choices. People of any gender can be reproductively coercive or be reproductively coerced, though it is most common for men to abuse their female intimate partners in this way. While this tactic is frequently used by intimate partners, family members and criminals in the sex trade also employ it. As many as one in four sexually active people experience reproductive coercion (BMJ).

There are two sides to reproductive coercion. Abusers may force or pressure their partners to become pregnant, to impregnate the abuser, or to continue with an unplanned pregnancy even though they do not want a child or wish to wait until a later time. On the other hand, abusers may force their partner to have an abortion, a vasectomy, or otherwise dictate medical choices that could affect reproductive ability. Either way, they are regulating their partner’s very personal choices.

Methods of Reproductive Coercion

Reproductive coercion can manifest in a multitude of ways. It can overlap with sexual assault if abusers force their partner to have sex when they don’t want to or sexual coercion if they threaten to end the relationship if they do not have sex. One of the most common methods abusers use to control their partner’s reproductive choices is through birth control. They may refuse to use a condom or to take birth control medication or force their partner to not use birth control. They may deliberately sabotage birth control by poking holes in condoms, for example, or breaking/removing them during intercourse, surreptitiously or forcefully. Tampering with birth control medications/devices, or restricting access to them by throwing them out, hiding them, or withholding funds to pay for them is also common. Some abusers simply lie about their method of birth control, telling their partner they have had a vasectomy when they have not or that they are on the pill when they are not. Lying can extend to removing birth control devices such as rings, IUDs, and contraceptive patches without their partner’s knowledge, or refusing to “pull out” after agreeing to use that method.

Other forms of reproductive coercion include deliberately attempting to pass on sexually transmitted diseases, monitoring menstrual cycles, spiking food or drink with known abortion inducing agents, or threatening to become violent if their victim does not comply with their wishes to either end or continue a pregnancy. Physically injuring them in a way that may cause a miscarriage or alter their ability to conceive or safely bring a fetus to term is physical abuse intersecting with reproductive control. Abusers can also manipulate victims into doing what they want through pressure, guilt, and shame, such as constantly talking about wanting to have kids despite knowing their partner does not or making them feel guilty about not wanting kids with the abuser, especially if they already have a child/children with someone else. With the recent Roe v. Wade reversal, abusers can use this ruling as a tactic to prevent or pressure their partner against getting an abortion. Some advocates argue that making contraceptive care or abortion care inaccessible is reproductive coercion on a structural level (RHJ).

Identifying and Normalizing

Depending on which tactics abusers use, victims may not even be aware that they are being reproductively coerced. Several of the tactics above can be extremely difficult or impossible to identify, even if a victim suspects something is wrong. There is also a level of societal endorsement of reproductive coercion in various ways. In some cultures, it is common for someone’s extended family, especially older female relatives, to have control over the victim’s reproductive decisions (BMJ). On a more subtle level, even comments made in jest can show how easily many people dismiss or minimize reproductive coercion as an issue. For example, on a 2018 episode of Saturday Night Live, comedian Pete Davidson joked about his then-girlfriend, “Last night I switched her birth control with Tic Tacs. I believe in us and all, but I just want to make sure that she can’t go anywhere.” By being flippant about controlling his partner and making personal choices for her, Davidson normalized this form of abuse and made it something to laugh at instead of condemn.

Another recent pop culture example occurs in the first season of the widely popular Netflix show, Bridgerton (based on the book series by Julia Quinn), in which the female main character forces her husband to not pull-out during sex (despite him saying “stop”) in an effort to get pregnant when he does not wish to be a father. While this is a complicated situation, it is a good example of how reproductive coercion can happen to anyone, not just women. While the couple resolving the issue of this abuse and going on to have children consensually could be seen as normalizing it or even empowering women, this scene did prompt negative reactions and generate discussion of sexual assault among viewers.

Special Populations

While anyone can be a victim of reproductive coercion, research indicates that younger women are particularly vulnerable. In the US, black women (37%), Latinx women (29%), and multiracial women (24%) are also more widely affected than white women (18%) (BMJ). Part of this stems from the fact that they make up a large part of communities that are underserved by the health care system and disproportionately affected by anti-choice reproductive health policies. Single, low-income, and undocumented people are likewise among the populations most at risk of reproductive coercion (Columbia). Access to health care and language barriers may contribute to this. For people with disabilities, forced or coerced sterilization by family members is a common form of reproductive coercion in some communities (MDPI). This is often done as an attempt to protect the person from unwanted pregnancies due to sexual assault or to manage menstruation, but it is still others exerting control over their reproductive system and choices. Forced sterilization is historically an issue in certain minority groups and even at a state-level in the context of colonization, eugenics, and genocide (BMJ).

What Can Victims Do?

If possible, victims who know or suspect they are being reproductively coerced can monitor their birth control methods more closely, such as obtaining them themselves instead of allowing their partner to do so, keeping them somewhere their partner is not aware of, and inspecting them for tampering before use. Health care providers can assist victims in taking back control of their own reproductive systems. They can provide birth control medication in unmarked packaging or suggest contraceptive methods that are less detectable and/or unable to be tampered with, such as shots or implants. It is becoming more common for medical professionals to screen for reproductive coercion at routine health checkups, but it is not practiced by all and, of course, does not identify all cases. Health care providers can also offer education and counseling to victims to help them recognize and understand reproductive coercion, as well as suggest strategies to safely resist it.

Reproductive coercion is a relatively newly classified abuse tactic that overlaps with other types of abuse, including sexual and physical. It can take many forms, both overt and covert, which can make it hard to identify and combat. Societal normalization, governmental policies, and lack of access to health care compound the issue. Greater public awareness of reproductive coercion and education of health care and law enforcement professionals are needed to change practices on an individual level and to better provide health care and education at a state level. In 2021, California became the first state to make “stealthing”, the non-consensual removal of a condom during intercourse, a civil offense (NYTimes). While this is a step in the right direction, more governments need to include reproductive coercion explicitly in laws and policies pertaining to domestic violence and sexual assault.

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