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Time: At family planning and domestic violence clinics, researchers are attempting to explain the higher rates of unwanted pregnancy in relationships involving violence. What their studies have discovered is that "reproductive coercion," where women are often threatened with pregnancy by their partners or have their birth control destroyed, is preventable. The recent reserach shows that simply asking women who visit clinics specific questions about reproductive coercion and providing them with information and new birth control options, can drasitically lower the rates of pregnancy as well as encourage women to leave violent relationships.
"Researchers who work in family planning and with victims of domestic violence say women are often being threatened with pregnancy by their partners. "Reproductive coercion, as it's known, takes several forms. Partners may verbally or physically threaten women if they use birth control or seek abortions, or they may throw away or damage birth control and remove condoms during sex. It usually takes place within an already abusive relationship, especially those that are emotionally abusive.
"It's another way a male partner tries to control a female partner," says Elizabeth Miller, associate professor of pediatrics at the U.C. Davis School of Medicine, who has led much of what little research there is on the issue. "Women say their partner tells them he wants to leave a legacy or have them in his life forever.
Now, in her latest research, co-authored with Jay Silverman of the Harvard School of Public Health and others, Miller concludes that there may be a simple and cost-effective way to help women who are in danger of being intimidated into pregnancy. Simply asking women who visit family-planning clinics if their partner has ever tried to force them to get pregnant, and providing them with information on how to deal with it, can help spur women to get out of abusive relationships or take measures to protect themselves.
The pilot study, published online by Contraception, included about 900 patients, most of whom were ages 24 or younger, who visited four Northern California family-planning clinics between May 2008 and October 2009. Counselors and clinicians at two of the clinics were trained to ask women about reproductive coercion. (Questions included, Has your partner tried to force you to become pregnant when you didn't want to be? Does your partner mess with your birth control? and Does your partner refuse to use condoms when you ask?) Women who responded "yes" to any question were offered advice on tamper-proof methods of pregnancy protection, including IUDs and Depo-Provera shots, and given emergency contraception. At the two other clinics, women were simply offered standard domestic-violence and sexual-assault screening. (See "The Abortion Battleground: Crisis Pregnancy Centers.")
At the sites where advice on contraception was offered, the odds of subsequent pregnancy coercion dropped by 70%; there was no change at the other two clinics. Moreover, it seemed that the probing about coercive reproduction served as a wake-up call to some women. "In the intervention clinics, women were 60% more likely to have left a relationship because it felt unsafe," says Miller."