She is everywhere. The image of the pregnant single teen is a staple in many hit TV shows, national news, gossip magazines and movies. Think Glee, The Secret Life of the American Teenager, 16 and Pregnant, Bristol Palin, Juno and Britney Spears’ pregnant 15 year old sister, Jamie Lynn Spears. The image of the pregnant teen is often used to get some laughs: there’s Juno’s hilarious one-liners, “they call me the cautionary whale,” and pregnant teen character Quinn Fabray’s funk solo on last week’s episode of Glee in which she and a group of her fellow pregnant classmates called “The Unwed Mothership Connection” sing and dance around, emphasizing their protruding bellies. While the depictions of these women may have brought the issue of teen pregnancy into the public consciousness and gotten people talking, these media figures inaccurately represent the real lives of many a young pregnant woman. Besides either glorifying or making her image the brunt of a joke, the causes and effects of many young pregnancies are simply ignored by the media.

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Reproductive Coercion: Connecting The Dots Between Partner Violence and Unintended Pregnancy

The following editorial originally appeared in the June edition of Contraception.

By: Elizabeth Miller, Beth Jordan, Rebecca Levenson, Jay G. Silverman

Reproductive health professionals are in a critical position to reach women victimized by abusive relationships. In the general population, physical and sexual violence victimization by an intimate partner affects an estimated one in four women across the life span, with one in five adolescent girls reporting such abuse.^{1, 2, 3} The prevalence of intimate partner violence reported among women utilizing sexual health services and seeking care in gynecologic and adolescent clinics is generally double these population-based estimates.^{4, 5, 6, 7} This is not surprising, as such victimization is consistently associated with increased pregnancy and sexually transmitted infection (STI), with abused women demonstrating disproportionately higher rates of seeking care at family planning and other health services related to sexual health, such as HIV and STI testing.^{8, 9, 10, 11, 12, 13, 14, 15, 16}

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New Study: Further Evidence of Link Between Domestic Violence & Reproductive Coercion

The study released yesterday by the Guttmacher Institute provides even more evidence that victims of domestic and dating violence often suffer reproductive control from their dating partners. Three in four respondents (74 percent) in this new study – of 71 domestic violence victims seeking services at a family planning clinic, an abortion clinic and a domestic violence shelter – reported that their partners had threatened to get them pregnant, forced them to have unprotected sex, sabotaged or interfered with their contraception, threatened them with sexual intercourse, tried to control the outcome of their pregnancies if they became pregnant, or in other ways tried to coerce their reproductive outcomes. These abusive behaviors can lead to unplanned pregnancy, sexually transmitted infections, and a host of other problems.

This study adds to the growing and irrefutable body of evidence that partner violence too often leads to unplanned pregnancy. We make a mistake by putting these issues in silos and promoting solutions that ignore the connection. If we are serious about stopping unplanned pregnancy in this country, we simply must address the sexual violence and reproductive control that often cause it. If we are serious about stopping dating and domestic violence, we must recognize that many victims grapple daily with sexual violence and reproductive coercion. And if we are serious about improving women’s health, we must address the violence that too many young women experience.

 

 

Today is National Women and Girls HIV/AIDS Awareness Day

Today, on National Women and Girls HIV/AIDS Awareness Day, we want to remind people about the links between HIV transmission and intimate partner violence. Studies have shown that women who are subjected to abuse, especially sexual abuse by intimate partners, are at greater risk of HIV infection. There are several ways in which coercion and violence make it more likely that a woman will contract HIV. Violence robs a woman of her ability to refuse sex with an infected partner or to insist on using condoms. Forced sex creates physical wounds that increase the opportunities for HIV to pass from one person to the other. And there is evidence that girls who suffer sexual abuse are more prone to risk-taking behaviors when they are older. But violence does not just pave the way for AIDS; the formula also works the other way around. Revealing her HIV status or even that she was tested may entail severe consequences for an abused woman.

The problems intensify if the woman is both HIV+ and pregnant.

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Partner Violence and Unintended Pregnancy: Time to Make the Connections

We have known for many years that violence and abuse are more closely associated with unintended pregnancy than with pregnancies that are intended. Forced sex, fear of violence if she refuses sex, and difficulties negotiating contraception and condom use in the context of an abusive relationship all contribute to increased risk for unintended pregnancy as well as for sexually transmitted infections including HIV. Newer research now also points to the influences of male control of contraception and pregnancy pressure on unintended pregnancy.

We are lead researchers of a new study, which appeared in Contraception online in late January. The research report, “Pregnancy coercion, intimate partner violence and unintended pregnancy,” highlights a phenomenon we labeled reproductive coercion to describe explicit male behaviors to promote pregnancy. Particularly for women with a history of partner violence, these behaviors are significantly linked with unintended pregnancy.

Such reproductive coercion takes many forms, but frequently involves a male partner’s direct interference with a woman’s use of contraception (’birth control sabotage’). It includes removing condoms during sex to get her pregnant, intentional breaking of condoms, and preventing her from taking birth control pills.2,3

In addition, a male partner may utilize threats and coercion to pressure a woman to get pregnant (’pregnancy coercion’), such as telling her not to use contraception and threatening to leave her if she doesn’t get pregnant.

Our previous qualitative research has pointed to a range of reasons that a man might engage in such behaviors including wanting to leave a legacy, desiring to keep a woman connected to him in some way, as well as need for control in the relationship. Clearly, much more research with men and boys needs to be done to understand male involvement in unintended pregnancies and how to positively engage men and boys in discussions of healthy relationships.

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Study: Reproductive Coercion a Factor in Unintended Pregnancy

A groundbreaking study released this week sheds light on a little-recognized form of abuse in which men use coercion and birth control sabotage to cause their partners to become pregnant against their wills.  The study, published in the January issue of Contraception, finds this kind of reproductive control to be especially common in relationships in which women experience physical or sexual partner violence.

“Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy” is the first quantitative examination of the relationship between intimate partner violence, reproductive coercion and unintended pregnancy.  It finds that young women and teenage girls often face efforts by male partners to sabotage their birth control or coerce or pressure them to become pregnant - including by damaging condoms and destroying contraceptives.  These behaviors, defined as “reproductive coercion,” are often associated with physical or sexual violence.

It also finds that among women who experienced both reproductive coercion and partner violence, the risk of unintended pregnancy doubled.

The study was conducted by researchers at the University of California Davis School of Medicine and the Harvard School of Pubic Health.  From August 2008 to March 2009, researchers worked at five reproductive health clinics in Northern California, querying some 1,300 English- and Spanish-speaking 16- to 29-year-old women who agreed to respond to a survey about their experiences.  They were asked about birth-control sabotage, pregnancy coercion and intimate partner violence.

Key findings include:

• Approximately one in five young women said they experienced pregnancy coercion and 15 percent said they experienced birth control sabotage;
• Fifty-three percent of respondents said they had experienced physical or sexual violence from an intimate partner; and
• Thirty-five percent of the women who reported partner violence also reported either pregnancy coercion or birth control sabotage.

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