Recent reproductive coercion and unintended pregnancy among female family planning clients

Elizabeth Miller, Heather L. McCauley, Daniel J Tancredi, Michele R. Decker, Heather Anderson, Jay G. Silverman

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Objective Reproductive coercion (RC) - birth control sabotage and coercion by male partners to become pregnant and to control the outcome of a pregnancy - has been associated with a history of both intimate partner physical and sexual violence (IPV) and unintended pregnancy among females utilizing reproductive health services. The temporal nature of associations of RC and unintended pregnancy (distinct from the impact of IPV), however, has remained less clear. Study Design A survey was administered to females aged 16-29 years seeking care in 24 rural and urban family planning clinics in Pennsylvania (n= 3539). Results Five percent of respondents reported RC in the past 3 months, and 12% reported an unintended pregnancy in the past year. Among those who reported recent RC, 21% reported past-year unintended pregnancy. Compared to women exposed to neither condition, exposure to recent RC increased the odds of past-year unintended pregnancy, both in the absence of a history of IPV [adjusted odds ratio (AOR) 1.79, 1.06-2.03] and in combination with a history of IPV (AOR 2.00, 1.15-3.48); history of IPV without recent RC was also associated with unintended pregnancy (AOR 1.80, 1.42-2.26). Conclusions Findings indicate the temporal proximity of the association of RC and unintended pregnancy, with recent RC related to past-year unintended pregnancy, both independently and in combination with a history of IPV. Recent RC is relatively prevalent among young women using family planning clinics and is associated with increased risk for past-year unintended pregnancy even in the absence of IPV. Implications Recent RC and a history of IPV are prevalent among female family planning clients, particularly younger women, and these experiences are each associated with unintended pregnancy. Pregnancy prevention counseling should include not only assessment for physical and sexual partner violence but also specific inquiry about RC.

Original languageEnglish (US)
Pages (from-to)122-128
Number of pages7
JournalContraception
Volume89
Issue number2
DOIs
StatePublished - Feb 2014

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Coercion
Family Planning Services
Pregnancy
Odds Ratio
Sex Offenses
City Planning
Reproductive Health Services
Sexual Partners
Pregnancy Outcome
Contraception
Counseling

Keywords

  • Contraception, barrier
  • Domestic violence
  • Family planning services
  • Pregnancy, unwanted

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Recent reproductive coercion and unintended pregnancy among female family planning clients. / Miller, Elizabeth; McCauley, Heather L.; Tancredi, Daniel J; Decker, Michele R.; Anderson, Heather; Silverman, Jay G.

In: Contraception, Vol. 89, No. 2, 02.2014, p. 122-128.

Research output: Contribution to journalArticle

Miller, Elizabeth ; McCauley, Heather L. ; Tancredi, Daniel J ; Decker, Michele R. ; Anderson, Heather ; Silverman, Jay G. / Recent reproductive coercion and unintended pregnancy among female family planning clients. In: Contraception. 2014 ; Vol. 89, No. 2. pp. 122-128.
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title = "Recent reproductive coercion and unintended pregnancy among female family planning clients",
abstract = "Objective Reproductive coercion (RC) - birth control sabotage and coercion by male partners to become pregnant and to control the outcome of a pregnancy - has been associated with a history of both intimate partner physical and sexual violence (IPV) and unintended pregnancy among females utilizing reproductive health services. The temporal nature of associations of RC and unintended pregnancy (distinct from the impact of IPV), however, has remained less clear. Study Design A survey was administered to females aged 16-29 years seeking care in 24 rural and urban family planning clinics in Pennsylvania (n= 3539). Results Five percent of respondents reported RC in the past 3 months, and 12{\%} reported an unintended pregnancy in the past year. Among those who reported recent RC, 21{\%} reported past-year unintended pregnancy. Compared to women exposed to neither condition, exposure to recent RC increased the odds of past-year unintended pregnancy, both in the absence of a history of IPV [adjusted odds ratio (AOR) 1.79, 1.06-2.03] and in combination with a history of IPV (AOR 2.00, 1.15-3.48); history of IPV without recent RC was also associated with unintended pregnancy (AOR 1.80, 1.42-2.26). Conclusions Findings indicate the temporal proximity of the association of RC and unintended pregnancy, with recent RC related to past-year unintended pregnancy, both independently and in combination with a history of IPV. Recent RC is relatively prevalent among young women using family planning clinics and is associated with increased risk for past-year unintended pregnancy even in the absence of IPV. Implications Recent RC and a history of IPV are prevalent among female family planning clients, particularly younger women, and these experiences are each associated with unintended pregnancy. Pregnancy prevention counseling should include not only assessment for physical and sexual partner violence but also specific inquiry about RC.",
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