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  • Women facing coercive control over their pregnancies

    Author: AAP

Jane's husband became resentful of her close relationship with their first baby, claiming she had manipulated their newborn daughter into only wanting her mother.

Then Paul gave Jane an ultimatum: fall pregnant with their second child, and have "his" baby who she could not "ruin", or he would divorce her.

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The 34-year-old dreaded going through another pregnancy. Her first birth had been traumatic and ended in an emergency caesarean.

She reluctantly agreed to the ultimatum and fell pregnant soon after stopping her contraception, but the pregnancy was difficult. She felt trapped and depressed.

Jane, whose name has been changed, is one of many Australian women who have experienced reproductive coercion and abuse.

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It can occur when an intimate partner or family member tries to control a woman's reproductive choices, by forcing them to fall pregnant or to have an abortion.

Rose, also not her real name, unexpectedly fell pregnant with her partner Liam and wanted to keep the baby.

But Liam could not accept the pregnancy and threatened physical violence if Rose, 23, did not have an abortion.

She sought help from her mother, but she also told Rose to terminate the pregnancy. Frightened and unsupported, she went to a GP who advised her to book an appointment with a national abortion provider.

"Forcing somebody to become a parent when they don't want to, or stopping them from doing that, that's really extreme control," Melbourne University researcher Laura Tarzia told AAP.

This form of abuse has only been spoken about internationally since 2010.

Dr Tarzia has been interviewing victims of reproductive coercion and abuse to gather evidence and build stronger data sets.

"A lot more people are starting to realise how much of an issue this is, and the harm that it causes," she said.

"We don't have good data at the moment on risk factors, because there have been so many issues with how reproductive coercion has been measured in previous research.

"We really need good, robust data to be collected in Australia so we have our own local data that can tell us more about what some of those risk factors are to be able to guide practitioners."

Risk factors can include a victim relying on male contraception, such as condoms, as it can be tampered with by a perpetrator; a lack of sexual autonomy; and if other types of domestic abuse already occur.

Reproductive coercion often overlaps with other physical, psychological and sexual abuse, and is commonly perpetrated by a male intimate partner.

Women from migrant or refugee backgrounds, who may have limited access to health care or depend on intimate partners and family members to translate for them, are particularly vulnerable.

Rosi Aryal Lees, a lead researcher with the Multicultural Centre for Women's Health, said structural and systemic barriers were enabling this abuse.

"When a doctor listens to the husband, doesn't listen to the woman and doesn't bother getting an interpreter involved in the situation at all, then the doctor is actually enabling reproductive coercion," she told AAP.

"The other issue is with the police, if they use the perpetrator as interpreter they will often misidentify the victim as the perpetrator."

She said migrant and refugee women were more likely to experience violence by multiple perpetrators, including family members, due to systemic discrimination, gender inequality and racism.

Victims of reproductive coercion are likely to come into contact with health services, which means GPs, abortion providers and sexual health centres need training on how to spot this abuse, Dr Tarzia said.

"There is even more need for health professionals, specifically, to be comfortable asking about and responding sensitively to this issue when it comes up with patients," she said.

"There's more awareness about general training in responding to intimate partner violence, and it's becoming more recognised that health settings are a really good place to do that.

"The next step is incorporating reproductive coercion and abuse into those training programs."

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