By Lily Barras (she/her)
Content warning: mentions of sexual violence, intimate partner violence, abortion access
As a Master of Public Health student, I feel passionately about reducing health inequalities, especially for women and gender diverse people. As you can imagine, having control over your own sexual and reproductive health is vital to overall wellbeing. In the wake of the potential overturn of Roe v Wade in the US, I think more people need to be talking about reproductive coercion (RC).
I believe case studies provide context on an issue that cannot be gained from regurgitating facts and statistics. So I’d like you to read about Nina’s story. This is from the women’s legal service in Tasmania.[1] The names have been changed for confidentiality.
Nina and George met a year ago. George knew that Nina was not taking any birth control, owing to medical reasons, and Nina kept having to remind George to wear a condom when they had sex. George would reluctantly agree. Nina didn’t realise it at the time, but George would often take the condom off part way through sex, without her consent.
Then, Nina found out she was pregnant.
Nina was concerned that they hadn’t known each other long enough to have a baby together, but George convinced her to continue with the pregnancy, telling her he would break up with her if she had an abortion. Towards the end of Nina’s pregnancy, George convinced Nina to leave her job, stay home, and not visit any friends. He asked Nina to give him control over her bank account, so he could “help manage her spending”. George justified these demands as being “good for the baby”. As Nina was heavily pregnant, she didn’t have the energy to fight it and agreed to comply. Things got worse after the baby was born, but Nina was now living in George’s house, relied on him for financial support, and was struggling with a newborn.
It felt impossible to leave.
Reproductive coercion comes in three main forms. Firstly, there is contraceptive sabotage, which can include removing a condom with the intention of getting a partner pregnant (which is what George was doing), throwing out a partner’s contraceptive pill, or even forcibly removing their IUD. Secondly, there is pregnancy coercion, which constitutes as pressuring someone into pregnancy, either through rape or coercion tactics (which were also used by George). Finally, reproductive coercion can include attempting to control the outcome of the pregnancy, either by preventing abortion access or forcing a person to terminate the pregnancy.
It is estimated that 8% of women have experienced some form of reproductive coercion. This is a hidden form of violence and control that has life changing consequences. Part of the reason I believe this is such an important topic to discuss is because often people within these situations find it difficult to identify, or place a name to what is happening. Preventing this from becoming more prevalent, relies on there being more mainstream conversations about it.
Reproductive coercion often intersects with other forms of violence. One study found that of people stating that they had experienced RC, a quarter of them hadn’t officially reported any other form of violence or control. However, 74% had reported domestic violence, while 24% reported sexual violence. [2]
Part of this conversation needs to be about what reproductive coercion actually looks like in Australia. Part of my research into this piece included reading the experiences of 350 women and gender diverse people who had called Children by Choice and were experiencing reproductive coercion. Of the 350, 60% of the instances were related to pregnancy coercion. Also of concern is the 6.1% of people who had an experience with a healthcare professional who was either unsupportive or judgemental, or tried to block their ability to access abortion services.
Here is another case study. This one comes from the Victorian Rural Women’s Health Organisation.[3]
Wendy is 16 and lives in a small rural town. She was reluctant to see a local doctor for contraception because an extended family member worked at reception. She and her boyfriend normally use condoms, but after an experience of unprotected sex, Wendy went to the local pharmacy for emergency contraception. When the pharmacist came to the counter, he lectured her, saying she was too young to be provided with emergency contraception.
Wendy later found she was pregnant.
Her boyfriend told her she had to have an abortion, otherwise everyone would think she was ‘sleeping around’. Wendy was nine weeks pregnant when she visited the regional community health centre, a two hour return drive away. The sexual health nurse discussed pregnancy options with Wendy, explaining that additional time needed for blood tests and screening ruled out medical termination. Wendy’s parents were angry with her and demanded she organise a surgical termination in Melbourne, 300 kilometres away.
So, there were a few different forms of reproductive coercion going on here. Firstly, from the pharmacist, who blocked her access to contraception, secondly her boyfriend, who tried to coerce her into having an abortion, and finally, from her parents, who further coerced her into terminating the pregnancy. “Embarrassment, fear of, or shame from family, community and refusal of doctor of pharmacist to supply contraception” was rated as the “top” issues affecting young people’s sexual health according to the young women and men surveyed in regional Victoria.
Additionally, it is common that many pregnant people feel as though they are trapped. That they must continue a pregnancy they don’t want because of reproductive coercion. Good access to abortion providers is essential in preventing this. Especially for rural Australians like Wendy or people facing other barriers, such as having a low-income or dealing with cultural pressures. In a lot of cases, pregnant people finding their way to the abortion clinic or GP can be the hardest part. This should not be the case.
Abortion is a form of healthcare and should be easily accessible to everyone.
So how would overturning Roe v Wade intersect with reproductive coercion? Before the Roe v Wade case in 1973, which legalised abortion in all states of America, there were some states where it was already legalised and others where it was not. This patchwork of states with pro-choice laws is likely to reoccur if the US supreme court overturns the case. Therefore, abortion will not be completely inaccessible in America. However, the issue is that abortion will become a privilege that, in most cases, only wealthy, white women will be given access to. If a pregnant person cannot afford to travel to a different state, cannot get time off work, or are already caring for children, abortion suddenly becomes inaccessible. Additionally, consider the research previously mentioned where 60% of cases of reproductive coercion involved coercion towards continuing the pregnancy. These coercion tactics involve anything from deliberately spending the money a person is saving to have an abortion to more physical acts, such as not allowing them to leave the house. A person in that situation will not be able to cross state borders to receive an abortion. Overturning Roe v Wade will not only result in more unsafe abortions, but it acts as an enabler for reproductive coercion.
It is easy to ignore the issues in the US and argue that we live in a country where this would never occur. The Roe vs Wade case is proof that our right to bodily autonomy is still up for debate by some, and that the laws in place to protect us are never truly safe. We need to keep fighting to ensure abortion is an accessible, safe option for every person, and that there are no barriers to getting this essential form of healthcare. I believe reproductive coercion is currently the greatest barrier. That is why the issue of reproductive coercion needs to be a mainstream conversation. So when we have conversations about abuse, reproductive coercion should be one of the forms we talk about. It is through education that we empower people to advocate for themselves and others.
References:
Women’s Legal Service Tasmania. Reproductive Coercion. 2021. Available from: https://womenslegaltas.org.au/wordy/wp-content/uploads/2021/08/Reproductive-Coercion-August-2021.pdf
Reid S, Owen F, Lee-Ack E, Hendron M, Currie T. Submission to Marie Stopes Australia Victorian Rural Women’s Health Organisations. 2018. Available from: https://www.whealth.com.au/wp-content/uploads/2020/08/Reproductive-coercion-Marie-Stopes-Submission-%E2%80%93-March-2018.pdf
Marie Stopes Australia. ‘Hidden forces: a white paper on reproductive coercion in contexts of family and domestic violence – Second edition’. Melbourne: Marie Stopes Australia; 2020.