Citation

Rosenfeld EA, Miller E, Zhao X, Sileanu FE, Mor MK, Borrero SB. Am. J. Obstet. Gynecol. 2018; 218(2): 239.e1-239.e8.

Affiliation

Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, University Drive (151C), Pittsburgh, PA 15240; Center for Research on Health Care, University of Pittsburgh School of Medicine, Suite 600, 230 McKee Place, Pittsburgh, PA 15213.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.ajog.2017.10.015

PMID

29056537

Abstract

BACKGROUND: Male partner reproductive coercion is defined as male partners' attempts to promote pregnancy through interference with women's contraceptive behaviors and reproductive decision making. Male partners may try to promote pregnancy through birth control sabotage such as taking away or destroying their partners' contraceptives, refusing to wear condoms, and/or verbally pressuring their partners to abstain from contraceptive use. Reproductive coercion is associated with an elevated risk for unintended pregnancy. Women experiencing intimate partner violence, racial/ethnic minorities and those of lower socioeconomic status, are more likely to experience reproductive coercion. Women veterans who use Veterans Affairs (VA) for health care may be particularly vulnerable to reproductive coercion as they are disproportionally from racial/ethnic minority groups and experience high rates of intimate partner violence.

OBJECTIVES: We sought to examine the prevalence, correlates, and impact of reproductive coercion among women veterans served by the VA healthcare system. STUDY DESIGN: We analyzed data from a national telephone survey of women veterans aged 18-44, with no history of sterilization or hysterectomy, who had received care within VA in the prior 12 months. Participants who had sex with men in the last year were asked if they experienced male partner reproductive coercion. Adjusted logistic regression was used to examine the relationship between participant characteristics and male partner reproductive coercion and the relationship between reproductive coercion and the outcomes of contraceptive method used at last sex, and pregnancy and unintended pregnancy in the last year.

RESULTS: Among the 1,241 women veterans in our study cohort, 11% reported experiencing male partner reproductive coercion in the past year. Black women, younger women, and single women were more likely to report reproductive coercion than their white, older, and married counterparts. Women who experienced military sexual trauma were also more likely to report reproductive coercion compared to women who did not report military sexual trauma. In adjusted analyses, compared to women who did not experience reproductive coercion, those who did were less likely at last sex to have used any method of contraception (76% vs. 80%; aOR: 0.61, 95% CI: 0.38-0.96), prescription contraception (43% vs. 55%; aOR: 0.62, 95% CI: 0.43-0.91) and their ideal method of contraception (35% vs. 45%; aOR: 0.63, 95% CI: 0.43-0.93). Those who reported coercion were more likely to have had a pregnancy in the last year (14% vs. 10%; aOR: 2.07, 95% CI: 1.17-3.64); there were no significant differences in unintended pregnancy by coercion status (6% vs. 4%; aOR: 1.63, 95% CI: 0.71-3.76).

CONCLUSION: Eleven percent of women veterans in our sample experienced male partner reproductive coercion, which may impact their use of contraception and ability to prevent pregnancy.

Copyright © 2017. Published by Elsevier Inc.

Language: en

Keywords

ECUUN; VA; contraception; reproductive coercion