Skip to main content
NCBI home page
NIHPA Author Manuscripts logoLink to NIHPA Author Manuscripts
. Author manuscript; available in PMC: 2024 Dec 1.
Published in final edited form as: J Interpers Violence. 2023 Jul 29;38(23-24):11954–11979. doi: 10.1177/08862605231190346

Contraceptive Sabotage and Contraceptive Use at the Time of Pregnancy: An Analysis of People with a Recent Live Birth in the United States

Sarah Huber-Krum 1, Marta Bornstein 2, Denise D’Angelo 1, Subasri Narasimhan 3, Lauren B Zapata 4, Kara Tsukerman 1,5, Yanet Ruvalcaba 1,5
PMCID: PMC10989733  NIHMSID: NIHMS1980374  PMID: 37515538

Abstract

Contraceptive sabotage and other forms of intimate partner violence (IPV) can interfere with contraceptive use. We used 2012 to 2015 Pregnancy Risk Assessment Monitoring System data from 8,981 people residing in five states who reported that when they became pregnant, they were not trying to get pregnant. We assessed the relationships between ever experiencing contraceptive sabotage and physical IPV 12 months before pregnancy (both by the current partner) and contraceptive use at the time of pregnancy using multivariable logistic regression. We also assessed the joint associations between physical IPV 12 months before pregnancy and ever experienced contraceptive sabotage with contraceptive use at the time of pregnancy. Few people ever experienced contraceptive sabotage (1.8%; 95% confidence interval [CI]: 1.4, 2.3) or physical IPV 12 months before pregnancy (2.8%; 95% CI: 2.3, 3.3). In models adjusted for age, race/ethnicity, marital status, education, and state of residence, ever experiencing contraceptive sabotage was associated with contraceptive use at the time of pregnancy (adjusted odds ratio [aOR]: 1.73; 95% CI: 1.06, 2.82), but not with physical IPV 12 months before pregnancy (aOR: 0.69; 95% CI: 0.46, 1.02). When examining the joint association, compared to not ever experiencing contraceptive sabotage or physical IPV 12 months before pregnancy, ever experiencing contraceptive sabotage was significantly related to contraceptive use at the time of pregnancy (aOR: 1.72; 95% CI: 1.00, 2.95). However, it was not associated with experiencing physical IPV 12 months before pregnancy (aOR: 0.68; 95% CI: 0.45, 1.04) or with experiencing both contraceptive sabotage and physical IPV 12 months before pregnancy (aOR: 1.21; 95% CI: 0.42, 3.50), compared to not ever experiencing contraceptive sabotage or physical IPV 12 months before pregnancy. Our study highlights that current partner contraceptive sabotage may motivate those not trying to get pregnant to use contraception; however, all people in our sample still experienced a pregnancy.

Keywords: domestic violence, sexuality, sexual assault

Introduction

A central tenet of reproductive autonomy is that everyone1 has the right to make decisions concerning their reproductive health2 free of discrimination, coercion, and violence (United Nations, 2015). Yet, autonomy may be constrained when a person experiences reproductive coercion, a form of intimate partner violence (IPV) that is defined as physical, sexual, or psychological tactics that interfere with reproductive goals (e.g., delaying, avoiding, or achieving pregnancy) (Fay et al., 2022; Grace & Anderson, 2018). The Centers for Disease Control and Prevention (CDC) defines IPV as physical or sexual violence, stalking, and psychological aggression (including coercion) by a current or former intimate partner (Breiding et al., 2015). Reproductive coercion may influence reproductive health goals directly through contraceptive sabotage (i.e., interference with the use of contraception to increase the chance of pregnancy) or indirectly through pregnancy coercion (i.e., any tactic to increase the chances of pregnancy) and controlling the outcome of a pregnancy (Grace & Anderson, 2018). In the United States, exposure to reproductive coercion ranges from as low as 7% to as high as 30% (Grace & Anderson, 2018; Rowlands & Walker, 2019). Data on self-reports reports of reproductive coercion rely on clinic- and/or community-based samples, and the wide variation in estimates are likely attributed to a lack of definitional and conceptual clarity, which has led to heterogeneity in how reproductive coercion has been defined and measured across studies (Grace & Anderson, 2018; Tarzia & Hegarty, 2021). Furthermore, reports of reproductive coercion are greater among racial and ethnic minority groups (Grace & Anderson, 2018; Hill et al., 2019; Holliday et al., 2017; Rosenfeld et al., 2018; Samankasikorn et al., 2019), people who are younger (e.g., less than 30 years) (Grace & Anderson, 2018; Muñoz et al., 2022; Rosenfeld et al., 2018; Samankasikorn et al., 2019), single or not married (Grace & Anderson, 2018; Rosenfeld et al., 2018; Samankasikorn et al., 2019), and with less education (e.g., less than a high school education) (Grace & Anderson, 2018; Samankasikorn et al., 2019). Understanding the interplay between reproductive coercion and reproductive health may strengthen efforts to support autonomous and informed sexual and reproductive health decisions and to prevent violence. Such endeavors would be in alignment with national goals such as Healthy People 2030 (Office of Disease Prevention and Health Promotion, n.d.), global health targets such as the Sustainable Development Goals (United Nations Department of Economic and Social Affairs Sustainable Development, 2022), and calls from global commissions to connect and address the relationship between violence and reproductive health (Starrs et al., 2018).

Reproductive coercion is most often perpetrated by current or former intimate partners and may co-occur with other forms of IPV (Miller, Decker et al., 2010); however, the frequency of co-occurrence is not clear. A study of five family planning clinics in California showed that 35% of women aged 16 to 29 years who sought care experienced co-occurrence of IPV (i.e., lifetime history of physical or sexual IPV) and reproductive coercion (i.e., lifetime history of pregnancy coercion or birth control sabotage) (Miller, Decker et al., 2010); however, co-occurrence within the same relationship was not assessed. A study of women presenting for routine obstetrics and gynecology care at a clinic in Rhode Island revealed that 32% of the 103 women who reported any type of reproductive coercion also reported they experienced physical or sexual IPV within the same relationship (Clark et al., 2014). Furthermore, some studies have shown that reproductive coercion is positively associated with physical IPV victimization among sexually active undergraduate women (Katz et al., 2017), sexually active female youth (McCauley et al., 2014), female young adults (Muñoz et al., 2022), and people with a recent live birth (Samankasikorn et al., 2019). Together, these findings suggest that reproductive coercion and other forms of IPV are related, and tthis coercion can occur without other forms of physical, sexual, or emotional IPV.

Reproductive coercion may affect reproductive health and well-being independent of its association with other forms of IPV. Several studies document that it is significantly associated with unintended pregnancy separate from physical and/or sexual IPV, and it also interacts with other forms of IPV to heighten the risk for unintended pregnancy (Grace et al., 2022; Jones et al., 2016; Miller, Decker et al., 2010; Miller et al., 2014). Contraceptive use may also be constrained by reproductive coercion within intimate partnerships through tactics that prevent its use or reduce its effectiveness. For example, female veterans aged 18 to 44 years who reported experiencing reproductive coercion were less likely to use any method of contraception (compared to no method) or prescription contraception (defined as intrauterine devices, subdermal implants, pills, rings, patches, or injections compared to nonprescription methods including condoms, natural family planning, withdrawal, or other methods). They were also less likely to use their ideal contraceptive method (compared to currently using a method that was not their ideal one) (Rosenfeld et al., 2018). Understanding how reproductive coercion is related to contraceptive behaviors can inform guidelines for contraceptive counseling, psychosocial support, and health services for those who have experienced it along with IPV and other programs and interventions that improve reproductive health and autonomy.

Contraceptive sabotage may influence the correct and consistent use of contraceptive methods. A systematic review showed that estimated exposure to contraceptive sabotage ranged considerably from less than 1% to 20% (Grace & Anderson, 2018). Several qualitative studies show that intimate partners may prevent effective contraceptive use by hiding or disposing of methods, preventing access to contraceptive care and services, or by refusing to effectively use male contraceptive methods (e.g., condoms and withdrawal); they may also remove condoms during sex and/or remove or destroy other contraceptive methods (e.g., removing vaginal rings or breaking subdermal implants), poke holes in condoms, and/or dissuade the use of female-controlled methods (e.g., by exaggerating side effects to scare or misinform partners) (Borrero et al., 2015; Giacci et al., 2022; Grace et al., 2020; Lévesque et al., 2021; Miller et al., 2007; Moore et al., 2010; Nikolajski et al., 2015). Inconsistent or incorrect use of methods may contribute to pregnancy. For instance, 48% of women who were classified as having an unintended pregnancy (Finer & Henshaw, 2006) and 54% of women who had an abortion reported that they used contraception during the month of conception and became pregnant (Mosher et al., 2004). A qualitative study using secondary data collected in 2008 and 2014 explored the reasons for contraceptive failure, which the authors defined as a woman reporting an unintended pregnancy or abortion resulting from either using a contraceptive strategy consistently or inconsistently or using a contraceptive strategy sporadically without the desire for pregnancy. It showed that one-third (23/69) of participants reported they experienced some form of reproductive coercion around the time they became pregnant (Frohwirth et al., 2022). For some of these women, reproductive coercion—in the form of contraceptive sabotage and pressure to become pregnant—contributed to inconsistent use or nonuse of their contraceptive method (Frohwirth et al., 2022). However, the age and secondary nature of the data are notable limitations.

We assessed the relationship between contraceptive sabotage and contraceptive use at the time of pregnancy among a population-based sample of people with a recent live birth who reported not trying to conceive when they became pregnant. Due to the complex and often co-occurring relationship with other forms of IPV, we also examined whether contraceptive sabotage was associated with contraceptive use at the time of pregnancy independent of and jointly with physical IPV 12 months before pregnancy. Past researchers have collected data on reproductive coercion from clinic-based samples, which tend to show higher rates of reproductive coercion (Grace & Anderson, 2018). By using a population-based sample, we are able to more accurately represent U.S. people with a recent live birth. Also, past studies on contraceptive sabotage that use or adapt the Reproductive Coercion Scale tend to focus on condom use (McCauley et al., 2017). We employed a measure of contraceptive sabotage that is not method-specific and therefore more inclusive of the various contraceptive methods that people may use to avoid pregnancy. Understanding how contraceptive sabotage is related to contraceptive use is an important first step in informing interventions and counseling efforts.

Methods

We used data from the Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based survey conducted in partnership with CDC and state and local health departments, of people in the United States who recently had a live birth. PRAMS is an ongoing study of which 46 states, the District of Columbia, New York City, Northern Mariana Islands, and Puerto Rico (referred to as sites) currently participate, representing 81% of all U.S. live births (Shulman et al 2018). To implement PRAMS, people with a live birth who are residents of and delivered their infant in a participating site are identified via vital record birth certificate files (Shulman et al 2018). Potential participants are selected using a stratified systematic sampling scheme. Sites may stratify two of six variables for oversampling of subpopulations: birth-weight, maternal race and ethnicity, education, and age, geographic area, and Medicaid status. PRAMS uses systematic sampling so that all potential participants have the same probability of being selected within each strata (Shulman et al 2018).

The PRAMS survey includes a core set of questions asked by all participating sites and standard questions that sites may choose to include in their questionnaires. Additionally, PRAMS requires a minimum overall response rate threshold for the release of data for each year (2012–2014: 60%; 2015–2017: 55%). Five sites (Massachusetts, Maryland, Ohio, Texas, and Virginia) chose to include a standard question about contraceptive sabotage in Phase 7 (2012–2015) and met the minimum overall response rate threshold.

Measures

Outcome: Contraceptive Use at the Time of Pregnancy.

Participants were asked, “When you got pregnant with your new baby, were you trying to get pregnant?” Response options were “yes” or “no.” If the participant responded “no,” they were asked, “When you got pregnant with your new baby, were you or your husband or partner doing anything to keep from getting pregnant? Some things people do to keep from getting pregnant include using birth control pills, condoms, withdrawal, or natural family planning.” Participants who responded “yes” were categorized as using contraception when they became pregnant; participants who responded “no” were categorized as not using contraception when they became pregnant. Participants who responded “yes” to trying to get pregnant were not asked the aforementioned question. Contraceptive use at the time of pregnancy was part of the core question set.

Independent Variables.

Key independent variables of interest included whether the participant ever experienced contraceptive sabotage (part of the standard question set) and physical IPV 12 months before pregnancy (part of the core question set). Both exposures were assessed in relation to the participant’s current partner.

Ever Experienced Contraceptive Sabotage.

We assessed whether a participant ever experienced contraceptive sabotage with their current partner with one survey item that asked,

Before you got pregnant with your new baby, did your husband or partner ever try to keep you from using your birth control so that you would get pregnant when you didn’t want to? For example, did they hide your birth control, throw it away, or do anything else to keep you from using it?

Participants who responded “yes” were categorized as ever experiencing contraceptive sabotage with their current partner; those who responded “no” were categorized as never experiencing contraceptive sabotage with their current partner.

Physical IPV 12 Months Before Pregnancy.

We measured whether participants experienced physical IPV 12 months before pregnancy with their current partner with one survey item asking, “During the 12 months before you got pregnant with your new baby, did your husband or partner push, hit, slap, kick, choke, or physically hurt you in any other way?” Participants who responded “yes” were categorized as experiencing physical IPV 12 months before pregnancy with their current partner, while those who responded “no” were categorized as not experiencing physical IPV 12 months before pregnancy with their current partner.

Covariates selected in the multivariable models were based on significant bivariate relationships, theoretical associations with contraceptive use, and model selection techniques to minimize multicollinearity. Thus, we considered age, race/ethnicity, marital status, education, state of residence, poverty status, urban/rural, parity, and insurance prior to pregnancy as covariates; ultimately, we retained age, race/ethnicity, marital status, education, and state of residence in adjusted models. Data on race was collected from birth certificate files; all other covariates were part of the core question set. Following the “HHS Implementation Guidance on Data Collection Standards for Race, Ethnicity, Sex, Primary Language, and Disability Status,” data were collected to adhere to the Office of Management and Budget (OMB) minimum categories for race (i.e., American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White) while including some sub-categories (e.g., Chinese, Japanese) (HHS, 2011). We regrouped some categories due to small sample sizes. We grouped together non-Hispanic Chinese (n = 198), non-Hispanic Japanese (n = 7), non-Hispanic Filipino (n = 51), and non-Hispanic other Asian (n = 503) as non-Hispanic Asian. We also grouped together non-Hispanic American Indian (n = 15), non-Hispanic Hawaiian (n = 1), and non-Hispanic other non-White (n = 82) as a combined race category for reporting.

We examined the collinearity between physical IPV 12 months before pregnancy and ever experienced contraceptive sabotage in the final model. The variance inflation factor—defined as an index of the amount of variance of each regression coefficient increased relative to a situation in which all of the predictor variables are uncorrelated (Cohen et al., 2002)—was 1.05 for physical IPV 12 months before pregnancy and 1.04 for ever experienced contraceptive sabotage. Thus, both were retained in the final model.

Analysis

More than 20,000 (20,959) people who resided in the five sites that included the survey items of interest and released data completed the PRAMS Phase 7 questionnaire (2012–2015). About 51% (51.3% or 10,756) of these people were not trying to get pregnant when they conceived, 8,881 (42.2%) were trying to get pregnant when they conceived, and 1,322 people (6.3%) did not respond to the question. Ninety-two percent (92.2% or 9,917) of the 10,756 people not trying to conceive when they became pregnant responded to the question about contraceptive use at the time of pregnancy. Nine percent (9.4% or 936) of these people did not provide full information about the variables in this study and were excluded. Thus, the analytical sample includes 8,981 people.

We used sampling weights to account for the PRAMS complex sample design (Shulman et al., 2018). Statistical significance was set at p < .05; we used 95% confidence intervals (CIs) to assess the statistical significance of estimated odds ratios (ORs). Data analysis was conducted using Stata SE version 16 (StataCorp, 2019).

We first estimated the weighted prevalence of participant characteristics overall and then by whether they were using contraception when they became pregnant and by whether they reported ever experiencing contraceptive sabotage. Then, we used Pearson’s chi-square tests of independence to compare the distributions between characteristics, ever experienced contraceptive sabotage, and contraceptive use at the time of pregnancy to understand the degree to which variables differ from one another (Gordon, 2018). The chi-square test of independence “determines whether two categorical variables in a single sample are independent from or associated with each other” (p. 450) (Franke et al., 2012).

We used logistic regression to examine the unadjusted and adjusted associations between ever experienced contraceptive sabotage, physical IPV 12 months before pregnancy, and other selected characteristics (i.e., race/ethnicity, marital status, education, age, and state of residence), and contraceptive use at the time of pregnancy. Next, we used Stata’s interaction command (i.e., # command) to assess the unadjusted and adjusted relationship between whether a participant ever experienced contraceptive sabotage and physical IPV 12 months before pregnancy (i.e., neither, only ever experienced contraceptive sabotage, only experienced physical IPV 12 months before pregnancy, or both) and contraceptive use at the time of pregnancy. This created indicators for each combination of the categories of the two variables (StataCorp, 2019).

Results

The largest percentages of the population were between the ages of 20 to 24 years and 25 to 29 years, 27.2% and 28.6%, respectively (Table 1). Just under half (46.9%) of the population identified as non-Hispanic White, whereas 21.4% of people identified as non-Hispanic black, and 24.7% identified as Hispanic of any race. Most people had some college education or more (54.2%) and were not married (54.4%). Almost 40% of people not trying to become pregnant reported they were using contraception when they became pregnant. Less than 2% (1.8%) of people had ever experienced contraceptive sabotage, whereas 2.8% had experienced physical IPV 12 months before pregnancy.

Table 1.

Selected Characteristics Among People with a Recent Live Birth Who Were Not Trying to Become Pregnant When They Conceived in Five States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2012 to 2015 (n = 8,981).

Characteristics Weighted % 95% CI
Age in years grouped
 <20 8.0 7.1, 9.1
 20–24 27.2 25.7, 28.8
 25–29 28.6 27.0, 30.2
 30–34 21.3 20.1, 22.6
 35–39 11.9 10.8, 13.1
 40+ 2.9 2.5, 3.5
Race/ethnicity
 Non-Hispanic White 46.9 45.9, 48.0
 Non-Hispanic Black 21.4 20.6, 22.3
 Non-Hispanic Asian 4.0 3.5, 4.6
 Non-Hispanic Multiracial 2.2 1.8, 2.6
 Non-Hispanic Othera 0.8 0.6, 1.1
 Hispanic of any race 24.7 24.0, 25.4
Education level
 Less than high school 15.7 14.4, 17.1
 High school 30.0 28.4, 31.7
 Some college or more 54.2 52.6, 55.9
Currently married
 No 54.4 52.7, 56.1
 Yes 45.6 43.9, 47.3
State of residence
 Massachusetts 18.6 18.4, 18.8
 Maryland 17.3 17.1, 17.5
 Ohio 28.4 28.1, 28.8
 Texas 29.0 28.6, 29.5
 Virginia 6.7 6.6, 6.8
Experienced physical IPV 12 months before pregnancyb
 No 97.2 96.7, 97.7
 Yes 2.8 2.3, 3.3
Ever experienced contraceptive sabotageb
 No 98.2 97.8, 98.6
 Yes 1.8 1.4, 2.3
Contraceptive use at the time of pregnancy
 No 60.0 58.3, 61.7
 Yes 40.0 38.3, 41.7
Open in a new tab

Note. CI = Confidence interval, IPV = Intimate partner violence.

a

Other includes other non-White, Hawaiian, and American Indian.

b

With current partner.

Bivariable Associations

Table 2 presents the weighted prevalence of demographic characteristics by reported contraceptive use at the time of pregnancy and experience with contraceptive sabotage. Contraceptive use at the time of pregnancy was positively associated with ever experiencing contraceptive sabotage (p < .05); however, it was not associated with physical IPV 12 months before pregnancy (p = .2464). Age, race/ethnicity, and marital status were also significantly associated with contraceptive use at the time of pregnancy. A greater proportion who were using contraception when they became pregnant were 24 years of age or younger, identified as Hispanic, and were not married (37.6%, 27.7%, and 56.6%, respectively) compared to those who were not using contraception when they became pregnant (33.7%, 22.7%, and 52.9%, respectively).

Table 2.

Weighted Prevalence of Selected Characteristics by Contraceptive Use at the Time of Pregnancy and Ever Experienced Contraceptive Sabotage Among People with a Recent Live Birth Who Were Not Trying to Become Pregnant When They Conceived in five States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2012 to 2015 (n = 8,981).

Contraceptive Use at the Time of Pregnancy Ever Experienced Contraceptive Sabotageb
Characteristics No Yes p-value No Yes p-value
Age in years grouped <.05 <.001
 <20 7.2 9.3 7.8 20.2
 20–24 26.5 28.3 27.2 28.4
 25–29 28.7 28.5 28.6 31.0
 30–34 21.6 20.8 21.5 12.2
 35–39 12.6 11.0 12.0 7.0
 40 + 3.4 2.12 3.0 1.3
Race/ethnicity <.05 <.05
 Non-Hispanic White 49.1 43.6 47.2 32.7
 Non-Hispanic Black 20.9 22.2 21.2 34.6
 Non-Hispanic Asian 4.2 3.8 3.9 9.6
 Non-Hispanic Multiracial 2.2 2.1 2.2 0.6
 Non-Hispanic Othera 0.9 0.7 0.8 3.1
 Hispanic of any race 22.7 27.7 24.8 19.5
Education level .7943 .2829
 Less than high school 15.4 16.9 15.6 22.6
 High school 30.3 29.7 30.0 30.4
 Some college or more 54.4 54.1 54.4 47.0
Currently married <.05 <.05
 No 52.9 56.6 54.1 70.1
 Yes 47.1 43.4 45.9 30.0
State of residence .2374 .5213
 Massachusetts 19.1 17.9 18.5 22.0
 Maryland 16.3 18.7 17.2 23.0
 Ohio 29.0 27.6 28.4 27.2
 Texas 28.6 29.7 29.1 23.0
 Virginia 7.1 6.1 6.7 4.8
Experienced physical IPV 12 months before pregnancy .2464 <.001
 No 97.0 97.6 97.6 76.1
 Yes 3.0 2.4 2.4 23.9
Ever experienced contraceptive sabotageb <.05
 No 98.6 97.7
 Yes 1.4 2.4
Contraceptive use at the time of pregnancy <.05
 No 60.3 47.4
 Yes 39.8 52.7
Open in a new tab

Note. IPV = intimate partner violence.

a

Other includes other non-White, Hawaiian, and American Indian.

b

With current partner.

Experiencing physical IPV 12 months before pregnancy and contraceptive use at the time of pregnancy were both positively associated with ever experiencing contraceptive sabotage (p < .001 and p < .05, respectively). Age, race/ethnicity, and marital status were also associated with ever experiencing contraceptive sabotage. A greater proportion who experienced contraceptive sabotage were 24 years of age or younger, identified as non-Hispanic black, and were not married (48.6%, 34.6%, and 70.1%, respectively) compared to people who never experienced contraceptive sabotage (35.0%, 21.2%, and 54.1%, respectively).

Multivariable Models

Table 3 presents the unadjusted and adjusted associations between ever experienced contraceptive sabotage, past year physical IPV, selected participant characteristics (i.e., race/ethnicity, marital status, education, age, and state of residence), and contraceptive use at the time of pregnancy. In the unadjusted models, ever experiencing contraceptive sabotage was positively associated with contraceptive use at the time of pregnancy (OR: 1.69; 95% CI: 1.05, 2.69), whereas past year physical IPV was not (OR: 0.79; 95% CI: 0.53, 1.18). In the fully adjusted model, the relationship between contraceptive sabotage and contraceptive use remained, such that people who ever experienced contraceptive sabotage had 1.73 times greater odds of having used contraception at the time of pregnancy compared to people who did not experience contraceptive sabotage (95% CI: 1.06, 2.82). Past year physical IPV was not associated with contraceptive use at the time of pregnancy in this model (Adjusted Odds Ratio (aOR): 0.69; 95% CI: 0.46, 1.02).

Table 3.

Unadjusted and Adjusted Associations Between Characteristics and Contraceptive Use at the Time of Pregnancy Among People with a Recent Live Birth Who Were Not Trying to Become Pregnant When They Conceived in Five States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2012 to 2015 (n = 8,981).

Outcome: Contraceptive Use at the Time of Pregnancy
Characteristics Unadjusted OR 95% CI Adjusted OR 95% CI
Ever experienced contraceptive sabotagea
 No Ref. Ref.
 Yes 1.69 1.05, 2.69 1.73 1.06, 2.82
Experienced physical IPV 12 months before pregnancy
 No Ref. Ref.
 Yes 0.79 0.53, 1.18 0.69 0.46, 1.02
Age in years grouped
 <20 Ref. Ref.
 20–24 0.82 0.61, 1.10 0.84 0.62, 1.14
 25–29 0.77 0.57, 1.02 0.78 0.58, 1.07
 30–34 0.74 0.56, 0.99 0.76 0.56, 1.05
 35–39 0.67 0.48, 0.94 0.68 0.47, 0.99
 40+ 0.49 0.31, 0.79 0.51 0.31, 0.83
Race/ethnicity
 Non-Hispanic White Ref. Ref.
 Non-Hispanic Black 1.19 1.04, 1.38 1.15 0.98, 1.33
 Non-Hispanic Asian 1.01 0.76, 1.35 1.03 0.77, 1.38
 Non-Hispanic Multiracial 1.05 0.72, 1.53 0.98 0.67, 1.43
 Non-Hispanic Otherb 0.88 0.44, 1.80 0.90 0.44, 1.85
 Hispanic of any race 0.00 1.11, 1.71 1.43 1.15, 1.79
Education level
 Less than high school Ref. Ref.
 High school 0.92 0.72, 1.18 0.99 0.76, 1.27
 Some college or more 0.94 0.76, 1.17 1.12 0.88, 1.43
Currently married
 No Ref. Ref.
 Yes 0.86 0.74, 0.99 0.93 0.79, 1.10
State of residence
 Massachusetts Ref. Ref.
 Maryland 1.22 1.06, 1.40 1.20 1.04, 1.38
 Ohio 1.01 0.87, 1.17 1.05 0.90, 1.24
 Texas 1.11 0.89, 1.37 1.00 0.81, 1.23
 Virginia 0.92 0.69, 1.23 0.93 0.69, 1.25
Open in a new tab

Note. IPV = intimate partner violence; OR = odds ratio.

a

With current partner.

b

Other includes other non-White, Hawaiian, and American Indian.

Adjusted odds for contraceptive use at the time of pregnancy only significantly increased for people who reported ever experiencing contraceptive sabotage and not past year physical IPV compared to people who experienced neither (aOR: 1.72; 95% CI: 1.00, 2.95) (Table 4).

Table 4.

Unadjusted and Adjusted Associations Between Contraceptive Use at the Time of Pregnancy and Ever Experience Contraceptive Sabotage and/or Past Year Physical Intimate Partner Violence Among People with a Recent Live Birth Who Were Not Trying To Become Pregnant When They Conceived in Five States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2012 to 2015 (n = 8,981).

Outcome: Contraceptive Use at the Time of Pregnancy
Characteristics Weighted % (95% CI) Unadjusted OR 95% CI Adjusted OR 95% CI
Ever experienced contraceptive sabotagea Experienced physical IPV 12 months before pregnancya
No No 95.9 (95.2, 96.4) Ref. Ref.
No Yes 2.3 (1.9, 2.9) 0.72 0.48, 1.10 0.68 0.45, 1.04
Yes No 1.4 (1.1, 1.8) 1.82 1.09, 3.03 1.72 1.00, 2.95
Yes Yes 0.4 (0.3, 0.7) 1.28 0.42, 3.92 1.21 0.42, 3.50
Open in a new tab

Note. Adjusted model controlled for age, race/ethnicity, education, marital status, and state of residence.

CI = confidence interval; IPV = intimate partner violence; OR = odds ratio.

a

With current partner.

Discussion

Among people with a recent live birth who reported not trying to become pregnant, we documented a significant positive association between ever experiencing contraceptive sabotage with their current partner and contraceptive use at the time of pregnancy. We also found that the effects of ever experiencing contraceptive sabotage were independent of past year physical IPV. Over half of people who reported ever experiencing contraceptive sabotage were not trying to become pregnant and using contraception, yet became pregnant.

Comparing our study findings to past research that has assessed relationships between reproductive coercion and contraceptive use is difficult. First, past studies have focused on clinic-based samples (Hill et al., 2019; Skracic et al., 2021) and female veterans (Rosenfeld et al., 2018). Our population-based sample consisted of people with a recent live birth residing in five states who were not trying to become pregnant at the time of pregnancy. Second, past studies have used different measures of reproductive coercion and have asked about it in relation to current and past partners over different periods of time than in the present study. Despite these differences, all past studies showed significant relationships with contraceptive use outcomes. Rosenfeld et al. (2018) found that women experiencing reproductive coercion were less likely to use any contraception, including prescription, and to use their ideal method. Hill et al. (2019) found that adolescent girls and women who had ever experienced adolescent relationship abuse and reproductive coercion were less likely to use dual-method contraception (i.e., condoms plus hormonal methods) compared to a hormonal method alone. Skracic et al. (2021) found that women who reported contraceptive sabotage (or what the authors label “behavioral forms of reproductive coercion”) were more likely to be using highly effective versus moderately effective methods and less likely to be using moderately effective methods versus low effective methods. Women who experienced what the authors labeled “verbal reproductive coercion” were more likely to use moderately effective versus low effective methods (Skracic et al., 2021). Altogether, these findings show that reproductive coercion may influence contraceptive use broadly. We also note that several measures of contraceptive sabotage in the existing literature focus exclusively on experiences with condoms, which assumes that other forms of contraception cannot be subject to sabotage. A strength of our study is that it captures contraceptive sabotage in a nonspecific way and is therefore more inclusive.

We did not find an association between contraceptive use at the time of pregnancy and past year physical IPV by a current partner. A meta-analysis that estimated the effect of IPV on women’s contraceptive use globally showed that physical IPV was significantly associated with reduced contraceptive use in four of five studies that measured exposure to it; however, the pooled odds ratio was not statistically significant (Maxwell et al., 2015). An additional study demonstrated that young U.S. women were less likely to use any contraception when recently exposed to physical IPV in their current relationship and that, among those who only used condoms, consistent use was lower with recent experience of physical IPV (Kusunoki et al., 2018). Different study findings may be due to varied study designs, samples, and measurement of physical IPV and contraceptive use. Divergent relationships between physical IPV and types of contraceptive methods may be possible; however, our study design did not allow for looking at contraceptive method-specific relationships, became the PRAMS survey did not collect data on the type of contraceptive method that was used at the time of pregnancy.

Implications for Screening and Prevention

Several major health organizations, including the American College of Obstetrics and Gynecology (ACOG) and the U.S. Preventive Services Task Force (USPSTF), recommend universal screening for IPV and reproductive coercion and referral to ongoing support services (ACOG, 2013; Curry et al., 2018). Furthermore, providing information about how IPV and reproductive coercion can impact health and reproductive choices may also be beneficial (Niolon et al., 2017). However, ensuring the privacy, safety, and confidentiality of all clients is important if universal screening is implemented. Maintaining appropriate training, attitudes, and skills to counsel and refer patients who may be experiencing IPV and reproductive coercion is also essential. Providers can offer a referral pathway to other appropriate health and social services (e.g., psychosocial counseling, community-based services, and quality family planning services) (Gavin et al., 2014; International Planned Parenthood Federation, 2022). USPSTF’s review of the existing evidence did not support implementing brief interventions or providing information about referrals without ongoing support services (Curry et al., 2018). We note that no universal or validated screening tool for reproductive coercion exists for use in clinical settings.

Best practices for counseling about the potential effects of reproductive coercion on contraceptive decisions is the subject of ongoing debate in the field (Fay et al., 2022). Contraceptive counseling practices that either explicitly or implicitly recommend certain methods do not respect patient autonomy and could be detrimental to a person who is experiencing reproductive coercion, particularly if their partner is coercing the use or nonuse of certain methods (Fay et al., 2022). Qualitative studies with healthcare and social service providers in Australia highlight the need for providers to be empathetic when discussing reproductive coercion and contraceptive choices, ensure that their patients feel safe, feel supported, and that their reproductive autonomy is respected (Tarzia et al. 2019a, 2019b). The study findings also highlight the lack of shared understanding about reproductive coercion and consensus about how providers should respond to it (Tarzia et al., 2019a, 2019b). Better comprehension about how providers can incorporate screening and discussions about reproductive coercion could inform the development of clinically relevant tools and patient-centered contraceptive counseling, and patient-centered, noncoercive contraceptive counseling that prioritizes patient preferences in the context of patients experiencing reproductive coercion.

Implications for Violence Prevention

Evidence-based strategies that focus on preventing physical, sexual, and emotional IPV may also mitigate the adverse effects of reproductive coercion because many forms of violence share similar risk factors (Wilkins et al., 2014). However, while reproductive coercion and other forms of IPV can co-occur, they are also distinct (we found that 23.9% of people who reported ever experiencing contraceptive sabotage experienced physical IPV 12 months before pregnancy, compared to 2.4% of people who did not report contraceptive sabotage). IPV prevention strategies may prevent some forms of reproductive coercion, but not all forms. Strategies specific to reproductive coercion may be needed. CDC’s prevention resources highlight strategies such as teaching safe and healthy relationship skills, disrupting the developmental pathways toward partner violence, creating protective environments, changing social norms, and strengthening economic supports as the best available evidence to prevent IPV (Niolon et al., 2017). These existing strategies may also prevent reproductive coercion given its association with IPV. They could be reviewed and tested to determine if they can also prevent reproductive coercion.

Few interventions focus on reducing reproductive coercion and lessening associated harms. However, one such intervention, the clinic-based Addressing Reproductive Coercion in Health Settings (ARCHES) can be delivered within a single session during routine family planning services by providers and has been shown to reduce reproductive coercion among women presenting to family planning clinics and reporting IPV (Miller et al., 2011). Still, ARCHES is limited because it only reaches those who can access reproductive health services, which may be difficult for people experiencing reproductive coercion or other forms of IPV. In addition, no interventions, programs, or other strategies currently exist that include the perpetrator of reproductive coercion. Strengthening the connections between family planning programs and policies and violence prevention strategies could ultimately improve existing interventions and programs (Miller, Jordan et al., 2010) and could also help with the development of novel strategies that focus on both the perpetrator of reproductive coercion and the person experiencing it.

Limitations

We cannot assess temporality or the direction of association (e.g., that ever experiencing contraceptive sabotage led to contraceptive use at the time of pregnancy) due to the cross-sectional nature of the PRAMS survey and lack of clarity about the time and order of experiences with contraceptive sabotage, past year physical IPV, and contraceptive use at the time of pregnancy. A longitudinal study design may be necessary to further elucidate the timing and effect of contraceptive sabotage and physical IPV on contraceptive behaviors.

Our study was limited to people with a recent live birth who were not trying to conceive when they became pregnant, excluding those whose pregnancies resulted in other outcomes (stillbirth, induced or spontaneous abortion), and people trying to conceive. Our analysis also only includes people residing in five states. Thus, we cannot generalize our findings to people outside of these states. Understanding contraceptive sabotage and other forms of reproductive coercion among people with other pregnancy outcomes may provide a more complete picture of the relationship between contraceptive use and reproductive coercion. Furthermore, Phase 7 of PRAMS did not include collecting data on sexual orientation or gender identity. Most research on reproductive coercion and contraceptive use focuses on the perspectives of cis-gender women in heterosexual relationships, and thus we have a limited perspective about how reproductive coercion and other forms of IPV may influence contraceptive use among LGBTQ+ populations.

We measured contraceptive sabotage and physical IPV using one question for each and did not assess other forms of reproductive coercion (e.g., pregnancy coercion) and IPV (e.g., sexual and emotional) that may be associated with contraceptive use at the time of pregnancy. Other studies have used adaptations of the Reproductive Coercion Scale (Hill et al., 2019; Rosenfeld et al., 2018). Future research could develop other multidimensional measures of reproductive coercion that reflect many experiences and test its relationship with contraceptive use. Furthermore, relatively few people reported past year physical IPV and contraceptive sabotage, which may have limited our ability to detect an association between past year physical IPV and contraceptive use at the time of pregnancy. Not only could this be due to measuring physical IPV with only one question, but could also be due to not assessing the frequency and severity of physical IPV. Larger samples that include people residing in all 50 U.S. states and its territories might improve statistical power to detect associations in future analyses.

Lastly, PRAMS did not collect data about the type of contraceptive method that was used at the time of pregnancy. Thus, we cannot disentangle relationships between contraceptive sabotage and use of specific methods.

Conclusions

Our study highlights that there is a significant positive association between past experiences of contraceptive sabotage and contraceptive use at the time of pregnancy. Recognizing that reproductive health outcomes are shaped by complex structural, social, and relational realities, rather than only individual choices, may help strengthen programs and may inform future research (Malarcher & World Health Organization, 2010). Questions remain about the mechanisms through which contraceptive sabotage influences contraceptive use. However, our findings support the growing body of evidence that it is associated with such use. Future research on reproductive coercion and its relationship with contraceptive behaviors in population-based samples may help develop evidence-based harm-mitigation and prevention interventions and screening tools for use in clinical settings.

Acknowledgments

The authors thank the PRAMS Working Group members: Alabama—Danita Crear, DrPH; Alaska—Kathy Perham-Hester, MS, MPH; Arkansas—Mary McGehee, PhD; Colorado—Alyson Shupe, PhD; Connecticut—Jennifer Morin, MPH; Delaware—George Yocher, MS; District of Columbia—Pamela Oandasan; Florida—Jerri Foreman, MPH; Georgia—Jenna Self, MPH; Hawaii—Emily Roberson, MPH; Illinois—Theresa Sandidge, MA; Indiana—Jenny Durica, MPH; Iowa—Sarah Mauch, MPH; Louisiana—Jane Herwehe, MPH; Maine—Tom Patenaude, MPH; Maryland—Diana Cheng, MD; Massachusetts—Emily Lu, MPH; Michigan—Cristin Larder, MS; Minnesota—Judy Punyko, PhD, MPH; Mississippi—Brenda Hughes, MPPA; Missouri—Venkata Garikapaty, MSc, MS, PhD, MPH; Montana—JoAnn Dotson; Nebraska—Brenda Coufal; New Hampshire—Paulette Valliere, MPH; New Jersey—Lakota Kruse, MD; New Mexico—Eirian Coronado, MPH; New York State—Anne Radigan-Garcia; New York City—Candace Mulready-Ward, MPH; North Carolina—Kathleen Jones-Vessey, MS; North Dakota—Sandra Anseth; Ohio—Connie Geidenberger, PhD; Oklahoma—Alicia Lincoln, MSW, MSPH; Oregon—Kenneth Rosenberg, MD, MPH; Pennsylvania—Tony Norwood; Rhode Island—Sam Viner-Brown, PhD; South Carolina—Mike Smith, MSPH; Texas—Rochelle Kingsley, MPH; Tennessee—Angela Miller, PhD, MSPH; Utah—Lynsey Gammon, MPH; Vermont—Peggy Brozicevic; Virginia—Marilyn Wenner; Washington—Linda Lohdefinck; West Virginia—Melissa Baker, MA; Wisconsin—Mireille Perzan, MPH; Wyoming—Amy Spieker, MPH; CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health.

Funding

The authors disclosed receipt of the following financial support for the research and/or authorship of this article: This project was partly supported by the Research Participation Program at CDC administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and CDC. Partial support for ORISE is funded through an Interagency Agreement between CDC and ACF OTIP. Salary support for Dr. Narasimhan was provided by BIRCWH Award Number K12HD085850, the GTCSA Award Number KL2TR002381, and the GCTC Grant Award Number U1TR002378; the content is authors’ sole responsibility and does not represent the official views of the NIH or the GCTSA.

Author Biographies

Sarah Huber-Krum, PhD, MSW, MPA, is a Behavioral Scientist in the Centers for Disease Control and Prevention’s Division of Violence Prevention. Her research uses social and reproductive justice frameworks to understand how violence shapes sexual and reproductive health, with a focus on pregnancy prevention and family planning.

Marta Bornstein, PhD, is a postdoctoral scholar at The Ohio State University in the College of Public Health. Her research focuses on sexual and reproductive health and justice of marginalized communities in the United States and internationally.

Denise V. D’Angelo, MPH, is a Health Scientist in the Centers for Disease Control and Prevention’s Division of Violence Prevention. Her research covers various topics related to maternal and infant health including intimate partner violence, substance use, family planning, and health insurance coverage.

Subasri Narasimhan, PhD, MPH, is an Assistant Professor at Emory University and a public health social scientist specializing in sexual and reproductive health, maternal and child health, and intimate partner violence in Sub-Saharan Africa, Asia, and the Southeastern United States.

Lauren B. Zapata, PhD, MSPH, is a Commander in the United States Public Health Service and a Senior Research Scientist in the Division of Reproductive Health at the Centers for Disease Control and Prevention. Her work focuses on contraception access, evidence-based contraception guidelines, and COVID-19 during pregnancy.

Kara Tsukerman is a ORISE fellow at the Centers for Disease Control and Prevention. She assists with projects that allow for a better understanding of the scope of sex trafficking and its associated risk and protective factors to advance the public health approach to trafficking.

Yanet Ruvalcaba, PhD, is a Behavioral Scientist at the Centers for Disease Control and Prevention’s Division of Violence Prevention. Her research spans across the domains of technology-facilitated violence, and of both intimate partner and sexual violence, with a health equity approach to violence prevention.

Footnotes

Disclaimer

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC) or the Administration for Children and Families’ Office on Trafficking in Persons (ACF OTIP).

Declaration of Conflicting Interests

The authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

1.

We prioritized using gender inclusive language throughout this manuscript to reflect that people of all gender identities use contraception, are capable of pregnancy, and may experience reproductive coercion. Past research on these topics generally more narrowly defines these populations as “women.” In these instances, we use their terminology to report findings.

2.

The World Health Organization (2022) defines reproductive health as, “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.”

References

  1. ACOG. (2013). Reproductive and sexual coercion. Retrieved from Washington, D.C.: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/02/reproductive-and-sexual-coercion [Google Scholar]
  2. Borrero S, Nikolajski C, Steinberg JR, Freedman L, Akers AY, Ibrahim S, & Schwarz EB (2015). “It just happens”: A qualitative study exploring low-income women’s perspectives on pregnancy intention and planning. Contraception, 91(2), 150–156. 10.1016/j.contraception.2014.09.014 [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Breiding MJ, Basile KC, Smith SG, Black MC, & Mahendra RR (2015). Intimate partner violence surveillance: Uniform definitions and recommended data elements, Version 2.0. Centers for Disease Control and Prevention. Retrieved April 22, 2022, https://www.cdc.gov/prams/methodology.htm [Google Scholar]
  4. Clark LE, Allen RH, Goyal V, Raker C, & Gottlieb AS (2014). Reproductive coercion and co-occurring intimate partner violence in obstetrics and gynecology patients. American Journal of Obstetrics and Gynecology, 210(1), 42. e41–e48. 10.1016/j.ajog.2013.09.019 [DOI] [PubMed] [Google Scholar]
  5. Cohen J, Cohen P, West SG, & Aiken LS (2002). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.). Lawrence Erlbaum Associates Publishers. [Google Scholar]
  6. Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW, Grossman DC, Kemper AR, Kubik M, Kurth A, Landefeld CS, Mangione CM, Silverstein M, Simon MA, Tseng C-W, & Wong JB (2018). Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults: US preventive services task force final recommendation statement. JAMA, 320(16), 1678–1687. 10.1001/jama.2018.14741 [DOI] [PubMed] [Google Scholar]
  7. Fay KE, Onwuzurike C, Finley A, & Miller E (2022). Integrating anti-violence efforts into sexual and reproductive health: Reproductive coercion as a case example. Contraception, 115, 75–79. 10.1016/j.contraception.2022.06.006 [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Finer LB, & Henshaw SK (2006). Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health, 38(2), 90–96. 10.1363/psrh.38.090.06 [DOI] [PubMed] [Google Scholar]
  9. Franke TM, Ho T, & Christie CA (2012). The chi-square test: Often used and more often misinterpreted. American Journal of Evaluation, 33(3), 448–458. 10.1177/1098214011426594 [DOI] [Google Scholar]
  10. Frohwirth L, Mueller J, Ragnar A, Williams P, Kochhar S, Castle SK, & Kavanaugh ML (2022). Understanding contraceptive failure: An analysis of qualitative narratives. Women’s Reproductive Health, 10(2), 280–302. 10.1080/23293691.2022.2090304 [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gavin L, Moskosky S, Carter M, Curtis K, Glass E, Godfrey E, Marcell A, Mautone-Smith N, Pazol K, Tepper N, & Zapata L (2014). Providing quality family planning services: Recommendations of CDC and the U.S. Office of Population Affairs. MMWR Recommendation and Reports, 63(Rr-04), 1–54. [PubMed] [Google Scholar]
  12. Giacci E, Straits KJE, Gelman A, Miller-Walfish S, Iwuanyanwu R, & Miller E (2022). Intimate partner and sexual violence, reproductive coercion, and reproductive health among American Indian and Alaska native women: A narrative interview study. Journal of Womens Health (Larchmt), 31(1), 13–22. 10.1089/jwh.2021.0056 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Gordon BS (2018). Chi-square test. In The SAGE encyclopedia of educational research, measurement, and evaluation (Vol. 1–4). SAGE Publications, Inc. [Google Scholar]
  14. Grace KT, Alexander KA, Jeffers NK, Miller E, Decker MR, Campbell J, & Glass N (2020). Experiences of reproductive coercion among Latina women and strategies for minimizing harm: “The Path Makes Us Strong”. Journal of Midwifery & Women’s Health, 65(2), 248–256. 10.1111/jmwh.13061 [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Grace KT, & Anderson JC (2018). Reproductive coercion: A systematic review. Trauma Violence, & Abuse, 19(4), 371–390. 10.1177/1524838016663935 [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Grace KT, Decker MR, Alexander KA, Campbell J, Miller E, Perrin N, & Glass N (2022). Reproductive coercion, intimate partner violence, and unintended pregnancy among Latina women. Journal of Interpersonal Violence, 37(3–4), 1604–1636. 10.1177/0886260520922363 [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. HHS. (2011). HHS implementation guidance on data collection standards for race, ethnicity, sex, primary language, and disability status. Retrieved from https://aspe.hhs.gov/reports/hhs-implementation-guidance-data-collection-standards-race-ethnicity-sex-primary-language-disability-0 [DOI] [PubMed]
  18. Hill AL, Jones KA, McCauley HL, Tancredi DJ, Silverman JG, & Miller E (2019). Reproductive coercion and relationship abuse among adolescents and young women seeking care at school health centers. Obstetrics & Gynecology, 134(2), 351–359. 10.1097/aog.0000000000003374 [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Holliday CN, McCauley HL, Silverman JG, Ricci E, Decker MR, Tancredi DJ, Burke JG, Documét P, Borrero S, & Miller E (2017). Racial/ethnic differences in women’s experiences of reproductive coercion, intimate partner violence, and unintended pregnancy. Journal of Womens Health (Larchmt), 26(8), 828–835. 10.1089/jwh.2016.5996 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. International Planned Parenthood Federation. (2022). Client-centred clinical guidelines for sexual and reproductive healthcare. Retrieved from https://www.ippf.org/sites/default/files/ippf_client-centred_clinical_guidelines_complete.pdf
  21. Jones KA, Cornelius MD, Silverman JG, Tancredi DJ, Decker MR, Haggerty CL, De Genna NM, & Miller E (2016). Abusive experiences and young women’s sexual health outcomes: Is condom negotiation self-efficacy a mediator? Perspectives on Sexual & Reproductive Health, 48(2), 57–64. 10.1363/48e8616 [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Katz J, Poleshuck EL, Beach B, & Olin R (2017). Reproductive coercion by male sexual partners: Associations with partner violence and college women’s sexual health. Journal of Interpersonal Violence, 32(21), 3301–3320. 10.1177/0886260515597441 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Kusunoki Y, Barber JS, Gatny HH, & Melendez R (2018). Physical intimate partner violence and contraceptive behaviors among young women. Journal of Womens Health (Larchmt), 27(8), 1016–1025. 10.1089/jwh.2016.6246 [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Lévesque S, Rousseau C, & Dumerchat M (2021). Influence of the relational context on reproductive coercion and the associated consequences. Violence Against Women, 27(6–7), 828–850. 10.1177/1077801220917454 [DOI] [PubMed] [Google Scholar]
  25. Malarcher S, & World Health Organization. (2010). Social determinants of sexual and reproductive health: Informing future research and programme implementation. Retrieved from https://apps.who.int/iris/handle/10665/44344
  26. Maxwell L, Devries K, Zionts D, Alhusen JL, & Campbell J (2015). Estimating the effect of intimate partner violence on women’s use of contraception: A systematic review and meta-analysis. PLoS One, 10(2), e0118234. 10.1371/journal.pone.0118234 [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. McCauley HL, Dick RN, Tancredi DJ, Goldstein S, Blackburn S, Silverman JG, Monasterio E, James L, & Miller E (2014). Differences by sexual minority status in relationship abuse and sexual and reproductive health among adolescent females. Journal of Adolescent Health, 55(5), 652–658. 10.1016/j.jadohealth.2014.04.020 [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. McCauley HL, Silverman JG, Jones KA, Tancredi DJ, Decker MR, McCormick MC, Bryn Austin S, Anderson HA, & Miller E (2017). Psychometric properties and refinement of the reproductive coercion scale. Contraception, 95(3), 292–298. 10.1016/j.contraception.2016.09.010 [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, & Silverman JG (2010). Pregnancy coercion, intimate partner violence and unintended pregnancy. Contraception, 81(4), 316–322. 10.1016/j.contraception.2009.12.004 [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Miller E, Decker MR, McCauley HL, Tancredi DJ, Levenson RR, Waldman J, Schoenwald P, & Silverman JG (2011). A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception, 83(3), 274–280. 10.1016/j.contraception.2010.07.013 [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Miller E, Decker MR, Reed E, Raj A, Hathaway JE, & Silverman JG (2007). Male partner pregnancy-promoting behaviors and adolescent partner violence: Findings from a qualitative study with adolescent females. Ambulatory Pediatrics, 7(5), 360–366. 10.1016/j.ambp.2007.05.007 [DOI] [PubMed] [Google Scholar]
  32. Miller E, Jordan B, Levenson R, & Silverman JG (2010). Reproductive coercion: Connecting the dots between partner violence and unintended pregnancy. Contraception, 81(6), 457–459. 10.1016/j.contraception.2010.02.023 [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Miller E, McCauley HL, Tancredi DJ, Decker MR, Anderson H, & Silverman JG (2014). Recent reproductive coercion and unintended pregnancy among female family planning clients. Contraception, 89(2), 122–128. 10.1016/j.contraception.2013.10.011 [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Moore AM, Frohwirth L, & Miller E (2010). Male reproductive control of women who have experienced intimate partner violence in the United States. Social Science & Medicine, 70(11), 1737–1744. 10.1016/j.socscimed.2010.02.009 [DOI] [PubMed] [Google Scholar]
  35. Mosher WD, Martinez GM, Chandra A, Abma JC, & Willson SJ (2004). Use of contraception and use of family planning services in the United States: 1982–2002. Advance Data 350(350), 1–36. [PubMed] [Google Scholar]
  36. Muñoz EA, Le VD, Lu Y, Shorey RC, & Temple JR (2022). Reproductive coercion and intimate partner violence victimization among a racially and ethnically diverse young adult sample. Journal of Interpersonal Violence, 38(1–2), NP1261–NP1278. 10.1177/08862605221092349 [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Nikolajski C, Miller E, McCauley HL, Akers A, Schwarz EB, Freedman L, Steinberg J, Ibrahim S, & Borrero S (2015). Race and reproductive coercion: A qualitative assessment. Womens Health Issues, 25(3), 216–223. 10.1016/j.whi.2014.12.004 [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Niolon PH, Kearns M, Dills J, Rambo K, Irving S, Armstead T, & Gilbert L (2017). Preventing intimate partner violence across the lifespan: A technical package of programs, policies, and practices. Retrieved from https://www.cdc.gov/violenceprevention/pdf/ipv-technicalpackages.pdf
  39. Office of Disease Prevention and Health Promotion. (n.d.). Healthy people 2030 family planning. Retrieved from https://health.gov/healthypeople/objectives-and-data/browse-objectives/family-planning
  40. Rosenfeld EA, Miller E, Zhao X, Sileanu FE, Mor MK, & Borrero S (2018). Male partner reproductive coercion among women veterans. American Journal of Obstetrics and Gynecology, 218(2), 239.e231–239.e238. 10.1016/j.ajog.2017.10.015 [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Rowlands S, & Walker S (2019). Reproductive control by others: Means, perpetrators and effects. BMJ Sexual & Reproductive Health, 45(1), 61–67. 10.1136/bmjsrh-2018-200156 [DOI] [PubMed] [Google Scholar]
  42. Samankasikorn W, Alhusen J, Yan G, Schminkey DL, & Bullock L (2019). Relationships of reproductive coercion and intimate partner violence to unintended pregnancy. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 48(1), 50–58. 10.1016/j.jogn.2018.09.009 [DOI] [PubMed] [Google Scholar]
  43. Shulman HB, D’Angelo DV, Harrison L, Smith RA, & Warner L (2018). The Pregnancy Risk Assessment Monitoring System (PRAMS): Overview of design and methodology. American Journal of Public Health, 108(10), 1305–1313. 10.2105/ajph.2018.304563 [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Skracic I, Lewin AB, & Steinberg JR (2021). Types of lifetime reproductive coercion and current contraceptive use. Journal of Womens Health (Larchmt), 30(8), 1078–1085. 10.1089/jwh.2020.8784 [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Starrs AM, Ezeh AC, Barker G, Basu A, Bertrand JT, Blum R, Coll-Seck AM, Grover A, Laski L, Roa M, Sathar ZA, Say L, Serour GI, Singh S, Stenberg K, Temmerman M, Biddlecom A, Popinchalk A, … Ashford LS (2018). Accelerate progress-sexual and reproductive health and rights for all: Report of the Guttmacher-Lancet Commission. Lancet, 391(10140), 2642–2692. 10.1016/s0140-6736(18)30293-9 [DOI] [PubMed] [Google Scholar]
  46. StataCorp. (2019). Stata statistical software: Release 16. StataCorp LLC. [Google Scholar]
  47. Tarzia L, & Hegarty K (2021). A conceptual re-evaluation of reproductive coercion: centring intent, fear and control. Reproductive Health, 18(1), 87. 10.1186/s12978-021-01143-6 [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Tarzia L, Wellington M, Marino J, & Hegarty K (2019a). How do health practitioners in a large Australian public hospital identify and respond to reproductive abuse? A qualitative study. Australian and New Zealand Journal of Public Health, 43(5), 457–463. 10.1111/1753-6405.12923 [DOI] [PubMed] [Google Scholar]
  49. Tarzia L, Wellington M, Marino J, & Hegarty K (2019b). “A Huge, Hidden Problem”: Australian health practitioners’ views and understandings of reproductive coercion. Qualitative Health Research, 29(10), 1395–1407. 10.1177/1049732318819839 [DOI] [PubMed] [Google Scholar]
  50. United Nations. (2015). Report of the international conference on population and development, Cairo, 5–13 September 1994. Retrieved from https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/a_conf.171_13_rev.1.pdf
  51. United Nations Department of Economic and Social Affairs Sustainable Development. (2022). Sustainable development goal 5: Achieve gender equality and empower all women and girls. Retrieved from https://sdgs.un.org/goals/goal5
  52. Wilkins N, Tsao B, Hertz M, Davis R, & Klevens J (2014). Connecting the dots: An overview of the links among multiple forms of violence. Retrieved from https://www.cdc.gov/violenceprevention/pdf/connecting_the_dots-a.pdf

RESOURCES