The American College of Obstetrics and Gynecology (ACOG) recently published a committee opinion discussing the subject of Sexual and Reproductive Coercion (SRC).
SRC is a pattern of physical violence or psychologically coercive behaviors intended to control a woman’s sexual decision making, contraceptive use, or pregnancy.
These behaviors are examples of intentional attempts of others, most commonly the male sexual partner, to control the sexual and reproductive rights of a woman.
The coercion includes contraceptive sabotage, where a patient’s partner intentionally hides birth control pills, refuses to wear a condom during intercourse, makes holes in condoms, or forcefully removing intrauterine devices or vaginal contraceptive rings in an attempt to get their partner pregnant against their will.
The coercion, however, may also include pressure from family and friends by embarassing or pressuring a woman through guilt or intimidation into having a child before the woman is ready. It also includes forcing a woman to have an abortion or termination of pregnancy.
Sexual and reproductive coercion is commonly associated with sexual and physical violence. One study involving adolescent mothers on public assistance reported birth control sabotage by over 50% of their dating partner.
Recommendations in order to assist patients at risk for sexual or reproductive coercion include (1) offering hotline numbers and referrals to local domestic violence shelters and agencies, (2) offering long-acting methods of contraception less detectable to their partners such as the IUD, the Implanon or Depo Provera Injectable. (3) When using an IUD, trimming the string inside the cervix in order to prevent the partner from feeling the string or being able to pull the IUD out, (4) Provide Emergency Contraceptive (Plan B) pills and (5) Provide harm-reduction strategies and safety planning.