Reproductive coercion: When a woman’s body has many ‘stakeholders’

As the gender discourse evolves, so are concepts generated and clarified. One expression in vogue is “reproductive coercion” (RC).

First used in academic literature in 2010 by Elizabeth Miller and colleagues, the term refers to “behaviour that interferes with the autonomous decision-making of a woman with regard to reproductive health”.

Such behaviours consist of pregnancy coercion, contraceptive sabotage and controlling the outcome of a conception.

This concept is a novel configuration of acts previously amalgamated under sexual abuse and considered part of intimate partner violence. More important is that it has stimulated new research on prevalence, manifestations, perpetrators and consequences of the behaviour, as well as how affected women cope.

Pregnancy coercion exists when a woman is pressured to become pregnant against her will. This may consist of persistent verbal pressure and adverse reactions against those using contraceptives without the knowledge and/or permission of significant others.

A study by Sabrina Boyce and others cites a man in Nairobi who coerced his wife to remove an implant because he insisted on getting another baby with her. Other men threatened their partners with separation/divorce, association with another woman, promiscuity and withdrawal of financial support. In some cases, the coercion graduated into physical battery and forced intercourse.

Contraceptive sabotage

It is considered contraceptive sabotage when a partner interferes with the woman’s access to and use of birth control products. This includes confiscating, hiding and destroying the contraceptives. For instance, one man placed the contraceptives in hot water to reduce their efficacy, and later gloated to his wife when she conceived. Some hid or tore their wives’ clinic cards.

In a study by Moulton and others (2021), contraceptive sabotage also manifested in “interfering with condom durability, refusal to use the prophylactics…deceit that the partner was infertile and gas lighting”.

Some women were forced into irreversible methods of contraception, such as tubal ligation, so they would never conceive again. Control over pregnancy is exemplified by blackmailing women into keeping unwanted pregnancies by making them feel guilty of abortion and denying them support towards the same. It also includes emotional manipulation through promises, pleas and family pressure.

Also read: Women secretly using family planning to avoid partner violence

The studies concur that key perpetrators of the behaviour are male intimate partners and their relatives, with mothers-in-law being prominent. They are informed by a norm that a woman’s primary function in marriage is to bear children, thus not conforming is a breach of contract.

In addition, there is an entrenched conviction that women’s bodies have ‘many stakeholders’ whose interests must be met. The Nairobi study established that women who had more children were assigned a higher status by in-laws than those who did not. In some instances, the latter faced discrimination in distribution of family resources, including food.

Overall, reproductive coercion subjugates women and denies them autonomy over their bodies. It also conflates complications such as exposure to sexually transmitted infections, injury from premature post-partum resumption of intercourse, side effects of switching contraceptives and dangers of recurrent use of emergency pills.

Women’s coping strategies include switching to less visible contraceptives, hiding pills at home, timing use when partners are absent, keeping clinic cards in obscure places, and using pseudonyms on the cards.

One kept her clinic card in the in-sole of the husband’s shoes from where she retrieved it every time she cleaned the footwear, in order to check her next clinic date.

In ironic blissful ignorance and delusion that he was in control, he kept it in safe custody on his way to work as she laughed her way to the clinic! Worryingly, some women trivialised or minimised the behaviour, including blaming themselves for it. Typical of women who have internalised violence, this response does not end the abuse and may worsen it.

A refreshing study by Laura Tarzia and Kelsey Hegarty (2021) argues that “lack of definitional and conceptual clarity about reproductive coercion … leads to inconsistency across prevalence data, a poor understanding of the risk factors, and difficulties in demonstrating the effectiveness of interventions in health settings”.

It notes that ambiguity of the term leads to inclusion of factors that are extraneous to coercion, and exclusion of mandatory ingredients such as fear, intent and control. This indicates the danger of the expression being distorted and misused.

Thus the scholars suggest that reproductive coercion be re-defined as “any deliberate attempt to dictate a woman’s reproductive choices or interfere with her reproductive autonomy. It can include physical, psychological or sexual tactics and occurs in a context of fear and/or control in an interpersonal relationship.”

As scholars mull over this, other pertinent questions arise. How does RC intersect with class, race, ethnicity, religion, marital status, type of marriage, health, education and other variables? What about the male perspective on the issue?

Dr Miruka is an international gender and development consultant and scholar ([email protected]).