Dataset Information

Reproductive coercion sometimes works: evaluating whether young African-American women who experience reproductive coercion or birth control sabotage are more likely to become pregnant.

ABSTRACT: Men engaging in reproductive coercion may coerce, force, or deceive female partners into pregnancy. This study evaluates whether the 3-month incidence of pregnancy is higher among women reporting reproductive coercion than similar women reporting no reproductive coercion. We tested this hypothesis in longitudinal data from a sample of African-American women ages 18-24 recruited from community settings in Atlanta, Georgia, US, in 2012-2014 (n?=?560). Participants were surveyed at baseline, 3 months, 6 months, 9 months, and 12 months. To reduce selection bias, we used full matching on 22 baseline variables related to demographics, economic power, risky alcohol use, and gender-based power inequality. We used logistic regression in the matched sample with outcome pregnancy 3 months later, controlling for baseline fertility intentions (n?=?482, n?=?458, n?=?452 at respectively 3, 6, 9 months). At 3 months, 15% of women reported reproductive coercion. At 6 months, 11.3% of women reporting coercion were pregnant vs. 4.6% of matched women reporting no coercion (p?=?0.06). Women reporting coercion had 3 times the odds of pregnancy as matched women reporting no coercion (AOR 2.95, 95% CI (1.16, 6.98), p?=?0.02). Among women pregnant after coercion, only 15% wanted to be pregnant then or sooner. Women reporting reproductive coercion are at greater risk of unwanted or mistimed pregnancies, and the semen exposure that caused these pregnancies could also transmit STI/HIV. Clinicians should screen patients for reproductive coercion; consider using semen exposure biomarkers such as PSA or Yc-PCR to identify condom sabotage or stealthing; and refer women experiencing reproductive coercion to supportive services.

SUBMITTER: Rosenbaum JE

PROVIDER: S-EPMC7384393 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Reproductive coercion sometimes works: evaluating whether young African-American women who experience reproductive coercion or birth control sabotage are more likely to become pregnant.

Rosenbaum Janet E JE DiClemente Ralph J RJ

Health services & outcomes research methodology 20200727 4

Men engaging in reproductive coercion may coerce, force, or deceive female partners into pregnancy. This study evaluates whether the 3-month incidence of pregnancy is higher among women reporting reproductive coercion than similar women reporting no reproductive coercion. We tested this hypothesis in longitudinal data from a sample of African-American women ages 18-24 recruited from community settings in Atlanta, Georgia, US, in 2012-2014 (n = 560). Participants were surveyed at baseline, 3 mont ...[more]

PMID: 32837268

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Project description:Increasing modern contraceptive use and gender equity are major foci of the recently ratified Sustainable Development Goals for 2030 and the Government of India. Coercion and sabotage by husbands and in-laws to inhibit women's access, initiation, continuation, and successful use of modern contraception methods (i.e., reproductive coercion) may contribute to low usage rates and unintended pregnancy in India; however, little is known about the extent of this problem. The current study assesses the prevalence of reproductive coercion, both husband and in-law perpetrated, among a large population-based sample. Data were collected from currently married women of reproductive age (15-49 years; N?=?1770) across 49 districts of Uttar Pradesh as part of an evaluation of a broad effort to improve the public health system in the state. Dependent variables included modern contraceptive use in the past 12 months, unintended pregnancy, and pregnancy termination. Independent variables included ever experiencing reproductive coercion (RC) by a current husband or in-laws and lifetime experience of physical and sexual intimate partner violence (IPV) by a current husband. Approximately 1 in 8 (12%) women reported ever experiencing RC from their current husbands or in-laws; 42% of these women reported RC by husbands only, 48% reported RC by in-laws only, and 10% reported RC by both husbands and in-laws. Among women experiencing RC, more than one-third (36%) reported that their most recent pregnancy was unintended; these women had 4 to 5 times greater odds of unintended pregnancy and a more than 5 times decreased likelihood of recent use of modern contraceptives than women not experiencing RC, after accounting for effects of demographics and physical and sexual IPV. Scalable and sustainable interventions in both clinical and community settings are needed to reduce RC, a potentially key factor in effective strategies for improving women's reproductive autonomy and health in India and globally.

Project description:Importance:Sight is often considered to be the sense most valued by the general public, but there are limited empirical data to support this. This study provides empirical evidence for frequent assertions made by practitioners, researchers, and funding agencies that sight is the most valued sense. Objective:To determine which senses are rated most valuable by the general public and quantify attitudes toward sight and hearing loss in particular. Design, Setting, and Participants:This cross-sectional web-based survey was conducted from March to April 2016 through a market research platform and captured a heterogeneous sample of 250 UK adults ages 22 to 80 years recruited in March 2016. The data were analyzed from October to December 2018. Main Outcomes and Measures:Participants were first asked to rank the 5 traditional senses (sight, hearing, touch, smell, and taste) plus 3 other senses (balance, temperature, and pain) in order of most valuable (8) to least valuable (1). Next, the fear of losing sight and hearing was investigated using a time tradeoff exercise. Participants chose between 10 years without sight/hearing vs varying amounts of perfect health (from 0-10 years). Results:Of 250 participants, 141 (56.4%) were women and the mean (SD) age was 49.5 (14.6) years. Two hundred twenty participants (88%) ranked sight as their most valuable sense (mean [SD] rating, 7.8 [0.9]; 95% CI, 7.6-7.9). Hearing was ranked second (mean [SD] rating, 6.2 [1.3]; 95% CI 6.1-6.4) and balance third (mean [SD] rating, 4.9 [1.7]; 95% CI, 4.7-5.1). All 3 were ranked above the traditional senses of touch, taste, and smell (F7?=?928.4; P?<?.001). The time tradeoff exercise indicated that, on average, participants preferred 4.6 years (95% CI, 4.2-5.0) of perfect health over 10 years without sight and 6.8 years (95% CI, 6.5-7.2) of perfect health over 10 years without hearing (mean difference between sight and hearing, 2.2 years; P?<?.001). Conclusions and Relevance:In a cross-sectional survey of UK adults from the general public, sight was the most valued sense, followed by hearing. These results suggest that people would on average choose 4.6 years of perfect health over 10 years of life with complete sight loss, although how this generalizes to other parts of the world is unknown.

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Project description:BackgroundReproductive coercion and abuse is a major public health issue, with significant effects on the health and well-being of women. Reproductive coercion and abuse includes any form of behaviour that intentionally controls another person's reproductive choices. The aim of this qualitative evidence synthesis is to explore women's experiences of reproductive coercion and abuse globally, to broaden understanding of the different ways reproductive coercion and abuse is perpetrated, perceived and experienced across settings and socio-cultural contexts.MethodWe searched Medline, CINAHL and Embase for eligible studies from inception to 25th February 2021. Primary studies with a qualitative study design that focused on the experiences and perceptions of women who have encountered reproductive coercion and abuse were eligible for inclusion. Titles and abstracts, and full texts were screened by independent reviewers. We extracted data from included studies using a form designed for this synthesis and assessed methodological limitations using CASP. We used Thomas and Harden's thematic analysis approach to analyse and synthesise the evidence, and the GRADE-CERQual approach to assess confidence in review findings.ResultsWe included 33 studies from twelve countries in South Asia, the Asia Pacific, North America, South America, Africa and Europe. Most studies used in-depth interviews and focus group discussions to discuss women's experiences of reproductive coercion and abuse. Reproductive coercion and abuse manifested in a range of behaviours including control of pregnancy outcome, pregnancy pressure or contraceptive sabotage. There were a range of reasons cited for reproductive coercion and abuse, including control of women, rigid gender roles, social inequalities and family pressure. Women's different responses to reproductive coercion and abuse included using covert contraception and feelings of distress, anger and trauma. Across contexts, perpetration and experiences of reproductive coercion and abuse were influenced by different factors including son preferences and social exclusion.ConclusionsWe reflect on the importance of socio-cultural factors in understanding the phenomenon of reproductive coercion and abuse and how it affects women, as well as how the mechanisms of power and control at both individual and societal levels work to perpetuate the incidence of reproductive coercion and abuse against women.

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Dataset Information

Reproductive coercion sometimes works: evaluating whether young African-American women who experience reproductive coercion or birth control sabotage are more likely to become pregnant.

Publications

Reproductive coercion sometimes works: evaluating whether young African-American women who experience reproductive coercion or birth control sabotage are more likely to become pregnant.

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