Validating a modified reproductive coercion scale aligned with intimate partner violence theory

Awarded 2020
Complex Family Planning Fellowship Research
Kathryn Fay, MD
University of Utah

Gender-based violence exists in many formats, including reproductive coercion, a concept newly recognized by the medical community. Reproductive coercion (RC) is defined as behavior that undermines autonomous decision making in areas of reproductive health as a method of maintaining power and control. Several types of coercive behaviors compose RC such as birth control sabotage (e.g. secretly puncturing condoms) and pregnancy pressure. RC is independently associated with negative reproductive health outcomes and distinct health seeking behavior, including sexually transmitted infection and unintended pregnancy as well as pregnancy testing and use of emergency contraception. Unfortunately, research examining strategies to identify and support women experiencing RC and restore reproductive autonomy beyond expert opinion is lacking.
In 2010, Dr. Elizabeth Miller published one of the first quantitative studies of RC demonstrating the significant relationship between pregnancy coercion and birth control sabotage with unintended pregnancy. Although RC existed and affected women for far longer, this article marked the beginning of RC’s treatment as a phenomenon deserving of greater study and recognition within medical literature. The investigator-derived RC question set used in this study has since served as the framework for most subsequent RC research in available literature. There are limitations to ongoing use of the Miller RC scale which this project will address.