Reproductive coercion is a form of gender-based violence. It is probably more common than we realize.

From access to contraception to safe abortion, awareness of reproductive health and rights is growing.

Reproductive rights and justice are issues of political debate and on the ballot around the world. But for some, the greatest threat to their reproductive autonomy comes from those closest to them.

Last week, preliminary findings were presented from the Australian Study of Health and Relationships on the prevalence of reproductive coercion and abuse nationally. This form of gender-based violence is when someone attempts to control the reproductive choices of another person using physical, sexual and/or emotional violence or threats. The study included 4,540 participants aged 16-69.

Initial analysis found that one in twenty reported exhibiting controlling behaviour regarding contraception, pregnancy and abortion.

So what makes this controlling behavior different from other forms of abuse? And how can we learn more about it?

What is it?

Reproductive coercion and abuse is most often perpetrated against women, girls, and LGBTQIA+ people, usually by a partner, parent, or in-law.

Someone can do this by forcing or coercing the other person to become pregnant or have an abortion. This can look like this:

• constantly pressuring the person to have a baby when he/she doesn’t want to

• refusing to allow them to use contraception, or withholding or destroying it

• harassing or stalking them to find out if they have had an abortion.

The recent rapid assessment for government on approaches to preventing gender-based violence does not mention the words “reproductive coercion and abuse”. But it has been clearly identified in several deaths related to domestic and family violence in Australia.

These controlling behaviors intersect with domestic, family, and sexual violence. Reproductive coercion, however, is unique in that it weaponizes a person’s reproductive capacity to control him or her.

What we don’t know

The Australian Study of Health and Relationships is conducted only once every ten years and the latest research is the first to estimate how common policing of another person’s reproductive rights might be on a national scale. The study’s findings provide vital data for sexual and reproductive health policies and programs across Australia.

However, comparative data is not yet available to allow us to identify trends over time.

The reported prevalence of one in twenty is likely an underestimate. This is because we know that people tend to underreport abuse and may not recognise or process what is happening to them at the time, a typical trauma response.

And subtle emotional manipulation or pressure are difficult to capture in broad population surveys.

Previous studies have lumped reproductive coercion and abuse together with sexual violence, and have ignored abortion or the different types of relationships in which this abuse occurs.

Every measure needs to be developed with people with lived experience and designed to ensure that communities such as First Nations Australians, LGBTQIA+ people, people with disability, migrants and refugees and young people are well represented. Too often they are left out of co-design processes or their experiences are made invisible by data gaps.

Last month’s report on missing and murdered First Nations women and children found that Closing the Gap’s data on violence against women and children is outdated and that the true number of murdered or missing Indigenous women and children is unknown.

Last year’s Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disabilities also highlighted the increasing levels of abuse against women with disabilities and the lack of proper consultation to involve them in solutions.

Our La Trobe and University of Melbourne team is developing a new rigorous measure to better capture the complex behaviours that other measures miss. It aims to compare reproductive coercion and abuse prevalence across countries and strengthen how we measure the impact of future interventions.

Once developed, testing will begin in maternal and child health settings, as the risk of abuse is greater around childbirth and nurses and midwives are well-placed to safely identify and support patients.

Additional steps will be needed to determine what questions health care providers can best ask to identify and respond to patients at risk without putting them at further risk.

What next? And where to get help

Reproductive coercion and abuse need greater attention in the current national discussion on gender-based violence and prevention.

A 2023 Senate inquiry into universal access to reproductive health services called for more research on reproductive coercion and abuse to inform guidelines and training for health workers. This requires better measurement of the full scale and patterns of the problem. We hope that policymakers will properly resource these areas that are critical to ending gender-based violence.

People experiencing reproductive coercion and abuse can contact 1800 My Options (VIC), Children by Choice (QLD) or 1800 Respect (National) for professional help.