Coerced Choice: Resigned Contraceptive Usership Among Individuals Affected by Reproductive Coercion.

Abstract

Partner-mediated reproductive coercion is a common form of violence that affects individuals' sexual and reproductive health goals. Clinicians' understanding of the scope of reproductive coercion continues to grow with direct implications for clinical interventions. The purpose of this study was to generate a more comprehensive set of reproductive coercion tactics used by intimate partners for recognition in a clinical setting. This was a qualitative study using grounded theory. Individuals were recruited through an established statewide community network to participate in videoconferencing focus groups regarding reproductive coercion. Discussions were moderated and recorded. Data were coded and then subjected to qualitative content analysis. Twenty community members participated. Participants described partner interference with reproductive and sexual health goals, including limitation of their contraceptive options. Although participants were able to access health care and use contraception as part of a goal to avoid pregnancy, they also reported dissatisfaction with their methods. Some participants described being forced to use an undesired form of contraception in the setting of reproductive coercion from abusive partners. Individuals affected by reproductive coercion may be able to access and exercise limited choice over their contraceptive options, but some may be unable to use the preferred method because of partners' behavior. Clinician awareness of the diversity of presentations of reproductive coercion, including individuals using long-acting reversible contraceptives, may facilitate individualized counseling and realignment of care with patient preferences.