In 2009, President Obama designated April as Sexual Assault Awareness Month to bring much-needed attention to the pervasiveness of this problem, prevent future crimes and aid survivors of violence. While stranger rape is the most commonly recognized and discussed form of sexual assault, forms that occur within intimate partner relationships—for example, attempts to impregnate a partner against her wishes through forced sex—are frequently overlooked.
A recent Guttmacher study examined male reproductive control over women—which occurs when a woman’s partner imposes his own reproductive intentions through intimidation, threats or physical violence—among women who had experienced intimate partner violence. The study found that many participants had encountered a range of controlling behaviors by their partners in an effort to get them pregnant, including violent rape and forced or unwanted intercourse (sometimes only unwanted because it was unprotected). Often male perpetrators accompanied forced sex with threats to make their partner pregnant, indifference toward her risk of unintended pregnancy from unprotected sex, refusal to allow her to obtain or use contraceptives or efforts to sabotage her birth control method.
This type of reproductive control can lead to a variety of negative reproductive health outcomes, including repeat unwanted pregnancies and abortions in a short time frame, sexually transmitted infections and women’s inability to control their childbearing. State regulations that affect abortion access for all women, such as waiting periods and counseling requirements, as well as the limited availability of public funding for abortions for poor women, can compound the risks to the health of women who have already been victims of reproductive control and other forms of sexual assault.
Health care providers are well-positioned to screen for these abuses and should build strong linkages to the family violence community for referring women for more specialized services. Widespread education and training of providers can help them identify patients who are experiencing verbal threats or dealing with issues such as coerced pregnancy and possible subsequent abortion. In addition, conducting prenatal care and abortion counseling in private can offer women in violent partnerships a safe environment to speak candidly with their providers. If women have experienced attempted or actual forced impregnation, providers should help women find appropriate services for further counseling and treatment.
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