Remember the time that actor Ian Somerhalder threw out his wife, actor Nikki Reed’s, birth control pills and we were supposed to think it was adorable? In case you don’t, here’s a brief refresher: The two had agreed they wanted to have kids, but after he unilaterally decided it was time to start trying, Somerhalder took it upon himself, in what can only be described as a moralistic fervor, to rid his wife of her pills by flushing them down the toilet without her consent.
“What’s so cool is that there’s this video of me with this handful of these little pills and she’s just [mimics panting and panicking]…panting,” said Somerhalder in an interview. So Reed’s husband removed her agency over when to get pregnant just because they had decided mutually that at some point they would. (Somerhalder and Reed eventually apologized. Let’s hope he actually learned something.)
If Somerhalder’s behavior sounds menacing and abusive, it’s because it is. Reproductive coercion is a form of domestic violence in which one person forces pregnancy upon an unwilling partner in the form of unprotected sex. Throwing out someone’s birth control is one example, but there are many more, including poking holes in condoms, hiding birth control and threatening to leave someone if they don’t agree to have unprotected sex with you.
D told me that in her 20s, she had a fling with a man who took the condom off during sex. “‘You didn’t even notice!’ he said. ‘Notice what?’ I asked. ‘In the middle of everything, I took the condom off, and you didn’t even notice,’ he said. I couldn’t believe it. I wasn’t on the pill. I was, like, 21. So angry. I never saw him again.” Later, she experienced reproductive coercion again after getting pregnant unintentionally via her long-term partner, who “pulled out all the stops to convince me to abort, including threats of suicide.” She eventually got a restraining order against him.
In 2013, in an article for The Cut, Kat Stoeffel wrote about Lindsay Clark, an OB-GYN resident in Rhode Island. “I wondered why women were getting pregnant so soon after they came to me for birth control counseling,” said Clark. After she surveyed 641 women seeking care at Providence’s Women and Infants Hospital, she found that 16 percent had been pressured to get pregnant by their husbands or boyfriends, and they were finding it increasingly difficult to use birth control since it was often hidden, sabotaged or they were threatened with harm or abandonment if they did use it.
While reproductive coercion is a type of domestic violence, it also exists alongside other forms of domestic violence we’re more aware of, such as inflicting actual physical pain upon one’s partner, as well as emotional abuse, such as gaslighting. Because reproductive coercion isn’t technically physical, as in it doesn’t always involve physical contact, many women don’t recognize it as abuse or violence.
Doctors and other medical personnel are now being taught to look for signs of reproductive coercion in their patients. In early 2013, the American College of Obstetrics and Gynecology authored a series of recommendations on how to screen for reproductive coercion, including questions doctors might ask their patients, such as, “Does your partner support your decision about when and if to become pregnant?” and “Are you worried your partner will hurt you if you do not do what he wants with the pregnancy?” There’s a high rate of unintended pregnancy among women in violent relationships, and a medical history involving a high number of abortions may be an indication that reproductive coercion is taking place (another reason not stigmatize anyone who has had multiple abortions).
Another sign doctors are encouraged to take note of are numerous visits to providers for pregnancy or STI testing.
“So if the patient is coming in frequently, instead of making assumptions about why they’re seeking care, perhaps thinking about how violence and coercion could be impacting the reason why they could be in need of these services,” said Heather McCauley, a social epidemiologist and an assistant professor of human development at Michigan State University, in a 2016 conversation with HuffPost. McCauley cited two different modes of reproductive coercion — one in which the partner threatens to leave if the woman doesn’t comply with his desires and another in which the partner actually tampers with birth control.
For medical providers, there are multiple ways to intervene in reproductive coercion situations. There’s talking with patients about relationships and making sure they are clear about what exactly domestic violence and reproductive coercion are. If the provider has gathered enough information about the patient’s situation, they should then go ahead and ask more direct questions about violence in her relationship followed by connecting her with resources such as The National Domestic Violence Hotline, Love Is Respect and Say Something.