A 21-year-old woman is in a relationship with a man who repeatedly tells her he wants to get her pregnant. Even though he is physically abusive, she too, wants to have a baby with him. But a few months into her pregnancy, he changes his mind. He threatens to punch her in the stomach to induce an abortion, or to throw her down the stairs if she doesn’t have one. Because he has been violent so many times before, she doesn’t want to risk it. So, five months pregnant, she goes to a clinic and has the abortion.
Another relationship snapshot: A woman, 24, doesn’t want her abusive boyfriend to get her pregnant, so she goes on the pill. The boyfriend pressures her to stop taking it, saying it is going to mess with her hormones and make her sick. Surreptitiously, she goes to a clinic and gets a Nuva Ring. When they are having sex one day, he feels the ring. Against her will, he reaches his hand inside of her and pulls it out.
These disturbing stories were recounted to researchers from the Guttmacher Institute by women sitting in the waiting rooms of family planning clinics and domestic violence centers. They are different from one another: one portrays a man who pushes a woman to get pregnant, only to irrationally pressure her to have an abortion, while the other shows an act of birth-control sabotage. But the stories have something in common: they hinge on themes of coercion, control, and pregnancy.
It’s no secret that couples use babies and baby-making to manipulate one another; the common stereotype is of a woman who tricks her partner into getting her pregnant. In recent years, however, research into the psychology of relationships is demonstrating that coercion by men is far more common than previously thought. Such reproductive coercion—both violent and otherwise—is a disturbingly common part of the story behind unwanted pregnancy, the researchers say, especially for young women.
“When you interview a young woman about her unwanted pregnancy, a word that often comes up is ambivalence—meaning they don't want to be pregnant but they're also ambivalent about using birth control,” said Elizabeth Miller, a medical anthropologist at the University of California-Davis who co-authored the Guttmacher study. “What we hadn't been asking is to what extent what we're calling 'ambivalence' may be related to violence or to coercion in the relationship.”
As in, when a young woman who claims she doesn’t want to get pregnant fails to make use of the condoms given to her by a nurse, there might be reasons why she isn’t using them other than she simply “forgot in the moment.”
Reproductive control—the term these academics and advocates have coined to describe the male behavior they’ve encountered—refers to when a male partner pressures a woman, through verbal threats, physical aggression, or birth-control sabotage, to become pregnant. Reproductive control can include rape, but also describes a host of coercive situations that don’t escalate to that level. (The term was formerly used in global public health literature to describe things like forced sterilization by national governments such as India and China). It can sometimes take a form as twisted as pushing a woman to get pregnant, and then, after she’s impregnated, pressuring her to abort.
When a young woman fails to make use of condoms, there might be reasons other than she simply “forgot in the moment.”
Prior to 2007, reproductive health advocates say that the relationship between coercion and pregnancy outcomes hadn’t been examined. Three years and a handful of studies later, they’ve attempted to quantify the pervasiveness of reproductive control. For women in violent relationships, somewhere between a third and half report having experienced some form of reproductive coercion. But even for women in relationships that are not violent, 15 percent report experiencing such controlling behaviors, according to a study of 1,300 women published in the journal Contraception in April.
But they acknowledge that there’s a huge amount of gray area. “At what point, does it become her desire as well?” Miller asks. This question is especially relevant to young women, who are more easily influenced by their partners and are slower to recognize abuse than older women.
In a 2007 study of teenage girls who had been in violent relationships and had gotten pregnant, the adolescents reported stories of boyfriends and partners doing things like removing or ripping holes in condoms without their knowing, flushing birth control pills down the toilet, forgetting to take them to clinic appointments for Depo Provera shots, and breaking their promises to withdraw during sex. Many young women said they hid their birth control from their partner. In one case, an 18-year-old girl who said she didn’t want to have a baby lied about being pregnant to her older boyfriend, who she was living with after her father had kicked her out of the house, because she wanted to make him “happy.” Of the 53 teenagers, one reported an attempt at coerced abortion: a 16-year-old who reported that her partner had gotten her pregnant “on purpose,” by refusing to use condoms, then pressured her to get an abortion. (She left him and had the baby.)
“The male partners were sabotaging birth control,” says Miller. “They would say things like, ‘We are going to make beautiful babies together,’ which is a very strong thing for a young woman to hear.”
For reproductive health advocates, the fact that some men coerce abortions after saying they want to have a baby demonstrates that the motive for pushing pregnancy in the first place was not the desire to raise children. “This is much less about the desire to be a father than it is about coercion and control,” says Lisa James, the health director with the Washington, D.C.-based Family Violence Prevention Fund. “It’s about making him tied to her so she will always have a permanent connection to him.”
For women in violent relationships, there’s a correlation between violence and pregnancy: when women become pregnant, the level of violence tends to spike. “Promoting pregnancy is, on the one hand, a way to control the woman,” says Ann Moore, a senior researcher with the Guttmacher Institute. “At the same time, it’s outside of his control. It’s a distraction from him. He realizes that something could be taking up this woman’s time besides him.”
The violence and abuse can reach extreme levels. In the Guttmacher study, which looked at a slightly older group of women, a 26-year-old participant told researchers she had had five abortions with the same partner, who refused birth control and refused to withdraw during sex. “He kept stopping it [the abortion] … He kept track [of when the appointments were], taking the car, [saying the car] wouldn’t work, saying, “I can’t come because of this and this but I have to be there [for the abortion], but I have to work this day,” so he kept dragging it out, “cause he wanted me to not be able to have it,” she was quoted as saying.
Another man, who threatened his teenage partner by saying he would make her pregnant, later denied paternity as she was going into labor. Another kicked his partner out of the house and claimed she cheated on him when she became pregnant. There were also instances where a man threatened to kill his partner if she didn’t have his baby. “He really wanted the baby,” the woman told the researchers that interviewed her. “He always said, 'If I find out you have an abortion…I’m gonna kill you.'”
• Danielle Friedman: A New Debate Over In Vitro• Dana Goldstein: The New Abortion Outrage• Joyce Tang: A New Fight Over Abortion AccessWhile the topic of reproductive control has received some public attention recently, one piece of the reproductive-control story, coerced abortion, has not surprisingly become a hot button political topic of its own. Coerced abortion has in fact gotten far more attention than coerced pregnancy, even if the latter is much more common. Earlier this year, the states of Tennessee and Oklahoma passed laws requiring abortion providers to post signs in their clinics informing women that it is against the law for anyone to coerce them into having an abortion, and Alabama and Missouri require providers to screen women to see if they have been coerced.
As health-care providers become more familiar with reproductive coercion, some have learned to come up with creative responses. When partners refuse condoms or flush pills, nurses will steer women toward a Depo Provera shot, says Christina Leone, who trains staff at a Planned Parenthood clinic in Concord, California. Leone, for example, instructs her clients who receive Depo shots to disguise the telephone number of the clinic in their cellular phones, so their partners don’t find it. “We try to be as discreet about it as possible,” she said.