Reproductive Coercion by Intimate Partners: Prevalence and Correlates in Canadian Individuals with the Capacity to be Pregnant

PLOS ONE RESEARCH ARTICLE Reproductive Coercion by Intimate Partners: Prevalence and Correlates in Canadian Individuals with the Capacity to be Pregnant Sylvie Lévesque ID1*, Catherine Rousseau2, Arianne Jean-Thorn3, Simon Lapierre4, Mylène Fernet1, Marie-Marthe Cousineau5 a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Department of Sexology, Université du Québec à Montréal, Montréal, Québec, Canada, 2 Interdisciplinary School of Health Sciences, Ottawa University, Ottawa, Ontario, Canada, 3 Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada, 4 School of Social Work, Ottawa University, Ottawa, Ontario, Canada, 5 School of Criminology, Université de Montréal, Montréal, Québec, Canada * Abstract OPEN ACCESS Citation: Lévesque S, Rousseau C, Jean-Thorn A, Lapierre S, Fernet M, Cousineau M-M (2023) Reproductive Coercion by Intimate Partners: Prevalence and Correlates in Canadian Individuals with the Capacity to be Pregnant. PLoS ONE 18(8): e0283240. https://doi.org/10.1371/journal. pone.0283240 Editor: Amy Michelle DeBaets, Hackensack Meridian Health, UNITED STATES Received: May 13, 2022 Accepted: March 3, 2023 Published: August 3, 2023 Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0283240 Copyright: © 2023 Lévesque et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Since the data contain potentially sensitive information about study participants, the Université du Québec à Objectives Despite the large body of research on violence against women, violence that specifically targets women’s reproductive autonomy and control over their reproductive health, called reproductive coercion (RC), is poorly documented in Canada. The purpose of this study is to determine the prevalence of RC behaviors in an adult Canadian community sample and to explore associated factors. Study design A self-report online questionnaire was administered from September 2020 to April 2021 in Quebec and Ontario, Canada. Participants were recruited via social media, sexual and reproductive health clinics, community-based anti-violence organizations, and the project’s partner organizations. The questionnaire contained validated RC questionnaire items and new items drawn from previous qualitative work. The sample comprised 427 participants, mostly self-identified as women (92%), aged 18 to 55 years (M = 29.01; SD = 6.64). Descriptive analyses and binary logistic regressions were conducted using SPSS 27. Results The results of this study show that 63.9% of participants reported at least one lifetime experience of RC. According to our data, contraceptive sabotage was the most common form (62.8%). Of the participants who had been pregnant, 9.8% reported control of pregnancy outcomes. Each RC category shows a different pattern of correlates. The findings also reveal that intimate partner violence (IPV) increases the likelihood of contraceptive sabotage. Moreover, the study suggests that low education level and IPV increase the risk for control of pregnancy outcomes. PLOS ONE | https://doi.org/10.1371/journal.pone.0283240 August 3, 2023 1 / 17 PLOS ONE Montréal (UQAM) Human Research Ethics Board has only approved storage of the dataset on secure institutional servers. Any requests to access the data can be made to Université du Québec à Montréal Human Research Ethics Board: ; Reference Ethics Protocol Number: 2020-3064. Funding: This study was made possible by a grant awarded to the first author (S.L.) by the Social Sciences and Humanities Research Council of Canada. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Reproductive coercion by intimate partners: prevalence and correlates in a Canadian sample Conclusion These findings underscore the importance of RC in the lives of many Canadian individuals with the capacity to be pregnant, and they highlight certain factors that place individuals at greater risk for RC. This knowledge can inform the development of prevention efforts and clinical interventions. Background Sexual and reproductive health is a fundamental human right [1]. It includes having safe and enjoyable experiences that are free from coercion, discrimination, and violence [1]. Reproductive coercion (RC) poses a significant threat to sexual and reproductive health. RC refers to behaviors that interfere with contraception and pregnancy decisions [2–4], often experienced at the hands of an intimate partners [2, 5]. Recent studies have focused predominantly on partner-perpetrated RC in heterosexual relationships [6, 7]. Accordingly, the findings show that RC is typically perpetrated by males in order to control the contraceptive and reproductive choices of adolescent girls and women [8, 9]. Following Miller’s pioneering work on RC, two types of behaviors have been identified in the literature: birth control sabotage and pregnancy coercion [10]. Birth control sabotage refers to behaviors that interfere with the use of contraception [8, 11, 12], including hiding, removing or destroying contraceptive methods [8, 13]. Pregnancy coercion refers to behaviors aimed at forcing an unwanted pregnancy [3, 13, 14]. This can take the form of threats, such as having a child with another partner if she does not become pregnant, or physically hurting and coercing the female partner [8, 9, 15]. In addition to these forms of RC, recent studies have brought to light many other facets of RC, primarily qualitative studies in which participants shared their experiences in detail [7, 16]. Two moments can be identified for the occurrence of RC: before and/or during pregnancy. While the above forms focus on the period before pregnancy, some behaviors occur while the person is pregnant. Grace and colleagues have proposed items addressing abortion coercion to isolate pregnancy-promoting intent from abortion-promoting intent [17]. Nikolajski and colleagues also document behaviors aimed at preventing access to abortion in a qualitative study [17]. Those behaviors are grouped into a 3rd category, called control of pregnancy outcomes [7, 18]. In fact, a variety of behaviors can be understood as RC, as these behaviors are intended to direct women’s reproductive trajectory, regardless of their choices or intentions [11, 18]. For example, participants have recounted manipulative behaviors such as providing (...truncated)