To improve women's reproductive health and prevent unwanted pregnancies in intimate partner violence, women and girls need access to improved female-controlled contraceptive methods.
Access to female-controlled contraceptive methods must be improved in order to help women and girls to counteract any risks to their reproductive health caused by intimate partner violence and reproductive coercion, observe US experts writing in this week's PLOS Medicine
. Jay Silverman and Anita Raj from the University of California in San Diego explain that intimate partner violence is a major contributor to poor reproductive outcomes, such as unintended pregnancy, among women and girls around the world.
Reproduction coercion consists of behaviors that directly interfere with contraception and pregnancy, reducing female reproductive autonomy. The two forms of reproductive coercion are pregnancy coercion and contraception sabotage.
The authors argue that to improve reproductive health, it is necessary to go beyond simply identifying women and girls affected by intimate partner violence but to also identify specific behaviors that reduce women and girls' control over their reproductive health and to help reduce any harm caused by these behaviors.
According to the authors, efforts of this kind by clinicians can help women and girls to improve their control over their reproductive health and reduce unintended pregnancy and unsafe abortion. They further state that availability of female-controlled forms of contraception may be key to assist women contending with male partners who are attempting to coerce them into becoming pregnant against their will. However, the authors argue that, in the longer term, reduction of intimate partner violence and reproductive coercion will require ongoing and multiple-sector efforts to transform the social norms that maintain men's entitlement to control of women's and girls' bodies and their reproduction.
The authors say: "Effective, sustainable, and scalable programs to address attitudes and norms that maintain abusive and controlling behaviors among men and boys should be considered for implementation within multiple sectors in order to reduce acceptability of men's perpetration of intimate partner violence and related domination of family planning decisions."
They continue: "A full range of contraceptive methods should be made broadly available at little or no cost, particularly those which are most within the control of women, for example, injectable and intrauterine forms in order to increase women's ability to space and prevent pregnancies and to maintain control over these decisions."