Condom Control: Reproductive Coercion as Adolescent Dating Abuse
By Meggie Royer, B.A., Education & Outreach Coordinator at Women’s Advocates, Inc. of Minnesota What is Women’s Advocates?
Contact Us Women’s Advocates is a domestic violence Admin/Office Line 651.227.9966 shelter for women and children that provides
Crisis Line housing, mental health therapy, support 651.227.8284 groups, legal help, childcare, and other 588 Grand Avenue services. We are based out of Minnesota. St. Paul, MN 55102 The Pete Davidson – Ariana Grande Case
On September 29, 2018, comedian and actor Pete Davidson returned to Saturday Night Live.
Davidson, who at the time was dating Ariana Grande, quipped “Last night I switched her birth control with tic-tacs. I believe in us and all, but I just want to make sure that she can’t go anywhere.”1
Both Davidson and Grande are 25. The Ian Somerhalder – Nikki Reed Case
In September 2017, Vampire Diaries actor Ian Somerhalder revealed on a pregnancy podcast that he had popped wife Nikki Reed’s birth control pills out of the pack and videotaped her panicking when she found it empty.
“It is a lot of work,” he said, “especially after a little bit of sangria.”2 What is Dating Abuse?
Dating abuse is a pattern of behavior that an individual uses to maintain power and control over an intimate partner or ex intimate partner, not solely limited to heterosexual relationships.
• It can be physical • It can include reproductive and/or sexual assault and control • It can be emotional • It can be financial
Dating abuse is a public health issue that impacts everyone, regardless of age, race, gender identity, religion, sexual orientation, or culture. 1 in 3 women and girls has experienced DV.³ What Are Warning Signs of Dating Abuse?
Females ages 18-24 and 25-34 experience the highest rates of intimate partner violence. More than half of all sexual violence survivors, including male and female adolescents and LGBTQ+ adolescents, report that the violence was caused by an intimate partner.4
Some warning signs of adolescent dating abuse include:5
• Excessive jealousy and possessiveness • Isolation and control of an adolescent’s daily activities and friends • Frequent monitoring of someone’s cell phone or computer usage • Threats to harm oneself or someone else • Verbal abuse and constant criticism • Framing of abuse as “for the victim’s own protection” • Financial control Adolescent Power and Control Wheel
The Power and Control Wheel is a tool developed in Duluth, Minnesota that is used to describe and illustrate various abusive behaviors as examples of power and control.6 Here is a version of the wheel adapted for teens. What is Reproductive Coercion?
Reproductive coercion is any behavior intended to maintain power and control over an individual’s reproductive health & decisions. It is commonly perpetrated by intimate partners, and can occur in both adolescent and adult relationships.
• Adolescent girls in physically abusive relationships are 3.5x more likely to become pregnant7
• Girls who experience physical dating abuse are 2.8x more likely to fear the consequences of negotiating condom use8
• 75% of women and girls who report reproductive coercion also report a history of intimate partner violence9 Adolescent Reproductive Power and Control Wheel
Just like the original Power and Control Wheel, here is an example of a Reproductive Power and Control Wheel for teens. Both dating abuse and reproductive coercion involve power and control.10
Reproductive coercion is dating abuse. Three Main Forms of Reproductive Coercion
There are three main forms of reproductive coercion:11
Birth control sabotage: interference with an individual’s birth control methods in order to force a pregnancy
Pregnancy pressure/coercion: threats, pressure, or behavior intended to force an individual to become pregnant, continue a pregnancy, or terminate a pregnancy against their wishes
Sexual coercion: coercive behavior intended to influence an individual’s sexual decision-making Examples of Reproductive Coercion
“He kept stopping it [the abortion]…He kept track of when the appointments were, saying the car wouldn’t work…saying, ‘I can’t come because of this and that but I have to be there for the abortion, but I have to work this day,’ so he kept dragging it out.”12 Examples of Reproductive Coercion
In November 2018, pregnant 18-year-old Madison Anthony of Ohio went to the doctor after a fight with her boyfriend, Joseph Smith. During the altercation, Smith punched Anthony in the stomach and told her she should have gotten an abortion and he wished she would get hit by a brain.
At the doctor’s office, Anthony was told that the baby no longer had a heartbeat as a result of the punch. Her unborn child died.13 Why Do Abusers Use Reproductive Coercion?
We can’t always know. We do know that abuse is always about power and control. And we do know that:14
• For some abusers, a pregnancy gives the victim more power
• This power may come in the form of controlling the abuser’s future through his new financial obligation
• This is where we see a greater likelihood of forced abortions or violence to induce a miscarriage
• Or, some abusers may believe that getting a girl pregnant will get her to stay with him Interventions for Reproductive Coercion Warning Signs of Reproductive Coercion
• “Losing” birth control pills, patches, rings15
• Condoms breaking repeatedly during sexual activity
• Missing or “forgetting” appointments for birth control injections
• Partner always present with victim at OBGYN appointments; may refuse to leave; may talk for victim16
• Frequent pregnancy testing
• Frequent abortions
• Frequent miscarriages Assessment
Confidential verbal assessment in private location – be sensitive to the language you use17
Is your partner ok with you using birth control? Has your partner ever threatened you because you did not wish to become pregnant? Has your partner ever refused to wear a condom? Do your condoms break a lot during sex? Have you ever had to hide your birth control? Have you ever been pressured to have an abortion? Warm Referrals
After a positive disclosure, respond with validation, belief, support, and caring, followed by:18 • What can I do for you next? • Ask permission to share strategies • Encourage individual to meet with an on-site advocate, or have an advocate come to the clinic • Allow them to use an office phone to speak with an advocate • Schedule a return visit • Ask about their safety once pregnancy is diagnosed Safety Planning
Shown here is a portion of a recently developed Reproductive Autonomy Scale from Dr. Ushma Upadhyay of the University of California San Francisco.19 Other Strategies
Recommend that individual keep emergency contraceptives in a small, thin envelope20
Offer to notify a partner(s) anonymously about any STI diagnoses
Discuss how to negotiate condom use with abuser, if safe
Provide information on adoption services
Provide information on where to obtain a safe, legal abortion
Discuss the importance of prenatal care Alternative Contraceptive Methods
If a patient does not want to become pregnant, it may help to suggest contraceptive methods that are more difficult to see or tamper with:21
Implanon Depo Provera IUD (Mirena or Paraguard) – consider cutting the strings for more difficult detection Alternative Contraceptive Methods Cont.
If a patient was recently forced to engage in unprotected sex and does not wish to become pregnant, it may help to suggest:22
Taking Plan B while still at the clinic, or send the patient home with the pill in an unmarked envelope
Inform the patient that a copper IUD can act as an emergency contraceptive if inserted within a week, and can continue to protect against pregnancy Impacts of Reproductive Coercion
The impacts of reproductive coercion range from emotional and sexual to reproductive and financial. These impacts include:
• Girls who have experienced intimate partner abuse are more likely to use emergency contraceptives23
• Substance abuse struggles and hyper-sexualized behavior
• Feelings of isolation, loneliness, and low self-esteem24
• Higher rates of ovary removal25
• Pelvic pain, vaginismus, dysmenorrhea
• Fears related to sexual pleasure and orgasm26 Disproportionate Burden for Women of Color
Non-Hispanic black and multiracial women are most likely to report reproductive coercion.27 Black women are also more likely than white women to attribute a pregnancy to reproductive coercion, and women of color are less likely to report satisfaction with their family planning clinic visits.28 Racism and DV Are Public Health Issues
It is also crucial to develop an understanding of racism and domestic violence as public health issues, and to practice the provision of trauma- informed care to all patients, victim/survivors, and clients. Thank You!
Thank you for attending this presentation!
Meggie Royer Education & Outreach Coordinator Women’s Advocates, Inc. [email protected] 651.726.5233
For other training opportunities, please visit www.wadvocates.org/our-services/ Sources
1. Proudfoot, J. (2018, October 1). The internet has turned against Pete Davidson for his controversial comments about Ariana Grande’s birth control [Blog post]. Retrieved from https://www.marieclaire.co.uk/entertainment/people/pete-davidson-birth-control-619160 2. Schwartzman, C. (2017, October 23). Ian Somerhalder and reproductive coercion [Blog post]. Retrieved from https://www.hercampus.com/school/ufl/ian- somerhalder-and-reproductive-coercion 3. Rakovec-Felser, Z. (2014). Domestic violence and abuse in intimate relationship from public health perspective. Health Psychology Research, 2(3), 62-67. 4. Black, M.C., Basile, K.C., Breiding, M.J., Smith, S.G., Walters, M.L., Merrick, M.T.,...Stevens, M.R. (2011). The national intimate partner and sexual violence survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. 5. Matud, M.P. (2007). Dating violence and domestic violence. Journal of Adolescent Health, 40(4), 295-297. 6. National Center on Domestic and Sexual Violence. (2016). Teen power and control wheel. Retrieved from http://www.ncdsv.org/images/Teen%20P&C%20wheel%20NO%20SHADING.pdf 7. Chamberlain, L., & Levenson, R. (2013). Addressing intimate partner violence, reproductive and sexual coercion. San Francisco, CA: Futures Without Violence. 8. Chamberlain, L., & Levenson, R. (2013). Addressing intimate partner violence, reproductive and sexual coercion. San Francisco, CA: Futures Without Violence. 9. Clark, L.E., Allen, R.H., Goyal, V., Raker, C., & Gottlieb, A.S. (2014). Reproductive coercion and co-occurring intimate partner violence in obstetrics and gynecology patients. American Journal of Obstetrics and Gynecology, 210, 42.e1-8. 10. Cappelletti, M.M., Gatimu, J.K., & Shaw, G. (2014). Exposing reproductive coercion: A toolkit for awareness raising, assessment, and intervention. Atlanta, GA: Feminist Women’s Health Center. Sources Cont.
11. American College of Obstetricians and Gynecologists. (2013, February). Reproductive and sexual coercion [Blog post]. Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual- Coercion?IsMobileSet=false 12. Moore, A.M., Frohwirth, L., & Miller, E. (in press). Male reproductive control of women who have experienced intimate partner violence in the United States. Social Science and Medicine. doi:10.1016/j.socscimed.2010.02.009 13. BieryGolick, K. (2019, January 31). After fight with boyfriend, a pregnant teen went to the doctor. They said her child was dead [Blog post]. Retrieved from https://www.cincinnati.com/story/news/2019/01/31/after-fight-with-boyfriend-a-pregnant-teen-went-to-the-doctor-they-said-her-child-was-dead/2713576002/ 14. Todd, A. (2017, October 19). Death by pregnancy: Why are so many moms-to-be dying? [Blog post]. Retrieved from https://www.womenshealthmag.com/life/a19950131/pregnant-women-dying/ 15. Miller, E., & Silverman, J.G. (2010). Reproductive coercion and partner violence: Implications for clinical assessment of unintended pregnancy. Expert Review of Obstetrics and Gynecology, 5(5), 511-515. 16. Kovar, C.L. (2018). Reproductive coercion: Baby, if you love me… The American Journal of Maternal/Child Nursing, 43(4), 213-217. 17. Miller, E., Tancredi, D.J., Decker, M.R., McCauley, H.L., Jones, K.A., Anderson, H.,...Silverman, J.G. (2016). A family planning clinic-based intervention to address reproductive coercion: A cluster randomized controlled trial. Contraception, 94(1), 58-67. 18. Miller, E., Tancredi, D.J., Decker, M.R., McCauley, H.L., Jones, K.A., Anderson, H.,...Silverman, J.G. (2016). A family planning clinic-based intervention to address reproductive coercion: A cluster randomized controlled trial. Contraception, 94(1), 58-67. 19. Upadhyay, U., & Foster, D.G. (2014). Reproductive autonomy scale. Retrieved from https://www.ansirh.org/research/reproductive-autonomy-scale Sources Cont.
20. Miller, E., Tancredi, D.J., Decker, M.R., McCauley, H.L., Jones, K.A., Anderson, H.,...Silverman, J.G. (2016). A family planning clinic-based intervention to address reproductive coercion: A cluster randomized controlled trial. Contraception, 94(1), 58-67. 21. Cappelletti, M.M., Gatimu, J.K., & Shaw, G. (2014). Exposing reproductive coercion: A toolkit for awareness raising, assessment, and intervention. Atlanta, GA: Feminist Women’s Health Center. 22. Cappelletti, M.M., Gatimu, J.K., & Shaw, G. (2014). Exposing reproductive coercion: A toolkit for awareness raising, assessment, and intervention. Atlanta, GA: Feminist Women’s Health Center. 23. Wilder, K.J., Guise, J., Perrin, N.A., Hanson, G.C., Hernandez, R., & Glass, N. (2009). Knowledge, awareness, perceptions, and use of emergency contraceptives among survivors of intimate partner violence. Obstetrics and Gynecology International, 2009, 1-6. 24. Walsh, K., Fortier, M.A., & DiLillo, D. (2010). Adult coping with childhood sexual abuse: A theoretical and empirical review. Aggression and Violent Behavior, 15(1), 1-13. 25. Rocca, L.G., Smith, C.Y., Grossardt, B.R., Faubion, S.S., Shuster, L.T., Stewart, E.A., & Rocca, W.A. (2017). Adverse childhood or adult experiences and risk of bilateral oophorectomy: A population-based case-control study. BMJ Open, 7(5), 1-17. 26. Kaliray, P., & Drife, J. (2004). Childhood sexual abuse and subsequent gynaecological conditions. The Obstetrician & Gynaecologist, 6, 209-214. 27. Basile, K.C., Smith, S.G., Liu, Y., Kresnow, M., Fasula, A.M., Gilbert, L., & Chen, J. (2018). Rape-related pregnancy and association with reproductive coercion in the U.S. American Journal of Preventive Medicine, 55(6), 770-776. 28. Clement, J., Wisdom, K., Bamel, D., & Rakover, J. (2017). Developing culturally responsive family planning. Orlando, FL: Institute for Healthcare Improvement. This project was supported by Grant No. A-CVS-2018-WOMADV-00013 awarded by the Office on Victims of Crime, Office of Justice Programs. The opinions, findings, and conclusions or recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice.