Drawing Connections: Intimate Partner Violence, Poverty, and Abortion


BY JEN ROTH

The consistent life ethic is traditionally seen as a way to draw connections among issues that do not seem related at first glance, such as war, the death penalty, and abortion. However, the connections among different forms of violence and injustice are sometimes more immediate. Recent research, including a study published in August 2012 by the Guttmacher Institute, has highlighted connections among intimate partner violence, poverty, and abortion.

Intimate partner violence and abortion

Multiple studies from countries around the world have established a link between intimate partner violence (sometimes also known as domestic violence) and unintended pregnancy and abortion.

The increased abortion rate among women who have experienced intimate partner violence begins with an increased prevalence of unintended pregnancy. A health survey in Massachusetts found that 40 percent of women who reported being abused had experienced one or more unintended pregnancies in the past five years, compared to 8 percent of non-abused women.

Women in abusive relationships who become pregnant face numerous pressures to abort. These include fear of being punished if their partner doesn't welcome the pregnancy, fear that the child will be abused, and the belief that having a child will make it impossible to leave the abusive partner for good. Among women who had abortions in the United States in 2008, about 7 percent reported having been physically or sexually abused by their aborted child's father.

Reproductive coercion

In 2010, University of California-Davis researcher Elizabeth Miller and her colleagues conducted the largest study to date of a phenomenon Miller has termed "reproductive coercion." Miller's team surveyed women aged 16-29 seeking reproductive health services in five clinics in northern California. Of these women, 53 percent had been physically or sexually abused by a partner at some point in their lives. Nineteen percent had experienced "pregnancy coercion," defined as a male partner using emotional or physical pressure or threats to get a woman to agree to become pregnant. Fifteen percent had experienced "birth control sabotage," in which their partner had deliberately interfered with their efforts to use birth control. Miller uses the umbrella term reproductive coercion to cover pregnancy coercion and birth control sabotage.

Reproductive coercion is often associated with intimate partner violence and may partly explain why intimate partner violence is associated with high rates of unintended pregnancy.

Guttmacher study of "disruptive life events" and abortion

In August 2012, the Guttmacher Institute published a study in the Journal of Family Planning and Reproductive Health Care about the circumstances under which women have abortions. The researchers surveyed 9,493 women who had abortions and found that most had experienced at least one "disruptive life event" in the last year, such as unemployment, divorce or separation from a partner, getting behind on the rent or mortgage, moving two or more times, or having a baby.

The women in the study who were living in poverty experienced more disruptive life events -- and hence, more abortions -- than the women who were living above the poverty line. Women living in poverty were also more likely to report having been physically or sexually abused by their partners.

In addition to the quantitative survey, researchers conducted in-depth interviews with 49 women. Nearly half of these women said that disruptive events interfered with their ability to use contraception consistently. Women reported losing health insurance and having trouble affording prescription contraception and getting to doctor's appointments. Consistent use, not simply any use of contraception, is key to preventing unintended pregnancy. Poverty and disruptive life events appeared to make consistent use more difficult.

There were no questions on the quantitative survey about reproductive coercion, but six of the 49 women interviewed in depth reported experiencing it.

Conclusions

Intimate partner violence and poverty make it more difficult for women both to avoid unintended pregnancy and to carry to term if they become pregnant.

For pro-life advocates who are working to reduce the demand for abortion, these data suggest two courses of action. The first is working to end poverty and abuse themselves and ensuring a strong social safety net to buffer against the effects of disruptive life events. The second is to ensure that women currently experiencing poverty and abuse have the information and healthcare access they need to prevent unintended pregnancy, as well as social and material support if they do conceive.

Mitigating the effects of injustice and working to end it are not mutually exclusive approaches. To give one example, Elizabeth Miller and her colleagues reported in 2011 on a pilot program that tested a new harm-reduction intervention for women experiencing abuse or reproductive coercion. The intervention enhanced standard intimate-partner-violence counseling by providing information on reproductive coercion and how to minimize the risk of unintended pregnancy by using birth control methods that were concealable or hard to tamper with. The enhanced intervention both reduced the incidence of reproductive coercion and increased the likelihood that women would leave abusive male partners.

Protecting lives that are threatened by poverty and intimate partner violence also turns out to be a way to protect lives that are threatened by abortion.

REFERENCES

A. P. Alio, H. M. Salihu, P. N. Nana, H. B. Clayton, A. K. Mbah, and P. J. Marty, “Association between Intimate Partner Violence and Induced Abortion in Cameroon, International Journal of Gynecology & Obstetrics 112, no. 2 (2011): 83–87; J. Fanslow, M. Silva, A. Whitehead, and E. Robinson, “Pregnancy Outcomes and Intimate Partner Violence in New Zealand,” Australian and New Zealand Journal of Obstetrics and Gynaecology 48, no. 4 (2008): 391–397;

I. Lockart, N. Ryder, and A. M. McNulty, “Prevalence and Associations of Recent Physical Intimate Partner Violence among Women Attending an Australian Sexual Health Clinic,” Sexually Transmitted Infections 87, no. 2 (2011): 174-176; Christina C. Pallitto, Claudia García-Moreno, Henrica A.F.M. Jansen, Lori Heise, Mary Ellsberg, and Charlotte Watts, on behalf of the WHO Multi-Country Study on Women's Health and Domestic Violence, “Intimate Partner Violence, Abortion, and Unintended Pregnancy: Results from the WHO Multi-Country Study on Women's Health and Domestic Violence,” International Journal of Gynecology and Obstetrics 2012, published online in advance of print September 10, 2012, http://dx.doi.org/10.1016/j.ijgo.2012.07.003.

Futures without Violence, “The Facts on Reproductive Health and Partner Abuse.” http://www.knowmoresaymore.org/wp-content/uploads/2008/07/The-Facts-on-Reproductive-Health-and-Partner-Abuse.pdf.

R. K. Jones, A. M. Moore, and L. F. Frohwirth, “Perceptions of Male Knowledge and Support among U.S. Women Obtaining Abortions,” Women’s Health Issues 21, no. 2 (2011):117-23.

E. Miller, M. R. Decker, H. L. McCauley, D. J. Tancredi, R. R. Levenson, J. Waldman, P. Schoenwald, and J. G. Silverman, “Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy, Contraception 81, no. 4 (2010):316-22.

R. K. Jones, L. Frohwirth, and A. M. Moore, “More than Poverty: Disruptive Events among Women Having Abortions in the USA,” Journal of Family Planning & Reproductive Health Care 2012, published online in advance of print August 20, 2012, http://dx.doi.org/10.1136/jfprhc-2012-100311.

E. Miller, M. R. Decker, H. L. McCauley, D. J. Tancredi, R. R. Levenson, J. Waldman, P. Schoenwald, and J. G. A. Silverman, “A Family Planning Clinic Partner Violence Intervention to Reduce Risk Associated with Reproductive Coercion,” Contraception 83, no. 3 (2011):274-80.

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