Being in abusive relationships makes women use contraception less often, a new, large meta-analysis of previous studies finds. When they do use contraception, they’re likely not to choose condoms.
The finding could explain why women in abusive relationships are more likely to get abortions and to contract HIV, which previous studies have documented. HIV prevention campaigns should think about addressing domestic violence, the meta-analysis’s authors write in a paper published last month in the journal PLoS One. So should campaigns to improve people’s access to contraception overall, the paper’s lead author, McGill University doctoral student Lauren Maxwell, said in a statement.
It’s not necessarily surprising that women in abusive relationships are less likely to use contraception. In violent relationships, abusers often refuse to use condoms and restrict their partners’ access to other types of contraception. For abusers, it’s just another, potent form of control — a type of abuse referred to as reproductive coercion.
What’s new in the meta-analysis is that it brings together so much data. The 10 studies included in the analysis cover five countries, including the United States, and more than 14,000 women. In addition, the analysis finds that, in studies, the abuse occurs first, then women start using contraception less often. A temporal relationship like that is important to establishing that something causes something else, and that the two things aren’t just correlated by chance. The analysis also finds that the more severely abusive a woman’s partner is, the less likely the woman is to use contraception — this is what’s called a dose-response relationship. Like sequential events, dose-response relationships are good evidence for causation.
In studies, it’s often hard to tease out causal relationships like this. Now that researchers have found one, it’s time to work to break the chain. An important step is ensuring that all women — including victims of abuse — are guaranteed their right to reproductive choice, including unimpeded access to the full range of contraceptive options and abortion services.
We tend to think of anti-choice antics as a separate issue from violence against women, except when anti-choice politicians slip up on occasion and say something that minimizes rape. Considering these findings and the growing body of research from which they came, we really should take a harder look at the connections between abuse of women and reproductive control. The abuser who hides the birth control pills, the sleaze who slips off the condom, the anti-choice protester yelling invective at women seeking abortions and the politician writing laws to make it harder to get contraception and abortion are all pieces of the same puzzle. All of them want to take away a woman’s basic right to self-determination, and all of them do it because they subscribe to an ideology that paints men as the natural dominators and even owners of women.
Indeed, looking over the extensive use of reproductive coercion by abusive men, it’s hard to deny that the best friend of a woman-beater is the anti-choice politician. Slip off the condom during sex to force her to get pregnant? Thanks to anti-choice lobbying, she’s going to have a hard time getting emergency contraception to thwart your plans. Keep hiding her birth control pills so that she has to go explain to her doctor why she needs more? Luckily for abusers, anti-choicers are shutting down Planned Parenthood clinics, making it both more expensive and more time-consuming for women to get that done. Successfully impregnate a woman you’re trying to trap with a baby? Thanks to anti-choicers, she may not be able to afford to travel across 10 counties to the nearest clinic to get an abortion and get away from you.
Not only do these restrictions prevent victims from terminating an unwanted pregnancy resulting from an abusive relationship, but they can also put women in grave danger. In violent relationships, abuse often escalates during pregnancy – in fact, homicide is one of the leading causes of death among pregnant women in the United States.
Further, victims who are forced to carry a pregnancy to term due to lack of abortion access are often unable to leave their abuser. Pregnancy and childbirth are a significant drain on a family’s financial resources, and women who are not financially prepared to have a child may not have the resources to do so on her own. Another concern is that once the victim has the child she has ensured that she will have a life long connection with her abuser. Studies have shown that batters use their children to continue abusing the mother – often, they use visitation and transfers of custody as an opportunity to continue their verbal and physical abuse. Furthermore, courts are generally not receptive to victims’ claims of fear of their abuser in the child custody context. For example, in the case of Jordan v. Jordan an appeals court required a victim to continue to be in contact with and cooperate with her abuser through the use of a parenting coordinator.
Anti-choice laws are harmful for all women, increasing the chances that women will resort to unsafe methods of abortion and reducing women’s control over reproductive, financial, and employment decisions, but for victims of domestic violence, the inability to exercise reproductive choice is quite literally a life-threatening situation. Indeed, if we want to help women get out of abusive relationships and stay alive in the aftermath, it’s increasingly becoming clear that one of the most important steps we can take is reversing the tide of anti-choice legislation.