Doctors should ask women about reproductive coercion

When a husband or boyfriend refuses to wear a condom or hides a woman’s birth control pills that’s a form of abuse called reproductive coercion, and the American College of Obstetricians and Gynecologists wants doctors to screen for it.

From USA Today:

“…In studies cited by the committee, “birth control sabotage” was reported by 25% of teen girls with abusive partners and by 15% of women who were physically abused. Some men go as far as to pull out a woman’s intrauterine device (IUD) or vaginal contraceptive ring, the committee says.

” ‘Often, it’s about taking away choices, taking away freedom, control and self-esteem,’ says Rebekah Gee, an obstetrician and gynecologist in New Orleans and assistant professor at Louisiana State University. She did not work on the opinion, but has studied the problem….

“The opinion says obstetricians and gynecologists can help women in these relationships by directing them to agencies and hotlines that help abused women, including the National Domestic Violence Hotline at 1-800-799-SAFE (7233). But it also says doctors can take direct action, by providing women with hard-to-detect birth control methods (including IUDs with the removal strings cut, if necessary) or a stash of emergency contraceptive pills (in a plain envelope).”

The article states that in a small study reports of reproductive coercion dropped 71 percent among women who go information about abuse. The article says many women don’t even realize it’s a form of abuse.

So what do you think: Would a doctor asking about this at your annual visit help? Would you talk to your daughters about this to make sure they know it’s not OK for men to do this? Has this ever happened to you?

60 comments Add your comment

A Realist

January 25th, 2013
7:18 am

A more likely scenario is your wife or girlfriend “forgetting” to take her birth control pill…..or lying about being on the pill in the first place in order to intentionally get pregnant because she “feels ready” (or hears the clock ticking) or to “trap” a man.

Jeff

January 25th, 2013
7:31 am

Thank you A. The frequency of the situation you described FAR exceeeds the frequency of the one TWG is talking about.

That being said, I would be willing to bet that it doesn’t apply to 99.9% of the people in this forum.

We should also be talking to our sons about their girlfriends doing this to them and not just be concerned about women being the “victim” of this scenario. Yet another reason for a demand for male BC pills. Put your sons on the pill.

dbm

January 25th, 2013
7:33 am

A Realist

January 25th, 2013
7:18 am

How do you know which is more likely? Doubtless both happen. Both are wrong. We need to be prepared to deal with both.

I recall a news report about a court case where the ruling favored a man who was subjected to what you are talking about. We need to be sure we’re dealing sufficiently with both.

mom2alex&max

January 25th, 2013
7:45 am

I didn’t expect misogynistic comments so early. To realist: you don’t KNOW this for a fact. I suspect they are both equally likely and both are equally WRONG.

I don’t have ant daughters, but if I did, they would be in the pill regardless of whatever assurances they give me that they won’t be having sex. I have sons and I have been talking to them about respect and responsibility when it comes to sex and girls.

But I would agree with you that I wish to God we had a male BC pill. My sons would be on it in a cold minute.

Grace Slick

January 25th, 2013
7:53 am

Just go to any upscale suburban neighborhood. Those women go to college to get their “MRS” degree – lock on to some guy going places, making bucks, determine his DNA is great for popping one out and then they get preggers very quickly after they get married – no more work, enjoy the country club and they are guaranteed 18% – 22% of hubbys gross for 18 years. Pop out kid #2 in a few more years and secure that gravy train.

Ann

January 25th, 2013
8:13 am

Well, men, if you think the actual situations are reversed, and women lie about being on the pill, or “forget” to take the pill, and want to “trap” a man, then the solution is simple: wear a condom. If you don’t want to become a father, then make sure you don’t.

SJ

January 25th, 2013
8:29 am

@Ann – Thank you! My thoughts exactly. It’s much easier to sit around and blame the woman. If a man is truly so determined not to have a child, then step up and take responsibility for contraception, regardless of what the other person says. Or don’t have sex.

Even if there were a male birth control pill, I would never rely on a man’s word that he had the contraception covered. Even if we were married. I’d take responsbility for myself. The same goes for a man who says he’s had a vasectomy.

Laurie

January 25th, 2013
8:37 am

Questions asked: “Would a doctor asking about this at your annual visit help? Would you talk to your daughters about this to make sure they know it’s not OK for men to do this?

Answer: YES. The answer is a no-brainer, especially with recent laws trying to stop women from getting abortions.

M.E.

January 25th, 2013
8:37 am

It’s possible the same men and women on this site pessimistically stereotyping women as just out to get a man would have a similar attitude and choice names for a woman who didn’t need or want them. People who disparage others do not know what real respect means and do not know how to teach respect to their children, who then perpetuate behaviors of rape and abuse. Changing your thinking will change society, and your relationships, for the better.

Jeff

January 25th, 2013
8:44 am

SJ, you act as if for some reason you are prevented from taking your existing BC if men had more options.

If you don’t trust a man to take a BC pill, why do you trust him to have sex with him in the first place? Why would you not want a “double layer” of protection. After, none of them are 100%. Why not use multiple.

FCM

January 25th, 2013
8:54 am

Certainly there are women who are out to “trap” a man. I know one Dad of 2 whose ex wife went on to have 3 more kids with 3 different men. She was exactly like A Realist described above. Do I think she is the majority of women NO.

Jeff is right that sons should be taught they have a responsibility in preventing things too. I say things because I am far more worried about the rise in STD rates of teens/20s than I am about a teen pregnancy. I have daughters. They are being educated and encouraged to wait, but I am realistic enough to know they may not. Having the people they will be dating in the future also be encouraged to wait, not pressure a person into sex, and if choosing to engage takes all necessary percautions would be preferred.

@ Ann…obviously I agree, and I know Jeff has said he is for male birth control pills.

As to should a doctor ask…better question, would the patient tell? If they are that manipulated they will not likely speak out, in my opinion.

FCM

January 25th, 2013
8:56 am

@ Jeff love your question “If you don’t trust a man to take a BC pill, why do you trust him to have sex with him in the first place?”

SJ

January 25th, 2013
8:57 am

@Jeff Men do have options. Some just don’t want to take responsibility for themselves. I never said I wouldn’t have sex at all. That’s just silly.

If a man told me that he was using a male birth control pill (if available) or had had a vasectomy, I’d say great. And treat that as double protection, while still protecting myself. Or requiring the use of a condom to prevent STDs, along with other birth control measures.

What I wouldn’t do is fail to take steps to protect myself, and then cry about being “trapped.” I’d acknowledge that if I truly didn’t want children, I’d be responsible enough to take all measures available to me to prevent them.

And it’s not a matter of trusting someone enough to have sex but not trusting them to handle birth control. Its an acknowledgement that birth control methods aren’t perfect and that people aren’t perfect.

Keepitreal

January 25th, 2013
9:33 am

This article is so funny cause my wife accidentally got pregent. She forgot to take the pill for two months.

But since I am a evil guy, it’s ok. I guess none of you godly women would do that…

Voice of Reason

January 25th, 2013
9:33 am

The more layers of protection you have in place, the better off you will be regardless of gender. Take responsibility for your side of the equation and protect what you have direct control over.

Keepitreal

January 25th, 2013
9:37 am

And to repond further, I was told by our woman marriage counsolor, it was so,etching I have to learn to accept.

Talk about being hypocrites…. When I guy goes for a check up, or to pay child support know asks if she got pregnant on purpose to get a free paycheck for 24 years… Yet it happend all the time….

Once male birth control pills have been invented, trust use women.. This will not be an issue anymore…

Young Lady

January 25th, 2013
9:37 am

SJ- Just like you should never just rely that contraception is covered.

Individual responsibility in contraception is key. Both partners have a responsibility based on what they want, which should have been communicated to each other, and they both have contraception choices to make.

The abuse is where a partner sabotages the choices made and it DOESN’T MATTER whether it’s a man or a woman sabotaging. It’s still wrong to intentionally go against what your partner wants. It’s not a men vs. women issue and trying to make it one dilutes the discussion about how to deal with it.

To Theresa- No it did not happen to me but it happened to my mom in the 70’s. She talked to me about it a lot when I became a teenager because she wanted to make sure I didn’t fall into the same traps she fell into as one.

Talking to me she expressed that it was my responsibility to take care of my contraception. I couldn’t rely on my partner no matter how much I loved him because if I don’t want child then that’s MY decision. We have to have open communication obviously about that decision because we don’t want someone that wants a child with someone that doesn’t, but what choices I make are my own. And if anyone tried to take my pills or do anything else I should just leave because it’s a sign of someone trying to control my choices and that kind of control won’t stop there.

I think it’s good advice for girls and boys because abuse isn’t a women’s issue. It’s a people issue.

ssidawg

January 25th, 2013
9:38 am

It’s easy…..if you don’t want to have a baby with the person you’re having sex with…..DON’T HAVE SEX with that person!!! No birth control is 100% reliable.

Voice of Reason

January 25th, 2013
9:58 am

@ssidawg

Ah yes the abstinence argument. Yes it’s 100% effective in preventing pregnancy but it is also 100% NOT a reasonable expectation for two consenting adults.

Do you honestly believe that someone who would coerce their partner into not using protection is going to just give up and throw in the towel when their partner says, “Hey let’s just not have sex?”

Abstinence is not the answer, proper protection is.

Misty

January 25th, 2013
11:03 am

What baffles me is the lack of responsibility. Dating? Why trust the other- use your own b.c. Stop blaming the other side! It’s not their responsibility to make sure female doesn’t get pregnant.

Libra

January 25th, 2013
11:04 am

Women sabotage BC, not men. There are absolutely no logical reason for a man to do this. I have not heard a single case. Men lack reproductive rights, that’s a given but in current legal system pushing women into having a child is a financial suicide for a man. Women got unrestricted legal power in reproduction and marriage. Men should not have unprotected vaginal sex unless there are absolute trust and legal safeguards. Stick with oral and anal.

iRun

January 25th, 2013
11:05 am

It’s pretty obvious none of you have ever worked in public health.

I do. And by that I mean I do public health research. And by that I mean I collect data and analyze it and publish it.

We do these sort of household health surveys. They’re massive and they include modules on sexual health.

This sort of thing happens all the time. ALL. THE. TIME.

Only, this is how it happens.

Your male intimate partner (often a spouse or steady partner) usually refuses with the threat of violence to wear a condom. And this isn’t the kind of threat of violence where you feel like, oh heck no I’m outta here. This is the kind of insidious upwelling pervasive threat that’s You didn’t see him do it but you can’t find them. Just this morning you found a giant crack in your diaphragm, so it’s no good. You tried to tell him no, wait until you get a new one but he stopped buying groceries and paying the power bill and it’s 7F outside.

When you got pregnant and you told him, he beat you so hard you got a concussion. He said he knew you’d been with Frankie when he was out at work. He was out two days and you couldn’t wait til he got home. But it’s not Frankie’s because you’re too scared to hardly leave the house. But he told you to get rid of it or he’s going to do it for you.

And THAT’S how these things really work. I’ve seen this in my work thousands of times.

mystery poster

January 25th, 2013
11:06 am

Hypothetical here…
Would the type of man who is so controlling as to pull out a woman’s IUD “allow” her to get her yearly GYN exam?

jarvis

January 25th, 2013
11:09 am

My kids doctor asked me if I owned a gun. I thought that was random.

I told her yes, but that I kept it very clean, didn’t let the kids touch it and that I didn’t feel like it was the root cause of my five-year-old’s pink eye.

jarvis

January 25th, 2013
11:21 am

On topic. Ahhhhh…..the plight of the ignorant.

To iRun’s point, these men are incapable of knowing what they are doing. They are animals. Their natural urges tell them that they should breed to further their blood lines. When reality sets in that they’ve actually got ANOTHER kid on the way, they lash out at the carrier.

The women in these situations have no self-esteem and no sense of self-worth. They keep these men around out of fear, but ended up with them in the first place because they are simple minded, and believe that they can to no better. It’s a sad sad cycle. What can be done to break it? If we had the answer to that, this’d be a better world.

Kat

January 25th, 2013
11:51 am

Guys – wear condoms; women – take the Pill. Protect yourself from what the other could do. And, if it’s even a concern, you may want to rethink your position (pun intended).

Kat

January 25th, 2013
11:57 am

@Keepitreal – how does a sane person “forget” to take the Pill for two months? I can see forgetting to take one in the morning one day, but 60 days in a row?

jarvis

January 25th, 2013
12:01 pm

Vasectomy. One day of pain….so worth the ease of mind.

Jeff

January 25th, 2013
12:20 pm

Jarvis, there are some doctors who require a signed consent of the wife in order to give a vasectomy to a married man.

mystery poster

January 25th, 2013
12:24 pm

@Jeff
When my mother got her tubal done in the ’70s she had to have her husband’s permission.

homeschooler

January 25th, 2013
12:32 pm

@ Jarvis, love you answer about the gun. The reason I left my child’s fist pediatrician is because I got annoyed with the social questions. Newly proposed legislation will demand more doctors ask these questions and more. Something to look forward to.
I do think this is something important to address. I have known women who were in controlling relationships and I could easily see this being a problem. Perhaps just passing out brochures to patients. It would bring this to the attention to possible victims (who may feel very alone) and also make others aware in case their girlfriends or other women come to them reporting this problem. I don’t see many women just admitting this is happening when asked but, like anything else, more public awareness could help some in these situations.
But please don’t start demanding legislation that every doctor has to discuss this, document it etc….I’m so sick of that crap.
And I agree that the number of women who “trap” men probably far exceeds the number of men denying bc to their partners. Still doesn’t lessen the seriousness of either. The “Trapping men” problem is very easy to fix though. Wear a condom. It’s that simple.

jarvis

January 25th, 2013
12:55 pm

@Jeff, that stinks. My did not, and he was great. Dr. Mark Haber at Georgia Urology…..can’t reccomend him enough.

He asked questions about our family (how many kids…gender of them…etc.), but he didn’t involve my wife. He did a great job. I was out of commission for the day of the surgery and sat on a bag of mini-limas, but I was moving again by the next day, and back to regular pain free movement the day after that.

I listened to my restrictions and didn’t life anything heavy for a week, but other than that no real restrictions.

jarvis

January 25th, 2013
1:10 pm

For the record, my wife was just as into me getting snipped as I was. Thought my last diatribe might have looked like that wasn’t the case.

Voice of Reason

January 25th, 2013
1:41 pm

If my doctor required me to get permission from my wife before I could have a procedure done I would find another doctor.

MomOf2Girls

January 25th, 2013
1:57 pm

@Kat – it doesn’t take forgetting the entire month. Missing 2 pills in a row is enough to compromise the protection.

@jarvis – great answer to the doc. Would be even better to let your kid answer, telling them the make, model, caliber, and then say how much fun it is to shoot.

Uh, please explain how...

January 25th, 2013
2:23 pm

…not using a condom is “sexual coercion”…If a wonman refuses to have sex, and in iRun’s scenario it appears no one was coerced into the act, then it is rape and not coercion, condom or no condom…

mom2alex&max

January 25th, 2013
2:50 pm

Jeff: my husband’s urologist didn’t need my permission, BUT he he require that I attend the consultation. And it baffled me how intent he was in making sure I understood without a shadow of a doubt how permanent this would be and how it would not be reversible. The whole thing was my idea! I had been bugging him for MONTHS about this!! YEAH, I wanted it done!

But I can see the wisdom of making sure that the wife at least KNOWS this is getting done.

FCM

January 25th, 2013
3:54 pm

@ Mystery in 2002 my (then) husband was asked if getting my tubes tied was ok with him.

FCM

January 25th, 2013
3:55 pm

@ mystery, I mean the doctor asked my husband if it was ok with him. Told him he had to sign the form.

catlady

January 25th, 2013
4:08 pm

This is disgusting! I know that there are men who refuse to use a condom, and there are women who “forget” to take the pill. This, however, is abuse. No, I would never be in relationship with a man like this, nor would my daughters. Perhaps that is because we are educated, have options, and a strong feeling of personal value and efficacy.

catlady

January 25th, 2013
4:10 pm

And should doctors talk about it, unsolicited, with patients? Probably, if this is commonplace.

homeschooler

January 25th, 2013
4:15 pm

I wonder if the doctors who require both spouses present or require both to sign the consent do it out of fear of being sued or if they do it out of a moral belief that both partners should be on the same page about such an important decision. I could see it both ways. My first thought was like VOR’s but, really, I believe that the spouse who is not getting the procedure has a right to know. It would be very unfair for a man to have a vasectomy or a woman to have a tubal ligation and not tell his or her spouse. The other spouse has a right to know. I don’t think they should have to agree but the doctor should do what he can to ensure the spouse is aware of the procedure. I had the Essure procedure. Don’t think my husband had to sign anything and I know he didn’t have to attend any consultations etc..

justmy2cents

January 25th, 2013
4:24 pm

Non-issue for me, but for my daughters the rule BETTER be no glove=no love! I am all for the shots/IUD- my family is entirely too fertile. My mother had me two years after having her tubes tied and an ovary removed…the thought of sex gets us knocked up LOL I would hope that my girls would not be in such a relationship to begin with, and if they found themselves in one, they would put those gun skills (a la Jarvis) we have taught them, to use. One thing my girls know is that I will NOT let a man put his hands on me in anger and that they know it is not acceptable at any time, for any reason. Yes there are plenty of women who entrap men; I find it repulsive as well.

Uncle Stonewall

January 25th, 2013
7:41 pm

This is yet another case of a completely inappropriate intrusion into the lives of others that leftwingers seem to think is okay. It is NOT the job or the duty of a doctor to ask questions of women that intrude into their personal relationships. The very premise of this is offensive. Doctors went to medical school to treat patients, not to engage in social reform. Your suggestion is offensive for numerous reasons including:

1) As numerous individuals have noted, the situation is usually that the WOMAN tries to intentionally get pregnant for the stability, commitment, and income potential of having children with a man. Unless a man is in love with a woman and really wants a life together, there are few in their right mind who would intentionally impregnate a woman and be stuck with child support and a broken relationship with their child.

2) Marriage is between 2 people and 2 people alone. It is COMPLETELY inappropriate to suggest that a married man be coerced to wear a condom by any outside influence and is outright disrespectful to the institution of marriage itself. Don’t get married if you don’t want kids unless your partner also feels this way. Period.

3) As archaic as it may sound, there are still some of us that believe sex outside of marriage carries inherent consequences. If you want to put yourself into the position of potentially getting yourself pregnant or having a kid, then man up/woman up and take care of it if it happens. If you don’t want the chance of someone ‘entrapping’ you with a kid, then maybe don’t have sex with them in the first place and that won’t happen.

mom2alex&max

January 25th, 2013
10:44 pm

Yeah Stonewall…life should be all unicorns and rainbows. But I am pretty sure you know it isn’t. And dang it must we harp on about the whole man trapping thing??? SERIOUSLY???? Why isn’t it even within your realm of possibility that men do this too?????

And doctors need to ask ALL kinds of questions…that’s how they effectively treat patients.

clanmack

January 26th, 2013
8:30 am

@Uncle Stonewall and all the others who say that it is more common for women to entrap men by becoming pregnant than for men to coerce pregnancy: You don’t cite any objective evidence. It is an old stereotype you refer to, based on anecdotes and stories whispered through the gossip networks you are part of. I have heard more stories of men who believe their sole reason for being is to impregnate as many women and sire as many children as possible than of women who have trapped men into a relationship. Both of these scenarios are abhorrent, immoral and unethical.
@iRun above-what studies have been done and what policy and social institutions are focused on these issues? I would like to see this kind of information in blogs, not just anecdotal, and often bloviating opinions, expressed here. These women and men are suffering and need help to break the cycle. One observation: There are many more women’s shelters to help women and their children who are victims of violent and rapacious men than the other way around. Men’s shelters serve mostly homeless men. Any one else wonder about that?

mom2alex&max

January 26th, 2013
8:50 am

clanmack: no I don’t wonder. I know full well WHY that is. I am SO sick and tired of the constant tirade from men on this forum that for some reason find it their lives’ mission to post about man entrapment. Usually accompanied by dire warnings about what happens to wives that won’t put out often enough to suit their preconceived notions.

Every volunteer at a women’s shelter? Ever hear he stories, see their wounds? Financial, emotional, verbal, physical and reproductive abuse are very real to those women. And there are thousands of them! For sure they don’t need to hear your BS about how they “entrapped” their man.

People like Stonewall et al make me SICK. As if all women cared about is trapping a man so they can be all “set” financially. *eye roll*

Faith

January 26th, 2013
9:26 am

As someone to whom this has happened, I probably should not have read the other comments. Shortly after I married my ex, the mask came off and things got terrible. Was ready to leave. He must have sensed this, because started pushing for kid. Wasn’t ready. He started flushing my pills and being forceful about sex. Got pregnant. Left when abuse ramped up, but without adequate resources, support, went back. That child saw so much before I finally left for good, that has had lasting emotional/behavioral scars, etc. Because of the “father’s rights movement” people don’t believe women who were abused. You finally feel safer telling when you leave, but just like the other commenters think getting pregnant is a trap set by women and never a method of control by men, people believe women who claim spouse abused her are just making it up as another trap. It’s sad. Add that to the prevailing “wisdom” that single mothers are the scourge of society, and you’re dammed any which way you go.

Former Active Duty

January 26th, 2013
11:36 am

Faith, I am glad to hear that you and your child were able to get out of that awful situation alive and hope that you are both doing well now. Having worked in maternal and child health for close to 20 years now, reproductive coersion happens more often than people realize. I’ve seen it on both sides, but more so with women being the target of the abuse. iRun is pretty spot-on with her assessment and she is right. Unless you have worked on the front lines in public health, you have no idea.

That being said, for those who say that a spouse should have to sign paperwork stating that they are aware of or approve of their spouse obtaining a vasectomy or tubal ligation, please consider this situation. A person is trying to leave an abusive situation and is planning to undergo either a tubal ligation, Essure, or a vasectomy in an effort to prevent an unplanned pregnancy that may prevent their escape. Now imagine that person being told that their abusive spouse will have to sign paperwork signifying their awareness or giving approval first.

10:10 am

January 26th, 2013
2:32 pm

Rather than think up ever more ways to involve government in our lives, why not accept that every wife has the duty to end a marriage she’s truly unhappy in.