Integrating Reproductive Health into Domestic Violence Services
While reproductive coercion is a common tactic of abuse, how can a domestic violence organization implement a way to ensure all participants are educated on reproductive coercion and how they can seek help? Next Door Solutions partnered with Santa Clara University to train domestic violence advocates on the nature of reproductive coercion and together they developed assessment tools to better serve victims.
Recognizing the Need
Reproductive or sexual coercion is the act of exerting power and control in a relationship where in the abuser seeks to control whether a female becomes pregnant or carries the pregnancy to term. This may mean that an abuser sabotages the victim’s birth control or pressures a female to become pregnant when she does not wish to be, it can also mean pressuring or forcing a female to terminate a pregnancy against her will. Tactics may include threats or acts of violence including injuring a pregnant female in such a way that causes her to miscarry. According to the American College of Obstetricians and Gynecologist , the leading cause of death of pregnant females is homicide, it is therefore critical that both health care providers and domestic violence organizations understand and are equipped to serve the unique needs of pregnant victims and victims who may have experienced or are experiencing reproductive coercion.
Victims of sexual coercion face a number of obstacles when seeking help. If they are pregnant, or think they may be pregnant they may feel especially vulnerable and fearful for their safety. If they wish to terminate a pregnancy they may not have access to medical care to do so safely, or they may fear that they will be judged or stigmatized. If they were pressured or forced to terminate a pregnancy against their will, they may also fear judgement from providers as well as having feelings of grief or loss. The range of emotions that females may experience as a result of reproductive coercion is just as complex as the physical aspects and both need to be handled with a high degree of compassion and professionalism.
Next Door Solutions to Domestic Violence sought to build their own capacity to to address reproductive coercion within their programs. To do so, they engaged Reproductive Justice Interns at Santa Clara University as well as Planned Parenthood to integrate reproductive health education into Next Door’s support groups. This evolved into Next Door Solutions integrating reproductive health into all aspects of their domestic violence programs with a clear path for medical care for victims who needed it.
Engaging a reproductive justice approach
Reproductive Justice is an intersectional approach to women’s health, coined by the organization SisterSong in 1994 and is defined as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities”. While mainstream and predominantly white voices had centered the reproductive health conversations on “choice”, Reproductive Justice focuses on access and recognizes that marginalized and vulnerable communities often have limited access to sexual health education, birth control, STI testing and treatment–and is therefore a helpful framework through which to view domestic violence, and sexual/reproductive coercion in particular. Next Door Solutions engaged a cohort of Reproductive Justice interns from Santa Clara University to increase victims and survivors access to sexual health education and health care services.
Shared expertise leads to sustainable solutions
The collaboration between Next Door Solutions and Santa Clara University, resulted in two key outcomes The first being that reproductive health became integrated throughout Next Door Solutions. Next Door Solutions staff ask about reproductive health during intake for the shelter to ensure that any incoming client could be linked to services and support immediately, Next Door Solutions staff have increased comfort in discussing reproductive health, reproductive coercion and control, allowing them to better support clients. Material regarding reproductive health is available at Next Door Solution’s main office and modules covering reproductive coercion and health are part of support group curriculum. The second outcome is that Next Door Solutions clients have increased access to reproductive healthcare, clients have access to emergency contraception and pregnancy tests at the shelter and case managers are able to assist them in getting an appointment at local health care clinics.
The leading cause of death of pregnant females is homicide, it is therefore critical that both health care providers and domestic violence organizations understand and are equipped to serve the unique needs of pregnant victims and victims who may have experienced reproductive coercion.