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Many Women Victims of 'Contraceptive Sabotage,' Experts Say
Date:1/23/2013

h care needs," Smith said.

"Chronic health care issues can be avoided, and women can manage the needs of their families and themselves much better if their reproductive decisions are not interfered with by an abuser," Smith said.

The ACOG said doctors should ask women about potential reproductive coercion when they screen for domestic violence in general -- something ob/gyns already know to ask about, Espey said.

Futures Without Violence, a nonprofit organization based in San Francisco, has developed wallet-sized "safety cards" with information on reproductive coercion that doctors can give to women. Doctors also can use those cards as a starting point for talking to their patients, said Rebecca Levenson, a senior policy analyst at Futures Without Violence.

The term "reproductive coercion" was coined several years ago after researchers began recognizing it as a distinct form of violence that some women suffer independent of other types of abuse, Levenson explained.

She said the ACOG is on the "cutting edge" in making its new recommendations, and it is important for ob/gyns to specifically ask about reproductive coercion because they can help women directly.

Espey agreed. Giving a woman a birth-control method that is not obvious to her abuser is one way.

"For example, an IUD with the strings cut off would protect against pregnancy but would not be felt by the partner during intercourse," Espey explained.

IUDs, or intrauterine devices, are implanted in the uterus, where they release small amounts of either copper or the hormone progestin to prevent pregnancy. Espey said the copper IUD might be preferable for women who are victims of abuse because they do not usually keep a woman from menstruating, and some abusers monitor their partner's periods.

Espey said the takeaway for women is that they have the right to decide whether and when to have children, and what to do about an unplanned pregnancy.

"Most women i
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