ACOG Recommends Routinely Screening Women for Reproductive and Sexual Coercion

The American College of Obstetricians and Gynecologists recommends that clinicians screen women and adolescent girls for reproductive and sexual coercion regularly, such as at annual examinations, at new patient visits, and during obstetric care. Coercion includes contraceptive sabotage, pregnancy coercion (threats or violent acts to force a woman to continue or terminate a pregnancy), and pregnancy pressure (insisting that a woman become pregnant against her will), and is often associated with other forms of intimate partner violence (IPV).

Clinicians should:

• Provide and explain how to use a concealable wallet-sized safety card (available from Futures Without Violence).

• Support patients who are experiencing coercion by validating their experiences and assuring them that the abuse is not their fault.

• Counsel affected patients about harm-reduction strategies and safety planning.

• Offer highly effective reversible contraceptive methods (e.g., intrauterine devices, implants, injections) that are readily concealed and more difficult than other methods for partners to subvert.

• Include IPV and reproductive and sexual coercion in the differential diagnosis when patients present for emergency contraception, for testing for pregnancy or sexually transmitted infections, or with unintentional pregnancies.

• Obtain education for themselves and their staffs about identifying and intervening in reproductive and sexual coercion.