title: Recent reproductive coercion and unintended pregnancy among female family planning clients.
abstract: OBJECTIVE
  Reproductive coercion (RC)--birth control sabotage and coercion by male partners to become pregnant and to control the outcome of a pregnancy--has been associated with a history of both intimate partner physical and sexual violence (IPV) and unintended pregnancy among females utilizing reproductive health services. The temporal nature of associations of RC and unintended pregnancy (distinct from the impact of IPV), however, has remained less clear.
  
  
  METHODS
  A survey was administered to females aged 16-29 years seeking care in 24 rural and urban family planning clinics in Pennsylvania (n=3539).
  
  
  RESULTS
  Five percent of respondents reported RC in the past 3 months, and 12% reported an unintended pregnancy in the past year. Among those who reported recent RC, 21% reported past-year unintended pregnancy. Compared to women exposed to neither condition, exposure to recent RC increased the odds of past-year unintended pregnancy, both in the absence of a history of IPV [adjusted odds ratio (AOR) 1.79, 1.06-2.03] and in combination with a history of IPV (AOR 2.00, 1.15-3.48); history of IPV without recent RC was also associated with unintended pregnancy (AOR 1.80, 1.42-2.26).
  
  
  CONCLUSIONS
  Findings indicate the temporal proximity of the association of RC and unintended pregnancy, with recent RC related to past-year unintended pregnancy, both independently and in combination with a history of IPV. Recent RC is relatively prevalent among young women using family planning clinics and is associated with increased risk for past-year unintended pregnancy even in the absence of IPV.
  
  
  CONCLUSIONS
  Recent RC and a history of IPV are prevalent among female family planning clients, particularly younger women, and these experiences are each associated with unintended pregnancy. Pregnancy prevention counseling should include not only assessment for physical and sexual partner violence but also specific inquiry about RC.
authors: Division of Adolescent Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15213, USA. Electronic address: elizabeth.miller@chp.edu.
authors: Elizabeth
authors: E
authors: Miller
authors: Division of Adolescent Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15213, USA.
authors: Heather L
authors: HL
authors: McCauley
authors: University of California Davis School of Medicine, Sacramento, CA, USA.
authors: Daniel J
authors: DJ
authors: Tancredi
authors: Department of Population, Family and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
authors: Michele R
authors: MR
authors: Decker
authors: Division of Adolescent Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15213, USA.
authors: Heather
authors: H
authors: Anderson
authors: University of California San Diego, San Diego, CA, USA.
authors: Jay G
authors: JG
authors: Silverman
mesh_terms: D000293:Adolescent; D000328:Adult; D003068:Coercion; D017579:Domestic Violence / Q000523:psychology* / Q000706:statistics & numerical data; D005193:Family Planning Services; D005260:Female; D006801:Humans; D011247:Pregnancy; D011275:Pregnancy, Unwanted / Q000523:psychology*; D055815:Young Adult
keywords: Contraception, barrier; Domestic violence; Family planning services; Pregnancy, unwanted