Don’t ask, just tell

Lately, I have been learning about reproductive coercion—all the ways someone could interfere with your birth control, or pressure you to get pregnant or end a pregnancy. I read this surprisingly personal post by a doctor sharing her experience with a female patient where she missed identifying that her boyfriend was preventing her from using birth control.

reproductive-coersion-flyerI asked my friend who is a doctor if she’s had similar experiences. She said she routinely underestimates the lack of control women have around their reproductive choices. “I talk to my patients as if they have control and they may not.” She told me doctors need scripted, short questions, like “Are your decisions around birth control and pregnancy respected? Do you want information on birth control that can’t be interfered with?”

When I was pregnant, health care staff didn’t wait for me to ask about things that could happen, like preeclampsia, they just routinely gave me the info I needed to be safe and healthy.

Reproductive coercion is far more common than preeclampsia. Healthcare providers are missing an opportunity. They don’t have to ask patients to disclose abuse. They should just routinely tell every woman of reproductive age about birth control that can’t be seen, felt, or interfered with, and places they can get support if they, or a friend, might need it.

My doctor friend and I both have teen daughters. Our girls roll their eyes when we try to talk to them about birth control. So we need someone else to do it. It would be a relief to know that their doctors will tell them about undetectable forms of birth control and emergency contraception—not wait for them to ask. 

6 thoughts on “Don’t ask, just tell”

  1. I agree! There is also a problem when the nurse hands you a DV questionnaire when he is sitting next to you.

  2. I agree that we all need to think creatively about how to get information into the hands of people who will most benefit. Thanks for your comments.

  3. Thanks for the note, and I agree with what you say about wishing our health care providers routinely had conversations with their patients about birth control. But I say also, not in lieu of the parents. Even if our children roll their eyes or refuse to discuss it, as patents we must continue to ask and initiate discussion. The next time they just might decide to engage, and they’ll know it’s safe to do so.

    I do, however, take issue with with some of the comments in the doctors post that inspired your observation here. I don’t believe that women or girls — you and you alone, as the article states — control your reproductive choices. I do believe women have the final say but it should not be a decision made in solitude or isolation. We need to educate our daughters to talk openly and confidently about their reproductive choices, whether to their partners, peers or parents. Empowering them with knowledge and options is an important way to break the cycle of coercion. Of course, I’m not advocating that they put themselves in harms way, but I do want to encourage openness, andinformed and knowledgeable conversations with their partners, who may be supportive and open to learning themselves.

  4. I agree that we need our kids to get information from lots of sources – parents are always play a critical role as their kids first source and primary source of information. I too hope all young people, and adults, will have relationships where reproductive health decisions and relationship issues can be shared with respectful, kind and loving partners.

  5. Thank you, Leigh. This is a critical issue when considering how coercive control works in the lives of women and girls and especially now that reproductive autonomy is challenged from idealogues intent on subjicating women through a narrow politiical/religious world view. Concerning the points raised in Josh’s post, I was presenting to a group of public health nurses just last week who serve pregnant and parenting teens. Several of them have reported that the parents of these teens actually collude with the teen’s abusive partner in exerting control over them. In some cases, it seems that the parent is utilizing the abuser for their own controlling “needs”. Whatever the case, “empowering them with options and choices” is an over-simplified view of the agency (or lack thereof) many young women possess. In additiion, once a dependency factor like having a child in common is put in place, further development of autonomy and agency to direct her life, set on a path of reaching goals and being free from further coercive control is exponentially more difficult and highly improbable leading to a liklihood of further harm to her and now of course to another generation, her child. Thanks again for this timely post!

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