Margaret, 22, lives with her 50 year old boyfriend in a caravan park in regional Queensland. She's not allowed outside when he's at home, and the only money she has is what he gives her. He makes her have sex with him every day, even though she doesn't want to. She was too afraid to tell him about her pregnancy, fearing he'd 'hurt' her and that he would make good on a threat to send her back to Asia if she didn't please him.
23 year old Sara's partner would flush her contraceptive pills down the toilet, and regularly forced her to have sex with him. Her pregnancy was the catalyst to her ending the relationship but she is now couch surfing while she tries to financially get back on her feet.
Kaylee was 19 with a boyfriend of three years who was emotionally and psychologically abusive. She was 18 weeks pregnant and her boyfriend wanted her to 'get rid of it'. Her own moral values won't allow her to terminate a pregnancy, but he said if she continued the pregnancy he would tell everyone the baby isn't his and that she'll be on her own. He said if she 'really loved him' she would have an abortion like he asked.
Lou, 34, was pregnant to her violent ex-partner. For weeks he oscillated between two extremes: one day threatening Lou with violence if she continued the pregnancy and saying he'd pay for her to access an abortion, and the next withdrawing the money and pleading with her to make a family with him. The day before her appointment for an abortion, he gave a final refusal to help her pay for it but said he would punch her in the stomach until she miscarried unless she got it "sorted".
All four women contacted Children by Choice in the past six months for help.
Even though a spotlight has been firmly planted on domestic violence of late – with state and federal enquiries and taskforces and awareness months and White Ribbon events and who knows how many articles on how many websites – the issue of reproductive coercion and sexual assault in abusive relationships remains shrouded in darkness.
The term reproductive coercion is used to define a range of male partner pregnancy-controlling behaviours. Ranging from birth control sabotage, where contraception is deliberately thrown away or tampered with, to threats and use of physical violence if a woman insists on condoms or other forms of contraception, to emotional blackmail coercing the woman to fall pregnant, or to have an abortion, as a sign of her love and fidelity, to forced sex and rape. The pregnancy is a tool of control, and a sign to a perpetrator of violence that they have power over their partner's body. Reproductive coercion is an easy and effective and cowardly way of manipulating and controlling a woman by limiting her autonomy over her fertility and reproductive health and choices.
So what do we know about violence, pregnancy and reproductive coercion? From international research and practice, we know a fair bit, and it makes for uncomfortable reading.
We know that in the US, this problem is suspected to be so large and yet so hidden that the American College of Obstetricians and Gynaecologists is recommending doctors screen for reproductive coercion alongside domestic violence.
We know that several studies into the rates of reproductive coercion have taken place, also in the US, with frightening results: one found that among 71 women with a history of intimate partner abuse, almost three quarters had experienced some form of reproductive control, as this 2010 article explains.
We know that American women who seek and are denied an abortion are more likely to remain in violent relationships than women who are granted access.
In Australia this is an emerging area of research. However, we know enough to understand how serious a problem reproductive coercion is, and how much risk our complicated abortion access processes place women in violent relationships under.
We know that during pregnancy women face an increased risk of intimate partner abuse, and that unintended pregnancy occurs more commonly for women in abusive relationships.
We know that using medical contraception to control fertility is often complicated for women in abusive relationships.
We know that in contacts to our counselling and information service in Queensland, 17.5% of our clients disclosed violence in 2013-14.
We also know that almost 40% of our clients reporting sexual violence also report domestic violence, highlighting the prevalence of forced sex within ongoing relationships that are also abusive in other ways.
While national data exists to show one in three women has experienced physical and/or sexual violence, we have to ask why more work has not been done in shining the light on the overlap between the two.
We should be working to ensure that reproductive coercion is recognised as a common marker of domestic violence, and that steps are taken to address both the perpetrator's behaviour itself and the risks that reproductive coercion places on women (unplanned or unwanted pregnancy, higher incidence of sexually transmitted diseases, and the trauma of rape and sexual assault).
We should know how many women experience reproductive coercion, so we can better respond to their complex physical, mental and emotional needs when they present to a service.
We should be ensuring these women have smoother pathways to accessing the services they need rather than the current patchy (and often tokenistic) responses to women in these times of crisis.
It is not enough to name reproductive coercion as a form of domestic violence: we must facilitate access to contraception, pregnancy health support and/or abortion for women in violent relationships, safely and affordably.
Relationships where physical and sexual violence, manipulation, financial control, and surveillance all coexist are the darkest end of the spectrum of men's violence against women, and women in these relationships are, quite often, dealing with this maelstrom alone. We can and must do better.
Kate Marsh is the Public Liaison Officer for Children by Choice.