WOMEN experiencing domestic violence often have their freedom and choices taken away from them, not least their reproductive health choices.
A study led by Ms Lauren Maxwell, PhD Student, McGill Domestic Violence Clinic, McGill University, Montreal, Quebec, Canada, has produced evidence that women who are abused sexually or physically by their partner are less likely to use contraceptives such as condoms, as they are at the mercy of their partner who can refuse to use them. They then resort to contraceptives such as injections or sterilisation in developing countries, or intrauterine devices in Western countries, putting themselves at risk of sexually transmitted diseases, unwanted pregnancies, and abortions.
These findings were collated from studies based in the US, India, South Africa, Zimbabwe, and Nicaragua, and suggest a causal effect of domestic violence on women’s contraceptive use. “When talking to abused women, I had often heard them mention they were opting for contraception methods their male partner could not refuse,” said Ms Maxwell. “I wanted to know whether, across countries, women who experience intimate partner violence are less able to use contraception, which might explain why rates of abortion and HIV transmission are higher among women abused by their partners.”
The study calls for further aid for women suffering from domestic violence, suggesting that goals such as those set by the UN to achieve universal access to reproductive health should take domestic violence into consideration. “We have not met our targets in terms of access to contraception,” Ms Maxwell said. “This is detrimental to maternal and child health and to women’s education. To improve both, we should consider partner violence when creating programmess designed to improve women’s access to contraception.”
The research suggests the importance of screening for intimate partner violence before involving men in contraceptive counselling, as the presence of violent partners could damage efforts to offer women contraception. Implementation of such a scheme could have a knock-on effect of enhanced training of healthcare providers to screen their patients for domestic violence, therefore improving the protection and sexual education of women worldwide.