Tuesday 1 April 2014

Intimate Partner Violence, Pregnancy and Abortion

The World Health Organisation defines Intimate Partner Violence (IPV) as “one of the most common forms of violence against women and includes physical, sexual, and emotional abuse and controlling behaviours by an intimate partner”. IPV has been shown to increase during pregnancy. Women’s Aid states that 30% of IPV starts during pregnancy and that between four and nine women out of every 100 are abused during their pregnancies and/or after having given birth. Women’s Aid identifies IPV as a prime cause of miscarriage, still-birth and of maternal deaths following childbirth.

One form of IPV is termed ‘reproductive coercion’ – where abuse relating to contraception or pregnancy decision-making is exercised by a woman’s partner. For example, the abuser may sabotage contraception, refuse to use it, or pressurise a partner into continuing or ending a pregnancy against their wishes. Perhaps unsurprisingly, a recent study found an association between IPV (naming rape and sexual assault, contraceptive sabotage and pregnancy coercion as examples) and termination of pregnancy. The study found that women in violent relationships were three times more likely to conceal an abortion from their partner as women in non-violent relationships and that “women undergoing terminations of pregnancy welcomed the opportunity to disclose their experiences of intimate partner violence and to be offered help”. What this tells us is that pregnancy support services need to be attuned to the risk factors for IPV and to be able to provide signposting and support where required. Domestic violence support services in turn, need to be equipped to provide accurate information on pregnancy choices and impartial support with pregnancy decision-making.

We were concerned to see that information about IPV and pregnancy is being misrepresented by anti-abortion organisation LIFE, in its recent ‘Finding Hope’ campaign. In a glossy animation LIFE claims that “the association between abortion and violence towards women is strong”. LIFE claims that one in four women seeking abortion are “victims of domestic violence” and “at least one in every four women seeking abortion, therefore, (is) not doing so freely but from a position of fear.” LIFE makes a causal relationship between IPV and abortion which is simply not in the data, implies that abortion itself is a form of violence, and states that “women who have abortions can become more self-destructive, and remain in or seek out abusive relationships as a form of self-punishment.” It is highly offensive to suggest that women have abortions, or remain in violent relationships as a form of ‘self-punishment’. It is also inaccurate to extrapolate this data to claim that a quarter of women seeking abortion do so out of ‘fear’.

It is not surprising that a large proportion of women who have abortions have also, at some point, experienced IPV. Both are very common within a lifetime. A third of women have an abortion. A quarter of women experience IPV. It is therefore inevitable that a significant number of those accessing abortion services will have also experienced IPV. What we know about IPV increasing during pregnancy, and about reproductive coercion as a form of IPV, means that there is of course a link between IPV, unplanned or unwanted pregnancy and therefore abortion, but this link is not one of simple causation as the LIFE Finding Hope campaign implies.

LIFE’s suggestion that “no one even asks them (pregnant women) if they are ok...let alone, why do you want an abortion...not even the health professionals tasked with caring for them” is particularly misleading. The Finding Hope campaign claims to, “draw attention to abortion providers' conveyor-belt service and their failure to adequately support women vulnerable to abuse”, the implication being that women seeking abortion are not assessed, supported or fully consenting to the procedure. In fact, bpas, a leading abortion provider and charity, takes a ‘routine enquiry’ approach to domestic abuse, which means staff routinely ask women about safety in their relationship. All staff are trained on domestic abuse issues and bpas provides information in formats which are accessible to a range of people and signposts to relevant agencies. The Royal College of Obstetricians and Gynaecologists advises medical professionals to work to identify those at risk of IPV and provide appropriate support.

LIFE’s campaign culminates in a fundraising appeal for its helpline service. LIFE, which campaigns against legal (and therefore safe) abortion does not appear to be promoting genuine advocacy on domestic violence issues, but rather conflates abortion with abuse in order to argue against abortion. We are particularly concerned that LIFE’s ‘counselling’ services have been shown to be misleading and biased, for example, one LIFE counsellor falsely claimed that abortion leads to an increased risk of breast cancer. Giving women false information in an attempt to influence their decision about a pregnancy is unethical. The narrative provided by LIFE, that women seek abortion only out of ‘fear’ or coercion, is simply not accurate, and negates women’s agency when it comes to making sometimes difficult choices about pregnancy. The connections between IPV and abortion are perhaps best looked at through the reproductive justice framework, which recognises that sometimes our 'choices' are restricted by factors such as economic status, race, class, location and so on. This useful factsheet from the National Women's Law Center, 'If You Really Care About Preventing Domestic and Sexual Violence, You Should Care About Reproductive Justice' makes clear the need to improve material conditions surrounding pregnancy and IPV and points out that restrictions on access to contraception and abortion services will only further constrain a person's ability to exercise bodily autonomy.

*****There is a confidential 24-hour National Domestic Violence Helpline on 0808 2000 247. This helpline is free and run in partnership by Refuge and Women's Aid who can provide information and support to those experiencing domestic violence. ******

Slide from LIFE's 'Finding Hope' animation which places abortion within a 'cycle of abuse'.

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