Survivor Perspectives on Clinical Support for Intimate Partner Reproductive Coercion: An Exploratory Qualitative Study.

INTRODUCTION

Intimate partner reproductive coercion (IPRC) is a common form of violence that undermines reproductive autonomy through behaviors such as contraceptive sabotage and pregnancy pressure. Although clinicians have the potential to offer meaningful support, data are limited regarding durable, consistent harm reduction interventions. Incorporating survivor perspectives is essential to ground clinical responses in lived experience and the complexities of IPRC. This study aimed to identify survivor-informed strategies to support reproductive autonomy.

METHODS

We conducted an exploratory qualitative study with individuals who spoke English or Spanish aged 18 to 50 years, were assigned female at birth, disclosed a history of IPRC, and received care at a large academic health care center in the Northeastern United States. Semistructured interviews were conducted via videoconference or telephone and recorded, transcribed, and analyzed using the Framework Method. This inductive, modified grounded theory-informed approach guided the development of survivor-informed propositions that deepen understanding of clinical encounters in the context of IPRC.

RESULTS

Twenty individuals participated in the study. Participants described IPRC as a spectrum of coercive behaviors rooted in control, gender norms, and cultural messaging. Social factors shaped experiences of IPRC and the perceived risks of clinical disclosure. Survivors identified clinical strategies that supported reproductive autonomy, including nonjudgmental language, confidentiality, access to discreet contraceptive options, and a range of communication styles. Suggestions for clinical approaches varied, highlighting the need for individualized, flexible care.

DISCUSSION: Survivors emphasized that effective clinical care for IPRC must go beyond education or screening and instead adopt a whole-person, trauma-informed approach rooted in trust, empathy, and humility. Clinicians' awareness of how structural and interpersonal factors intersect with experiences of IPRC may support more responsive and equitable care. Future research should explore how survivor-informed approaches affect outcomes across diverse clinical and community contexts.