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Healthcare Provider-Based Contraceptive Coercion: Understanding U.S. Patient Experiences and Describing Implications for Measurement

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  • Laura E. T. Swan

    (Department of Population Health Sciences, University of Wisconsin-Madison, Madison 53706, WI, USA)

  • Lindsay M. Cannon

    (Department of Sociology, Center for Demography and Ecology, University of Wisconsin-Madison, Madison 53706, WI, USA)

Abstract

Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a novel measure: the Coercion in Contraceptive Care Checklist. In early 2023, we surveyed reproductive-aged people in the United States who were assigned female at birth about their contraceptive care. We describe the frequency of contraceptive coercion in our sample ( N = 1197) and use open-ended descriptions to demonstrate nuances in these experiences. Finally, we debut our checklist and present psychometric testing results. Among people who had ever talked to a healthcare provider about contraception, over one in six participants (18.46%) reported experiencing coercion during their last contraceptive counseling, and over one in three (42.27%) reported it at some point in their lifetime. Being made to use or keep using birth control pills was the most common form of coercion reported by patients (14.62% lifetime frequency). Factor analysis supported the two-factor dimensionality of the Coercion in Contraceptive Care Checklist. Inter-item correlations were statistically significant ( p < 0.001), providing evidence of reliability. The checklist was also related to measures of quality in family planning care (downward coercion: t [1194] = 7.54, p < 0.001; upward coercion: t [1194] = 14.76, p < 0.001) and discrimination in healthcare (downward coercion: t [1160] = −14.77, p < 0.001; upward coercion: t [1160] = −18.27, p < 0.001), providing evidence of construct validity. Findings provide critical information about the frequency and manifestations of contraceptive coercion. Psychometric tests reveal evidence of the Coercion in Contraceptive Care Checklist’s validity, reliability, and dimensionality while also suggesting avenues for future testing and refinement.

Suggested Citation

  • Laura E. T. Swan & Lindsay M. Cannon, 2024. "Healthcare Provider-Based Contraceptive Coercion: Understanding U.S. Patient Experiences and Describing Implications for Measurement," IJERPH, MDPI, vol. 21(6), pages 1-14, June.
    • Handle: RePEc:gam:jijerp:v:21:y:2024:i:6:p:750-:d:1411325
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    References listed on IDEAS

    as
    1. Laura E. T. Swan & Samantha L. Auerbach & Gretchen E. Ely & Kafuli Agbemenu & Jessica Mencia & Nimah R. Araf, 2020. "Family Planning Practices in Appalachia: Focus Group Perspectives on Service Needs in the Context of Regional Substance Abuse," IJERPH, MDPI, vol. 17(4), pages 1-25, February.
    2. Senderowicz, Leigh, 2019. "“I was obligated to accept”: A qualitative exploration of contraceptive coercion," Social Science & Medicine, Elsevier, vol. 239(C).
    3. Higgins, J.A. & Kramer, R.D. & Ryder, K.M., 2016. "Provider bias in long-Acting reversible contraception (LARC) promotion and removal: Perceptions of young adult women," American Journal of Public Health, American Public Health Association, vol. 106(11), pages 1932-1937.
    4. Geampana, Alina, 2016. "Pregnancy is more dangerous than the pill: A critical analysis of professional responses to the Yaz/Yasmin controversy," Social Science & Medicine, Elsevier, vol. 166(C), pages 9-16.
    5. Palan, Stefan & Schitter, Christian, 2018. "Prolific.ac—A subject pool for online experiments," Journal of Behavioral and Experimental Finance, Elsevier, vol. 17(C), pages 22-27.
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