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Many abused women may be sexual "coercion" victims

OB-GYNs are being cautioned to look for signs that their patients are being pressured into having a baby by their partners trying to sabotage their contraception.

"Most OB/GYNs are probably unfamiliar with sexual and reproductive coercion as an entity and probably don't ask about it," Dr. Eve Espey, chairwoman of the ACOG's Committee on Health Care for Underserved Women, said to HealthDay.

The American College of Obstetricians and Gynecologists (ACOG) issued new guidelines for doctors to detect and recognize reproductive "coercion" in the February 2012 issue of Obstetrics and Gynecology. A panel of experts looked at existing studies to form the new guidance.

Reproductive coercion can include hiding or tampering with a woman's birth control, poking holes in a condom or removing it during sex, forcefully removing IUDs and vaginal rings, forcing a woman to continue a pregnancy using threats or violence, and purposely trying to give her a sexually transmitted disease.

Epsey said there are no statistics on how common reproductive coercion is, but one study of teenagers on public assistance revealed that two-thirds of those who said they were domestic violence victims said their partner attempted to negatively alter their birth control. Another 2011 survey revealed one in four women was physically abused by a partner.

And, in 2010 the Centers for Disease Control and Prevention discovered that 4.8 percent of women in the U.S. said their partner tried to get them pregnant against their will or blocked them from using birth control.

"Given how prevalent [domestic] violence is, reproductive coercion is probably not uncommon," Espey guessed.

The same CDC survey showed that 8.7 percent of men said that their partner attempted to get pregnant against their wishes or stopped them from using birth control. However the ACOG's recommendations do not extend to men.

ACOG recommends that OB-GYNs who screen women for this form of abuse during annual exams, prenatal and postpartum visits and other appointments. Red flags include unintended pregnancies, the presence of an STD or HIV.

Sexual violence is four times more likely in women who have unintended pregnancies, CBS News medical correspondent Dr. Jon LaPook reported.

Doctors can also advise more hidden birth control methods, such as inserting IUDs with the strings cut and prescribing birth control pills in plain envelopes. Medical professionals can also direct women to agencies and hotlines that help abused women, like the National Domestic Violence Hotline.

What would cause a man to do this? LaPook spoke to one expert who said, "It's all about power -- about a man controlling a women's body. And a man who does this is much more likely to be violent with women."

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