Abstract
BackgroundReproductive coercion (RC) is quite a common form of violence against women. However, it mostly goes unrecognized by victims. It can take several expressions aiming at limiting a woman’s reproductive autonomy. Thus, the frequency and how reproductive coercion can be resisted must be investigated. There is limited research regarding RC in Latin America. Therefore, this study aimed to measure RC prevalence and associated factors and to explore the women experiences and coping strategies for RC.MethodsA convergent mixed-methods approach with parallel sampling was conducted in western Nicaragua. A quantitative phase was applied with 390 women 18–35 years old attending three main urban primary health care facilities. Lifetime and 12 months of exposure to RC behaviors including pregnancy promotion (PP) and contraceptive sabotage (CS) were assessed. Poisson regression with a robust variance estimator was used to obtain adjusted prevalence rate ratios and 95% Confidence Intervals (CIs). In addition, seven in-depth interviews were analyzed using content analysis.ResultsEver RC prevalence was 17.4% (95% CI, 13.8–21.6) with similar proportions reporting ever experiencing PP (12.6%, 95% CI 9.4–16.3) or ever experiencing CS (11.8%, 95% CI 8.7–15.4). The prevalence of last twelve months RC was slightly lower (12.3%, 95% CI, 9.2–16.0) than above. Twelve months PP (7.4%, 95% CI 5.0-10.5) and CS (8.7%, 95% CI 6.1–12.0) were also similar. Women considered that control is an expression of care. Women’s higher education was a protective factor against ever and 12 months of exposure to any RC behaviors by a current or former partner. Informants described a broad spectrum of coping strategies during and after exposure to RC. However, these rarely succeeded in preventing unintended pregnancies or regain women’s long-term fertility autonomy.ConclusionsIn Nicaragua, men’s RC is a pervasive continuous phenomenon that can be enacted through explicit or subtle behaviors. Women used different strategies to cope with RC but rarely succeeded in preventing unintended pregnancies or regain their long-term fertility autonomy. Thus, these findings highlight the need for a comprehensive health system response on different expressions of RC. There are important implications for improving female reproductive agency in Nicaragua and elsewhere.