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When He Throws Your Birth Control Pills in the Bin

Pressuring someone not to use birth control is called reproductive coercion and it's a form of intimate partner violence.

by Kimberly Lawson
12 August 2019, 1:00pm

Illustration by Hunter French

This article originally appeared on VICE US.

After the birth of her first child, Alice was hesitant about having more kids. Her husband was verbally and emotionally abusive, she told VICE, and hadn’t been helpful enough with caretaking after the birth of their baby. “I wasn’t sure I could handle [another baby] essentially alone,” she said.

Alice, a woman in her 30s whose name has been changed to protect her identity, wasn’t on birth control; she and her husband had been using the withdrawal method for two years. One night, Alice and her husband had sex to move on from an argument.

Without telling Alice, her husband decided not to pull out during intercourse.

“No warning, no discussion, no asking if he could—[he] just did it,” Alice, who’s now divorced, recalls. “I freaked out. I...was immediately furious that he did that without discussing it with me. I checked the app I used to track my period and I was in the ovulation window. I said, ‘Great, you just got me pregnant, asshole!’ He said, ‘Well, I want more kids anyway.’”

Alice did become pregnant from that incident; her children are now two and five years old.

She still gets upset when she thinks about that night. “It was absolutely consensual sex, but after he did that, I got the same sick feeling I got after previous sexual assaults. I don’t think he necessarily had a master plan to trap me, but I do think he just had such little respect for me, he did not care at all about my feelings on the matter.”

When it comes to contentious (or even unlikely) relationships and unexpected pregnancies, a dominant stereotype is of a woman trying to exert control over a man—i.e., she allegedly “trapped” him by becoming pregnant, also called "the baby trap."

This narrative—a popular topic for debate on online forums like reddit—is so ingrained in our culture that when a famous man has a child with a lesser-known woman, people immediately raise the question of whether or not he was “trapped."

Certainly, women can keep men in relationships by getting pregnant, said Heather McCauley, a social epidemiologist at Michigan State University. (The reality, of course, is that when women do become pregnant and have a child, they are much more likely to spend more time parenting than men.) But clinicians often report hearing stories that show the opposite to be true, she continued. “Partners messing with their birth control, pressuring them to get pregnant, and threatening to leave them if they didn’t get pregnant,” McCauley said.

This type of behavior—in which men exert control over a woman’s choice to become pregnant—is one tactic of abuse known as reproductive coercion. What’s horrifying is that when this little-discussed behavior is talked about more broadly, it’s often portrayed in a lighthearted way. See Pete Davidson’s flippant remarks last year on Saturday Night Live about swapping then-fiancée Ariana Grande’s birth control pills with Tic-Tacs.

"He kept telling me having kids was the next step"

Reproductive coercion is broadly defined as “behavior intended to maintain power and control in a relationship related to reproductive health” by the American College of Obstetricians and Gynecologists (ACOG). Examples include sabotaging contraception, such as hiding or destroying birth control pills, purposely poking holes in a condom, removing a condom during sex, or not pulling out during intercourse as agreed upon; pressuring a partner to get pregnant when they don’t want to; and threatening violence if she doesn’t agree to comply with her partner’s wishes, whether it’s to terminate or carry the pregnancy. For some people in states with strict abortion laws, getting pregnant against their will could mean they're effectively forced to carry a pregnancy to term.

As many as one in four women between the ages of 18-45 who sought primary care said they had ever experienced reproductive coercion, according to a review in the journal BMJ Reproductive & Sexual Health published in January. Black and multiracial women, as well as younger women and teen girls appear to be disproportionately at risk for this type of abuse. In fact, McCauley co-authored a new study published this month that found almost one in eight girls between ages 14 and 19 reported reproductive coercion within the last three months.

Behaviors that fall under the umbrella term of reproductive coercion aren’t illegal, though people outside of the United States have been charged for certain acts, including nonconsensual condom removal and piercing holes in a condom.

Lauren, whose last name we’ve withheld to protect her privacy, said she was 23 when her ex-fiancé started talking about having kids.

“We were newly engaged, and he kept telling me that it was the next step and that we didn't need to wait to get married before we started trying and wouldn't it be fun to start ‘practicing,’” she recalls. After her prescription for birth control ran out, she said, he found ways to deter her from picking up her refills and started asking to have sex without a condom.

“We were fooling around one day and he just didn't put a condom on,” Lauren, now in her 30s, recalls. “That was one of the many defining moments of our relationship when I knew that things were dangerous and I needed to start coming up with an exit strategy. The way he just went ahead with something so important, that I had made my feelings so clear about—I knew that nothing would ever be crossing a line for him.” The following morning, Lauren said she went to Planned Parenthood to get Plan B and an emergency refill of her birth control.

Their one-year relationship, Lauren continued, was also marked by physical and emotional abuse. Once, she said, “he strangled me until I almost blacked out.” She said she ultimately had to take out a restraining order against him.


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Reproductive coercion is a form of intimate partner violence and can happen alongside other types of IPV. A 2014 study found that 32 percent of 641 women who reported having been coerced also said they’d been threatened, physically hurt, or forced to do something sexually by the same partner. Another recent study suggests an association between women who became pregnant from rape and experiences of reproductive coercion: “Women raped by an intimate partner and reporting rape-related pregnancy were significantly more likely to have experienced reproductive coercion compared with women who were raped by an intimate partner but did not become pregnant,” the authors wrote last year. In short, pregnancy is linked to abuse and control.

Sam Rowlands, a visiting professor at Bournemouth University in the United Kingdom who led the BMJ review published in January, said reproductive coercion presents on a spectrum. On one end, a person may be verbally coerced to continue an unwanted pregnancy; on the other, there may be sexual violence. “There seems to be a common feeling at the more extreme end of the scale of keeping the whole thing a secret and being reluctant to divulge information or seek help because of fear of retaliation,” he explains.

Regardless of where a person’s experience falls on the spectrum, not being able to make these important life decisions can be devastating. “Reproductive control takes away a woman's self-worth, self-esteem, and ability to have control over her reproductive intentions,” Rowlands said. “She is belittled and undermined.”

"It felt like it was normal, and I was just being sensitive”

Beth, who agreed to speak with VICE on the condition of changing her name, remembers feeling pressured by her husband to have children before she was ready.

Her first pregnancy went well, she said, but it didn’t take long before her husband began pressing her to have a second. “He’s very good at making me agree with him,” Beth said. “You talk and you talk and you talk, and no matter what you say, he turns it around so that you end up thinking you’re stupid or you’re wrong or you can’t believe you thought that way and he was so obviously logically right.”

To complicate matters, Beth, who’s in her 30s, was diagnosed with an autoimmune disorder before her daughter’s first birthday. She thought her health would be a legitimate enough reason to avoid getting pregnant again.

Instead, Beth recalls, he used her illness as another way to coerce her into having more children. “Now that I have this disease, he [didn’t] want [our daughter] to feel like she’s got to take care of me for the rest of her life. That she needs a sibling to help shoulder the load. He just made me feel really guilty that I was putting all this pressure on my two-year-old.”

Beth became pregnant a second time, as her husband had insisted. The pregnancy wasn’t easy—her child had to be induced early—and Beth said she felt like her husband was frustrated by the experience. “I was getting weaker and sicker and it was upsetting his life because he needed to help out more with my preschooler. No two pregnancies are the same, but I think he was angry that I [supposedly] was not doing it right.”

Eventually, the couple split up; they are now in the process of a divorce. “His coercion was definitely a factor,” she said. “No matter what I said or did, I was always wrong.”

While Beth acknowledges that it was her husband who pushed to have children and talked her into making decisions she didn't agree with, she admits she still feels ashamed. “I consider myself a smart person and yet I let this happen to me and now my kids are tied to him as well,” Beth said. “I should have known better. And I do know better. If anybody else had told this stuff to me, it seems so obvious. But when it was me, it just felt like it was normal, and I was just being sensitive.”

She adds: “I love my girls, and I wouldn’t trade them for anything. I just wish I’d been able to feel like I’d been a part of the decision.”

“They don’t even recognize that behavior as abusive"

McCauley, the social epidemiologist at Michigan State University, said it’s not uncommon for people to have trouble identifying these types of experiences as abuse.

“I see this especially in my work with youth,” McCauley said. Teenagers often don’t know what a healthy relationship looks like, she explained, because the relationships they’re familiar with—whether in their families or those portrayed in the media—are often unhealthy.

She thinks the same is true for young women with partners who exert pressure or use coercion to control a woman’s reproductive autonomy. “They don’t even recognize that behavior as abusive,” McCauley said. “They think that’s what it means to be in a relationship.”

Researchers only began looking at reproductive coercion as a form of abuse in the mid-2000s, so there are still many unknowns around the behavior and its effects. What McCauley and others have been able to accomplish, though, is to help healthcare providers understand what reproductive coercion is and how they can inform their patients. For example, McCauley’s team partnered with nonprofit Futures Without Violence to produce safety cards to distribute in family planning facilities. As a result, clinicians can share methods of harm reduction with their patients, including types of birth control their partner can’t interfere with (like IUDs and implants) and ensuring they have access to emergency contraception and pregnancy testing.

“We can’t ourselves influence perpetrator behavior,” McCauley said, “but we can make sure survivors have everything they need to be safe.”

Otherwise, the consequences are lifelong—particularly for those who live in parts of the country where access to abortion care is limited. For certain people, getting pregnant means having a child whether they want to or not.

Alice, the woman whose husband refused to withdraw during intercourse, said that while her second child is her “greatest treasure...there’s a big part of me that wishes I had run for the hills at the first sign of abuse. Or the first time my gut said to go," she said. "Now I will be raising two kids alone, and I feel awful for bringing children into such a messed-up situation.”

How to spot reproductive coercion

In 2017, the slang term “stealthing” took the Internet by storm. Before Alexandra Brodsky, then a law fellow at the National Women’s Law Center, published her study on nonconsensual condom removal that April, discussions of people secretly removing condoms during sex without their partner’s knowledge were largely confined to chatrooms and private conversations. Not only did Brodsky’s study give language to what appeared to be a familiar experience for many who read and shared the paper, it also horrified some lawmakers, prompting them to consider reclassifying the act as rape.

It’s unclear where exactly nonconsensual condom removal falls on the spectrum of sexual violence. Experts say, however, that removing protection before or during sex without consent is one type of reproductive coercion.

Advocates say reproductive coercion is a form of relationship abuse that many people aren’t even aware of. But it happens—a lot. According to a 2011 survey from the National Domestic Violence Hotline, 25 percent of callers reported their partner had sabotaged their birth control or pressured them to become pregnant as a way to control them.

Megan Shackleton is the executive director of One Love, a nonprofit working to help educate young people on what healthy and unhealthy relationships look like. “The public’s misconceptions about reproductive coercion are rooted in a fundamental misunderstanding of relationship abuse and the cycle of violence that keeps people locked in,” she said.

While people often don’t recognize how severely damaging this manipulation can be, she adds, reproductive coercion is also particularly hard to spot because it typically happens in private, and it's been left out of mainstream portrayals of abuse.

Reproductive coercion can take the form of threats, physical violence, or emotional manipulation. In addition to nonconsensual condom removal, other examples include refusing to wear a condom, hiding your birth control pills, removing your IUD without your permission, persuading you to have a baby when you don’t want to, or guilting you into having an abortion when you don’t want one.

Sam Rowlands, the UK-based expert in sexual and reproductive health who published the study that found up to 25 percent of women visiting sexual health clinics reported a history of reproductive coercion and control, provided potential red flags or signs to look out for. Rowlands said it may be helpful for women to look at screening questions that medical professionals use to determine if a patient is at risk for intimate partner violence and reproductive coercion.

Some of those questions for reproductive coercion include:

• Do they support my decision about when or if I want to become pregnant?

• Have they ever tried to get me pregnant when I didn't want to be pregnant?

• Have they ever refused my request to use condoms?

• Do we agree on what I should do about a (wanted or unwanted) pregnancy?

Rowlands also points out that it’s important, if possible, to address indicators of an unhealthy relationship behavior early on. “The more entrenched reproductive control becomes, the more difficult it can be for a woman to extricate herself from the abuse,” he said.

As with other forms of abuse, every person’s experience is unique. Experts advise that if you suspect your partner is manipulating your reproductive choices, find an advocate—such as the National Domestic Violence Hotline—to talk you through your specific situation and potential options. You can also ask your healthcare provider to help you find different ways to protect yourself from an unintended pregnancy, such as forms of contraception that can’t be easily detected (i.e., an implant or a shot).

In addition to learning about the subtle behaviors of unhealthy relationships, Shackleford said it’s important to trust your gut. “If something feels off in your relationship, it’s likely because something is off. Your partner should never make you feel uncomfortable or unsafe.”

If you believe you are being coerced into decisions regarding your reproductive health, contact the UK National Domestic Violence Hotline on 0808 2000 247.