Reproductive Coercion – Health & Social Service Based Prevention
If you think you may be experiencing Reproductive Coercion and are seeking free, confidential, non-judgemental, and pro-choice support, counselling, or community resources – please reach out to Planned Parenthood Ottawa and we will help you get the care you need.
What does informed consent mean in my practice?
Informed Consent: The Native Women’s Association of Canada created a Know Your Rights Toolkit for Sexual and Reproductive Health which outlines the meaning of free, prior, and informed consent. *the toolkit uses binary language that does not reflect the scope of gender identities affected by reproductive coercion*
The First Nations Health Authority has created a comprehensive Framework for Cultural Safety and Humility grounded by the following definitions:
Cultural Safety: an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the health care system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.
Cultural Humility: a process of self-reflection to understand personal and systemic biases and to develop and maintain respectful processes and relationships based on mutual trust. Cultural humility involves humbly acknowledging oneself as a learner when it comes to understanding another’s experience.
As a healthcare or social service provider, you will never be able to self-declare any “safe space” for a patient or client based on varying marginalizations, oppressive contexts, and due to the inherent power dynamics that ground access to care and services. That being said, you can actively reflect on your understanding of informed consent, cultural safety, cultural humility and how you apply these principles of care in your practice, particularly when it comes to consultations about contraception, family planning, pregnancy, abortion, and STI navigation.
Respecting reproductive autonomy means that patients should be given all of the following information: courses of treatment and/or service options and their purpose, benefits, risks, potential side effects, and alternative options (along with benefits and risks of each alternative). They should also be given information about follow-up, cost and insurance coverage for any proposed prescription, procedure, assessment, or testing, and procedure reversal (e.g prior to IUD insertion, you must discuss length of effectiveness, desires around future family planning, removal process, removal appointment booking – particularly for people living in rural communities, and logistical support).
How can I build the skills to ensure informed consent underlies my provision of care?
Shared decision-making and client-centred care
- Recognizing the weight of your suggestions, opinions, anecdotes, advice etc.
- Active listening
- Allowing client to lead the conversation
- Not making assumptions about a client’s experience based on their gender expression or identity and that of their partner/s
- Asking open-ended questions to gather information and allowing clients to speak
- Not centering yourself in provision of care
- Not pressuring or encouraging disclosure
Proposing new ideas or treatment options tentatively
- E.g “Based on what you’ve told me about your prior experience with birth control, it sounds like the implant might be a good fit for you. Do you want to explore that option together?” VS. “You should go on the implant.”
Not making guarantees and setting honest expectations
- Ensuring that clients know that they are the expert of their own experience, situation, and body – no two people are the same and will not have the same reaction to different forms of care or methods of treatment
- Avoid making assumptions about your client’s experience
Trauma-Informed care
- Acknowledging that people are more likely to experience trauma than not (especially within the healthcare and social service systems). We are aware of how trauma can show up in our clients lives & experiences and how it affects their engagement with our services (or broader health care services). We recognize what trauma can look like and present as. Trauma is whatever a client deems it is to them. As service providers we have a responsibility to mitigate continued harm or retraumatization during our care.
Book A Free Reproductive Coercion Prevention Workshop
For service providers that support individuals who are seeking reproductive care, experience gender-based violence, or individuals who are choosing to parent or not to parent.
- Identify and support clients experiencing Reproductive Coercion (RC)
- How RC manifests in intimate relationships and public institutions
- Understand the responsibility of preventing RC as service providers
Intervention and Prevention: Further Reading and Resources
Below is a list of resources for healthcare and service providers to learn more about how to safely intervene or reduce harm when supporting someone experiencing Reproductive Coercion and work towards sustainable prevention. *many of these resources use binary language that does not reflect the scope of gender identities affected by reproductive coercion*
Factsheets
- Planned Parenthood Federation Of America: IPV and Reproductive Coercion Fact Sheet
- Virginia Sexual and Domestic Violence Action Alliance – Reproductive and Sexual Coercion: a Toolkit for Sexual and Domestic Violence Advocates
- Futures without Violence: Addressing Intimate Partner Violence, Reproductive and Sexual Coercion: A Guide for Obstetric, Gynecologic and Reproductive Health Care Settings
- Pregnancy and Substance Use: Harm Reduction Toolkit
- Futures without Violence: Teen Dating Violence and Reproductive Coercion: Innovative Opportunities for Programs and Partnerships (Webinar Slides)
- CUES (Confidentiality, Universal Education and Empowerment, Support) Intervention and Prevention Resources