Reproductive Coercion among Pregnant Women Attending Antenatal Clinic, at the Holy Family Hospital, Techiman

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Date

2021-01

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University of Ghana

Abstract

Background: Despite the global recommendation of rights to reproductive health, women are still unable to exercise this autonomy for several reasons. Reproductive Coercion (RC) is any external conduct that hinders the autonomy of a person to make decisions regarding their reproductive health. It mainly affects women of reproductive age. RC comes in several forms such as pressuring a woman into getting pregnant, controlling the outcome of another woman‘s pregnancy, sabotaging another person‘s contraceptive use and compelling or coercing a woman to get sterilization. RC is a global public health issue that adversely affects sexual and reproductive health, mental health as well as maternal and child health. So far, the greater number of studies on RC, its prevalence and associations emanate from studies conducted on populations in the U.S. In Ghana there is dearth of published information on RC as regards the prevalence rates. The objective of this study is to determine the prevalence of reproductive coercion and its associated factors among pregnant women attending antenatal care at Holy Family Hospital, Techiman. Materials and Methods: A systematic random sampling method was used to recruit women attending ANC at the Holy Family hospital, Techiman, into the study. A structured questionnaire was used to capture relevant information on the socio-demographic, economic and reproductive characteristics, cultural views on RC, as well as the experience of RC and Intimate Partner Violence (IPV) which is any act of physical violence, sexual abuse/ coercion, stalking, and psychological/emotional abuse by a current or former intimate partner. This questionnaire had eight sections. Section 1 describes the individual factors such as age in completed years of the participant and her partner, her current relationship status, religion, employment of participant and her partner, income and highest educational level attained by the participant and her partner. Section 2 described other socio-economic characteristics and belief system of participants. Section 3 described the reproductive and obstetric history of the participants. Sections 4 and 5 measured participants recent and lifetime experience of reproductive coercion from the current partner only. Section 6 measured respondents‘ experience of IPV in her current pregnancy. Section 7 and 8 measured respondents‘ experience of IPV in her current relationship and their lifetime experience of IPV. Questionnaires were checked for errors and completeness before final entry into Microsoft excel and exported to Stata version 15.0 e (Stata Corporation, Texas, USA) for analysis. Descriptive statistics were determined for the population. Percentages were reported for categorical variables. Means and standard deviations were determined for continuous variables. Graphs and percentages were used to report on the experience of reproductive coercion. In addition, Pearson Chi-square or Fisher‘s exact test (when required) was used to determine the association between the dependent variable (experience of reproductive coercion) and each categorical independent variable (Age groups, educational level, relationship status, work and income, IPV). Finally, logistic regression models were used to test for association between reproductive coercion and independent variables. Statistical significance was determined at p<0.05. The results showed that the proportion of respondents who experienced reproductive coercion was 25.5% ( 95% CI = 21.1% - 30.2%). The results from a multiple regression of variables that showed a significant association with RC in the bivariate analysis revealed that factors that were significantly associated with RC included the following: age in years, relationship status, influence from external family on the number of children to have, tribe rewards women or couples for large families, personal believe that a woman who aborts an unwanted pregnancy is not a good woman, physical IPV in current pregnancy, overall physical IPV from current partner, sexual IPV in current pregnancy, sexual IPV from current partner, lifetime experience of physical IPV from previous partners, lifetime experience of sexual IPV from previous partners. Controlling for the effect of all other variables, respondents who reported an experience of RC were 12.51 times more likely to report an experience of physical IPV from their current partner compared with those who had never experienced physical IPV from their current partners (aOR = 12.51; 95% CI = 1.53 – 102.34; p = 0.018). Respondents who reported an experience of RC were 5.42 times more likely to have reported a lifetime experience of sexual IPV from previous partners compared with those who had never had a lifetime experience of sexual IPV from previous partners (aOR = 5.42; 95% CI = 1.20 – 24.59; p = 0.028). This study provided an important opportunity to initiate understanding of the prevalence and patterns of RC in the Ghanaian context and also serve as a foundation on which future research into RC in Ghana could be conducted. Findings of this study are useful for advocacy and improvement in women‘s reproductive health.

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MA. Public Health

Keywords

Ghana, Holy Family Hospital, Techiman, Techiman, Reproductive Coercion, Pregnant Women, Antenatal, Clinic

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