Clinician views and experiences with reproductive coercion screening in a family planning service

Abstract

Background Reproductive coercion refers to behaviour that interferes with a person’s reproductive autonomy, such as contraceptive sabotage, pregnancy coercion, controlling a pregnancy outcome or forced sterilisation. Routine screening for reproductive coercion, together with clinician education, was implemented at a family planning service in New South Wales, Australia, in December 2018. A study was undertaken to explore the views and experiences of clinicians in undertaking reproductive coercion screening at this service. Methods Clinicians were invited to complete an online survey and interview to discuss their understanding of reproductive coercion and their views and experiences of undertaking reproductive coercion screening. Descriptive and thematic content analysis was conducted. Results Clinicians deemed reproductive coercion screening to be relevant and important in family planning services. Key barriers to reproductive coercion screening and responding to disclosures included time constraints and limited appropriate referral pathways. Ongoing education and training with resources such as a decision-support tool on reproductive coercion screening and management, as well as effective multi-disciplinary collaboration, were identified as strategies to improve the screening program. Conclusions Findings from our study highlight that clinicians’ perceived reproductive coercion screening as a relevant and important component of sexual and reproductive healthcare. Ongoing reproductive coercion education, training and support would ensure the competency and confidence of clinicians undertaking screening. Identifying appropriate referral pathways with multi-disciplinary collaboration (involving clinicians, social workers, support workers and psychologists) would support clinicians in undertaking screening and responding to disclosures of reproductive coercion in Australian health care settings which provide family planning and sexual and reproductive health services.