A mixed method study of UK Nurses’ perceptions of reproductive coercion in comparison to people with a wombs’ responses to the Reproductive Coercion Scale Adaption in an ethnic probability sample of UK residents

The rate of reproductive coercion in the UK is unknown. There are three domains to the construct of reproductive coercion: birth control sabotage; pregnancy coercion; and abortion coercion. Reproductive coercion has negative consequences for partners with a womb and on infant and maternal health. Primary responsibility for family planning consultations in the United Kingdom (UK) have shifted from General Practitioners to Nurse Practitioners. Therefore, the first study objective was to interview Nurses to understand their perspectives of male family planning practices within consultations to gain insight into the phenomenon of reproductive coercion in the UK. The second study objective was quantitative and utilized the interviews with Nurse Practitioners to pilot an adaption of the Reproductive Coercion Scale using an ethnic probability sample. The design employed a sequential mixed methods approach, where study 1 was completed and analysed prior to study 2 commencing. Study 2 was then conducted and analysed. The findings from both studies were triangulated and generalized. The setting for the interviews in study 1 was a medical practice. Five interviews were conducted with Nurse Practitioners from the same general practice. The interviews were analysed using discourse analysis. Two discourses emerged from the analysis; discourse one, ‘Supportive “International” partners are rarely seen in Nurses’ consultations’, and discourse two; ‘Nurses have confounding perceptions of coercive practices’. For study 2 the setting was online using the crowd sourcing platform Prolific. 397 people with a womb participated in the initial scale adaption pilot and the responses to the scale were analysed using descriptive statistics as regression models were insignificant. For study two, the ethnic probability sample showed that it was white people with a womb and white others, who identified as non-religious or Christian, that were most at risk for reproductive coercion, groups not mentioned at risk of reproductive coercion in the Nurses’ interviews. There are also several practices Nurses should be aware of, as the following items showed the highest rates of reproductive coercion in study 2: ‘Told you not to use birth control’, ‘Taken off the condom during sex’, ‘Refused to Attend an Abortion Appointment with You’, and ‘Made you have sex’. Coercive practices not mentioned in the Nurse interviews. To address the cultural bias present medical practices should provide space for self-reflection and encourage Nurses to engage in self-reflection. As well as providing Nurses general training on the broader issues of coercive control that they are more likely to come across in their practice. The 15-item Reproductive Coercion Scale Adaption can further be used in the UK to screen for potential coercion and remove bias from the screening process, as it showed excellent reliability.