Introduction

Reproductive coercion and abuse (RCA) is a form of violence against women,Footnote 1 (Grace & Anderson, 2018) defined as any deliberate attempt to dictate a women’s reproductive choices or interfere with her reproductive autonomy (Tarzia et al., 2021). Most commonly perpetrated by male intimate partners, RCA shares the hallmarks of other forms of interpersonal violence, in that perpetrators often use coercive control and/or abuse to assert control. RCA encompasses a myriad of behaviours that can be physical, psychological or sexual in nature. It can take the form of contraceptive sabotage (where women are either prevented from accessing contraception or their contraception is tampered with), pregnancy coercion (where a woman is coerced or forced into becoming pregnant) and controlling the outcome of a pregnancy (either forcing a woman to have an abortion or remain pregnant) (Grace, 2016; Miller et al., 2010). Although RCA is most often perpetrated by male intimate partners, family members such as in-laws can also be involved or perpetrate themselves (Gupta et al., 2012). RCA has been linked to negative health impacts both mental (McCauley et al., 2014) and physical (Northridge et al., 2017). Current prevalence data is inconsistent and varies across settings (Rowlands & Walker, 2019), however recent studies suggest that it is a common yet hidden problem (Sheeran et al., 2023; Tarzia et al., 2020; Wood et al., 2023) in Australia and elsewhere.

With the exception of formative work by Miller and colleagues in 2010 (Miller et al., 2010), and more recent work by Tarzia and Hegarty (2021), little has been done to understand the nuances around what constitutes RCA. Most of the current literature focuses on interventions and outcomes and does not delve into the complexities of each of the behaviours labelled as RCA. There are also a number of gaps in the qualitative knowledge base. For instance, comparatively more research has been done with victim/survivors who experience contraceptive sabotage and pregnancy coercion (Moulton et al., 2021) whereas studies exploring forced termination of a wanted pregnancy are limited. There are also few studies undertaken with victim/survivors who carried a forced pregnancy to term. The most likely explanation for this discrepancy is that most research has been conducted in family planning clinics and other settings where women have not continued with their pregnancy (Miller et al., 2011; Moore et al., 2010; Nikolajski et al., 2015). This is despite evidence identifying pregnancy as a vulnerable time for women abused by their partners, with violence often increasing and sometimes commencing when a woman becomes pregnant. (Brownridge et al., 2011; Burch, 2004). Given the acknowledged connection with co-occurring violence, (Grace & Anderson, 2018) it is important to understand whether RCA is also occurring.

A small number of qualitative studies exist, largely focused around the response to RCA in health settings and on intervention effectiveness (Lévesque & Rousseau, 2019; Paterno et al., 2018; Uysal et al., 2020a, b). Some studies also focus on unintended pregnancy (Grace & Anderson, 2018; Rowlands & Walker, 2019) and women’s acknowledgement of RCA (Lévesque & Rousseau, 2019). Moulton et al. (2021) recently undertook a qualitative meta-synthesis aimed at exploring women’s perceptions and experiences of RCA, as well as barriers they might face in receiving appropriate interventions. Less than half of the studies found in their search investigated RCA as the primary phenomenon. Due to the lack of specific qualitative studies in the area, the review authors reported low confidence in their findings around women’s perceptions and experiences beyond descriptions of the type of abuse that they endured. In short, there is a lack of in-depth investigation globally into how experiencing RCA affects victim/survivors and what it means to experience RCA. To address the numerous gaps in literature around women’s experiences of RCA, this qualitative study aimed to explore the nuances of how RCA affected women’s lives. We undertook in depth interviews with victim/survivors exploring the research question; ‘What are women’s lived experiences of reproductive coercion and abuse?’ drawing on Interpretative Phenomenological Analysis (Smith et al., 2009) to make sense of the findings. There is increasing acknowledgement within research and policy that the voices of victim/survivors need to be heard, in order to ensure that interventions and responses are tailored. Currently, RCA remains a hidden form of violence that is poorly understood; this study therefore has important implications for health and specialist practice.

Methods

This qualitative study drew on interpretative phenomenological analysis to understand women’s lived experiences of RCA. Phenomenological approaches in general are concerned with understanding the nature or “essence” of particular phenomena as they are experienced by participants (van Manen, 1990) They have their roots in philosophy – specifically the work of Husserl and Heidegger (Smith et al., 2009). Interpretative phenomenological analysis is a newer method developed within the psychological sciences and becoming increasingly used in the health and human sciences (Smith et al., 2009). It focuses on understanding lived experience, whilst also recognising that this requires interpretation on the part of the researcher. This differentiates it from other phenomenological approaches that require the researcher to attempt to separate their own prior knowledge or experience from the analytical process (Tufford & Newman, 2012).

Participant Recruitment

We chose to recruit from the community to capture a broad range of women, including those who had, or had not sought help. This involved advertisements placed on the university student portal, the researchers’ social media channels, and the social media pages of state and territory domestic violence services. Participants self-selected to take part in the study by clicking on the advertisements, which directed them to an expression of interest form where they could provide their safe contact details for the research team to follow up and organise an interview time. Informed consent was obtained at this time via a participant information sheet and written consent form. Women were eligible to participate if they were over eighteen years, had sufficient English comprehension to provide informed consent and participate in an interview, and self-identified as having had an experience of RCA. We defined RCA as a ‘yes’ answer to the following question: Has someone ever: Tried to get you pregnant when you didn’t want to be? Tried to force you to get an abortion or keep a pregnancy when you didn’t want to? This definition was specifically chosen to encapsulate as many women’s experiences as possible.

Data Collection

Interviews were conducted between August and December 2019. Twenty women who had experienced RCA were recruited to participate (see Table 1). Ten interviews were conducted face to face and ten were conducted over the phone. Interviews lasted an average of fifty-two minutes. The first author, who is a doctoral candidate with several years’ prior research experience in the field, undertook all interviews. In addition to qualitative research training received as part of their course, they received additional support from the second and third authors around the particular techniques required when undertaking sensitive interviews and trauma-informed research practice (Campbell et al., 2019). After the first few interviews had been done, the team read through the transcripts and collaboratively discussed what was working well and what could be improved in terms of the interview style.

Table 1 Participant demographics (N = 20)
Full size table

Face to face interviews were conducted in quiet, private rooms in the university. As the researchers were unable to travel to participants in different states, some interviews were conducted over the phone. Some participants also felt more comfortable being interviewed over the phone rather than face to face, as acknowledged by Mealer and Jones. (Mealer & Jones, 2014). Interviews were semi structured using the following questions: “Can you tell me about a situation where you felt pressured or forced by someone to make a choice that affected your reproductive health? For example, pressure to end a pregnancy, to get pregnant, or to use or stop using birth control to get you pregnant? Can you tell me about how this experience affected you?”.

Participants were invited to elaborate as much as possible around their thoughts and feelings and were prompted to do so at appropriate times. At the conclusion of each interview, participants were also asked a series of demographic questions. The interview guide was not adjusted throughout the interviews as it continued to provide a good foundation to start conversation with participants around their experiences.

Ethical Considerations

This project was approved by [University] Human Research Ethics Committee (Project identification: 1853440.2). As there was a potential risk of distress to the women who participated in this project, a distress protocol was created and utilised where needed. The protocol involved stopping to give participants time to pause the interview if the topic of conversation became too difficult for them, steps for the researcher to follow as well as additional services to refer to for further help. Every participant was offered a safety card with a list of contact numbers of useful resources. Women were also offered a small gift voucher as a token of appreciation for participating. The first author, who conducted all the interviews, met regularly with the other researchers to discuss progress, address any challenges and to ensure the risk of vicarious trauma was reduced. In addition to their academic training, they also have professional experience as an ambulance emergency call-taker and have received extensive training in responding to trauma.

Data Analysis

The researchers followed steps for analysis as outlined by Smith and colleagues (Smith et al., 2009). The first step of analysis involved the researchers familiarising themselves with the data by reading and re-reading to begin to recognise narratives and how they connect together. The second step involved initial coding and note taking at a descriptive level. The third step delved deeper into the meaning behind what the participants were saying by beginning to develop themes across individual interviews. At this point, the first and third authors met to compare and discuss their analysis of the data. After these first initial discussions all three authors met again to discuss and develop the themes. The final steps involved drawing connections between the transcripts to develop over-arching themes that reflected the experiences of the participants as a whole. Whilst the first author has a background in science, the third author is a sociologist who has worked for nearly a decade in the area of sexual and domestic violence. The second author has a clinical background and is an international expert in violence and health. These diverse perspectives and levels of experience meant that the research team approached data analysis and coding in different ways, leading to robust discussions around the meanings underlying what participants said and how these should be categorised.

Results

Twenty women participated in the study. Although the majority of participants had experienced RCA in Australia and identified as Australian, six other countries were represented within the sample. Eight participants spoke English as a second language. The majority of the participants had a university degree and were between the ages of twenty-five and forty-five. Overwhelmingly the participants had experienced RCA when they were under the age of twenty-five.

The results are explored through the following themes; I didn’t have a way out, I still feel guilty and I don’t feel worthy. These themes are discussed in detail below.

I Didn’t Have a Way Out

For many women, their partners manipulated their circumstances so that they felt there was no way out of pregnancy or abortion. Women were threatened with repercussions such as physical violence, or with the loss of their relationship. For some women, even when no explicit threats were made, their partners made it very clear that they would be harmed if they did not comply:

But it was more than pressure, pressure is not an adequate adjective for that if you know what I mean? ... There was no doubt in my mind that if I didn’t do what I was supposed to do that I would disappear, like I knew… It was very evident, he made it well known that he knows what to do, that he knows how to get around law, that he knows how to manipulate the system and that he has a number of people in his back pocket, he made it very clear, I knew. There was no choice – Participant 3

I remember him saying something along the lines of ‘I want that thing out of you, so yeh it was pretty clear there would be more violence if I didn’t have the abortion. – Participant 1

Then I told him [I was pregnant] and he basically said well, you've got to get rid of it. There was absolutely no choice in his mind… I had no rights and I felt as though I had no choice other than to go through with the termination… he left before I did [the abortion] but would ring me regularly to make sure I'd done it and would threaten me and say if you don't do this don't think that I'm going to have anything to do with it. Pretty much he never said that he'd come back and kill us both but he sort of hinted at that. – Participant 19

For others, the psychological pressure put on them was too much for them to bear and they succumbed to what their partner wanted:

This man had this reaction to [the pregnancy] - well, I'm going to basically make your life hell. I took that to mean he …was actively going to be aggressive towards me, or… just make my life difficult… I can't be with somebody, I can't have a baby with someone like that…I just thought, well, I really don't have any other option… but to have a termination, even though I didn’t really want to. – Participant 4

For some women it was the threat of their partner refusing to talk to them or support them that forced them into doing what their partner wanted. Often the decision in question went against the woman’s personal morals but they felt like they were backed into a corner.

I felt pushed into taking it [Medical termination of pregnancy] because the person basically told me they would stop talking to me if I didn’t do this… to say to someone I’m not going to speak to you unless you end this pregnancy… is pretty extreme in my opinion… I saw no way out of it other than doing what I did. – Participant 20

Basically, I just said to him ‘what are we going. To do? I don’t have a job, you don’t have a job.’ He said that if I had an abortion, he would leave me.– Participant 17.

Women who became pregnant against their wishes felt an overwhelming sense of dread and fear at being connected to the perpetrator for the rest of their lives through a child. As the following participant describes, she had to continue with the pregnancy despite her feelings about her partner:

[I felt] devastated. I didn’t want to be tied to him for the rest of my life. That was, [the] worst thing that could ever happen basically.- Participant 8

Some women knew that their partner had deliberately tried to impregnate them as a way to have ultimate control over them; this further exacerbated their feelings of fear and being trapped as their pregnancy continued:

As soon as I said no, I don’t want it [the pregnancy] …he was very mean. He told other people [that I was pregnant] in front of me …One instance I remember crying being [like] ‘I don't want to be attached to him forever’. – Participant 9

When he [found out] that I wanted [to] divorce him, then he went to the next level… he actually trapped me into being pregnant. – Participant 6

Other women felt they wouldn’t be believed or understood if they told someone. This was further compounded by not knowing who they could talk to. Women felt that sex and choice around pregnancy is not something you talk to other people about, leaving them alone and unsupported.

Being pregnant, feeling trapped when I'm pregnant and around the sex stuff was very different - a very different feeling to the rest of the controlling behaviour… It's not something you talk about. You don’t say that… I didn’t tell anybody about that. Nobody knew any of that, not even my best closest friend. So, you feel trapped in that situation because you can’t tell anybody, nobody knows, I couldn’t get help. So, I was feeling really alone in that situation. - Participant 17

For participants who came from a migrant background, cultural norms around sex, marriage and reproduction presented additional barriers to help-seeking, both within Australia and from their families at home:

We're very conservative, the whole family. I can't even tell my parents about it [the abortion] because they're - I don't know what they would do. – Participant 5

I think I felt terrified because I was at a situation where I was already alone and I was afraid if I bring a baby back [to my home country], they would throw me out, which might make me feel more alone than I already am. So, cultural background was a big, big factor. – Participant 14

It’s not possible to have a child [when unmarried], its illegal in my country, you cannot be accepted in any way, so it’s a whole different culture there… I could have left that baby in some orphanage or somewhere else and not telling the world that this is something that happened… If you have a child, you have to get married… there is no concept or possibility, people will tell you, you are a whore, you are a slut, your whole family will be dishonoured. Because of the religious, the religious element. Participant 16

It could be argued that the participants still made “choices” within the constraints of their personal circumstances, cultural backgrounds, and beliefs about abortion. Thus, we suggest that women’s experience across this theme is not so much one of having “no choice” (although some participants did describe it using this language) but rather, of having “no way out” of making a bad choice, where every option had negative repercussions.

I Still Feel Guilty

Overwhelmingly the women in this study expressed strong feelings of guilt. Despite recognising their lack of autonomy around their reproductive decisions, many still felt partly responsible for their actions. Both women who experienced a termination and women who continued with pregnancy felt guilt for different reasons, as outlined below.

For participants who were forced to have an abortion, a profound sense of loss and guilt was described.

I was feeling even more guilty (because I was forced to do it). I’m not doing good to anyone, I killed someone, technically. It was really bad. Because mothers are supposed to protect their kids, right? So if you are the one killing yours, where do you stand? What’s the moral standing of that?- Participant 12

Some women spoke about how they had always wanted children, others spoke of their moral and ethical objections to abortion.

I feel like I killed the baby, this was a bad thing that I did. I am also sad because I couldn’t stay with the guy and have a family, but I think it’s the second thing. The first is that I feel like I killed a baby, I feel that and I think I didn’t have to do it (but he made me). - Participant 11

Women who had been forced to remain pregnant against their will also felt a strong sense of guilt. For some women this guilt was around the pregnancy, whilst for others it surfaced once the baby was born. Several felt guilt that they had brought their children into an unsafe environment with their abuser. Many women who were forced into a pregnancy felt guilt about how they interacted with their children and the lack of love and connection they felt they should have had to their children.

The first time I hold her I was - it’s like, oh this is my baby. But it was not like… I’m studying at the moment…That’s what I really want, I want to study. That’s what I want in my life. So, when I got accepted [into university] I’m like, ‘Oh, my god I got accepted!’ But when my baby was born, I didn’t feel that way. It’s bad, because I’m a mother.. - Participant 6

When she [my daughter] was there like I had this physical person there which relied on me I felt so guilty because I didn’t want her to be there. I didn’t want to have her. I wanted to abort her and even though I wasn’t bonding with her and a lot of that was by choice like I didn’t – though that wasn’t happening I still felt guilty because she wasn’t supposed to be there in a way and she was. She was there because it was not my choice. - Participant 15

For some women, these conflicted and guilty feelings about motherhood continued to impact on their relationship with their children in an ongoing way.

Now I have a baby boy. When I see my boy, sometimes I feel that I have sacrificed two [aborted daughter] babies for you and if he does bad behaviour… I feel that ‘you are here because of these two sacrifices, otherwise you would not be there.’ I feel this inside, I know its terrible… It affects my relationship with my son, that’s true, because I feel bad, like what am I thinking about, he doesn’t have any role, why am I blaming him? It’s my fault, why I’m blaming him? – Participant 10

I Don’t Feel Worthy

This theme describes a sense of shame, as distinct from the feelings of guilt outlined in the earlier theme. Whereas women’s feelings of guilt were linked to their sense of responsibility towards their children, RCA also had more internalised impacts on their own identity and self-esteem. Indeed, many participants were left feeling a sense of worthlessness from their experiences of RCA. They felt that what had happened to them was at odds with who they saw themselves to be. This led them to feel that they should have ‘known better,’ despite also feeling they were trapped and had no one to turn to.

Many of the participants, for example, had previously regarded themselves as strong, independent women who could make their own choices about their sexual and reproductive health. Yet, experiencing RCA forced them to revisit their own perceptions of themselves:

I felt like a bit of a failure because I sort of said I wasn’t going to be like that [in response to asking how she felt when she found out she was pregnant], I was going to travel around, I was going to work, I was going to do my own sort of thing you know? – Participant 3

Nothing about this make sense. I'm a very smart female by the way. None of it adds up to who I am. But I guess I've known him for a long time and it seemed happy at the time.- Participant 9

It made me feel worthless, worthless because I am not a liability. I am not something to be ashamed of, I can take care of myself. – Participant 12

For some women who had been forced into a pregnancy, broader societal expectations about women’s role in controlling reproduction also impacted on their self-concept. Women felt that they would be perceived as irresponsible or promiscuous for having an unwanted child.

[people] they just sort of think, oh well you’re just a piece of trash lady…I don't know, everyone just treated me like I was this big hoe, and because I was the single mum. I don't know, that’s how I felt, maybe I'm projecting onto everybody, and it’s my own bad self-esteem. – Participant 4

A lot of the blame comes, focuses back on the woman, because she’s the one that has to carry the baby, she’s the one who decides if she wants to have that child or not, she’s the one that has to provide. Don’t worry about if it’s a dead shit dad, don’t worry about that, but ‘oh why is she having a baby when she can’t afford to have one, she doesn’t have a job’ and at the same time… even just in general women are always seen to have more responsibility than the man, plus everything else. – Participant 2

I still took on all the responsibility of becoming pregnant and having the termination. I still carry that responsibility, but its not something that I would have done, I was also careful, I was very responsible. I’ve never been in trouble with the law, I have just never had anything at all like that. – Participant 3

For both participants who had experienced pregnancy coercion and those who had been forced to have a termination, being compelled to adopt an identity that did not align with their life goals and personal beliefs had lasting emotional impacts. The fallout from RCA had the potential to impact their relationships with their children as well as future relationships with new partners. Women were forced to face the reality of being ‘a woman who had an abortion’ or ‘a woman who didn’t want a baby.’ It also jarred with their own sense of who they were as a person. Consequently, many women suffered with poor mental health.

I think it was sort of holding me up a little bit you know, [the sense that] you’ve been strong, you’ve done this, you’ve done that. It [my self-esteem] was sort of chipped away a little bit [by the RCA] because it didn’t actually take that long to become really depressed and I ended up attempting to take my own life, only 3 years later. – Participant 3

Like, some people are allowed to have their babies, and other people can't, because they stuffed up. I felt like I was one of those people, [because in the past I said] like it’s all too hard, just get rid of it. Participant 4

I felt dirty, like I was young and I already… just had a bit of self-loathing I think as well. I think it set me on a bit of a trajectory as well into another relationship and then I fell pregnant again when I was 16. I think I was just a lost kid anyway and I think then getting caught up in [the RCA] it just, it made me feel pretty worthless, I think. – Participant 14

Discussion

This study aimed to understand women’s lived experiences of RCA and contribute to the limited body of qualitative literature focused exclusively on this form of violence against women. Although a recent systematic review and qualitative meta-synthesis found over thirty studies where RCA was mentioned, the majority of these studies addressed RCA (or behaviours that we would now understand as RCA) as a peripheral issue to sexual or intimate partner violence more broadly. (Moulton et al., 2021) Further, whilst some qualitative research has explored the types of behaviours that women experience, few studies have investigated how women make sense of these experiences and their impacts.

Women in our study recalled experiences of being trapped through both direct physical violence and indirect methods of coercive control, leaving them no option but to continue with or abort their pregnancy, depending on the intent of their partner. Many of the various forms of RCA described by women in this study were consistent with Moulton and colleagues’ qualitative metasynthesis, including: disposing or withholding contraception, male partner deception, gaslighting and misinformation about contraception, condom interference or refusal, pregnancy coercion, forced termination of pregnancy, men’s contradictory responses to reproductive outcomes and migration and visa status weaponised (Moulton et al., 2021). The outcome of these various controlling behaviours was that women felt trapped by the perpetrator regardless of what method of RCA was used. Women who experienced forced abortions felt they had no option but to abort when faced with the prospect of a lack of resources with which to raise a child on their own, especially in cultures where this is not accepted (Ahmad et al., 2004). This study was conducted in Australia where abortion is legal however, abortion is a highly contentious medical procedure in some countries, and some commentators have argued that RCA is a potential reason to limit access to abortion (Pike, 2023), taking away safe methods of termination of pregnancy would likely to lead to more harm for women who would be forced to access less safe methods. Rather, we argue that it highlights the importance of abortion service providers being aware of RCA and confident to identify and respond sensitively if it occurs. Consistent with prior literature (Moore et al., 2010; Moulton et al., 2021), other women explained that they felt trapped knowing that they would need to co-parent with their partner and felt that this was the ultimate form of control, to always be connected to him through the child.

Participants expressed strong feelings of guilt over their actions, despite being coerced or forced into an unwanted reproductive outcome. This guilt took on a different focus depending on whether the women had been forced to continue or terminate a pregnancy. Women who were forced to terminate a pregnancy felt guilt around taking away a potential life and used strong language like ‘murdered’ their unborn child. This is despite the fact that abortion is legal for any reason in Australia anytime until 16–24 weeks depending on the individual state or territory legislation. As Kumar and colleagues describe in their conceptualisation of abortion stigma, ‘abortion stigma is a social phenomenon where a negative attribute is ascribed to women who have a termination of pregnancy and marks them as inferior to the ideals of womanhood and is challenging the assumption about the ‘essential nature’ of women’. (Kumar et al., 2009) Although the literature on abortion consistently suggests that women who voluntarily choose to terminate a pregnancy do not experience mental ill-health or other problems (Charles et al., 2008), women in this study were not able to make that choice for themselves and did experience ongoing mental ill-health as a result.

On the other hand, women who were forced to have children in this study often spoke about how they struggled to bond with their baby, suffered from post natal depression and struggled with ambivalent feelings towards their children. They felt guilt that their children were not being loved the way they deserved, but could not feel what they knew they should have felt towards their children.

Compounding the experience of RCA was a sense of worthlessness and ‘forced’ identity as a ‘woman who had an abortion’, or a ‘woman who didn’t want a baby,’ which had long term damaging impacts to how women saw themselves. Despite recognising that their choices to terminate or keep a pregnancy had been coerced, women nonetheless felt that their decisions made them unworthy of being a mother, and diminished their self-worth as a person. In the context of IPV, O’Doherty and colleagues (O’Doherty et al., 2016) have also explored women’s experiences assuming a forced identity and the implications of this for their health and well-being. Our study builds on this work, suggesting that for many of the women victim/survivors of RCA, the self-imposed identity of ‘mother who murdered her child’ or ‘mother who didn’t want her child to be born’ had impacts on their ongoing mental health.

The findings from this study have implications for healthcare and how health professionals approach and identify RCA. Current research around best practice to respond to women experiencing RCA has focused on women attending family planning clinics and improving their access to contraception (Decker et al., 2017; Price et al., 2019; Uysal et al., 2020a, b), with far less focus on how services can support women’s mental health and wellbeing. Our findings suggest that feelings of guilt associated with abortion could potentially be a red flag for service providers that a woman is experiencing RCA. Although some women do experience guilt after an abortion for other reasons, sensitively enquiring about whether there is pressure or coercion to terminate the pregnancy could offer an opportunity for disclosure. Similarly, in the antenatal setting, feelings of ambivalence towards a pregnancy or newborn could be an indicator to explore further with the woman. Our findings also suggested that feeling trapped was a key part of the experience of RCA. It is important for health practitioners to understand that this may lead to a reluctance to disclose as the dynamics of such relationships and coercive control provide less opportunity for women to feel disclosing could be possible. Whilst this is not unique to RCA and is a feature of broader patterns of coercive control, practitioners across specialist domestic and family violence services could consider asking about RCA if women present with other forms of abuse and violence.

Strengths and Limitations

This study is one of the only studies to recruit women directly from the community, not through clinics or domestic violence shelters. Women from multiple cultural backgrounds were able to contribute, giving a broader understanding of the lived experience of RCA. The in depth nature of Interpretive Phenomenological Analysis is also a strength as the researchers were able to analyse and understand the nuances of each individual woman’s experience. Keeping the recruitment materials broad meant that a range of different types of experiences of RCA were also reflected in the data.

There were also limitations to this study. Although the participants were diverse in experiences and ethnic background, the majority were highly educated. Moreover, no women in same sex or gender diverse relationships or of Aboriginal or Torres Strait Islander descent were recruited. Having the interviews only in English may have potentially acted as a barrier for women, not only for non English speakers, but for women where English was their second language, given the sensitive nature of the topic.

Implications

Findings show that although the experience of RCA has similarities to IPV, there are differences that need to be acknowledged and understood by the academic and health community. The experience of coercive control and the insidiousness of unseen control and the impacts on women needs to be further explored to fully understand where RCA fits in the realm of violence against women. RCA is still a largely unknown phenomena in the community and this limits women’s opportunities to seek support. In particular, researchers and clinicians need to further focus on pregnant women experiencing RCA given the future implications women experience. Clinicians could work towards recognising post natal depression, or issues bonding with a baby as a possible red flag for RCA. Although guilt and shame are recognised generally in women who have an abortion, further research needs to be conducted on whether this could be an indication that the woman was coerced or forced into their abortion. It is important for service providers to acknowledge the impact of societal and cultural pressures on women and how these affect how women feel when experiencing RCA. The long term impacts on women and by extension their children, places the need for RCA to be more readily recognised both in the medical community and society overall.