Understanding the Link Between Reproductive Coercion and Covert Use of Contraception as a Safety Strategy for Women Experiencing Violence in Nairobi's Urban Informal Settlements

Shannon N Wood; S Rachel Kennedy; Irene Akumu; Catherine Tallam; Ben Asira; Linnea A Zimmerman; Nancy Glass; Michele R Decker

doi:10.1177/10778012221108422

Understanding the Link Between Reproductive Coercion and Covert Use of Contraception as a Safety Strategy for Women Experiencing Violence in Nairobi's Urban Informal Settlements

Violence Against Women. 2023 May;29(6-7):1343-1367. doi: 10.1177/10778012221108422. Epub 2022 Aug 24.

Authors

Shannon N Wood¹, S Rachel Kennedy², Irene Akumu³, Catherine Tallam³, Ben Asira³, Linnea A Zimmerman¹, Nancy Glass^{2

4

5}, Michele R Decker^{1

2

6}

Affiliations

¹ Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
² Johns Hopkins School of Nursing, Baltimore, MD, USA.
³ Mashinani Department, Ujamaa-Africa, Nairobi, Kenya.
⁴ Department of International Health, 25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Center for Global Health, 15851Johns Hopkins University, Baltimore, MD, USA.
⁶ Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

PMID: 36000323
DOI: 10.1177/10778012221108422

Abstract

This mixed-methods study examined the relationship between reproductive coercion (RC) and covert contraceptive use among intimate partner violence survivors in Nairobi, Kenya. Quantitative analyses utilize baseline data from the myPlan Kenya trial (n = 321). Purposive in-depth interviews (IDIs) (n = 30) explored women's reproductive safety strategies. Multinomial analyses indicated increased covert use and decreased overt use compared to nonuse, for women experiencing RC; logistic models similarly report increased odds of covert use with RC experience. Qualitative data contextualize women's reasons for use and challenges faced. Integration of reproductive safety strategies into family planning and violence services can improve the safe use of contraception.

Keywords: contraception; covert use; intimate partner violence; reproductive coercion; safety planning.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Coercion*
Contraception
Female
Humans
Intimate Partner Violence*
Kenya
Violence