Researchers from King’s College in London published a comprehensive review finding an association between abortion (TOP) and intimate partner violence (IPV). “Associations between Intimate Partner Violence and Termination of Pregnancy: A Systematic Review and Meta-Analysis” published on Jan. 7 in the PLOS Medicine journal reviewed 74 studies from 1985 to 2013 following women who had abortions and experienced physical, sexual, or emotional IPV. The researchers’ meta-analysis concluded that 24.9 per cent of women seeking abortions experienced IPV in their lifetime. “Women welcomed the opportunity to disclose IPV and be offered help,” the researchers found.

The review states that “violence can lead to pregnancy and to subsequent termination of pregnancy, and…there may be a repetitive cycle of abuse and pregnancy.” They caution health care professionals that simply putting a focus on “preventing conception” will not solve a woman’s relationship problems. Moreover, “good practice obligates that termination services should have robust policies for ensuring women’s safety and confidentiality, providing information and referral pathways for those who disclose IPV, and exemplar guidance exists.”

IPV associated with abortion included rape, sexual assault, coercion, and interfering with contraceptive use. Women experiencing violence in their relationships were three times more likely to hide their abortions from the partner. “IPV was cited as a reason for wanting TOP, and rape-related pregnancy had a particularly high chance of leading to TOP,” write the authors. Women who faced violence from partners and had an abortion were also likelier to experience “psychosocial problems including depression, suicidal ideation, stress, and disturbing thoughts.” None of the studies followed up on the future effect of IPV and abortion on the woman and her relationship.

The “highest quality” study found that women seeking a third abortion had a two and a half times higher chance of having a history of physical or sexual violence. Two of the studies reviewed discovered that “pregnancy associated with sexual coercion” and ending in abortion was 1.8 to 3.8 times more likely to be linked to IPV. A “low quality” study of migrants to the US from the Indian subcontinent who had previously sought “sex selection services” found that a third of the women were abused and neglected because they did not give birth to a baby boy. The researchers also found a few “very low quality” studies and a “medium quality” study that suggested some women were pressured into having an abortion by the abusive partner.

“Because violence may begin or intensify during pregnancy, some countries recommend routine questioning about intimate partner violence during antenatal care. However, women seeking termination of pregnancy…are not routinely asked about intimate partner violence,” note the authors. They claim it is important to discover the associations between IPV and abortion to deal with the “global health concerns” of IPV and “unsafe” abortions.

“This research report by Hall and colleagues is without a doubt the most extensive review of the literature on the topic of intimate partner violence and abortion,” writes Dr. Priscilla Coleman, professor of human development and family studies at Bowling Green State University, for the World Expert Consortium for Abortion Research and Education.

She notes, however, that “the conclusions should be tempered by the limited high quality original research that has been conducted in vastly different cultural settings on the topic.” Weaknesses that the researchers discovered in their own work included disparities in the results of the studies that were reviewed, possible underreporting of IPV and abortion, as well as lack of confirmation of whether IPV actually occurred.

“Routine screening for intimate partner violence in general, and coercion to abort in particular, is far from the norm. Instead, abortion providers callously and routinely look the other way, even when women present with obvious symptoms of domestic violence,” Coleman commented.

In 2011, the House of Commons defeated C-510, 178-97, a private member’s bill introduced by Rod Bruinooge (CPC, Winnipeg South) that would have added coercing an abortion to the Criminal Code. Bruinooge was moved to act on the issue after Roxanne Fernando, a Winnipeg immigrant, was beaten and left to die on the side of a road by her boyfriend and his accomplices when she refused his demand to have an abortion.

Pro-abortion politicians such as Liberal MP Marlene Jennings and NDP MP Irene Matheyssen described the bill as an attack on a woman’s “right to choose.” Conservative MP Kelly Block (Saskatoon-Rosetown-Biggar) said Parliament needed “to promote a culture of respect for women who make the choice to be mothers.”