Reproductive Coercion and Abuse Among Forcibly Displaced Populations Worldwide: Evidence from a Systematic Review

Abstract

Reproductive coercion and abuse (RCA) is a significant public health issue, with high prevalence expected in forcibly displaced populations. Despite its severe health impacts, studies on the extent, determinants, and impacts of RCA in forcibly displaced populations are notably lacking. This systematic review examines forcibly displaced women’s experiences of RCA, its perpetrators, associated factors, and health consequences. We conducted a systematic search across nine databases—Medline, CINAHL, Web of Science, PsycINFO, Embase, Global Health, Scopus, Emcare, and SocIndex—on July 30, 2024, using targeted search terms related to RCA and forcibly displaced populations. We included studies of any design (qualitative, quantitative, and mixed methods) published at any time and in English, regardless of study settings. We used a socio-ecological framework to guide our narrative analysis of the findings. A total of 15 studies were included in the review, demonstrating various forms of RCA. These included coerced and unwanted sex, intentional contraception misuse, forced pregnancy, forced abortion, imposition of contraception without consent, control over reproductive decisions, forced marriage, and physical abuse for failing to give birth to male offspring. RCA was found to be supported and exacerbated by a range of challenges situated across multiple socio-ecological levels: individual (economic dependency, accommodation), relationship (partner), community (community members, religious and cultural norms), institutional (armed forces, international forced migration), and societal and global levels (country-level policies, state actors, international forced migration). The findings underscore the need for targeted interventions that address the underlying socio-economic, legal, and cultural factors contributing to RCA in these settings.