Recognising and responding to reproductive coercion in general practice: a qualitative study.

Abstract

Background: Reproductive coercion (RC) is a form of gender-based violence that interferes with reproductive autonomy. General practice is a key primary care setting where individuals, particularly women, access support for sexual and reproductive health (SRH). However, limited research explores how general practice clinicians recognise and respond to RC. We aimed to explore how general practitioners (GPs) and practice nurses (PNs) recognise and respond to RC in Australian general practice.

Methods: A qualitative descriptive study was conducted using semi-structured interviews with 10 GPs and 6 PNs. Interviews were conducted via Zoom, transcribed verbatim and analysed using inductive content analysis.

Results: Participants identified consultation-based 'red flags', including partner dominating the consult, patient discomfort, and disruptions in appointment or contraception use, that prompted RC inquiry. Participants proactively asked about RC in SRH consultations, tailoring questions to the context of contraception, pregnancy, or abortion care. Balancing safety, autonomy, and support was described as challenging, especially in cases involving adolescents or women with disabilities where carers or parents influenced patient consent. Participants described practical and patient-centred strategies, such as using telehealth consultations, discreet signals, covert care planning, and whole-of-practice team-based vigilance, to support women experiencing RC in general practice.

Conclusions: Findings highlight how general practice clinicians in Australia recognise and respond to RC and can inform the development of clinical guidelines and practice approaches to strengthen recognition and response to RC in general practice.