A Scoping Review of Reproductive Coercion and Abuse During Pregnancy.

Abstract

Reproductive coercion and abuse (RCA) during pregnancy encompasses behaviours that pressure, manipulate, or force decisions about continuing or terminating a pregnancy. Despite its serious consequences, RCA during pregnancy remains under-examined. This scoping review aimed to synthesise existing evidence on RCA during pregnancy, including prevalence, forms, and other related factors. In addition, the review aimed to identify gaps in existing literature to inform future research. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Scoping Review guidelines, four databases (PubMed, Embase, Scopus, and PsycINFO) were searched up to March 2025. Eligible studies were peer-reviewed and reported primary data on RCA during pregnancy. Data were charted for study design, population, type of RCA, perpetrator, and findings. Qualitative data were explored thematically, while quantitative findings were summarised descriptively. Seventy-six studies were included in the final review. Reported prevalence ranged from <1% to 68%, reflecting inconsistent definitions and measures. Qualitative studies described varied forms of RCA during pregnancy, including threats, pressure, deception, and systemic control by partners, family, or cultural structures. Quantitative studies largely focussed on RCA towards abortion by male partners, under-capturing RCA towards pregnancy continuation. Evidence suggests coercion towards pregnancy continuation may be equally or more common but less often recognised, partly due to stigma, societal ideals of motherhood, and provider discomfort discussing abortion. RCA during pregnancy was associated with emotional and health impacts, particularly among women facing intersecting vulnerabilities. Improved measurement tools, inclusion of diverse populations and men, and evaluations of interventions are urgently needed in future research.