Intimate Partner Violence: when abortions are administered without permission

Manna Mostaghim is a PhD Candidate in the Health Policy Department at the LSE. Her PhD thesis is on the provision of publicly subsidised IVF for women with a high BMI in the UK.

An abortion is a medical procedure that also requires the consent of the person who is pregnant to terminate a pregnancy. Reasons for the want – or requirement – to have an abortion is no one else’s business.

There have been two reported incidents in the last year, where women were unwittingly supplied with mifepristone and misoprostol, drugs that are used to induce medical abortions, by a sexual partner. In both cases, the women did not want to terminate the pregnancy, but drugs were administered to procure a miscarriage.

The reports of these two cases have used headlines to decry the use of abortion drugs to facilitate a miscarriage. But the administration of mifepristone and misoprostol to an un-consenting person by a sexual partner is not an abortion; it is intimate partner violence (IPV).

Intimate Partner Violence (IPV) and Abortion

IPV is any form of emotional, physical and sexual abuse perpetuated by a partner. Globally, and in the UK, “the most common perpetrators of violence against women are male intimate partners or ex-partners”. 

According to Refuge, “…40-60 percent of women experiencing domestic abuse had been abused while pregnant…”. People who experience IPV while pregnant have a greater risk of reproductive health conditions and enduring chronic health conditions. 

IPV can also mean forced pregnancy. As researcher Pam Lowe says, “Policy responses to date have often focused on abortion coercion, but this obscures the evidence that forced pregnancy is more common than forced abortion”. Conversely, people who have abortions are more often subject (or have been subjected to) to IPV.

The introduction of Telemedical Early Medical Abortion (TEMA) in Britain became a siren call to the anti-abortion movement to weaponise the statistics that link IPV and abortion. In a parliamentary submission, the Society on the Protection of Unborn Children made a baseless extrapolation that the introduction of tele-medicine would prompt an increase in IPV.

But as discussed in a previous Abortion Rights blog:

Anti-abortion advocates also assert that women that experience IPV are more at risk of experiencing reproductive coercion in TEMA settings. This is due to the claim that TEMA could prevent healthcare practitioners from making visual assessments of IPV and/ or it would inhibit a women’s ability to confidentially disclose their experience of IPV. A major component of the objection to TEMA is that it prevents a healthcare practitioner from identifying an abusive person, in the patient’s physical proximity, who may influence their conduct and require them to hide their abuse.   

A joint briefing by several pro-choice organisations in 2018, alternatively claimed that limiting access to abortion care by demanding in-patient appointments places vulnerable women in danger. This because women and pregnant people reported that it was travel to sexual and reproductive health services that increased the chances for abusive partners and relations to discover that they were seeking an abortion – which could lead to more abuse. 

In some cases, the desire to hide their abortions resulted in women and pregnant people taking desperate measures to access abortion care and services in secret. For example, prior to the implementation of TEMA, 8% of women were recorded as attempting to illegally procure abortion pills, risking significant jail time, to avoid their abortions being discovered in their abusive relationships. However, since the implementation of TEMA, illegal transactions to procure abortion pills online “ha[ve] fallen by 88%” in the UK. The uptake in using legal avenues to procure abortion pills has been attributed to the flexibility and safety provided by remote consultations. 

Further, according to a study by Neff et al, “Partner conflict or IPV is often a factor in the decision to have an abortion, and those who obtain abortions end their abusive relationships faster and experience less partner violence than those who give birth”.   

Media stories that therefore present abortion pills as a tool to facilitate IPV wildly mischaracterise the overwhelming use of mifepristone and misoprostol to provide a salve for persons subject to IPV – rather than the basis of IPV.   

IPV is the problem – not abortion pills  

We need to fund civil infrastructure, and social security policies, to undermine the ability of abusive partners to maintain control on their targets. The end of IPV in the UK requires a sustained policy effort that can fund holistic support for persons subject to IPV. Alongside disseminating public health campaigns that can educate people on how to avoid – or to leave IPV settings.

We need to provide anyone subject to IPV access to medical services including abortions. To explicitly, or implicitly, link abortions to IPV thus needs a more thoughtful and comprehensive portrait of how IPV and abortions are linked.   

Abortion Rights therefore calls upon journalists reporting in the media on the use of abortion pills in IPV settings to:

·  Explicitly identify these incidences as IPV, ie to identify it as a sexual partner procuring an unintended miscarriage – rather than frame it as an abortion.

·  Acknowledge that women and pregnant people who are subject to IPV should have a right to procure an abortion – with reference to statistics that support the fact that abortions can compel a target of IPV to leave an abusive dynamic sooner.