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

Area of Science:

• Gender-based violence research
• Primary healthcare
• Reproductive health

Background:

• Reproductive coercion (RC) is gender-based violence impacting reproductive autonomy.
• General practice is crucial for sexual and reproductive health (SRH) services.
• Limited research exists on clinician recognition and response to RC in primary care.

Purpose of the Study:

• To explore how general practitioners (GPs) and practice nurses (PNs) recognize and respond to reproductive coercion (RC).
• To understand clinician experiences in Australian general practice settings.

Main Methods:

• Qualitative descriptive study design.
• Semi-structured interviews with 10 GPs and 6 PNs.
• Inductive content analysis of transcribed interviews.

Main Results:

• Clinicians identified 'red flags' (e.g., partner dominance, patient discomfort) prompting RC inquiry.
• Proactive, context-tailored questioning in SRH consultations was employed.
• Challenges included balancing safety, autonomy, and support, particularly for vulnerable populations.
• Strategies included telehealth, discreet signals, covert care planning, and team-based vigilance.

Conclusions:

• General practice clinicians in Australia possess methods for recognizing and responding to RC.
• Findings can inform clinical guidelines and practice improvements for RC support.
• Strengthening RC recognition and response in primary care is essential.