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Reproductive coercion: the role of clinicians in general practice
Susan Saldanha1,2, Khue Le1,2, Jessica R Botfield1,2
1Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic 3004, Australia.
Abstract:
Reproductive coercion (RC) is a form of gender-based violence that directly undermines reproductive autonomy, and can result in significant sexual, reproductive and mental health harms. Clinicians in general practice are well-positioned to address RC, given the central role of general practice in sexual and reproductive health care, as well as domestic and family violence response. Yet, RC often remains poorly understood in this setting, and guidance for clinical responses is underdeveloped. In this forum article, we examine why RC should be prioritised in general practice settings, outline what an appropriate response could involve in general practice, and discuss the system-, clinician-, and patient-level challenges and considerations to identifying and responding to RC in general practice. We also draw attention to how clinical practices, particularly in sexual and reproductive health care, can unintentionally reproduce dynamics of RC, and must be consciously managed to uphold patient autonomy. We argue for a more intentional role for general practice in RC recognition and response, underpinned by context-specific evidence-based guidelines, targeted training and integrated system-level support, to safeguard reproductive autonomy among general practice patients.
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