Beyond conventional indicators: Reproductive coercion and its overlap with measured intimate partner violence in...

Reproductive coercion is an under-recognised form of violence against women and is not routinely captured by standard measures of intimate partner violence, which commonly focus on physical, sexual, and emotional violence. This study examined the association between reproductive coercion and these measured forms of intimate partner violence and estimated the proportion of women who reported reproductive coercion without reporting any of the physical, sexual, or emotional violence items included in the survey.

We analysed nationally representative data from 24,951 ever-married women, including 22,161 currently married women, in the Bangladesh Violence Against Women Survey 2024. Outcomes were physical, sexual, emotional, and any conventional IPV, assessed in the past 12 months among currently married women and over the lifetime among ever-married women. Exposures were reproductive coercion pattern and contraceptive coercion typology. Survey-weighted Poisson regression with robust standard errors estimated adjusted prevalence ratios (aPRs) with 95% CIs for associations with conventional IPV. Survey-weighted logistic regression examined factors associated with reproductive coercion without reported conventional IPV and was considered exploratory because of the small number of events. Survey-weighted prevalence estimates were applied to 2022 census population counts to derive population estimates with 95% uncertainty intervals (UIs).

In the past 12 months, 27.30% of currently married women reported conventional IPV and 3.59% reported reproductive coercion; corresponding lifetime prevalences among ever-married women were 60.40% and 9.25%. Including reproductive coercion increased the prevalence of any reported abuse to 28.61% and 61.18%, respectively. Reproductive coercion was associated with a higher prevalence of each form of conventional IPV, with the largest aPRs among women reporting multiple forms of reproductive coercion. Reproductive coercion without reported conventional IPV was reported by 1.31% (95% CI 1.08-1.59) of currently married women in the past 12 months and 0.78% (0.60-1.01) of ever-married women over the lifetime, corresponding to approximately 645,483 (95% UI 532,154-783,449) and 437,414 (337,106-567,462) women, respectively.

Reproductive coercion captures a dimension of violence against women that is only partly reflected in conventional IPV measures. Women reporting reproductive coercion without conventional IPV might have experienced unmeasured or unreported violence; therefore, this group indicates a measurement gap rather than absence of other abuse. Including validated reproductive coercion measures in national violence surveys could improve evidence for health, legal, and social support responses.