By Lisa Rapaport
(Reuters Health) - Nearly one in eight sexually active teen girls are pressured by their partners to have unprotected sex and try to conceive when they don't want a baby, a U.S. study suggests.
Researchers focused on what's known as reproductive coercion, a form of relationship abuse that can involve things like poking holes in condoms, hiding birth control pills, physically hurting girls who refuse to have unprotected sex, or threatening to break up with them if they don't want a baby.
The study team examined survey data from 550 sexually active girls 14 to 19 years old who sought care from high school health centers. Overall, 12% reported experiencing reproductive coercion within the past three months, and 17% reported physical or sexual abuse.
"Abuse among all types of romantic relationships is common," said Amber Hill, lead author of the study and a researcher at the University of Pittsburgh School of Medicine in Pennsylvania.
"Reproductive coercion, another form of relationship abuse, involves a range of behaviors that include pressuring a partner to become pregnant when they don't want to be, destroying birth control or preventing the use of birth control, and removing condoms during sex (to get her pregnant)," Hill said by email. "Reproductive coercion impacts teens as well as adults and leads to poor health outcomes, such as unintended pregnancy and sexually transmitted infections."
Teens who experienced reproductive coercion in the study were more than four times as likely as those who didn't to report recently experiencing physical or sexual abuse in their relationships, Hill and her colleagues report in Obstetrics & Gynecology.
Relationship coercion and physical and sexual abuse were more common among teen girls who had partners at least five years their senior and among girls who reported two or more recent sexual partners.
Relationship abuse was associated with higher odds that girls would seek testing or treatment for sexually transmitted infections. But it didn't impact requests for pregnancy tests, which may be because girls could easily get over-the-counter tests, the researchers note.
All of the teens in the study received care at school health centers in Northern California, and it's possible results might be different elsewhere.
Even so, dating abuse is much more common than many teens or parents may realize, said Emily Rothman, a professor of community health sciences at the Boston University School of Public Health who wasn't involved in the study.
It can happen in any couple, and with any hook-up, making it critical for young women to recognize the warning signs, Rothman said by email.
"Warning signs include not paying attention to what you say you want to do or not do, being selfish in bed, or careless with your feelings," Rothman said. "A good partner listens to you, cares about how you feel, and doesn't make you feel awkward about it."
Help is available by calling the National Domestic Violence Hotline at 1-800-799-SAFE (7233). Loveisrespect also provides free support and information for teens and young adults who need help with dating abuse: (Chat at www.loveisrespect.org, Text loveis to 22522 or call 1-866-331-9474).
"If you are a teenager and you find yourself crying over what somebody said or did to you more than once or twice, it's not OK and the relationship may not be a healthy one," Rothman added. "And even if both sides know it's just a hook-up, there are still ways of being sweet and nice in a hook-up or ways that are rude, controlling, harmful and unacceptable."
SOURCE: https://bit.ly/2TEo2Rl Obstetrics & Gynecology, online July 11, 2019.