When Partner Abuse Isn’t a Bruise But a Pregnant Belly

Lynn Harris

Sexual violence and coercion by intimate partners plays a critical role in unintended pregnancy, the spread of sexually transmitted infections, poor maternal outcomes and in abortion. The problems of violence, control, and contraceptive sabotage are so widespread that public-health advocates see teen pregnancy as a "canary in a coal mine" or one indicator of possible abuse.

Janey (not her real name) was 19 when she fell "head over heels" for a guy six years her senior.

He
moved in just weeks after their first date, which was before she
learned about the cheating. When she confronted him, repeatedly, he
raped her, repeatedly. When she told him to move out, he threatened her
with more violence. Meanwhile, condoms: not happening. Hormonal birth
control like the Pill, she says, made her sick.  

"The first time
I got pregnant against my will, I had the baby," she says. Along with
several STDs. (He’d been her only partner.) After a stint in jail for
violating an ex’s order of protection, he was back, promising never to
hurt her, gushing about family happiness.

The — yes — second
pregnancy occurred when she’d run out of money for emergency
contraception, having purchased it more than 10 times before from her
college nurse. He refused to help her pay for an abortion. "He thought
another baby would keep me in his life forever," Janey says.  

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Thankfully,
he was wrong. She finally secured an order of protection; he wound up
back in jail for separate reasons. Janey graduated from college, has a
good job and now lives in Arizona with two healthy children.  

Media
attention to the Chris Brown-Rihanna saga, which technically ended
Monday when Brown pleaded guilty to felony assault, certainly got
people talking — for better or for worse — about teen dating abuse and intimate partner violence.

But
many violence and public-health experts agree that at least one major
issue was, and has for too long remained, missing from that
conversation. For girls like Janey, as you can see, partner violence
doesn’t show up in police photos as swollen bruises. Instead, the evidence might be their swollen, pregnant bellies. 

Sexual
coercion and "reproductive control," including contraceptive sabotage,
are a common, and devastating, facet of dating and domestic abuse. A
growing number of studies, experts and young women
themselves are testifying to boyfriends demanding unprotected sex,
lying about "pulling out," hiding or destroying birth control —
flushing pills down the toilet, say — and preventing (or, in some
cases, forcing) abortion.

The implications for young women’s and public health are profound, among them unintended pregnancy,
miscarriage and STDs, including HIV. (Some STDs are cured easily — if
tested for and treated — while others can lead to chronic pelvic pain,
ectopic pregnancy, even infertility.) While this problem is not
brand-new, only now are we starting to understand its scope — and,
ideally, starting to learn from its consequences. 

"Partner violence is not just about hitting," says Patti Giggans, executive director of Peace Over Violence,
noting how long it took to raise awareness that "partner violence"
occurs at all. Now another alarm must be sounded, she says:  "Sexual
coercion is the most secretive part."  

Secretive, and pervasive. In what is said to be the first study
in adolescent health literature "to document the role of abusive
partners in promoting teen pregnancy," Elizabeth Miller, M.D., Ph.D.,
assistant professor in pediatrics at the University of California,
Davis School of Medicine, found that among 61 racially and ethnically
diverse girls in Boston’s poorest neighborhoods, 53 were in were in
abusive and sexually active relationships at the time they were
interviewed — and 26 percent of them said their partners were
"actively trying to get them pregnant by manipulating condom use,
sabotaging birth control," or simply sweet-talking them about "making
beautiful babies" together. Several reported hiding their birth control
from their boyfriends; one girl told researchers her boyfriend "tried
to get me pregnant on purpose, and then made me have an abortion." 

Jill A. Murray,
Ph.D., a leading author and expert on teen dating violence, does
counseling in high school teen-mother programs. Of one recent group,
she says, "every single one of the girls was in an abusive
relationship, of which the pregnancy or the child was a product."

The
problem is so widespread, in fact, that public-health advocates are
working to cast teen pregnancy in a whole new light: not as a measure
of "promiscuity," or a failure of cluefulness, but rather as a canary
in the coal mine of partner violence.

"We have to treat pregnancy
itself as a warning sign," says Murray. "I always tell other counselors
that I’m training, ‘When you see a pregnant teen girl, always, always
assess for an abusive relationship, because 99 percent of the time,
that will be the case.’ "  

Of course, not all teenage girls are
100 percent averse to getting pregnant. But that doesn’t mean they’re
in healthy relationships.

"Teen pregnancy is likely emerging out
of unhealthy relationships," says Miller. "That’s not the only
mechanism for teen pregnancy, but it is an important one that we’ve
managed to miss for a very long time."  

Miller, for her part,
has vowed not to miss it again. Nine years ago, she was working as a
volunteer physician in a teen health clinic in Boston when a
15-year-old girl asked her for a pregnancy test. It was negative. But
two weeks later, the girl wound up in the ER with a severe head injury.
The girl’s boyfriend had pushed her down a flight of stairs.

"I
assumed all she needed was to be educated about her contraceptive
options," Miller recalled. "Later, I wondered what I had missed. Could
I have asked a question that would have identified that she was in an
abusive relationship?"  

Last week, a new study
revealed that while teen sex rates remain the same, teen contraceptive
use is down. Fingers were pointed — deservedly so, one imagines — at,
among other things, abstinence-only education that downright demonizes
condoms.

But even as a growing body of research underscores the
role male partners play in condom use and negotiation, no suggestion
was made that those stats might include some girls who are forgoing
condoms against their will, even those bolstered by condom-friendlier
sex ed.

"The person you’re ‘negotiating’ condom use with may not be interested in negotiation," says Miller.  

"The
picture out there is ‘just get women birth control,’ " adds Esta Soler,
president of the Family Violence Prevention Fund, which has launched a
public awareness campaign
about reproductive abuse in relationships. "But, because of coercion or
sabotage, they may not have control over whether they use it." 

And
it’s not just about pregnancy. Dr. Anne Teitelman, Assistant Professor
in the School of Nursing at the University of Pennsylvania, is an
expert on partner abuse and HIV risk. In her published review on this
link among adolescent girls, she found  six studies
identified an association between intimate partner violence and
increased risk for HIV (as in condom non-use). Among adolescent girls,
survivors of partner abuse are significantly more likely than others to
be diagnosed with an STD.

Dr. Teitelman’s research findings also
indicate that verbal abuse, as well as physical abuse, is linked with
increased HIV risk among adolescent girls.

Teitelman, who is also
a Family Nurse Practitioner, observed this association firsthand,
before studies began to confirm the link.

"We’re giving teens all
this information about prevention in the clinic, and yet I see them
back all the time for STI testing," she says. So, she began to ask, "
‘What’s not working on our end? What are the obstacles in their lives
that are making this difficult for them?’ I was not a partner-abuse
researcher before, but I became one because that was one of the major
answers." 

What drives young men to abuse in this way?

"It’s
clearly out-and-out control of a woman’s body. Control for control’s
sake," says Miller. It’s an urge that stems, experts say, from an
inability to manage their own fears and insecurities.

In one 2007
study, some boys acknowledged outright that they insisted on condomless
sex as a way to establish power over female partners. (There is
evidence of analogous male-on-male sexual violence, but it hasn’t been
studied in depth.)

Other research found that some men took a
woman’s request for a condom as an accusation of cheating, or an
admission that she had slept around or strayed. And for some, yes, the
goal is fatherhood — but not so much of the "involved"
variety; rather, it’s a desire — as with Janey’s ex — to mark one
woman as "mine" forever. Or, according to Patti Giggans, young men in
gangs say, "I’m not gonna be around forever. I’ve gotta leave my
legacy."  

(Still, Jill Murray is quick to note, she sees this
problem in all classes, schools and neighborhoods she visits. "I don’t
want parents to think, ‘Oh, my kids’ aren’t in a gang, so they’re
safe.’ ") 

And the girls: Why do they stay? Classic
domestic-violence pathology, say experts. In an unfortunate mix of
psychological circumstances, some girls take such intense control to
mean, "I’m really special to this person," says Giggans. Plus,
remember: Often, they have this guy’s kid.

Perhaps most
important is: what can be done? Some of the most essential work is
already under way: experts like Miller and Teitelman have not only
recognized pregnancies, STDs — or repeat requests for testing — as
warning signs and are working to train other teen health care providers
to do the same. (Janey’s 10 requests for Plan B should have sent up some sort of red flag.)

"Providers
need to be asking questions like, ‘Is this a pregnancy that you wanted?
Did your partner ever mess with your birth control?’ " says Miller.   

Peace Before Violence is one of many organizations working specifically to educate boys about healthy relationships in programs that focus on the positive aspects of strength and masculinity.

Others
train boys’ coaches to talk to their athletes about calling out their
peers on violence against women and misogyny. Researchers,
including Teitelman, are also studying exactly how parents can best
educate their kids, not just about the birds and the bees, but also
about standing up to sexual coercion. (In one study, Teitelman found
teen girls whose mothers had talked to them about resisting sexual
pressure were twice as likely to delay sex, or use condoms during sex;
when fathers did the same, they were five times more likely to have
safe sex.)  

And yes, we need to get even more dating-violence education into the schools. Though of course in this economy — which some
blame for a further rise in dating violence itself — "most schools are
barely doing sex ed and basic health," says Elizabeth Miller. Her
vision: stop "siloing" the issues that affect teen sexual health and
relationships.

"It doesn’t make sense to talk about substance
abuse use this week and pregnancy next week and STDs the following week
and then healthy relationships the week after that," she says. "We need
to be talking about how they’re all linked together."

This article was first published by Alternet.

Analysis Economic Justice

New Pennsylvania Bill Is Just One Step Toward Helping Survivors of Economic Abuse

Annamarya Scaccia

The legislation would allow victims of domestic violence, sexual assault, and stalking to terminate their lease early or request locks be changed if they have "a reasonable fear" that they will continue to be harmed while living in their unit.

Domestic violence survivors often face a number of barriers that prevent them from leaving abusive situations. But a new bill awaiting action in the Pennsylvania legislature would let survivors in the state break their rental lease without financial repercussions—potentially allowing them to avoid penalties to their credit and rental history that could make getting back on their feet more challenging. Still, the bill is just one of several policy improvements necessary to help survivors escape abusive situations.

Right now in Pennsylvania, landlords can take action against survivors who break their lease as a means of escape. That could mean a lien against the survivor or an eviction on their credit report. The legislation, HB 1051, introduced by Rep. Madeleine Dean (D-Montgomery County), would allow victims of domestic violence, sexual assault, and stalking to terminate their lease early or request locks be changed if they have “a reasonable fear” that they will continue to be harmed while living in their unit. The bipartisan bill, which would amend the state’s Landlord and Tenant Act, requires survivors to give at least 30 days’ notice of their intent to be released from the lease.

Research shows survivors often return to or delay leaving abusive relationships because they either can’t afford to live independently or have little to no access to financial resources. In fact, a significant portion of homeless women have cited domestic violence as the leading cause of homelessness.

“As a society, we get mad at survivors when they don’t leave,” Kim Pentico, economic justice program director of the National Network to End Domestic Violence (NNEDV), told Rewire. “You know what, her name’s on this lease … That’s going to impact her ability to get and stay safe elsewhere.”

“This is one less thing that’s going to follow her in a negative way,” she added.

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Pennsylvania landlords have raised concerns about the law over liability and rights of other tenants, said Ellen Kramer, deputy director of program services at the Pennsylvania Coalition Against Domestic Violence, which submitted a letter in support of the bill to the state House of Representatives. Lawmakers have considered amendments to the bill—like requiring “proof of abuse” from the courts or a victim’s advocate—that would heed landlord demands while still attempting to protect survivors.

But when you ask a survivor to go to the police or hospital to obtain proof of abuse, “it may put her in a more dangerous position,” Kramer told Rewire, noting that concessions that benefit landlords shift the bill from being victim-centered.

“It’s a delicate balancing act,” she said.

The Urban Affairs Committee voted HB 1051 out of committee on May 17. The legislation was laid on the table on June 23, but has yet to come up for a floor vote. Whether the bill will move forward is uncertain, but proponents say that they have support at the highest levels of government in Pennsylvania.

“We have a strong advocate in Governor Wolf,” Kramer told Rewire.

Financial Abuse in Its Many Forms

Economic violence is a significant characteristic of domestic violence, advocates say. An abuser will often control finances in the home, forcing their victim to hand over their paycheck and not allow them access to bank accounts, credit cards, and other pecuniary resources. Many abusers will also forbid their partner from going to school or having a job. If the victim does work or is a student, the abuser may then harass them on campus or at their place of employment until they withdraw or quit—if they’re not fired.

Abusers may also rack up debt, ruin their partner’s credit score, and cancel lines of credit and insurance policies in order to exact power and control over their victim. Most offenders will also take money or property away from their partner without permission.

“Financial abuse is so multifaceted,” Pentico told Rewire.

Pentico relayed the story of one survivor whose abuser smashed her cell phone because it would put her in financial dire straits. As Pentico told it, the abuser stole her mobile phone, which was under a two-year contract, and broke it knowing that the victim could not afford a new handset. The survivor was then left with a choice of paying for a bill on a phone she could no longer use or not paying the bill at all and being turned into collections, which would jeopardize her ability to rent her own apartment or switch to a new carrier. “Things she can’t do because he smashed her smartphone,” Pentico said.

“Now the general public [could] see that as, ‘It’s a phone, get over it,'” she told Rewire. “Smashing that phone in a two-year contract has such ripple effects on her financial world and on her ability to get and stay safe.”

In fact, members of the public who have not experienced domestic abuse may overlook financial abuse or minimize it. A 2009 national poll from the Allstate Foundation—the philanthropic arm of the Illinois-based insurance company—revealed that nearly 70 percent of Americans do not associate financial abuse with domestic violence, even though it’s an all-too-common tactic among abusers: Economic violence happens in 98 percent of abusive relationships, according to the NNEDV.

Why people fail to make this connection can be attributed, in part, to the lack of legal remedy for financial abuse, said Carol Tracy, executive director of the Women’s Law Project, a public interest law center in Pennsylvania. A survivor can press criminal charges or seek a civil protection order when there’s physical abuse, but the country’s legal justice system has no equivalent for economic or emotional violence, whether the victim is married to their abuser or not, she said.

Some advocates, in lieu of recourse through the courts, have teamed up with foundations to give survivors individual tools to use in economically abusive situations. In 2005, the NNEDV partnered with the Allstate Foundation to develop a curriculum that would teach survivors about financial abuse and financial safety. Through the program, survivors are taught about financial safety planning including individual development accounts, IRA, microlending credit repair, and credit building services.

State coalitions can receive grant funding to develop or improve economic justice programs for survivors, as well as conduct economic empowerment and curriculum trainings with local domestic violence groups. In 2013—the most recent year for which data is available—the foundation awarded $1 million to state domestic violence coalitions in grants that ranged from $50,000 to $100,000 to help support their economic justice work.

So far, according to Pentico, the curriculum has performed “really great” among domestic violence coalitions and its clients. Survivors say they are better informed about economic justice and feel more empowered about their own skills and abilities, which has allowed them to make sounder financial decisions.

This, in turn, has allowed them to escape abuse and stay safe, she said.

“We for a long time chose to see money and finances as sort of this frivolous piece of the safety puzzle,” Pentico told Rewire. “It really is, for many, the piece of the puzzle.”

Public Policy as a Means of Economic Justice

Still, advocates say that public policy, particularly disparate workplace conditions, plays an enormous role in furthering financial abuse. The populations who are more likely to be victims of domestic violence—women, especially trans women and those of color—are also the groups more likely to be underemployed or unemployed. A 2015 LGBT Health & Human Services Network survey, for example, found that 28 percent of working-age transgender women were unemployed and out of school.

“That’s where [economic abuse] gets complicated,” Tracy told Rewire. “Some of it is the fault of the abuser, and some of it is the public policy failures that just don’t value women’s participation in the workforce.”

Victims working low-wage jobs often cannot save enough to leave an abusive situation, advocates say. What they do make goes toward paying bills, basic living needs, and their share of housing expenses—plus child-care costs if they have kids. In the end, they’re not left with much to live on—that is, if their abuser hasn’t taken away access to their own earnings.

“The ability to plan your future, the ability to get away from [abuse], that takes financial resources,” Tracy told Rewire. “It’s just so much harder when you don’t have them and when you’re frightened, and you’re frightened for yourself and your kids.”

Public labor policy can also inhibit a survivor’s ability to escape. This year, five states, Washington, D.C., and 24 jurisdictions will have passed or enacted paid sick leave legislation, according to A Better Balance, a family and work legal center in New York City. As of April, only one of those states—California—also passed a state paid family leave insurance law, which guarantees employees receive pay while on leave due to pregnancy, disability, or serious health issues. (New Jersey, Rhode Island, Washington, and New York have passed similar laws.) Without access to paid leave, Tracy said, survivors often cannot “exercise one’s rights” to file a civil protection order, attend court hearings, or access housing services or any other resource needed to escape violence.

Furthermore, only a handful of state laws protect workers from discrimination based on sex, sexual orientation, gender identity, and pregnancy or familial status (North Carolina, on the other hand, recently passed a draconian state law that permits wide-sweeping bias in public and the workplace). There is no specific federal law that protects LGBTQ workers, but the U.S. Employment Opportunity Commission has clarified that the Civil Rights Act of 1964 does prohibit discrimination based on gender identity and sexual orientation.

Still, that doesn’t necessarily translate into practice. For example, the National Center for Transgender Equality found that 26 percent of transgender people were let go or fired because of anti-trans bias, while 50 percent of transgender workers reported on-the-job harassment. Research shows transgender people are at a higher risk of being fired because of their trans identity, which would make it harder for them to leave an abusive relationship.

“When issues like that intersect with domestic violence, it’s devastating,” Tracy told Rewire. “Frequently it makes it harder, if not impossible, for [victims] to leave battering situations.”

For many survivors, their freedom from abuse also depends on access to public benefits. Programs like Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), the child and dependent care credit, and earned income tax credit give low-income survivors access to the money and resources needed to be on stable economic ground. One example: According to the Center on Budget and Policy Priorities, where a family of three has one full-time nonsalary worker earning $10 an hour, SNAP can increase their take-home income by up to 20 percent.

These programs are “hugely important” in helping lift survivors and their families out of poverty and offset the financial inequality they face, Pentico said.

“When we can put cash in their pocket, then they may have the ability to then put a deposit someplace or to buy a bus ticket to get to family,” she told Rewire.

But these programs are under constant attack by conservative lawmakers. In March, the House Republicans approved a 2017 budget plan that would all but gut SNAP by more than $150 million over the next ten years. (Steep cuts already imposed on the food assistance program have led to as many as one million unemployed adults losing their benefits over the course of this year.) The House GOP budget would also strip nearly $500 billion from other social safety net programs including TANF, child-care assistance, and the earned income tax credit.

By slashing spending and imposing severe restrictions on public benefits, politicians are guaranteeing domestic violence survivors will remain stuck in a cycle of poverty, advocates say. They will stay tethered to their abuser because they will be unable to have enough money to live independently.

“When women leave in the middle of the night with the clothes on their back, kids tucked under their arms, come into shelter, and have no access to finances or resources, I can almost guarantee you she’s going to return,” Pentico told Rewire. “She has to return because she can’t afford not to.”

By contrast, advocates say that improving a survivor’s economic security largely depends on a state’s willingness to remedy what they see as public policy failures. Raising the minimum wage, mandating equal pay, enacting paid leave laws, and prohibiting employment discrimination—laws that benefit the entire working class—will make it much less likely that a survivor will have to choose between homelessness and abuse.

States can also pass proactive policies like the bill proposed in Pennsylvania, to make it easier for survivors to leave abusive situations in the first place. Last year, California enacted a law that similarly allows abuse survivors to terminate their lease without getting a restraining order or filing a police report permanent. Virginia also put in place an early lease-termination law for domestic violence survivors in 2013.

A “more equitable distribution of wealth is what we need, what we’re talking about,” Tracy told Rewire.

As Pentico put it, “When we can give [a survivor] access to finances that help her get and stay safe for longer, her ability to protect herself and her children significantly increases.”

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

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White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.