Background: Reproductive coercion (RC) is a type of abuse where a partner intentionally attempts to interfere with fertility through deception or violence, often by manipulating one’s contraceptive use or reproductive decision-making. Cross-sectional studies on the magnitude of RC across sub-Saharan Africa have noted associations with contraceptive use. No studies have longitudinally examined RC experiences as related to future contraceptive dynamics, including discontinuation or forgoing use altogether.
Methods: Two rounds of longitudinal population-based cohorts across eight sites in sub-Saharan Africa, from November2020 to January 2023, were used to prospectively examine past-year RC’s impact on future contraceptive dynamics(discontinuation and switching vs. continuation for contraceptive users at baseline; adoption vs. continued non-use for contraceptive non-users at baseline) using bivariate and multivariable multinomial and logistic regression.
Findings: Minimal differences in women’s past-year RC experiences were observed over a two-year period. In many settings, RC prevalence decreased. Only in Uganda did past-year RC increase between rounds (15.8% to 17.8%).RC’s impact on contraceptive dynamics over one year differed by setting. In Burkina Faso, women with past-yearRC had a three-fold increased risk of discontinuing contraception, as compared to continuing (RRR = 2.63; 95%CI = 1.28–5.42; p<0.01). In Uganda, past-year RC was marginally associated with reduced odds of contraceptive adoption, compared to continued non-use (p<0.1).

Reproductive coercion; Contraception; Reproductive health; Sub-Saharan Africa; Longitudinal