Pregnancy decision-making support for pregnant people with intellectual disability experiencing violence and reproductive coercion

Ms Victoria Tucker1, Ms Stephanie Chen1, Ms Kari Vallury1

1WWILD Sexual Violence Program, Wooloowin, Australia

Background
In Australia people with disability experience 1.8 times higher rates of violence, including extreme forms of intimate partner violence/sexual assault, and greater barriers to accessing services. Reproductive coercion (RC) is an increasingly recognised form of Domestic Family Violence and Sexual Assault (DFVSA), using intentional behaviour to establish and maintain power through pregnancy pressure, contraceptive sabotage and pregnancy outcomes control. Little is known about the inclusion of RC and interactions with experiences of reproductive autonomy for people with intellectual disability (PWID).

Method
Children by Choice and WWILD collaborated to conduct a systematic literature review, facilitate focus groups with PWID and DFVSA services, reviewed existing resources and co-designed new collaborative training modules and held community of practice knowledge sharing workshop for Queensland DFVSA workers.

Results

  • Early identification and addressing of support needs, provided by family/partners, enabled pregnancy decision-making autonomy;
  • Professional bias assuming a lack of parenting capacity, combined with a lack of adequate training in sexual/reproductive health rights for PWID, increases risk of poor quality of care, and pressure to end pregnancy.

Implications

  • There are meaningful gaps for health professionals in training supporting pregnant PWID with an equality of care, choice, and health information.
  • Development of easy-read resources in Queensland for DFVSA clients is necessary to promote health literacy and reproductive autonomy.
  • Further participatory research into lived experience for pregnant PWID experiencing reproductive coercion and best practice for DFVSA/health workers to improve practitioner and systems responses to reproductive coercion, and training for health professionals.

Biography:

Victoria Tucker has worked in the Intellectual Disability field for 18 years and is WWILD’s Trauma counsellor, Group/Community Education worker for people with Intellectual Disability experiencing sexual and domestic and family violence. WWILD actively supports self-advocates to share their stories and participate in inclusive research.