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Abstract

This article addresses women’s experiences of abortion in the context of domestic violence, more specifically the decision-making process and the influence of the perpetrators in their decision. The data were collected through semistructured individual interviews with four Canadian women, aged between 23 and 36 years at the time of the interviews. Overall, the findings suggest that the factors influencing women’s decision can be grouped into the following four categories: domestic violence, the women’s individual situation, the couple’s situation, and external constraints. Implications for policies and practice are discussed.

Keywords

abortion decision making domestic violence pregnancy

Introduction

Domestic violence is a social problem resulting from inequality between men and women, where women occupy a subordinate position in society (Status of Women of Canada, 1993). This problem was first theorized by feminist authors in the 1970s, who have conceptualized domestic violence as a form of social control, intrinsic to the patriarchy (Dobash & Dobash, 1979). In this sense, the social structures and institutions that maintain patriarchy allow men, both implicitly and explicitly, to oppress and exploit women, who are treated unfairly based on their gender (Thompson, 2001).

Within a male-dominated society, there is an alliance between sexuality and violence. Indeed, men often hold a position of authority and power, and women have been socialized to give in to men’s requests for sexual favors (Kelly, 1988). This dynamic of power and control has particular implications for women who live with an abusive partner, since the perpetrator’s tactics leave them facing multiple challenges, such as birth control sabotage and forced sex, which can lead to unintended pregnancies. When facing unintended pregnancies, abused women may decide to have an abortion. However, they might have to deal with significant challenges due to the perpetrator’s control (Moore, Frohwirth, & Miller, 2010).

Given the high prevalence of domestic violence among women interrupting an unintended pregnancy (see Literature Review section), this article specifically addresses the decision-making process that leads some women to opt for abortion in the context of domestic violence.

Literature Review

Domestic violence can lead to unintended pregnancy in various ways, particularly if the woman is subjected to sexual violence. Rape has often been considered as a form of domestic violence in the literature, in the context where rape can be one of many control tactics used by a violent partner (McMahon & Schwartz, 2011). Very few studies have focused on rape and pregnancy, but data from the National Women’s Study (Holmes, Resnick, Kilpatrick, & Best, 1996) revealed that 32,101 pregnancies result from rape each year in the United States and 50% of these unintended pregnancy end in abortion. Given that the offender is often known to the victim, rape-related pregnancy “is closely linked with family and domestic violence” and 40% of them “resulted from multiple assaults (…) and thus occurred in the setting of ongoing violence or abuse” (p. 323).

A recent study conducted with 53 women at four domestic violence shelters showed that 66% of women were forced into sexual intercourse by the perpetrator (de Bocanegra, Rpstovtseva, Khera, & Godhwani, 2010). Although sexual violence is evident at times, other times, women feel compelled to acquiesce to the partner’s sexual advances (Fortin, 2001). For instance, Basile (1999) discusses the notion of “rape by acquiescence,” whereby women agree to have intercourse with the perpetrator, fearing the consequences of refusing. For some women, saying “no” may result in an increase of violence (Kelly, 1988) or threats toward themselves or their children (de Bocanegra et al., 2010).

Another way in which domestic violence can lead to unintended pregnancy is by the perpetrator’s control over the woman’s sexuality and contraception (Coggins & Bullock, 2003). Moore, Frohwirth, and Miller (2010) call it “reproductive control,” whereby the perpetrators “demand or enforce their own reproductive intentions whether in direct conflict with or without interest in the woman’s intentions, through the use of intimidation, threats, and/or actual violence” (p. 1738). Women in violent relationships are therefore limited in their contraceptive choices (Gee et al., 2009) and are less likely to consistently use contraception (Coker, 2007). On the other hand, the perpetrators are more likely to interfere in contraceptive use (Campbell, Pugh, Campbell, & Visscher, 1995; de Bocanegra et al., 2010). Women who are living with a violent partner are therefore at an increased risk of unintended pregnancy (de Bocanegra et al., 2010), sometimes leading to abortion.

Very few qualitative studies have focused on the experiences of women who have terminated an unintended pregnancy in the context of domestic violence, but some quantitative studies have attempted to measure the prevalence of this issue. Research evidence varies, but all studies found rates of domestic violence that falls within the range of 15% to 25% among women who have had an abortion (Bourassa & Bérubé, 2007; Ely & Otis, 2011; Evins & Chescheir, 2002; Leung, Leung, Chan, & Ho, 2002; Romito et al., 2009; Roth, Sheeder, & Teal, 2011; Wiebe & Janssen, 2001). That said, women who have abortions are more likely than women in the general population to declare previous or current family and domestic violence, in all its forms (Bourassa & Bérubé, 2007; Romito et al., 2009).

A study by Romito et al. (2009), conducted in an Italian hospital, revealed that women having abortions (n = 445) experienced higher rates of psychological and physical violence during the 12 months preceding the study, compared to women continuing their pregnancies (n = 438). This association was only found in women less than 30 years of age in their sample. In Canada, Bourassa and Bérubé (2007) compared a sample of 350 women, recruited at a family planning clinic, who had terminated their pregnancies with a sample of 653 women, recruited at a perinatal clinic, who had continued their pregnancy (control group). For the year preceding the study, they noted that rates of domestic violence were 3 times higher and rates of physical and sexual abuse were 4 times higher in women who had an abortion. The study also found that 50% of women having an abortion while the pregnancy was initially planned had been victims of physical or sexual abuse during their pregnancy. Since violence tends to escalate during pregnancy, some women can make the decision to abort in order to prevent further violence, or they may realize they do not want to raise a child in a violent home. Physical and sexual abuse, past or present, is also correlated with repetitive abortions. More specifically, in a sample of 1,145 participants at a regional provider for abortion services in Canada, Fisher et al. (2005) point out rates of domestic and sexual violence 2.5 times higher for women who had three or more abortions than among women who had their first abortion.

A qualitative study conducted by Moore et al. (2010) sheds a light on the concept of “reproductive control” which helps better understand those high rates of domestic violence among women undergoing an abortion. Drawing upon a qualitative methodology with a sample of 71 women with a prior history of domestic violence, the authors explain that reproductive control can be “laid out along a temporal continuum” (p. 1739). A total of 74% of their sample were subjected to reproductive control before sexual intercourse (“pregnancy promotion” and “contraceptive sabotage”), during sexual intercourse (“sexual violence,” “condom manipulation,” and “contraceptive sabotage”), and postconception (“controlling pregnancy outcomes” and “interfering with health care”). When it comes to abortion, on one hand, perpetrators can coerce women into carrying the pregnancy to term using a wide range of controlling behavior, denying them access to abortion and even threatening to kill them if they go ahead with the abortion procedure. On the other hand, they can coerce women into having an abortion; some perpetrators even threaten violence “with the intention of bringing about the end of the pregnancy” (p. 1741).

In the same vein, abused women are less likely to disclose abortion to their partner. A study conducted at a clinic in Texas on a sample size of 818 women revealed that 20.9% of the participants, who had terminated an unintended pregnancy and had not mentioned their abortion to the perpetrator, feared that the perpetrator would object and that 7.9% had not disclosed their abortion as it would be likely to result in an episode of physical violence (Woo, Fine, & Goetzl, 2005). Even though there were other reasons for not disclosing the abortion to the partner, the authors were particularly concerned about the fact that 23.7% of nondisclosers had been victims of sexual or physical violence (or both) in the year preceding the abortion compared to 12% of disclosers. Drawing upon results from a sample of 9,493 women in 95 different clinics, Jones, Moore, and Frohwirth (2011) indicate that 62% of women victims of domestic violence will discuss abortion with their spouse, compared to 84% among women in the general population. The authors reported that, for abused women, abortion could be a strategy employed to avoid a “permanent connection” with the perpetrator.

In the literature, little attention has been paid to women's decision-making process regarding abortion when facing an unintended pregnancy in the context of domestic violence. A qualitative study by Williams and Brackley (2009) documented the reasons to terminate an unintended pregnancy in the context of domestic violence, as described by a cohort of eight participants recruited through a women’s health clinic. The results highlight that an increase in violence, in both frequency and intensity, the fear of the abuser, and the desire to end the abusive relationship were all factors in encouraging women to terminate their pregnancies. For the majority of participants, the decision to terminate the pregnancy had been directly related to domestic violence and the fear of having contact with the abusive partner after the birth of the child. However, they did not specifically address the decision-making process, which remains undocumented in the literature despite all of the challenges women can face.

Methodology

This study is underpinned by a feminist perspective. This perspective has influenced every component of the research, including the research objectives and the research questions. Indeed, domestic and sexual violence has been defined as a social problem that affects mostly women, in a social context where inequalities still exist between men and women (Johnson, Ollus, & Hevala, 2008). Abortion has also been considered as a women’s rights issue.

Over the last few decades, feminist researchers have paid particular attention to women’s experiences and to women’s accounts of those experiences, which has been a challenge to the historical tendency to silence women and exclude them from the production of knowledge (Brooks, 2007). This has also enabled feminist researchers to shed light on realities that would have otherwise remained invisible. In this perspective, the current study was aimed at giving a voice to abused women and to explore an issue that has not been given sufficient attention, unintended pregnancy and abortion in the context of domestic violence. Drawing from a feminist standpoint epistemology, this research considered that, as an oppressed group, women are in a position to understand patriarchy and its consequences and that such an understanding should provide the foundations for social change (Thompson, 2001). Even though the research did not involve a large number of women, it appeared crucial to give those women a voice in order to provide a better understanding of this situation and make it more visible in the scientific, social, and political arenas.

The purpose of this study was to explore the experiences of women who had terminated a pregnancy in the context of domestic violence. This exploratory study draws upon a qualitative methodology in order to understand the experiences of women. The women who took part in this study had to be aged 18 or over and having terminated at least one pregnancy within the context of domestic violence in the last 5 years. The participants were recruited on a voluntary basis, through two domestic violence shelters. Semistructured individual interviews were conducted in French, with a sample of four women living in the province of Québec, Canada. Each woman was met for a single interview lasting between 60 and 90 min. The participants were aged between 23 and 36 at the time of the interviews. None of them were married nor had been married to the perpetrator, and the violence lasted between 3 and 12 years. These women had each interrupted between one and nine pregnancies, one of them had a miscarriage and all of them had one child with the perpetrator. Two women had one more child prior to meeting the perpetrator. One woman underwent two decision-making processes: one leading to an abortion and the other one leading to her carrying the pregnancy to term.

The interview guide was divided into three sections, each section addressing a dimension of women’s experience. The first section sought to understand domestic violence in the life of women, the reaction to pregnancy, and the options that had been considered. The second part of the interview guide explored the impact of domestic violence on contraceptive use, sexuality, and decision making related to abortion. The third section aimed to document the experiences of women in services they had been in contact with. Ethical approval was given by the Office of Research Ethics and Integrity at the University of Ottawa.

All the interviews were transcribed into a Microsoft Word document and following the transcription, the data were imported into N’Vivo 8 in order to facilitate the content analysis. Content analysis is a “careful, detailed, systematic examination and interpretation of a particular body of material in an effort to indentify patterns, themes, biases, and meanings” (Berg, 2006, pp. 303–304). It is a relevant method of analysis in the field of social work research, as it allows the evaluation of social and collective phenomenon, while allowing the researcher to understand the reality of people (Tutty, Rothery, & Grinnell, 1996). A combination of words, sentences, and paragraphs were grouped into five themes to categorize the transcripts: domestic violence, sexuality, pregnancy, abortion, and intervention. Each of these themes was broken down into subcategories. The category “abortion” has then been subdivided into four themes: domestic violence, the women’s individual situation, the couple’s situation, and external constraints. To ensure the rigor of the research, these categories had been discussed with a colleague and a professor at the University of Ottawa who were working on similar research topics. Since they were external to the research, their recommendations ensured a fair interpretation of the different angles that the principal investigator might have overlooked.

With respect to the study limitations, given the small sample size, the findings cannot be generalized to the general population. Another limitation is the lack of diversity in the participant’s individual characteristics, in terms of their age, their ethnicity (white Canadian women), and their language (French). It seems necessary to recall that this is an exploratory study and that the limits listed previously are considered in the analysis.

Findings

Overall, the findings reveal that the decision-making process through which the research participants had gone through is complex and dynamic. Through their discourse, we can identify that the factors influencing their decision can be grouped into the following four categories: domestic violence, the women’s individual situation, the couple’s situation, and external constraints.

Domestic violence

The first factor, domestic violence, affects the other three elements and had a major influence on the participants’ decision to terminate their pregnancy. The women initially had serious concerns for their future baby, given the violent behavior of the perpetrator. One woman explained, among other things, that her husband had became increasingly aggressive with their young son and that although she had tolerated episodes of physical abuse toward herself, she would not have tolerated violence directed against their son. Her partner’s behavior had a significant influence on her decision to end the pregnancy:

You beat me, but you will not beat my child. This is not happening. He said, “Yeah, but he doesn’t stop whining.” But it’s a baby; he will whine. It’s normal.

Furthermore, all participants had decided to terminate the unintended pregnancy based, at least in part, on domestic violence and the lack of support of the perpetrator in these circumstances. The participants expressed their fear of having to remain with the perpetrator if they had continued the pregnancy, while taking stock of violence within the couple:

Well, another child…how much longer will I have to stay with him? It’s going to be hell on earth.

He beats me, he tells me to f *** off, he treats me like shit. Do I feel like having another child with him?

The fear of staying with the perpetrator is accentuated by the control he has over all the decisions, including the termination of the pregnancy. Although the participants stated that the decision to terminate an unintended pregnancy must be made by the woman, in fact, the perpetrators do not seem to agree to this. Three participants indicated that the perpetrator had made all the decisions in the relationship and explained how they had felt pressured to have an abortion:

Every morning in the kitchen he left notes with all the addresses of places where they perform abortions: “Did you call? Have you done what I told you?” I ended up calling. This is how it happened.

I wouldn’t have had nine abortions. He had the upper hand for sure.

In addition to the wide range of strategies that had been used by the perpetrator to control the pregnancy outcome, this particular woman explains how her partner had reached out to her family and friends so that she would opt for an abortion. He had used psychological violence against her and had been threatening her in various ways, telling her he would not be involved as a father and would “throw her out on the street.” Faced with resistance from this woman, he had also tried to manipulate her best friend:

He went as far as calling my best friend so she would make me change my mind.

This pressure must be understood in the context where a decision has to be made fairly quickly. In this regard, the participants felt that they had not had enough time to think about their options. The pressure put on them by the perpetrator had also created sadness and feelings of resentment, especially when they had been threatened. Furthermore, the stress that has been caused by domestic violence and the increase in physical violence during pregnancy had also affected the women’s decision. In certain circumstances, the pregnancy was too far advanced to have an abortion. For instance, this woman explains how the perpetrator had punched her while she was 7 months pregnant with their first child:

When I got pregnant, it was as if he took ownership of me. (…) Physical violence started after the end of the term when I could get an abortion.

The women’s individual situation

Although domestic violence has a major influence in women’s decision-making process, there are also other factors to consider. In regard to individual factors, the participants identified a wide range of emotions that had emerged throughout the decision-making process. They expressed joy, sorrow, anger, and fear. They added the feeling of not being ready to have a child, not wanting more children, poor “timing,” or not “feeling the pregnancy.” They also indicated that adoption had not been considered as an interesting alternative. The women may have been happy to be pregnant and may have hoped that their partner share their happiness. For one particular woman, finding out that she had been pregnant with twins had uncovered several questions, even if the final decision to end the pregnancy had been clear in her mind:

I was hoping he would change his mind but he was making all the decisions. If it was only for me, I would have kept them. Twins…it’s something!

The participants also expressed how previous abortions had been a challenging step in their lives, even for those who had gone through several of them. When the women had a previous abortion that turned out to be physically or psychologically difficult, the decision-making process became more complex. As raised by these two participants, past experiences had complicated their decision-making process. While one mentioned the psychological difficulties she had encountered after her first abortion, the other referred to physical difficulties after her eighth abortion:

I didn’t want to have an abortion. I didn’t want to go through this again. I knew I didn’t have the strength to go through all that. I would have given up a lung, a leg or an arm rather than having an abortion.

I'll tell you that my previous abortion, it was a terrible experience. The doctor really hurt me. Look, I felt everything; it’s as if I was being stabbed in the uterus. I was crying during the abortion. I really suffered and it got worse after. She really messed up; my uterus is all cicatrized. I was traumatized afterward.

Regardless of the participants' previous experiences with abortion, their discourses suggest that it was important for them to have a termination within the first few weeks of pregnancy. However, stress and anxiety caused by the climate of violence meant that women can learn they are pregnant at an advanced stage of pregnancy. One participant explained that she had begun to proceed to a second abortion, but that feelings of guilt, combined with a pregnancy of 24 weeks, made her change her mind:

Then I thought it was so immoral to do that. I was taking away someone’s life. I was a murderer.

Besides their feelings and their past experiences regarding abortion, the women’s decision had also been greatly influenced by their use of drugs and alcohol. The women who had resorted to substance abuse when they found out they were pregnant reflected on the potential impact on the fetus. For three participants, their perception of parental roles in these circumstances had led them to consider that the continuation of the pregnancy was not an option. This woman in particular, faced with a first pregnancy with the perpetrator, knew right away she was going to have an abortion:

He was feeding me with speed so that I’d stay with him. Without realizing it, my addiction became increasingly strong. So when I found out I was pregnant, I was already at eight weeks. I knew that I had misused quite a lot during that time.

Another topic that emerged from women’s discourses is the doubt about their own ability to be “good” mothers. As their uncertainty about the perpetrator’s parenting had derived from his aggressive behavior and lack of involvement with their current children, their insecurity about their own potential role as mothers had emerged from episodes of emotional abuse, where the perpetrator had denigrated them:

You work night shifts, what kind of mother are you going to be?

You’re not good; you’ll be a bad mother.

Finally, the women’s perspectives on abortion had played a role in the decision-making process. The participants had various representations of abortion, according to their life experiences and personal beliefs. The following quotes demonstrate the differences in the participants’ opinions about abortion and how this can influence their decision making. While the first quote illustrate a participant’s views regarding abortion and leaded to her ending the unintended pregnancy, the second quote exemplify how the participant felt about abortion and may explain why she decided to carry her second unintended pregnancy to term, after having a previous abortion in the context of domestic violence:

You see, I’ve never seen abortion as murder or taking away someone’s life.

I thought it was immoral to do that. I was taking away someone’s life. I was a murderer.

The couple’s situation

The third category comprises the difficulties encountered by the couple at the time of pregnancy. The participants discussed topics of uncertainty about the stability of the relationship, which seemed to significantly influence their decision. In these circumstances, women may feel “on edge” and can begin to question the stability of their relationship with their partner:

In terms of your relationship…you know it’s not going well.

I wasn’t sure how long I was gonna stay with him.

Moreover, the women were uncertain whether they would have benefited from the moral and financial support of the perpetrator after birth. This woman had been concerned about the responsibilities lying ahead at the arrival of a baby and had been afraid she would have had to take care of everything. She explained that her partner had never invested time or money with their son and that, even when pregnant, she had not received any support from him:

I thought: will he look after the baby? I’m already stressed out and tired; then our son would wake up, he (partner) didn’t want to get up. He was whining: “Get up!,” when I was always the one who was taking care of him.

These difficulties were amplified by the alcohol and drug consumption of the perpetrator. While drugs may have helped the women cope with domestic violence, the perpetrators’ misuse of drugs and alcohol had amplified violent behavior toward the women and their children. When their partner had been under the influence of drugs or alcohol, these two women were having difficulty in predicting their moods and felt on the edge:

He started doing cocaine (…). He started drinking (…). Then he talked about steroids. Gradually, he was losing patience with me…He was really losing it.

He was drinking a lot, a whole lot. I never knew what to expect when he was drunk.

Aside from the partner’s consumption of drugs and alcohol, the women also had serious concerns about their partners’ parenting skills. Three participants mentioned the lack of financial and moral support, as well as the general lack of interest in, and involvement with, the children they already had:

I was wondering if he was going to take care of the future baby. He already didn’t take care of our son.

External constraints

With respect to the fourth element, external constraints, the confusion surrounding the decision making of women is exacerbated by social pressures that may cause some guilt about abortion. Indeed, the women had felt that their family, their friends, and society had made a judgment about them, regardless of their history of domestic violence. These two women in particular explained how they felt “guilty” and “uncomfortable” even though they only had one abortion:

No, but I feel guilty and everyone tells me it was my fault…but it’s not that simple.

If I turned towards society, including people I know, my friends and all, this is when the discomfort was happening.

One of the participants explained how her family and her friends had not known about the violence but had been aware that the couple was having difficulties. She explained how she had fear people would criticize her for having a child in an “unhealthy” relationship:

I felt pressure on his part but also a social pressure since people around me knew that I was in an unhealthy relationship.

Aside from the fear of being criticized and judged by their surrounding, women can also fear child protection services, which can have a significant influence on their decision making. This woman discussed the pressure she felt since child protection services had clearly stated that she was not to see the perpetrator again. The arrival of a baby could have had significant consequences for her family:

We were not allowed to see each other. If I had written that he was the father on the birth certificate, they would have realized that we slept together. I was going to lose two children to child protection services, he was going to go to jail, and I was going to be in trouble …

Despite all of these constraints, one participant, inspired by her personal experience, stressed the importance for other women to make a decision for themselves and not for the perpetrator or any other person. She wanted to convey the following message to women who face unintended pregnancies in the context of domestic violence:

My advice would be to think properly and healthily about what you do: is it really my choice or is it the choice of my boyfriend, my spouse, my husband, the father of this child? Is it really what I want, as an individual, as a woman, as a person to have an abortion?”

Discussion

The decision-making process of the research participants varies according to four elements: domestic violence, the women’s individual situation, the couple’s situation, and external constraints. These four elements are part of a broader social context and are therefore influenced by society, through myth about abortion and perhaps the influence of prolife movements.

With regard to domestic violence, the increase in violence by the perpetrator, both toward children and women, the lack of support in pregnancy, and the transition from verbal and psychological abuse to physical abuse have had a major influence in the participant’s decision. The four participants mentioned their feeling of powerlessness regarding their decision, since the perpetrators were controlling every aspect of their lives. This could also explain, in part, why two participants had repetitive abortions. This is coherent with the findings from the study conducted by Fisher et al. (2005), which indicates a correlation between physical and sexual abuse, past or present and repetitive abortions.

These findings also indicate that women had used contraception irregularly due to the control and violence perpetrated by their partners. This has been pointed out in Coker’s (2007) literature review suggesting strong evidence for “sexual risk-taking behaviour” “such as inconsistent condom use, partner nonmonogamy and multiple sex partners” (p. 150) and domestic violence. Similar results were found in a study conducted by Gee et al. (2009), whereas the participants experiencing domestic violence reported more often that their partner made it difficult for them to consistently use birth control.

The participants also discussed the challenges created by emotional insecurity and uncertainty about their future roles as mothers. This is consistent with the findings from two empirical studies conducted in the United Kingdom, which highlighted the challenges and difficulties involved in mothering in the context of domestic violence (Lapierre, 2010; Radford & Hester, 2006). These findings demonstrate that the women’s mothering is often complicated by the perpetrators’ abusive behavior. In his study, Lapierre (2010) shows that the violence creates additional responsibilities for the women, while at the same time having less control over their actions.

The findings also suggest that the perpetrators significantly pressure women by putting in place various strategies to influence their decisions, going as far as manipulating the women’s families or friends. It is therefore not surprising that the women in this study discussed the fear of disclosing the pregnancy to their partners. This is also consistent with the findings from the study conducted by Woo, Fine, and Goetzl (2005), which suggest that abused women are less likely to disclose their pregnancy to their partner, in comparison with women in the general population.

Elements included in the couple’s situation were difficult to dissociate from domestic violence, since the couple’s situations were entrenched with violence. Nonetheless, the women expressed worries regarding the instability of the relationship, the lack of moral and financial support, the perpetrators’ drug and alcohol abuse, and their parental skills. Since these factors were more or less linked to domestic violence, further research is needed to evaluate whether these factors would be the same without the presence of domestic violence.

In addition, the misogynistic attitude of the participant’s partners had reinforced the blame and a sense of guilt related to their abortion, even in circumstances where they had felt pressured to terminate the pregnancy. This is raised in two qualitative studies, where women are discussing feelings of guilt but rather related to their desire to have an abortion when their partner forces the continuation of pregnancy (de Bocanegra et al., 2010; Moore et al., 2010). This guilt may lead women to make a decision with which they are not comfortable and seems to be an additional way for the perpetrators to control women’s decisions.

Implications for Policies and Practice

In regard to intervention with these women, both practitioners and nurses in abortion clinics must be qualified and able to recognize potential situations of domestic violence, especially when a woman does not want to disclose her pregnancy to the partner. Indeed, abortion clinics have a responsibility toward women and should screen for domestic violence. Wiebe and Janssen (2001) have pointed out that a particular challenge is the presence of the partner in the room, which suggests that partners should remain in the waiting room during the preabortion visit, so women are more likely to disclose abuse. For Wiebe and Janssen (2001), screening in abortion clinics is “challenging but feasible.” Nonetheless, the participants in the current study were in favor of such screening, although they mentioned they may not have been ready to disclose domestic violence at the time of the termination. Furthermore, one participant mentioned the importance of an educational component. The preabortion visit could be seen as a good opportunity to introduce women to the cycle of violence and the wheel of power and control.

Similarly, the options available to women when they find themselves confronted to an unintended pregnancy within the context of domestic violence must be clearly explained by any professionals, whether it is in shelters, health care system, abortions clinics, or communities organization. We cannot assume that women want to continue their pregnancies before conducting an intervention that deconstructs the myths surrounding abortion. If women want to carry the pregnancy to term, they must be supported in their decision and resources ought to be available to ensure their safety and well-being. If they decide to terminate the pregnancy, it is important not to psychologize their choice, especially when their choice may be linked to the presence of domestic violence in their lives. Even if women report feeling excited about the pregnancy, we must reframe this attitude in a social context where motherhood is valued, and where it is very difficult for women to express ambivalence toward their pregnancy or toward their mothering role.

It also appears that partnerships must be developed between abortion clinics and domestic violence shelters. Practitioners in shelters should, wherever possible, accompany women to abortion clinics. This support enables women to better define their needs and past dissatisfactions, and get through this potentially difficult time in their lives. Moreover, professionals and counselors in social and medical services must clearly be aware of the orientation of so-called support centers or pregnancy crisis center which claims to help mothers and children. Some of these organizations have a prolife vision and can put pressure on women to continue their unintended pregnancy, regardless of their situation (Shaw, 2006).

On a positive note, abortion may be perceived as a form of resistance and as the beginning of a process of empowerment in women’s lives. Even if the perpetrators have significant power and privileges and may directly or indirectly attempt to maintain their control over women, abortion may be, in certain circumstances, the beginning of a contemplative process to leave the abusive partner. This suggests that abortion in the context of domestic violence could facilitate the process of leaving the perpetrator. However, women may also choose to leave the perpetrator and carry their pregnancy to term in a safe environment, free from violence. Women should be able to make their own decision in the circumstances and should not be forced to terminate or carry a pregnancy to term against their will. In that sense, workers in shelters should maintain a prochoice approach and respect women’s decisions.

Conclusion

This research was concerned with providing women with a safe space to talk freely and openly about their experiences. It also provided them with an opportunity to reflect on their personal experiences and to locate them within a broader social context (Brooks, 2007). In this sense, feminist research can be empowering for women and can even become a political tool for the emancipation of women (Skinner, Hester, & Malos, 2005).

Overall, the findings suggest that different variables can influence women’s decision-making process in the context of domestic violence, but all of them are to a certain extent, influenced by the control of the perpetrator. This implies that the woman’s individual situation, the couple’s situation, and external constraints cannot be isolated from the dynamic of violence and abuse in women’s lives. In fact, it is likely that the perpetrator will use his power and control throughout women’s decision-making process and will have the final say. Furthermore, abortion remains a decision that has to be made fairly quickly. With all the stress caused by domestic violence, women did not feel they have had enough time to think about it as much and as clearly as they would have wanted to. The pressure put on them by the perpetrators also created feelings of resentment, especially when it was combined with threats.

At last, the participants were subjected to the control of the abusive partner prior to the unintended pregnancy, in line with the temporal continuum of reproductive control (Moore et al., 2010). They may have had several different reasons to terminate the unintended pregnancy and various factors influencing their decision, but domestic violence was the main issue they were facing. Thus, the real problem they were confronted to was the violence of the perpetrator, and as Coker (2007) suggests, the prevention of violence, by challenging our culture which support violence and control, remains the best option with positive long-term impacts on women’s reproductive health.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Social Sciences and Humanities Research Council of Canada [grant number 766-2011-0862].

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