Before getting married, JV and her husband, SV, decided never to have a baby.

“We were both in our mid-30s, had hardly had an opportunity to see the world and were both doing really well in our careers. We didn’t want a baby to change any of that,” says JV, a Mumbai-based IT professional.

However, after three years of marriage, her in-laws kept pressuring her to have a child. “I couldn’t understand why my husband didn’t want to disclose our pact to them,” she says. He kept delaying it. Soon after, he started agreeing to have sex only if was unprotected, she added.

“He wasn’t ready to use protection. Once, he threw a fit when he found out I that I had taken a birth control pill. Every time we’d have sex, it was to have a baby — when I didn’t want one at all,” she recounts. While she kept taking the pill without letting him know, she did get pregnant. “Despite trying hard, everyone in the house got to know about it accidentally. I did try bringing up abortion as an option, but they threatened me with a lot of things. I eventually had to keep the baby,” said JV.

“This is a classic case of birth control sabotage,” said psychologist Dr. Nirmita Agarwal, who runs her own practice in Mumbai. Birth control sabotage is defined as interfering with a person’s reproductive anatomy and autonomy. This interference could include throwing away contraception deliberately, or tampering with it, threatening women with physical violence if they use contraception, blackmailing them emotionally into sex or pregnancy, or forcing them to have an abortion, she explained.

In many other cases, Dr. Agarwal said that male partners also lie about having had ‘the snip’ (vasectomy). They might also forcefully remove contraceptive devices like the IUD, fail to practice withdrawal during sex, or pierce condoms. She added that stealthing, that is, the covert removal of a condom during sex, is also a form of birth control sabotage. Another common act that would qualify, and is practiced a lot in rural India, is spiking food and drink with agents known to induce abortion.

Related on The Swaddle:

The Effects of Spousal Abuse Can Linger Long After the Violence Stops

Birth control sabotage “is predominantly perpetrated by male partners, but some evidence and reports suggest that other family members, especially older female relatives, may take control of reproductive decision-making, too,” Dr. Agarwal said.

According to a 2015 study published in the American Journal of Obstetrics and Gynecology, men are also affected by birth control sabotage butthe difference is that if they unwittingly get someone pregnant, they have the option to walk away; women who become pregnant against their will or intention have to live with the consequences: either growing and birthing (and potentially raising) a baby, or bearing the stigma of an abortion.

Therefore, while both may be victims of it, birth control sabotage disproportionately affects women, whose degree of control over their reproductive lives is determined by their decision-making power and autonomy within the household. Lack of both, in a majority of Indian households, means women’s reproductive choices are to varying degrees governed by their male partners.

A recently released UN report confirms the presence of birth control sabotage in India in an excerpt that says, “…various studies from India document pressure from partners and other family members with regard to women’s sexual and reproductive health.” Due to lack of reporting of such cases, exact figures are unavailable. But globally, as many as one in four women attending sexual and reproductive health care services say they are not allowed to take control of their own reproductive lives.

Researchers of the same report write,“The degree of control that a male partner can have will vary from mild to extreme. Milder amounts of control may not seem unhealthy or abusive to the victim. Women in long term relationships may also become inured to significant levels of reproductive control.”

Related on The Swaddle:

The Balancing Act: ‘My Husband Feels He Must Discipline Me By Hitting Me’

This has far worse associations and effects beyond the lack of reproductive autonomy. A 2019 paper says most women, globally, who accessed telephone counseling about an unplanned pregnancy also reported experiencing reproductive coercion, along with domestic violence and mental health issues. Liz Price, the lead author of this paper, said that early research into the issue suggests reproductive coercion is more likelyused to make a woman continue a pregnancy, rather than terminate one.

“It’s a very easy way to establish a lasting connection with a woman,” she said. “Regardless of whether the relationship continues, forcing a woman to continue with a pregnancy she doesn’t want means that you are bound together through that shared child. You’re much more physically vulnerable, you’re much more economically dependent, your time outside of the home is much more restricted so it’s much easier to hold a woman in a place where other forms of violence and control can continue.”

Psychologists point out even more negative consequences of birth control sabotage.

“Not only are women at risk of unintended or unwanted pregnancies, but they may themselves respond by lying about their use of contraception, pregnancy testing, etc., and risk harm if they try to negotiate contraceptive use in a violent relationship,” says Dr. Agarwal. “What’s worrying is that they may not always be aware that they are being subjected to reproductive control, especially if this isn’t accompanied by physical or sexual violence.”

Related on The Swaddle:

40% of Women Who Commit Suicide Globally Are Indian. Most of Them Are Married.

Therefore, health care professionals have a key role in picking up and preventing this form of abusive behavior.

Dr. Sarah Kapadia, a senior counselor at a Mumbai-based pregnancy and maternal counseling center, Moms First, said one way to help women whom you suspect are experiencing reproductive coercion would be to assess them alone, away from the partner. “This will help understand if there is coercion at all and get to the bottom of it. Practitioners can also reinforce information onvarious types of contraception and resources available to their patients,” she added. “Give people an option and ask ‘are you in control of when and how you have sex?’ If you aren’t, maybe these are some other contraceptive methods that might be better for you rather than the pill that can just be thrown away by the male partner.”

Violation of women’s rights in the name of family planning is common, says Dr. Kapadia. “A woman should have control over her body. That means she has the right to decide when she gets married, with whom, how many children and the desired spacing between them. This along with the availability of reliable health care facilities and safe contraception is then need of the hour to reduce numbers of birth control sabotage globally.”