When Ebony Keeley began dating Mike*, she thought she had met the person she’d spend the rest of her life with. The pair had an immediate connection, and from the day they met Mike called Ebony his soulmate.
He mirrored her beliefs and interests, sent her gifts, idealised her for being a hyper-independent woman, and essentially placed her on a pedestal. The pair spoke of marriage and babies early on, travelled, discussed moving in together and even began looking at buying a house.
Then Mike started making negative comments about Ebony’s family, suggesting they did not care about her, and she gradually distanced herself from them. Looking back, the 26-year-old Brit now recognises the red flags: intense love bombing, subtle isolation from family and friends, and gaslighting.
Three months into their relationship, Ebony says she experienced sexual violence, threats and physical abuse, including being urinated on, having her fingers slammed in doors and being bitten. After a year of dating, the couple went their separate ways. The emotional attacks continued – with Mike commenting on Ebony’s weight and accent – but so did the love bombing. “I was in a trauma bond,” says Ebony, who prior to Mike was in a relationship with Love Island UK star George Fensom.
“[Mike] sent food deliveries to my apartment, wrote ‘love’ letters, promised change, spoke about therapy, children, becoming engaged … And because of my low self-esteem and the hope that I could somehow ‘heal’ him, we got back together.” Then came the pregnancy.
Despite the state of the relationship, Ebony was thrilled as she’d previously believed it might be difficult to carry a pregnancy due to having polyendocrine metabolic ovarian syndrome (PMOS, formerly PCOS). She called Mike to tell him the good news. “He demanded I take abortion pills,” she says of his reaction.
“I felt a sudden sense of fear and I realised he was not going to allow me to bring my child into the world. I was afraid of the consequences of refusing him. That’s when I began experiencing what I later discovered was called reproductive coercion.”
Coined by American Dr Elizabeth Miller and colleagues in a seminal paper in 2010, reproductive coercion is a form of gender-based violence where someone (usually an intimate partner, but not always) seeks to control another person’s reproductive choices using physical, sexual or emotional violence.
In 2024, the World Health Organisation reported that almost one in three women who’ve been in a relationship have been physically and/or sexually abused by their partner; sexual and gender-based violence are leading causes of death and disability for women worldwide. According to the 2024 State of the World Population Report by the UN’s sexual and reproductive health agency, nearly one in 10 women lack control over contraceptive decisions. While there are no detailed studies on reproductive coercion prevalence, research across various countries suggests rates between 10 and 27 per cent.
Findings from the 2024 Australian Study of Health and Relationships estimated that one in 20 adults have experienced reproductive coercion and abuse (RCA). In a series of studies, Susan Saldanha, research fellow from the SPHERE Centre of Research Excellence at Monash University, examined why reproductive coercion should be better recognised and prioritised by GPs.
Her research highlighted a range of scenarios in which reproductive coercion can result in sexual, reproductive and mental health harms, covering two main areas: promoting and preventing pregnancy.
Examples of promoting pregnancy include insemination by rape, threats of abandonment or isolation if pregnancy does not occur, a man claiming to be infertile or having had a vasectomy, stealthing [non-consensual removal of a condom], or refusing contraception or abortion on religious grounds.
On the other hand, preventing pregnancy includes physical assault to cause miscarriage, emotional pressure to force contraception, sterilisation or abortion, financial threats and legal threats such as deportation. Given her Indian heritage, Saldanha is particularly interested in the experience of women from different backgrounds. “In India, there are a lot of social and cultural norms tied to making decisions in a family,” she says.
“Who makes the decisions? It is mostly the man. When you live in a joint family in India, it’s also not even the couple that makes the decisions – it’s sometimes the parents and mothers-in-law. So the society that you live in, whether patriarchal or a collectivist culture, plays a big part.” Saldanha acknowledges it can be difficult to differentiate between the norm and coercion.
“Making decisions about a pregnancy when you’re in a couple is very common: ‘Is this a good time for us to be pregnant? What do we do about a pregnancy?’ There could be disagreement between partners, which is normal,” she says.
“But it becomes coercion when there’s a power imbalance and fear, when the woman genuinely fears what the partner is going to do.” Ebony knows that fear all too well. Following an early pregnancy scan, she was pressured daily by Mike to book an abortion appointment. “We saw a midwife afterwards, and he spoke mostly on my behalf, telling them that ‘we’ were not sure about continuing the pregnancy,” she says.
“Immediately after the appointment, he drove me to the nearest abortion clinic and demanded to be seen by staff. He took a card from the clinic. I lived with a persistent fear he would spike me with abortion pills.” Things escalated, with Mike hitting her in the stomach twice and telling Ebony he would “hate our child the moment they were born”. She delayed booking the abortion for as long as she could but eventually, feeling trapped, helpless, isolated and fearful, she went through with the procedure. “I remember praying that my baby would be looked after and safer on the other side away from him,” she says, crying.
Two days afterwards, Mike broke up with her. Ebony was later diagnosed with PTSD, depression and anxiety, and suffered sleep loss, memory loss, agoraphobia and suicidal thoughts. Reconnecting with her mum, nan and best friend, whom she had become isolated from during the relationship, and making new friendships with other women who experienced abusive relationships have helped her find strength once again.
Ebony has gone on to document her experience on social media to spread awareness of reproductive coercion, and created an app called HerHaven that empowers survivors. Since telling her story publicly, hundreds of women in similar situations around the world have messaged her, with many admitting they did not know reproductive coercion was even a form of abuse. But there has also been a lot of judgement and stigma.
“When I first started openly grieving, I received a lot of distressing messages, often from fake accounts,” Ebony recalls. “Messages like, ‘You murdered your son’ and ‘Stop acting like you were a victim’. Some messages were particularly triggering. ‘Do you know what they do during the procedure?’ and ‘Your child was a full-on human’.” Dr Sara Whitburn, clinician and medical director of Sexual Health Victoria, says the stigma of reproductive coercion is often compounded by the stigma around family violence, sexual health and pregnancy choices.
“We also need to think about people who have barriers to health access already, such as First Nations people, those from different culturally and linguistically diverse backgrounds, and LGBTQIA people accessing spaces that might be quite gendered,” Whitburn says. “Having more education and having reproduction coercion spoken about more openly will hopefully support decreasing those barriers.”
While there is growing awareness within the healthcare community, Whitburn notes the complexity around recognising this form of coercion. In the 2022–2023 Senate inquiry into access to reproductive healthcare in Australia, one of the key recommendations was that primary-care providers need more training and support for reproductive coercion and abuse.
Whitburn’s advice is for clinicians and GPs to use available resources like Children By Choice, an independent organisation that champions the reproductive rights of women, as well as The White Book, an evidence-based guideline developed by the Royal Australian College of General Practitioners to recognise and safely respond to patients experiencing abuse. There are particular red flags Whitburn looks for that could signal reproductive coercion.
“It could be somebody who sees you for an abortion after they’ve recently had an abortion. Now that’s somebody’s right and choice, and it’s about supporting them, but if you are seeing someone who perhaps didn’t feel comfortable choosing contraception if that’s what they want, it would be a bit of a flag,” she explains.
“Or if somebody’s feeling very undecided … if you’re getting a sense that maybe there’s something stopping them from making decisions, I would explore that. There’s still more to be done around health professionals feeling comfortable with what questions to ask and then also what help to offer if somebody discloses reproductive coercion.”
In her research, Saldanha found that healthcare providers can, often unintentionally, limit reproductive autonomy through biased advice, failing to refer patients or through restrictive practices; tackling both conscious and unconscious provider bias is vital to delivering care. “There’s awareness, but there’s a lot that clinicians don’t know to do,” Saldanha says. “You have to recognise it’s not a one-size-fits-all option. It has to be women-led. It’s about supporting clinicians to better support women … But then also, what do we actually do once we find out [reproductive coercion is happening]? We need to ensure referrals are in place. There’s always a disconnect between general practice and domestic violence referrals. A lot more funding needs to go into the system itself to ensure those referrals are in place.”
Ultimately though, GPs cannot address reproductive coercion alone. “It all comes down to autonomy,” Saldanha says.
“It is about knowing that everybody can make decisions for themselves, and needs to be able to make a choice about whether they want to become pregnant or what to do about an abortion and what form of contraception to use.” Despite her traumatic experience, Ebony still hopes she will be pregnant again one day. “Pregnancy is one of the most vulnerable times in a woman’s life, and being abused during that time changed my outlook significantly,” she admits.
“It removed the invisible deadline I once had in my mind, which I think many women are conditioned by society to hold, because I’d always imagined I’d have my first child by 26. Now, my focus is on healing and ensuring that when I do become a mum – even though I would say I already am one now – it’s in a safe, supportive relationship. I believe when the timing is right, both love and motherhood will come. And when they do, I know I’ll be entering that chapter of life stronger, happier, healthier and more grateful than ever.”
For violence or abuse support, call 1800 737 732, text 0458 737 732 or visit 1800respect.org.au.
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