Intimate partner violence and sexual violence has led to a disproportionately high prevalence of poor reproductive and sexual health outcomes among American Indian and Alaska Native women, said a study published in the peer reviewed Journal of Women’s Health.
The study showed that 96 per cent of women participated in the study reported experiencing violence at the hands of a partner. It said that 45 per cent women reported reproductive coercion (RC). Of the 56 women sampled, 95 per cent had been pregnant and 57 percent reported unexpected (mistimed or unintended) pregnancy, said the study co-authored by Elizabeth Miller (UPMC Children’s Hospital of Pittsburgh and University of Pittsburgh School of Medicine).
SEXUAL HEALTH EDUCATION
Most of the women did not talk or discuss with their family about sex because of shame and guilt. One woman was quoted as saying in the report that whenever a sexual encounter was on television, she and her siblings were sent out of the room. She said that her mother never discussed sex with her. Another young woman pointed out that when she got her period, her mother expressed exasperation about having to address this with her. When asked about whether their mothers spoke with them about sex, women consistently stated that it was left up to schools. However, the report noted that sex education through schools was minimal with one or two hours of classes in high school on biology and condoms. However, no discussion on contraception, consent, relationship abuse, or communication was held.
Women were also found to be reticent to go to the doctor and learn about contraception, as they never got encouragement for this from their mothers or family. Among women who did seek care, health care providers rarely discussed contraception. Apart from this, the report finds that a source of (mis) information about sex and contraception came from men with whom the women were having sex. Women’s lack of information translated to not being informed that they even had a choice about contraceptive decisions in their sexual relationship, increasing opportunities for coercion and unplanned pregnancies
About half of the women described male partners trying to impregnate them on purpose, refusing to use condoms and tampering with contraceptive methods. Women attributed reproductive coercion to community norms limiting education about sexuality, hindering disclosure of Sexual Violence in their families and communities, including lack of awareness of RC as an aspect of abuse. The women also talked about alcohol and other date rape drugs. They also noted failure on the part of law enforcement officials and US Attorney’s Office to respond to such violence.
Several women said that they grew up surrounded by drugs and alcohol They pointed out that alcohol and drugs was a prerequisite to sex. Some of them also talked about abuse in childhood and using substances for coping others. One woman explained that she used drugs during sexual encounters to numb the pain she felt as a result of previous abuse. Others stated drinking or drugs could lower inhibitions and allow them to have sex with fewer traumas. Several women noted their first unintended pregnancy (usually in adolescence) occurred while being coerced into using drugs or alcohol. Majority of the women elaborated on experiences during adolescence of agreeing to have sex when they did not want to have it, and fearing anger from their partner if they disagreed. One woman points out in the report how a trusted male friend got her drunk and then forced her to have sex for the first time while she was unaware of what was happening.
LAW ENFORCEMENT AND OTHER SOCIAL SERVICE AGENCY
Majority of the women stated that no action was taken or any resolution achieved when they contacted tribal police or authority. Many reported feeling unsafe, not taken seriously, or even ridiculed. Women perceived that law enforcement (tribal, state, or federal) was on the side of the perpetrator. Some women reported reaching out to other services for help with minimal results.
HEALTH CARE SYSTEM
The study found that local health care services as unhelpful. Most of the women said that they were asked about IPV only during a pregnancy by their gynaecologist and not by any other health care provider. Mental health services were difficult to receive, as in the case of a woman who was denied a prescription for an antidepressant because the provider did not want to prescribe medicine for domestic issues.