When I was training to become a doctor, one of my patients was a 25-year-old woman. She already had one child and didn’t want to get pregnant again. She’d been using the birth control patch, but came to me because the patch wasn’t working for her. When I asked her “why not?” she said, “Because when my boyfriend sees it, he pulls it off me.”

That was my first encounter with birth control sabotage. Birth control sabotage is a form of reproductive coercion, which is a fancy term for a simple but disturbing idea… It means someone is bullying or intimidating their partner into sexual situations that put them at risk for an unwanted pregnancy. It could mean that a partner is sabotaging a woman’s birth control, like my patient. It also includes a partner threatening violence or threatening to leave if a woman doesn’t get pregnant.

Reproductive coercion is abuse—and it may be depressingly common.

There is evidence that birth control sabotage is common, although we need more research to understand exactly how common. Birth control sabotage can take many forms. For example, women have reported:

• Partners poking holes in condoms or taking condoms off during sex (a.k.a. stealthing),

• Partners hiding or throwing away birth control pills, and

• Partners removing the ring, or even an IUD.

We do know that all types of reproductive coercion are more common in relationships that have physical or sexual violence. In the U.S., approximately one in four women have experienced physical or sexual violence with a partner at least once during their lifetime.

So what can you do?

If your partner is controlling your birth control, it is a sign of a larger relationship problem. Everyone should be able to protect their body from an unwanted pregnancy without threats or sabotage. You deserve to be with someone who respects you and your plans for the future—including when or whether you want to have a baby.

• If you want support to get out of a violent relationship, call the national Hotline anytime 24/7 at 800-799-SAFE, or talk to your healthcare provider about local resources.

• If you have friends who can help keep you safe, connect with them privately using the Circle of Six app on your smartphone.

• There are also online projects like Know More, Say More that are designed to help stop birth control bullying and other types of reproductive coercion.

In the meantime, try tamper-proof birth control.

Ideally your partner should support your birth control choices, but if you find yourself involved with someone who you suspect wants to get you pregnant against your will, there are some methods your partner can’t mess with.

The shot (a.k.a. Depo-Provera). Once you get the shot, there is no way a partner can change or mess with it—or even know you’ve had it if you don’t tell them. Each shot lasts for 3 months, so you have to be able to get to the clinic regularly if you want to keep using it.

The implant. It sits just under the skin on the inside of your upper arm, so your partner wouldn’t notice it unless they went looking for it. (If they do, they might find it since insertion leaves a bruise for a few weeks.) The implant can last for up to three years, so it could be more convenient than the shot.

The IUD. It’s placed in your uterus, where it should be discreet and difficult to tamper with. It has small strings that can be tucked behind your cervix when the IUD is placed so that a partner shouldn’t notice them during sex. If you want an IUD but you’re concerned about a partner finding the strings, talk to your provider about possible solutions.

In a bind, there’s emergency contraception (EC). Actually, the most effective form of EC is the ParaGard IUD. It is over 99% effective in preventing pregnancy up to 5 days after unprotected sex and it goes on to provide up to 12 years of protection from pregnancy.

The other forms of emergency contraception are pills like Plan B One-Step, Next Choice One Dose, and ella. You need a prescription for ella, but you should be able to get Plan B One-Step or a generic brand of levonorgestrel-based EC at your local pharmacy or online without a prescription.

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