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While the World Health Organization (WHO) just released a report on violence against women, it may not fully capture the adverse effects of violence on a woman’s reproductive health (RH).

For example, in a culture in which it is normatively permissible to inflict violence on a partner, it is often normatively alright to extend this violence to non-partners as well, because women in general are seen as somehow deserving of violence. And the other way around too: if it is alright to attack unknown women, it becomes more alright to assault one’s intimate partner as well. That is, a high level of sexual violence against intimate partners might predict higher levels of violence against non-partners (and therefore predict overall higher RH impacts) and vice versa.

Similarly, men who have the freedom and the supporting circumstances to demand sexual submission from intimate partners often also have multiple sexual partners, frequent encounters with sex workers and to practice unprotected sex in general, which means that they are more likely to contract a sexually transmitted disease themselves and in turn more likely to infect their partners as well.

Moreover, a tendency to sexual violence usually accompanies a tendency to physical violence in general. And so, to the possible impacts of sexual violence on RH (STIs including HIV, unwanted or unintended pregnancies, induced abortions, poor pregnancy and delivery outcomes for psychosocial reasons), one should add the direct effects on poor RH (such as miscarriages, stillbirths, premature deliveries, maternal mortality) of non-sexual violence. Experiencing violence (such as being pushed down the stairs) will of course increase a pregnant woman’s risk of experiencing a miscarriage, severe injury or death.

In any case, sexual violence (and arguably non-sexual gender-based violence as well) is in itself a reproductive health issue; that is, it is an assault on a woman’s sexual and reproductive health in and of itself, regardless of whether it results in adverse consequences for the usual components of RH – sexual activity that is free of the risk of infection, injuries to the reproductive tract, unintended pregnancy, unsafe pregnancy or delivery and  poor maternal or child mortality or morbidity outcomes. This broader definition of SRHR (sexual and reproductive health and rights) that we now subscribe to includes the right to bodily integrity and the right to sexual relations free of discrimination, coercion or violence. By this measure, the reproductive health of a woman who experiences intimate partner violence is severely compromised even if it does not result in a sexually transmitted infection or an unwanted pregnancy or a miscarriage or a maternal or child death. In other words, sexual violence is an independent component of poor RH in addition to its impact on the other components of RH; there is no double counting involved.