Pregnancy coercion includes any behaviors intended to coerce or pressure a partner to become or not become pregnant, or to coerce or pressure a partner to impregnate them. Pregnancy coercion involves various tactics, including verbal threats related to impregnation, coerced sex, interference with or refusal to use male-controlled contraception (i.e., condoms, withdrawal), interference with or pressure not to use or to use female controlled contraception (i.e., hormonal methods), monitoring menstrual cycles or gynecological visits, pressure for or against sterilization or other medical related methods, and monitoring of ovulation. Threatened or completed physical violence may also be perpetrated against a partner to coerce them to become pregnant or coerce a partner to impregnate them.
Birth control sabotage involves tampering with contraception or interfering with the use of contraception. Birth control sabotage includes removing a condom after agreeing to wear one (also called stealthing), damaging a condom, removing or lying about the use of contraception (including vaginal rings, intrauterine devices (IUDs), and contraceptive patches), or throwing away or lying about the consumption of oral contraceptive pills. Other methods of birth control sabotage include preventing a partner from obtaining or refilling contraceptive prescriptions, refusing to wear a condom, stating that a condom is being worn when one is not, not withdrawing after agreeing to do so, not informing a partner after ceasing the use of female-controlled contraception or removing contraceptive devices, and not telling a partner if a condom broke or fell off.
Gender and sexual power dynamics and coercion associated with sexual power dynamics are both linked to condom nonuse. Even women with high sexually transmitted infection knowledge are more likely to use condoms inconsistently than women with low STI knowledge when there is a high level of fear for abuse.
Controlling the outcome of a pregnancy is an attempt to influence a partner to terminate a pregnancy. This can include abortion coercion--pressuring, threatening, or forcing a partner to have an abortion. A Guttmacher Institute policy analysis states that forcing a woman to terminate a pregnancy she wants violates the basic human right of reproductive health.
Reproductive coercion in October 2018 was reported by 5-14% of women in family planning clinic settings and lifetime experience has been reported by 8-30% of women in a range of settings in the US.
In a sample of urban women aged 18–44, 16% reported experiencing reproductive coercion. In a family planning clinic setting in California, 13% of patients reported experiencing reproductive coercion in October 2018. Among California girls aged 14–19 seeking school-based health services, 12.4% reported experiencing reproductive coercion. Among women aged 16–29 seeking family planning in California, 19.1% reported experiencing pregnancy coercion in their lifetime. 15.0% of women in California, aged 16–29, seeking family planning reported experiencing birth control sabotage. In a sample of college-aged women in the northeastern United States, 8% reported experiencing reproductive coercion in their lifetime; 3.9% reported experiencing birth control sabotage in their lifetime, and 6.8% reported experiencing pregnancy coercion in their lifetime. In a Texas sample, 1% of non-pregnant women aged 16–40 reported experiencing pregnancy coercion in their lifetime. Among Pennsylvania family planning clinic patients, reproductive coercion was reported at 5% in October 2018. In a sample of adolescents aged 14–20 in Boston, 20% had been coerced into having sex without a condom.
Among women seeking an abortion in the United States, between 0.1% and 2.0% are coerced to have an abortion by an intimate partner. Furthermore, one study of males between the age of 18-35 who had ever had sex found that 4.1% had attempted to compel a partner to have an abortion and 8.0% attempted to prevent a partner from having an abortion.
Teenage girls in physically violent relationships are 3.5 times more likely to become pregnant and are 2.8 times more likely to fear the possible consequences of negotiating condom use than non-abused girls. They are also half as likely to use condoms consistently compared to non-abused girls, and teenage boys perpetrating dating violence are also less likely to use condoms. Teenage mothers are nearly twice as likely to have a repeat pregnancy within 2 years if they experienced abuse within three months after delivery. 26% of abused teenage girls reported that their boyfriends were trying to get them pregnant.
Among women seeking abortions in Northern China, 2.1% reported that they were being forced to have an abortion by their partner.
Among women in Côte d'Ivoire over the age of 18 with a male partner, lifetime prevalence rates of reproductive coercion perpetrated by an in-law of 5.5% and 6.0% have been reported. Lifetime prevalence of reproductive coercion among women in Côte d'Ivoire over the age of 18 perpetrated by a male partner is 18.5%. Reproductive coercion by in-laws was reported by 15.9% of women who were maltreated by their in-laws, versus 2.8% who were not maltreated. Additionally, reproductive coercion by in-laws was reported by 16.3% of women who experienced physical violence by their in-laws, versus 5.9% who did not report violence.
Among married women aged 15–49 in Jordan, 13% reported that a parent or in-law tried to stop them from using contraception, including their mother-in-law (36%), mother (27%), or sister-in-law (11%). Furthermore, 11% reported that their husband refused to use contraception or tried to stop them from using contraception, and 89% reported their husband had expressed disapproval of contraception. In total, 20% of ever-married Jordanian women report that their husband or someone else has interfered with their attempts to prevent pregnancy.
In India, a study conducted in the state of Uttar Pradesh reported that about 1 out of 8 women (12%) were subjected to Reproductive Coercion by their current husbands or in-laws. Additionally, 36% of the women facing Reproductive Coercion reported that their current pregnancy was unintended.
Suggested screening questions in health settings for assessing potential reproductive coercion include:
Family planning clinicians can use strategies to help prevent adverse reproductive health outcomes among women who experience reproductive coercion. Strategies include educating patients on the reproductive health impacts of reproductive coercion, counseling on harm reduction strategies, preventing unintended pregnancies by offering discrete, effective birth control methods that may not be detectable by a partner (such as IUDs, emergency contraception, contraceptive implants, or contraceptive injections), and assessing their patient's safety prior to notifying partners about sexually transmitted infections. Interventions that provide awareness of reproductive coercion and provide harm reduction strategies to address reproductive coercion have been found to reduce pregnancy coercion by 71% among women experiencing intimate partner violence.
Emergency contraception can be used after sex without contraception in order to prevent an unwanted pregnancy. In the United States, levonorgestrel (LNG) Plan B One Step and other generics (the morning after pill or emergency contraception) can be acquired by persons of any age. When taken within 72 hours of sex without contraception, Plan B and generics can help prevent an unwanted pregnancy. Other options for emergency contraception in the United States include ulipristal acetate (available with a prescription) taken within five days of sex without contraception, and the insertion of a copper IUD within five days of sex without contraception.
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American College of Obstetricians Gynecologists (February 2013). "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. 121 (2 Pt 1). LWW: 411–5. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion
Park, J., Nordstrom, S. K., Weber, K. M., & Irwin, T. (2016). Reproductive coercion: uncloaking an imbalance of social power. In American Journal of Obstetrics and Gynecology (Vol. 214, Issue 1, pp. 74–78). Elsevier BV. https://doi.org/10.1016/j.ajog.2015.08.045 https://doi.org/10.1016/j.ajog.2015.08.045
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Miller E, Silverman JG (September 2010). "Reproductive coercion and partner violence: implications for clinical assessment of unintended pregnancy". Expert Review of Obstetrics & Gynecology. 5 (5): 511–515. doi:10.1586/eog.10.44. PMC 3282154. PMID 22355296. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282154
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
American College of Obstetricians Gynecologists (February 2013). "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. 121 (2 Pt 1). LWW: 411–5. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion
Park, J., Nordstrom, S. K., Weber, K. M., & Irwin, T. (2016). Reproductive coercion: uncloaking an imbalance of social power. In American Journal of Obstetrics and Gynecology (Vol. 214, Issue 1, pp. 74–78). Elsevier BV. https://doi.org/10.1016/j.ajog.2015.08.045 https://doi.org/10.1016/j.ajog.2015.08.045
Park, J., Nordstrom, S. K., Weber, K. M., & Irwin, T. (2016). Reproductive coercion: uncloaking an imbalance of social power. In American Journal of Obstetrics and Gynecology (Vol. 214, Issue 1, pp. 74–78). Elsevier BV. https://doi.org/10.1016/j.ajog.2015.08.045 https://doi.org/10.1016/j.ajog.2015.08.045
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
American College of Obstetricians Gynecologists (February 2013). "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. 121 (2 Pt 1). LWW: 411–5. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion
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Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
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Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
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Walker, Susan; Rowlands, Sam (2019-01-01). "Reproductive control by others: means, perpetrators and effects". BMJ Sexual & Reproductive Health. 45 (1): 61–67. doi:10.1136/bmjsrh-2018-200156. ISSN 2515-1991. PMID 30622127. S2CID 58546639. https://srh.bmj.com/content/45/1/61
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Walker, Susan; Rowlands, Sam (2019-01-01). "Reproductive control by others: means, perpetrators and effects". BMJ Sexual & Reproductive Health. 45 (1): 61–67. doi:10.1136/bmjsrh-2018-200156. ISSN 2515-1991. PMID 30622127. S2CID 58546639. https://srh.bmj.com/content/45/1/61
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Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Grace KT, Anderson JC (October 2018). "Reproductive Coercion: A Systematic Review". Trauma, Violence & Abuse. 19 (4): 371–390. doi:10.1177/1524838016663935. PMC 5577387. PMID 27535921. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577387
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
Grace KT, Fleming C (December 2016). "A Systematic Review of Reproductive Coercion in International Settings". World Medical & Health Policy. 8 (4): 382–408. doi:10.1002/wmh3.209. PMC 5423714. PMID 28503353. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5423714
American College of Obstetricians Gynecologists (February 2013). "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. 121 (2 Pt 1). LWW: 411–5. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
American College of Obstetricians Gynecologists (February 2013). "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. 121 (2 Pt 1). LWW: 411–5. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
American College of Obstetricians Gynecologists (February 2013). "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. 121 (2 Pt 1). LWW: 411–5. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
American College of Obstetricians Gynecologists (February 2013). "ACOG Committee opinion no. 554: reproductive and sexual coercion". Obstetrics and Gynecology. 121 (2 Pt 1). LWW: 411–5. doi:10.1097/01.AOG.0000426427.79586.3b. PMID 23344307. https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Reproductive-and-Sexual-Coercion
Chamberlain L (2010). "Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion" (PDF). Futures Without Violence. https://www.futureswithoutviolence.org/userfiles/file/HealthCare/Repro_Guide.pdf
Haeger KO, Lamme J, Cleland K (2018). "State of emergency contraception in the U.S., 2018". Contraception and Reproductive Medicine. 3: 20. doi:10.1186/s40834-018-0067-8. PMC 6123910. PMID 30202545. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123910
Haeger KO, Lamme J, Cleland K (2018). "State of emergency contraception in the U.S., 2018". Contraception and Reproductive Medicine. 3: 20. doi:10.1186/s40834-018-0067-8. PMC 6123910. PMID 30202545. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123910
Haeger KO, Lamme J, Cleland K (2018). "State of emergency contraception in the U.S., 2018". Contraception and Reproductive Medicine. 3: 20. doi:10.1186/s40834-018-0067-8. PMC 6123910. PMID 30202545. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123910
Haeger KO, Lamme J, Cleland K (2018). "State of emergency contraception in the U.S., 2018". Contraception and Reproductive Medicine. 3: 20. doi:10.1186/s40834-018-0067-8. PMC 6123910. PMID 30202545. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123910