Background: Reproductive coercion and abuse (RCA) is a hidden form of violence against women. It includes behaviours intended to control or dictate a woman’s reproductive autonomy, for the purpose of either preventing or promoting pregnancy. Main text: In this commentary, we argue that there is a lack of conceptual clarity around RCA that is a barrier to developing a robust evidence base. Furthermore, we suggest that there is a poor understanding of the way that RCA intersects with other types of violence (intimate partner violence; sexual violence) and – as a result – inconsistent definition and measurement in research and practice. To address this, we propose a new way of understanding RCA that centres perpetrator intent and the presence of fear and control. Recommendations for future research are also discussed. Conclusion: We suggest that IPV and SV are the mechanisms through which RCA is perpetrated. In other words, RCA cannot exist without some other form of co-occurring violence in a relationship. This has important implications for research, policy and practice including for screening and identification of women in reproductive healthcare settings.