The Best Intentions Unintended Pregnancy and the Well-Being of Children and Families (1995) / Chapter Skim
Currently Skimming:
Personal and Interpersonal Determinants of Contraceptive Use
Personal and Interpersonal Determinants of Contraceptive Use
Pages 160-182
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From page 160... ...
In fact, there is persuasive evidence that personal and emotional factors are closely connected to inadequate contraceptive vigilance and therefore unintended pregnancy. For example, in a series of telephone interviews with 760 women aged 18-35 at risk of unintended pregnancy, researchers learned that 23 percent of the women interviewed were sexually active but using no contraception, despite no apparent desire to become pregnant.
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From page 161... ...
UNDERLYING THEMES Although not often explicitly stated, much of the research on the psychology of contraceptive use views efforts to avoid unintended pregnancy as being based on a "benefit: burden ratio" the notion that sexually active individuals and couples carry within themselves a complicated equation balancing the benefits and burdens of becoming pregnant (or causing pregnancy) and having a child versus the benefits and burdens of not becoming pregnant (or causing pregnancy)
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From page 162... ...
has referred to this as the "personal calculus of choice." And Miller (1986) has argued that a woman's contraceptive vigilance and her actual use of birth control on any given occasion frequently depend on where the internal balance lies among her positive and negative feelings toward getting pregnant and toward her contraceptive method.
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From page 163... ...
Anderson, for example, has written about differing male and female orientations to sex and childbearing as one explanation for unintended pregnancy among very poor inner-city adolescent girls in particular. He describes the important role for young men and boys that sexual activity itself may play in building and sustaining self-esteem and a sense of self-worth.
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From page 164... ...
Histories of dysfunctional relationships with largely absent fathers set the stage for unhealthy relationships with other males who may easily draw them into destructive sexual liaisons. She suggests that in order to understand adolescent pregnancy and childbearing, one must recognize the troubled childhoods and families that shape the development of girls who then go on to become teenage mothers.
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From page 165... ...
Yet survey data show that more than 85 percent of births to unmarried women less than 20 years old are unintended at the time of conception (Chapter 21; in Zabin's small sample, described above, the figure is arguably higher. It is puzzling that these two images are so out of sync with each other the belief that teenagers are having babies largely as the result of conscious choice, versus survey data saying that the vast majority of births to teenagers are unintended at conception.
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From page 166... ...
These include personality characteristics, feelings about sexuality and fertility and about specific contraceptive methods themselves, such behavioral factors as alcohol and substance abuse, family and peer interactions, and the quality of a couple's relationship. These are reviewed briefly in this section.
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From page 167... ...
(1979) , for example, found that high self-esteem was associated with more positive attitudes toward contraception and more effective contraceptive use among adolescent clients of family planning clinics.
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From page 168... ...
, and high levels of guilt about sexual issues further predispose adolescents to taking contraceptive risks (Morrison and Shaklee, 1990~. Similarly, among 13to 20-year-old sexually active single females attending family plaming clinics, significant relationships were found between guilt over premarital sex and both consistency of contraceptive use and contraceptive method choice at last intercourse (Herold and Goodwin, 1981~.
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From page 169... ...
Furthermore, the hypothesized relationship seems to hold regardless of whether a female or a male contraceptive method is used. Focus groups designed to learn more about how adolescents feel about obtaining contraception at clinics confirm the importance of shame, embarrassment, and fear related to the medical examinations; embarrassment about being sexually active; and concern about confidentiality (Silverman and Singh, 19861.
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From page 170... ...
And because contraceptive devices must be obtained before intercourse, lack of planning for the event is closely associated with either the failure to use any method of birth control at all or use of such poor methods as withdrawal. In a 1994 survey of more than 500 high school students, three-fourths of those who were sexually active said that their first sexual experience "just happened" (SIECUS/Roper poll, 1994)
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From page 171... ...
A wide variety of studies confirm that attitudes toward contraception and feelings about specific methods are strong predictors of contraceptive behavior and patterns of contraceptive use (Balassone, 1989; Morrison, 1989; Grady et al., 1988; Miller, 1986; Tanfer and Rosenbaum, 1986; Houser and Beckman, 19781. As noted briefly in Chapter 5, one reason women often give for not using contraceptives is that they are concerned about the side effects or health risks of contraception in general and of specific methods in particular (Zabin et al., 1991; Sawyer and Beck, 1988; Forrest and Henshaw, 19831.
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From page 172... ...
. Consistent with this view, an exploratory study based on interviews with married, young women drawn from a family planning clinic found a clear association between unplanned sex, alcohol consumption, and nonuse of contraception (Flanigan and Hitch, 19861.
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From page 173... ...
found, for example, that family communication about sex and birth control appeared to count for very little with regard to levels of contraceptive use among sexually active teenagers. Similarly, using data collected over a period of two years from teenagers and their mothers, Newcomer and Udry (1985)
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From page 174... ...
Since the analysis by Mosher and Horn is confined to those who made a family planning visit, these findings do not necessarily contradict the findings of other research (reported above) showing a lack of communication about sex and birth control between parents and their daughters or the findings indicating that family communication about these matters count for very little in explaining contraceptive behavior among sexually active teenagers.
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From page 175... ...
examined the sources and effect of social support on contraceptive use in a small survey of sexually active female and male college students. Although friends and partners were identified as equally supportive, only partner support was found to be related to contraceptive use.
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From page 176... ...
Although sometimes associated with unprotected sex, alcohol or substance abuse are often not isolated influences explaining poor contraceptive use (or nonuser, but may rather be part of more general patterns of problem behavior and risk-taking. Unfortunately, the research that lies behind many of these observations rests largely on samples of low-income black urban teenagers and white college students, even though a large portion of unintended pregnancies occurs among other groups.
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From page 177... ...
Inderbitzen H Predicting contraceptive behavior among college students: The role of communication, knowledge, sexual anxiety, and self-esteem.
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From page 178... ...
Correlates of contraceptive behavior among unmarried U.S. college students.
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From page 179... ...
Self images and contraceptive behavior. Basic Appl Soc Psychol.
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From page 180... ...
Parent-child communication and adolescent sexual behavior. Fam Plann Perspect.
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From page 181... ...
Severy LJ. Couples' contraceptive behavior: Decision analysis in fertility.
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From page 182... ...
Emerson M Reasons for delay in contraceptive clinic utilization: Adolescent clinic and nonclinic populations compared.
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