Risking the Future Adolescent Sexuality, Pregnancy, and Childbearing, Volume II: Working Papers and Statistical Appendices (1987) / Chapter Skim
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3 Contraceptive Decision-Making Among Adolescents
3 Contraceptive Decision-Making Among Adolescents
Pages 56-77
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From page 56... ...
, it may be especially problemmatic for teenagers. This is because effective use of contraception is linked to the process of defining oneself as sexually active, becoming aware of pregnancy risk and its consequences, developing motivation to prevent pregnancy and taking active steps to prevent an unwanted pregnancy The major question that will be addressed in this chapter is, given sexual activity, what determines whether a teenager takes active steps to prevent pregnancy?
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From page 57... ...
A second study found that 85 percent of never-married sexually active women 20-24 were currently using contraception (Tanfer and Horn, 1984~. Table 2.8 shows the methods currently used by never-married users 15-19 and 20-24 in 1982.
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From page 58... ...
Table 2.9 shows the current method used by Hispanic and nonHispanic teenage contraceptive users in 1982. Two thirds of Hispanic teenagers use the pill and 9 percent use the IUD or are sterilized, which results in a very high level of use of effective methods (pill, IUD, sterilization)
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From page 59... ...
is poorer than current use (Table 2.8~; this is the case for those whose first intercourse occurred when they were under 18 as well as those whose first intercourse occurred when they were 18 and older (Table 3.3; Figure 3.1~. Nonuse at initial intercourse and during the first months of sexual activity appears to be problemmatic: the risk of pregnancy is highest in those months (Zabin et al., 19801.
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From page 60... ...
in 1971, 1976 and 1979. Although the National Survey of Family Growth conducted in 1982 was released in 1984, so far no analytic studies of the type that would show factors associated with contraceptive decisionmaking have been completed.
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From page 61... ...
In 1976 only two out of five could name the time of month of greatest pregnancy risk. On the other hand, a number of contraceptive methods do not require any knowledge of time of greatest risk, and some studies suggest that users of such methods are least knowledgeable about timing of pregnancy risk (Presser, 19777.
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From page 62... ...
found that after adjusting for other differences between young women, in particular the age at first sex, current age, SES and family stability the race difference was not statistically significant. The difference in use of a contraceptive method at first sex by age at the time remained highly significant; women who were older at first intercourse were much more likely than women who were younger to have used a method at that time.
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From page 63... ...
They found that, for women 15-44 in 1982, there was a substantial race difference in use of contraception at first intercourse -- whites were much more likely than blacks to use a contraceptive method at that time. When they controlled for differences between blacks and whites in education of mother, year of first intercourse, ethnicity/religion, age at first intercourse and whether ever discussed menstrual cycle with a parent, that race difference declined slightly but did not disappear.
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From page 64... ...
; in contrast, half of black female users reported using female and half reported using male methods, with most of the female methods being prescription methods. The reports of white male users are very similar to those of white female users, with 7 out of 10 reporting use of a male method at first intercourse.
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From page 65... ...
Table 2.10 shows that sexually inexperienced women are less likely than experienced women to correctly perceive the time of greatest pregnancy risk in the menstrual cycle. There is very little work on adoption of contraception after first intercourse -- either the process or the types of methods used.
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From page 66... ...
One of the most important factors associated with currently using contraception are current age and length of time sexually active. Zelnik et al.
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From page 67... ...
Included in the model were a series of socioeconomic background characteristics as well as a series of variables measuring perceived advantages and disadvantages of pregnancy and perceived pregnancy risk. She found that using effective contraception at last intercourse was associated with a high score on the subjective probability of pregnancy, a low score on perceived advantages, a high score on perceived disadvantages of pregnancy, a low estimate of the probability of using abortion if pregnancy occurs, and a low rating of disadvantages of birth control.
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From page 68... ...
did not find either duration of exposure to pregnancy risk or current age to be associated with contraceptive continuation (continuous contraceptive use over 15 months as measured by two different measures)
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From page 69... ...
However, the association was weak for black teens and there was no association for white teens. They did find that the older the preferred marriage age, the greater the continuity of contraception among white and black teenagers (Nathanson and Becker, 19831.
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From page 70... ...
Table 2.11 shows use failure rates for unmarried women over the period 1979 to 1982, from the National Survey of Family Growth (Grady et al., 19861. Failure rates vary substantially by age, contraception method, duration of exposure, poverty ratio income, race, parity and contraceptive intention of the woman.
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From page 71... ...
(1985) found that the failure rates for single women were somewhat lower than those for married women.
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From page 72... ...
Polit et al., (1981) found that teen women who believe that the female should take responsibility for birth control tend to be more effective contraceptors.
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From page 73... ...
Prediction of pregnancy was strongly affected by the measure of contraceptive continuation used (Furstenberg et al., 1983~. The most refined measure, the measure that included prospective as well as retrospective reports of contraceptive use over a 15 month period, was the best predictor of pregnancy and was also best explained by a number of characteristics of adolescents; random error appeared to be minimized.
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From page 74... ...
found male partners to be perceived by women as frustrated and feeling relatively powerless in preventing pregnancy (p. 133J: Men are socially cast into the role of passive spectators to contraceptive decision making by the same social and technological changes that structure the way in which women take risks.
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From page 75... ...
There are no race differences in contraception at first intercourse, once other factors such as socioeconomic status are controlled. Background factors had only weak influences on the initiation of contraception.
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From page 76... ...
However, since their pregnancy rates also appear to be higher, how good our understanding is of actual contraceptive practice is in question. Nor do we know the full extent of differences in pregnancy or contraceptive failure rates by age.
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From page 77... ...
(1981) in contrast, found that, net of other factors, a previously pregnant woman was a less effective contraceptor, measured in terms of effectiveness of current contraception.
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