birth control
Swedish students' attitudes toward abortion.

Lindell ME, Olsson HM.

The Swedish abortion legislation of 1975 gave women the right to make a decision about abortion before the end of the 18th week of pregnancy. The number of abortions is rising in Sweden as a chosen method of birth control. The attitudes of students toward abortion were studied in 1986-1987. A questionnaire containing items on how sex education is taught, the anatomy and physiology of reproduction, contraceptives, sexually transmitted diseases, and legal abortion was answered by 421 high school students. Results pertaining to the students' attitudes toward abortion are reported. Two thirds of the students believed that the decision about an abortion should be made by the man and woman together. Nearly all respondents believed that abortion should not be considered a method of birth control. These results may be considered a guide for interventions to prevent the need for abortion. One fourth of all pregnancies in Sweden terminate in abortion. The students in the present study thought of abortion as a solution. Authors studying samples with different cultural backgrounds have reported similar attitudes.

PIP: Sweden enjoys a well-organized family planning system in which sex education has been obligatory in schools for the past 30 years and women have had the legal right since 1975 to decide whether or not to have an abortion before the end of the 18th week of pregnancy. Abortion services have been provided free for 18 years. Following the enactment of this abortion legislation, the frequency of abortions initially increased, stabilized, then increased once again in the early 1980s. The number of abortions is presently increasing in Sweden as a chosen method of birth control. This study was conducted to assess high school students' knowledge and attitudes on abortion. 421 students aged 17-18 years from 7 schools in Orebro County responded to questionnaires in 1986-87 on how sex education is taught, the anatomy and physiology of reproduction, contraceptives, sexually transmitted diseases, and legal abortion. This sample comprised 10% of the county high school population. Two-thirds believed that decisions about abortions should be made jointly by male and female partners, and almost all feel that abortion should not be considered as method of birth control. Abortion should instead be considered as a solution to unplanned pregnancy. Authors studying samples with different cultural backgrounds have reported similar findings. With 25% of pregnancies in Sweden ending in abortion, these results may be considered as a guide for interventions to prevent the need for abortion.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8407619&dopt=Abstract birth control



birth control
Women's satisfaction with birth control.

Rosenfeld JA, Zahorik PM, Saint W, Murphy G.

Department of Family Practice, East Tennessee State University, Bristol 37620.

BACKGROUND. Contraception is a major component of preventive health care for women. There are indications that women are not satisfied with the methods of birth control currently available. Dissatisfaction with contraceptive methods may lead to unplanned pregnancies. METHODS. Adult women visiting the family health center over a 1-year period were invited to participate in a research interview. Questions were asked about demographic variables and the women's use of, and their satisfaction with, contraceptive methods. RESULTS. Many women were displeased with the present methods of birth control. This is reflected in the numerous methods used by each woman, and by frequent use of permanent sterilization as a contraceptive method. Women were as dissatisfied with oral contraceptives as they were with the less efficacious methods such as condoms, foams, gels, and rhythm. The only methods that had a greater than 70% satisfaction rate were tubal ligations and partner's vasectomies. CONCLUSIONS. There is significant dissatisfaction with the methods of contraception currently available. Increased patient-physician discussion and education may improve satisfaction with birth control methods now used. New methods of contraception may be needed to prevent unplanned pregnancies.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8426136&dopt=Abstract birth control



birth control
Pregnancy, STDS, and AIDS prevention: evaluation of New Image Teen Theatre.

Hillman E, Hovell MF, Williams L, Hofstetter R, Burdyshaw C, Rugg D, Atkins C, Elder J, Blumberg E.

UCSD/SDSU Joint Clinical Psychology Program 98182.

New Image Teen Theatre combines peer education and theatre in an informative and entertaining package. This study was undertaken to assess the effectiveness of New Image Teen Theatre on altering teenagers' attitudes, knowledge, and intentions regarding sexual behavior. A total of 143 adolescents between the ages of 13 and 19 viewed the performance. The performance focused on the prevention of pregnancy, AIDS, and STDs and included content aimed at increasing communication. Teen participants completed pretest and posttest questionnaires. Almost half of the adolescents reported having engaged in sexual intercourse. About one third of the sexually active reported never using birth control, and only 21% reported consistent use of condoms. These results confirm adolescents' risk for pregnancy, STDs, and AIDS in particular. Following the performance, the teens reported significantly more willingness to discuss sexual issues with others, significantly greater intention to use birth control (for sexually active teens), and demonstrated significantly greater sexual knowledge. Furthermore, they indicated that they had experienced more positive emotions than negative emotions while viewing the production. Results suggest that theatre education may set the stage for more comprehensive interventions designed to prevent pregnancy, STDs, and AIDS.

PIP: Teen theater as a nontraditional form of education combining peer education and theater in an entertaining and informative manner. The study evaluates Planned Parenthood's Teen Theater and its influence on a teenagers willingness and comfort in discussing sexual issues with others, intentions to delay intercourse, intention to use birth control, intention to protect oneself from STD's, and knowledge and affect. A pre and post test were given to 143 subjects (73 male and 70 female) who participated at 4 churches and 3 schools. Most had been recommended by youth groups. Ethnic diversity was evidenced in 54 whites, 29 blacks, 32 Hispanics, 5 Asians, 4 Native American, and 12 others not identified. Correlation matrices were constructed to assess the degree of correlation among pairs of similar items, and between affect and other dependent measures. Trends were measured by means and standard deviation; multifactorial ANOVAs were used to assess differential effects of site, gender, and ethnicity. Independent t test were used to assess differences between those who answered all questions versus those who answered few. Dependent t tests were used to assess significant changes pre and post test for discussion, comfort, intention, and knowledge variables. The results indicated sexual activity to constitute 41%of the group with a mean frequency of 2.46 for coitus. 37.9% reported having sex more than 1/week, 24.1% only once, 17.2% 1/month, 15.5% 1/week, and 5.2% 2/month. 31% reported never using birth control and 47.6% consistently used contraceptives. 21.4% reported occasional use. The pill and condom were the items of choice. ANOVAs indicated that teens responding to all questions engaged in more intercourse (t(126)=2.96, p.005). After viewing teen theater, there was more willingness to discuss sexual topics (t(80)=10.01, p.001), greater intention to use birth control (t(43)=3.02, p.01), and had greater sexual knowledge (t(92)=10.01, p.01). Significant effects on discussion, intention to use condoms and delay intercourse were not found. There was also significant relationship between affect variables and other dependent variables. In separate analysis of discussion and knowledge, each aspect was found to be significant for discussion and all but 1 knowledge item. The results suggest that the production may influence peer and parent communication as well as birth control use, albeit not a powerful intervention but moving in the direction of a more sexually responsive manner. This intervention may be used to attract larger numbers and to set the stage for more intensive interventions. Aiding teens in overcoming objections to condom use is still needed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1777341&dopt=Abstract birth control



birth control
Unplanned pregnancy among active-duty Army females as a readiness issue.

Borsay-Trindle LA, Pass CM, Gilzean SM.

Army Nurse Corps, Ft. Gordon, GA 30905.

Unplanned pregnancy creates significant problems for active-duty female soldiers and also elicits concern among military leaders when planning for mobilization. The purpose of this three-group comparative survey is to ascertain probable reasons for unplanned pregnancy occurrence that will be useful in developing appropriate interventions directed at decreasing the incidence of such pregnancies. Active-duty female soldiers (n = 112) in-processing at a large military installation responded to a 41-item questionnaire focused on respondents' reproductive histories, beliefs and knowledge about contraception, and contraceptive use. Descriptive statistics, the Kruskal-Wallis One-Way Analysis of Variance, and Chi-Square non-parametric statistical tests were used for analysis of the data. Findings revealed that when compared to the two post-adolescent groups, the adolescent female soldiers reported: (a) a greater number of sexual partners, (b) greater frequency of intercourse, (c) less knowledge about the reproductive cycle, and (d) greater non-use of any birth control method.

PIP: This article describes the results of a survey designed identify the reasons behind the high rate of unplanned pregnancies among active-duty female soldiers. While anticipated pregnancies do not pose a problem for the military, unplanned pregnancies disrupt mobilization plans, thereby limiting combat readiness. Furthermore, those females soldiers who complete the pregnancy face the difficulties of raising a child while serving in the military. The army also incurs costs during the pregnancy and recovery period. Lacking any existing literature concerning unplanned pregnancies among active-duty women, researchers conducted a 3-group comparative survey. The survey interviewed a total of 112 women stationed at a southwestern army post. This total was divided into 3 groups: 35 adolescents (17-19 of age), 40 post-adolescents (20-23), and 37 adults (24-37). 61% of all the women were single, while 30% were married. The survey contained questions concerning their birth control practices; their sexual attitudes, beliefs, and behaviors; and their reproductive histories. 1/2 of the soldiers had been pregnancy at least once. 44% of unmarried women participated contraception, compared to 61% of those married. All groups demonstrated inadequate understanding regarding contraception and contraceptives. Only 39% correctly identified the mid-cycle as the most likely time for conception. But compared to the 2 other groups, the adolescent females had a higher risk of having an unplanned pregnancy. They indicated having a greater number of sexual partners, greater frequency of intercourse, less knowledge of the reproductive cycle, and lower rates of birth control practice.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1900595&dopt=Abstract birth control



birth control
The sexual and contraceptive socialization of black adolescent males (black adolescent sexuality).

Tucker SK.

Medical College of Georgia, School of Nursing, Augusta 30912-4250.

The major source, quantity, and quality of sex and contraceptive information African-American males received as teenagers, and the impact of that information on sexual and contraceptive behavior, were examined among 250 males ranging in age from 12 to 70 years. Mothers were the major sources of sex and birth control information for the adolescent, young adult, and middle adult groups. Fathers and male friends were the second sources most indicated. All of the sample received sex information, and only a small proportion received no birth control information. The amount of sex information received was found to be a significant predictor (P = 0.0018) of the age at first intercourse and the regularity of use of birth control after that. The amount of birth control information received was also a significant predictor (P = 0.0093) of the regularity of use of birth control after the first coitus. Because parents influence their children's behavior through a socialization process, their support of their teenage sons in matters of sexuality and contraception may be of potential value in mitigating the effects of early, unprotected sex.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1924103&dopt=Abstract birth control



birth control
Familial correlates of sexually active pregnant and nonpregnant adolescents.

Barnett JK, Papini DR, Gbur E.

University of Arkansas.

The relationship of familial, demographic, and individual characteristics to the probability of pregnancy was examined among 124 sexually active adolescent females. Logistic regression analyses revealed that adolescent pregnancy status was a function of a combination of demographic and familial variables. Adolescents who were pregnant at the time of the study perceived their families as having low levels of family strength, perceived communication with parents as closed, came from homes characterized by family fragmentation (i.e., only one parent or no parent living in the home), came from low-income households, were unlikely to use any method of birth control, and were more likely to be married than their nonpregnant counterparts.

PIP: The differences in demographic characteristics, sexual practices, perceptions of family functioning, and individual factors among pregnant and nonpregnant adolescents were studied. 124 sexually active adolescent Caucasian females aged 12-19 years from an Arkansas clinic of which 57% were pregnant, participated in a nonrandom sample in 1988-89. 62.1% were from disrupted families (39.5% divorced, 12.9% remarried, and 9.7% widowed). Family disruption was higher among the pregnant sample (72% vs. 50.8%). 16.9% of the total sample were high school dropouts, but the majority were in the pregnant sample (28% vs. 5%). 91% of the pregnant sample had a family income of $20,000 vs. 66% of the nonpregnant sample. The procedures and instruments used are described. The following questionnaires were involved: 1) a demographic questionnaire for age, race, educational and marital status, parents' marital status, and socioeconomic status; 2) a sexual history questionnaire for pregnancy status, use of birth control, prior pregnancies and outcomes, and frequency of sexual activity; and 3) the Family Adaptability and Cohesion Evaluation Scale, the Family Strengths Questionnaire, the Parent Communication Scale, and the Adolescent Self-Esteem Scale. Stepwise logistic regression and chi square tests were used to predict pregnancy status. 6 variables out of 11 were significantly related to pregnancy status: lower perception of family strengths, problems with parent communication, married, low family income, birth control, and single parent or no parent family composition. 80% of pregnant and nonpregnant teens were predicted. The mean for perception of family strengths for pregnant vs. nonpregnant adolescents was 33.29 vs. 39.87, which means for pregnant teens a perception of a lack of pride and harmony in their families. Lower scores were also evident on the Parent Communication Scale (-1.22 vs. 2.62). Although not significant, pregnant adolescents saw their families as flexible but not very cohesive and had lower self-esteem scores. Nonpregnant adolescents were more likely to use birth control than pregnant adolescents. The results support prior findings with some variation in the effect of parent and child communication, and insignificant effects of perception of family adaptability, and self-esteem. The limitations are the lack of generalizability to other regions, and the model itself which did not assess familial factors such as parental control or other developmental factors such as self-worth. Causality is not determined.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1927676&dopt=Abstract birth control



birth control
Follow-up of adolescent oral contraceptive users.

Delmore T, Kalagian WF, Loewen IR.

Regional Niagara Health Services Department, St. Catharines, Ontario, Canada.

PIP: Clients in birth control centers (St. Catharines, Niagara Falls, and Welland) in Ontario, Canada were profiled in 1989; factors affecting compliance with the use of oral contraceptives (OCs) were investigated. Compliance was assessed for those 16 years and after 3 months of OC use. A control group and 2 study groups were randomly formed. 1 group was told about a follow up telephone call if the 3-month checkup appointment was not kept and the other not told. Compliance was determined by keeping the follow-up appointment and taking the pill as directed. Self-administered questionnaires were obtained at the 1st appointment and the 2nd study group was interviewed at the 3-month appointment time. Of the 334 intake interviews, 28.4% were adolescents 16 years old. Information on birth control came most frequently from friends (78.7%; then high school classmates, 61.4% grade school classmates, 61.4%; and family, 38.0%). 94.3% had a boyfriend, primarily a steady one. 82.4% were sexually active before the Center visit. 21.3% had had sex when 15 years old. 9.2% of those sexually active had never used birth control. 85.2% of those using contraception had used a condom at least once, and 33.9% used withdrawal. In the preceding month, birth control was used 60% of the time. 46% of mothers and 25% of fathers were considered supportive of birth control. 228 16 years participated in the compliance study. The 2 study groups and the control group were not significantly different in their compliance. The only statistically significant predictor of compliance (from the intake interview) was the previous use of the condom. Those more likely to be compliant were the 10.9% sexually active who had never used a condom. Continuing with the family doctor, not sexually active, advice to stop, side effects concerns, and remembering to take the pill were the most common reasons for noncompliance. The implication for health and sex education is that emphasis needs to the placed on the risks taken by using withdrawal as a birth control method. Birth control education must begin before students become sexually active. Grade 8 is suggested as an appropriate time. A 3-month recheck appointment is unnecessary. For those not complying with the 3-month appointment, follow up is necessary. Compliance issues needs to be researched for the 16 group.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1954596&dopt=Abstract birth control