birth control
An investigation of verbal interaction, knowledge of sexual behavior and self-concept in adolescent mothers.

Horn ME, Rudolph LB.

Department of Psychology, Austin Peay State University, Clarksville, Tennessee 37044.

Variables commonly considered to be major factors in contributing to the incidence of adolescent pregnancy may be only part of the total pattern. This study sought to examine the adolescent mothers' communication with significant others and their knowledge about sex, pregnancy, and birth control methods. Self-concepts of the adolescent mothers were compared with those of the published norms of the Tennessee Self-Concept Scale. The study included 23 adolescent mothers between the ages of 13 and 19 who were gravida 1 as indicated by their medical records. They were given a questionnaire constructed from previous research. They also completed a communication scale and the Tennessee Self-Concept Scale. The findings of the present study indicated that most adolescent mothers considered their communication with their parent mothers to be one of mutual understanding. However, it appears that most adolescent mothers obtain much of their information about sex, pregnancy, and birth control methods from significant others. The self-concepts of these adolescent mothers were lower in comparison to the norm. The results indicate a need for further research in the area of adolescent sexual development, sex education in the school, and increased involvement of parents in the communication of sexual mores.

PIP: This study of 23 US adolescent mothers (AM) between the ages of 13 and 19 showed that many of the variables thought to be major factors contributing to the incidence of adolescent pregnancy such as severe life crises, promiscuity, and lack of knowledge about birth control, may be only part of the total pattern. This study sought to examine the AM's communication with their mothers, their friends, and their significant others, and their knowledge about sex, pregnancy, and birth control methods. Self-concepts of the AMs were compared with those of the published norms of the Tennessee Self-Concept Scale. The findings indicated that while most AMs considered their communication with their parent mothers to be one of mutual understanding, most of the AMs obtained much of their information about sex, pregnancy, and birth control from friends and significant others. The self-concepts of these AMs were lower in comparison to the norm. The results indicate a need for further research in the area of adolescent sexual development, sex education in the school, and increased involvement of parents in the communication of sexual mores. author's modified

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3434383&dopt=Abstract birth control



birth control
Family planning for inner-city adolescent males: pilot study.

Reis J, Reid E, Herr T, Herz E.

School of Nursing, State University of New York, Buffalo 14214.

The results of a pilot family planning program (FPP) in a pediatric practice are reported for 66 inner-city male adolescents. The FPP was designed to eliminate registration barriers to the procurement of contraceptives by adolescent males, and to prompt the community neighborhood health center (CNHC) providers to initiate discussion of birth control with their male adolescent patients. Utilization data show that males were more likely to receive contraceptives if the provider first raised the topic of birth control to them. Unstructured follow-up interviews with 27 adolescent male FPP users identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives from the CNHC. If health care providers are sensitive to male adolescents' feelings about birth control, community health centers potentially could serve as a cost-effective source of contraceptives for sexually active male adolescents.

PIP: The results of a pilot family planning program (FPP) in a pediatric practice are reported for 66 inner-city US male adolescents. The FPP was designed to eliminate registration barriers to the procurement of contraceptives by adolescent males, and to prompt the community neighborhood health center (CNHC) providers to initiate discussion of birth control with their male adolescent patients. Utilization data show that males were more likely to receive contraceptives if the provider first raised the topic of birth control to them. Unstructured follow-up interviews with 27 adolescent male FPP users identified a desire for anonymity and confidentiality, and embarrassment or discomfort as the key reasons for not seeking contraceptives from the CNHC. If health care providers are sensitive to male adolescents' feelings about birth control, community health centers potentially could serve as a cost-effective source of contraceptives for sexually active male adolescents. author's modified

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3434408&dopt=Abstract birth control



birth control
The effects of religious beliefs on the health care practices of the Amish.

Adams CE, Leverland MB.

The religious and cultural beliefs of the Amish result in many health care beliefs and practices which are significantly different from the dominant American culture. For example, the Amish are excluded from social security and health insurance coverage; they have different perceptions of health and illness; they do not practice birth control; they often lack the preventive practices of immunizations and prenatal care; and they may use a variety of traditional and nontraditional health care providers. Only by understanding the religiocultural belief system of this minority religious sect can nurse practitioners effectively meet the health care needs of their Amish patients.

PIP: An understanding of the religiocultural belief system of the Amish religious sect is essential if nurse practitioners are to meet the health care needs of Amish patients. The Amish are exempted from social security and reject health insurance coverage, do not practice birth control, and often veto preventive practices such as immunization and prenatal care. A nonjudgmental, open attitude is required on the part of health professionals to encourage Amish families to attend clinics where health monitoring can be maintained and health education provided. As a result of a view of illness that defines it in terms of a failure to function in the work role rather than as a set of symptoms, there is often a delay in seeking medical treatment. Amish men outlive Amish women, in part because of the high birth rate (average of 7 live births/woman). Birth control and abortion are forbidden by religious doctrine, even when pregnancy is life threatening. The Amish church has no rule against immunization, but only 16-26% of Amish children have received immunizations against the common childhood diseases. Reinforcing the rejection of preventive medicine is the low educational status of the Amish people; higher education is prohibited. This further implies that health instructions must be given in simple, clear language. Nurse practitioners must accept the fact that no amount of education will persuade Amish women to practice contraception. To continue to advocate family planning in the Amish community is to risk alienating couples from the health care system.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3446212&dopt=Abstract birth control



birth control
[The problem of birth control in schizophrenic patients]

[Article in Chinese]

Xun ML.

PIP: A study was made of 250 sterilized schizophrenics (50 men and 200 women) who had been hospitalized between 1972-1983. All had been diagnosed by more than 2 physicians as being schizophrenic for at least 5 years, and had used at least 1 kind of birth control since becoming ill. 258 healthy subjects were chosen as a control group. The marriage rate of schizophrenics is between 32.8-45.6% for males, and 57.6-67.9% for females. The subjects ranged in age from 26-50 years, 40.5% of whom were between 31-40 years. Length of illness was between 5-21 years, averaging 11.8 years. Prior to sterilization, subjects had an average of 2.7 children. Following the 1980 directive of having 1 child per couple, the schizophrenic 1 child rate was 1/8-1/4--that of the control group. 56.8% of the subjects started birth control 6-12 years after the onset of illness, and 3/5 used contraceptives for sterilization. 42.4% of the subjects' children were born after 1 of the parents had become ill; 2/3 of these children were conceived during the illness. The rate of complication from the birth control operation was similar to that of healthy persons. The rate of effectiveness in birth control was lower among schizophrenics, especially the women, than in healthy people, as evidenced by the fact 15.2% of the subjects' children were born after the subjects had taken birth control measures. It is concluded that female schizophrenics be given priority and that sterilization be the foremost method of birth control.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3582024&dopt=Abstract birth control



birth control
Young adults' contraceptive practices: an investigation of influences.

Lowe CS, Radius SM.

This study investigated young adults' contraceptive behaviors and attitudes through application of a comprehensive, theoretical framework. Specifically, a social-psychological approach to understanding preventive behaviors (e.g., contraceptive practices), was developed, incorporating the Health Belief Model and other factors, which offered a means for evaluating the extent to which contraceptive behaviors were influenced by individual and group characteristics. The study group consisted of 283 unmarried students at several schools who were, on average, 19 years of age. Results suggested that effective contraceptive behavior associated most strongly with respondents' perceiving relatively few barriers to their use of contraception, their maintenance of extensive interpersonal skills, and their regarding peer norms as consistent with effective contraceptive behavior. Findings also underlined a need for continuing education about sexuality and contraception. Dangerous misinformation prevailed regarding respondents' knowledge of areas that include anatomy, physiology, and appropriate use of effective contraceptive methods. Finally, results implied a need to consider broad behavioral, social, and interpersonal issues as they relate to young adults' effective contraceptive behavior. Future studies of contraceptive risk taking are encouraged to examine both individual and social factors affecting sexual and contraceptive practices if unplanned pregnancy is to be minimized, if not eliminated.

PIP: A social-psychological approach to understanding preventive behaviors was developed, incorporating the Health Belief Model and other factors, to offer a means for evaluating the extent to which contraceptive behaviors in young adults are influenced by individual and group characteristics. The study group consisted of 283 unmarried US college students, who, on the average, were 19 years of age. Dangerous misconceptions prevailed with regard to respondents' knowledge of areas including anatomy, physiology, and appropriate use of effective contraception. 68.2% of the sample said that they had experienced coitus. Of those reporting coital experience, 56.6% did not take adequate precautions to prevent pregnancy at the time of their 1st coitus. Among the sexually experienced, 76.9% reported use of specific methods deemed effective at last coitus. More than 60% underestimated pregnancy rates of adolescents, and approximately 43% agreed that "pregnancy just isn't something that would happen to me or a sexual partner." 85.1% agreed that dealing with an unplanned pregnancy would be painful, and 86.7% disagreed that contraception made coitus less enjoyable. 94.7% believed that males and females should share the responsibility for birth control. However, 72.5% of both sexes thought males should be responsible for birth control availability while, in a separate item, 88.3% felt it was the female's responsibility. Furthermore, 27.3% held the notion that females with accessible contraception would be deemed promiscuous. 52.4% agreed that coitus should be spontaneous, 40.8% also felt that birth control makes intercourse seem preplanned. Effective contraceptive behavior associated most strongly with respondents' perceiving relatively few barriers to use of contraception, maintenance of extensive interpersonal skills, and their regarding peer norms as consistent with effective contraceptive behavior.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3618332&dopt=Abstract birth control



birth control
[Immigrant women at the health center. Monitoring of pregnancy and contraception]

[Article in Norwegian]

Austveg B.

PIP: Over the past decade, Norwegian cities have experienced an influx of immigrants, many from third world countries. Women from these societies have brought with them cultural traditions and mores regarding birth, prevention and their own bodies which can present many problems and challenges to public health personnel. This study specifically deals with the experiences of midwives and clinicians working with immigrant women in Oslo, and offers some recommendations to health care staffs in their counseling and treating such women. Many things which seem obvious to Western-trained clinicians may not seem so to their patients, and when staff are not understood or are questioned they may interpret this as a challenge of their authority and competence. For example, Norwegian health workers, having been reared in a society concerned about the "population explosion" and often having been trained to readily equate large families with poverty and/or ignorance of birth control, must attempt to try and understand that this is not necessarily true, and that such attitudes can limit the effectiveness of counseling in sensitive areas. Most Asian and African societies see children as an economic resource. The author accordingly urges health care workers to approach their patients in this area, as in others, with empathy and to try and be aware of their assumptions. Cultural traditions should also be taken into account when recommending a particular form of birth control to a woman or couple requesting such advice. Some methods will be more or less acceptable to different nationalities. For instance, many Asian cultures view menstruation as a necessary part of nature's plan to maintain balance between the "hot" and "cold" forces of the body, and since oral contraceptives often reduce flow, they might be considered as harmful. Condoms, on the other hand, may be more readily acceptable since they do not affect body rhythms. Coitus interruptus is the most widely practices form of birth control in the world, and is probably more reliable than the West believes. Despite stereotype thinking that women fail to reach orgasm with this method, most couples who practice it seem to experience no problems. The rhythm method usually will be less attractive to women of many societies, since examining one's own cervix secretion and touching one's body will be unacceptable to many. In counseling or parental care and birthing, workers are urged to realize the role ritual plays, and to accept such practices as Pakistani mothers massaging their young infants and themselves. Unless harmful medically, we should be careful not to criticize such practices, but to learn from them in creating a good relationship with patients. Giving birth in a large Norwegian hospital may itself seem frightening to many immigrant women, and if a Moslem woman there is criticized for keeping still after giving birth (for 40 days in the Islamic faith), this may only create more anxiety. Guidelines are provided for promoting physician-patient communication, such as talking to and looking at the patient--not the interpreter--and to avoid using difficult sentences or concepts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3645839&dopt=Abstract birth control



birth control
[Changes in the midwifery profession. 23. A process leading to legislation of family planning]

[Article in Japanese]

Obayashi M.

PIP: Family planning legislation was officially discussed at the Japanese Cabinet meeting for the 1st time in October 26, 1951. Negative effects of abortion on women's health had prompted this move, which reflects changes in the Japanese government's attitude towards birth control. For many years birth control was suggested only to save mothers' lives and not to regulate the nation's population size. During the 5 years after WWII, when Japan lost all of her colonies and her industry was virtually non-existent, Japanese population increased by 15%. 47% of that increase was due to returnees from overseas. The Committee on Population Policy, established in November 1946, proposed the following to the government: By rebuilding the economy, the nation's capacity to accomodate its excessive population will be strengthened. A civilized nation should have an economic power matched with its population size, and within this context birth control can have a positive effect. A Eugenic protection law passed in 1948 resulted in too many cases of abortion. Various individuals and groups such as Socialist party members and medical doctors held meetings where family planning was discussed and advocated. McArthur's GHQ chose not to cooperate because of a great opposition from American Catholics. In 1954, the Population Problem Probe Committee decided that the government should deal with family planning as part of its overall population policy not just as a means of protecting maternal health.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3648181&dopt=Abstract birth control