NOTE TO EDITORS: The June 2008 issue of Perspectives on Sexual and Reproductive Health, a quarterly, peer-reviewed professional journal published by the Guttmacher Institute, features the following:
A new analysis of data from the California Maternal and Infant Health Assessment looks at the relationship between pregnancy intention (intended, mistimed, unwanted or unsure) and preterm birth (before 37 weeks’ gestation), and finds disparities among different racial and ethnic groups. According to Pregnancy Intention and Preterm Birth: Differential Associations Among a Diverse Population of Women, by Aimee Afable-Munsuz and Paula Braveman, women who did not intend their pregnancy had a greater likelihood of experiencing a preterm birth. In analyses adjusting for socioeconomic and demographic variables, pregnancy intention was significantly related to preterm birth among immigrant Latinas, but not among white, black or U.S.-born Latina women. The authors suggest that the relationship between pregnancy intention and preterm birth varies by women’s racial or ethnic group, in part because of the varying meanings of "unintended pregnancy" across populations.
Setting educational and vocational goals may not be enough to motivate teens to delay pregnancy, according to Association of Conventional Goals and Perceptions of Pregnancy with Female Teenagers’ Pregnancy Avoidance Behavior and Attitudes, by Sara Jumping-Eagle et al. A survey of sexually active female teens who were inadequate contraceptive users found that three-quarters of participants had educational or vocational goals, and eight in 10 of these teenagers perceived their goals to be achievable. However, fewer than half of them thought that a pregnancy would prevent them from achieving these goals. The authors found that female teenagers with goals were more likely than those without goals to have used a contraceptive at last intercourse, but not to state that they wanted to avoid pregnancy, would have an abortion if they became pregnant or planned to use a prescription contraceptive. The authors suggest that encouraging teens to formulate educational and vocational goals may be less important than ensuring that they have concrete, personally relevant reasons to believe that teen childbearing is a threat to what they want most for themselves.
A new analysis of data from the 2002 National Survey of Family Growth finds that only 3% of women aged 15–44 had received counseling on emergency contraception from a clinician and only 4% of women who had ever had sex with a male partner had used the method in the previous year, according to Counseling About and Use of Emergency Contraception in the United States, by Megan L. Kavanaugh and Eleanor Bimla Schwarz. The study also shows that the majority (73%) of women who had used emergency contraception had done so only once, contrary to the popular misconception that when emergency contraception is readily available, women substitute its use for the use of routine contraceptive methods. Those women who had been counseled by a clinician about emergency contraception in the previous year were considerably more likely than others ever to have used the method. The authors suggest that clinicians can play a pivotal role in ensuring that women have accurate information about how to access and use emergency contraception, which can in turn increase their use of the method.
The Opposite of Sex? Adolescents’ Thoughts About Abstinence and Sex, and Their Sexual Behavior, by N. Tatiana Masters et al., addresses teens’ views on abstinence and sexual activity to determine whether attitudes and intentions impact sexual behavior. The authors collected data over a two-year period from Seattle teens aged 12–15, and found that those teens with positive attitudes and intentions about abstinence were less likely to subsequently engage in sex, whereas those with positive attitudes and intentions about having sex were more likely to engage in sexual activity. However, they found that positive attitudes and intentions toward sex were more powerful predictors of having sex than positive attitudes and intentions toward abstinence were of abstaining. This research casts doubt on whether solely instilling positive abstinence attitudes and intentions in youth can be expected to have a strong impact on preventing sexual activity.
According to Factors Associated with Contraceptive Choice and Inconsistent Method Use, United States, 2004, by Jennifer J. Frost and Jacqueline E. Darroch, among a nationally representative sample of women aged 18–44, 38% of all women surveyed were using oral contraceptives, 18% other hormonal or long-acting methods, 32% condoms and 12% other methods. A greater proportion of white women than of foreign-born Hispanics, blacks, and Asians and other women were using the pill, while condom use was more common among black women and Asians and other women than among whites. Among respondents, 37% reported not being satisfied with their method; women who were not completely satisfied with their method were more likely to use it inconsistently. Virtually all pill users (98%) reported having a reminder or routine to help them remember to take their pill every day. Yet 38% reported having missed at least one active pill in the prior three months. Among condom users, 61% reported that they had not used the method every time they had sex or they had put the condom on after beginning sex at least once in the prior three months. The authors suggest that greater efforts are needed to provide women and their partners with a range of method options, to facilitate selection of methods that best suit their needs and circumstances, and to identify and assist users who are dissatisfied or are having difficulties using contraceptives effectively.
Pathways from Family Religiosity to Adolescent Sexual Activity and Contraceptive Use, by Jennifer Manlove et al., looks at the relationships between family religiosity in early adolescence and later reproductive health outcomes. Analyzing data from the 1997 National Longitudinal Survey of Youth, the authors find both direct and indirect associations between family religiosity and sexual behavior. The authors find that cohesive family environments and positive peer networks contribute to reduced levels of risky sexual behaviors among adolescents from religious families. However, the study also indicates that parents who monitor their children’s activities and peer environments, engage their families in regular activities and foster strong parent-child relationships can help reduce risky sexual behaviors, regardless of family religiosity.