Advancing Sexual and Reproductive Health and Rights
Perspectives on Sexual and Reproductive Health
Volume 42, Number 3, September 2010


You’re a newly trained obstetrician-gynecologist, fresh out of a residency program that prepared you to perform abortions, and you have every intention of providing that service. However, as Lori Freedman and colleagues report in this issue of Perspectives on Sexual and Reproductive Health (see article), you may be in for a surprise. In qualitative interviews with doctors 5–10 years out of training, the researchers learned that of the 18 who had intended to perform abortions, only three were doing so. In most cases, the ones who were not said that the reason was restrictive workplace policies—formal or informal, explicit or implicit. Another common deterrent was the wish to avoid straining professional relationships because of differing feelings about abortion provision. Contrary to popular assumptions, fear of violence or harassment was not a major deterrent. The authors discuss ways in which residency programs might try to change “the culture of obstetrics and gynecology practice.”

Also in This Issue

•Stephanie Mollborn extends the research on teenage parents’ educational outcomes by examining differences among adolescent parents, rather than between them and their childless peers, and including both mothers and fathers (see article). Her analyses, using data from the -National Education Longitudinal Study, demonstrate that teenage fathers may fare no better than teenage mothers and thus may be equally in need of interventions to help them complete a high school education. Furthermore, traditional family structures and parenting norms may not be beneficial, as Mollborn found some negative associations between them and high school completion.

•In focus group discussions conducted by Aletha Y. Akers’s team, black parents in Pennsylvania described contraception as one of the most important sexual health topics for parents to discuss with their children; their adolescent children echoed that feeling in separate focus groups (see article). Yet both parents and children reported that they discuss it only indirectly; furthermore, participants’ comments revealed gaps in parents’ knowledge about available methods and -biases in parents’ approaches that reinforce sexual double standards for young males and females. Given black teenagers’ high pregnancy rates, the researchers emphasize the need for programs to help black parents play effective roles in their teenagers’ sexual development.

•If the experience in Arkansas is any indication, states are unlikely to succeed in reducing abortion levels among minors by replacing parental notification laws with parental consent laws. Ted Joyce analyzed statewide data and found no association between such a change in the Arkansas law and either the overall abortion rate or the rate of second-trimester abortions among minors in the state (see article). One in 10 minors who had an abortion during the study period used the law’s judicial bypass option. Joyce concludes that “it is the requirement of parental involvement, and not whether the policy is a notification or consent statute, that may alter minors’ reproductive outcomes.”

•Childbearing intentions have well-established links with race and ethnicity and with relationship type. Lina Guzman and coauthors (see article) show that they also vary by relationship type within racial and ethnic groups. For example, black women are more likely than whites to have an unintended birth, but the difference is evident only among those who are married. Among cohabiting women, foreign-born Hispanics (but not their U.S.-born peers) are at lower risk of having an unintended birth than are whites. The authors stress that interventions aimed at reducing unintended childbearing should be “tailored to a woman’s relationship type” and recognize how relationship status may affect her childbearing intentions.

•Pregnancy intentions appear to be an independent predictor of pregnancy among Latina adolescents, but not to mediate the effects of underlying risk factors, according to Corrine H. Rocca and colleagues (see article). In a longitudinal study involving 213 Latina teenagers, the researchers found a positive association between the degree to which young women wanted to become pregnant and their odds of doing so; the degree to which teenagers thought a pregnancy would make them happy bore no such association, and neither measure changed the associations between other variables and pregnancy risk. Thus, despite young Latinas’ relatively favorable attitudes toward pregnancy, their high pregnancy rates “may be less a function of intentional choice and more of circumstances.”

•Christine J. De Rosa and coauthors report (see article) that 9% of middle school students surveyed in Southern California had ever had intercourse and 8% had ever had oral sex; the proportions reporting either activity were considerably smaller among sixth and seventh graders than among those in eighth grade, which suggests that the middle school years are an important period for early interventions. Students who reported experience with oral sex were likely to say that they had also had intercourse, and those who had had only oral sex were likely to be anticipating having intercourse in the near term. Thus, the findings do not seem to support the notion that young -people engage in oral sex in lieu of intercourse.

•Do statutory rape laws err by focusing on age differences between partners? In analyses using data from the National Longitudinal Study of Adolescent Health, Sarah Koon-Magnin and colleagues found that female adolescents with partners three or more years their senior are at increased risk of having intercourse ( see article). However, the association does not hold for females older than 16, and it disappears once the male partner’s educational status is taken into account. If social context outweighs partner age differences in determining sexual risk, the authors suggest, laws’ focus on age may be unwarranted and may result in some low-risk adolescent males’ unfairly being categorized as sex offenders.

—The Editors