You are 16 years old and find yourself pregnant: What do you decide to do?
a). Get an abortion? b). Carry the pregnancy to term, and keep the baby? c). Carry the pregnancy to term, and give the baby up for adoption?
Unfortunately, for too many adolescents, the above is more than simply a multiple-choice question; it is a critical and potentially life-altering decision. Two articles in this issue of Family Planning Perspectives explore influences on how teenagers deal with this problem. Madeline Zavodny [go to article] examines the role of the male partner's characteristics. Using data from a subset of women surveyed in the 1995 National Survey of Family Growth (NSFG) who first had sex at ages 15-19, she finds that 17% became pregnant while in their first nonmarital sexual relationship. Partner's race, age and religion all had decided influences on pregnancy resolution. For instance, young women whose partner was of a different race or ethnicity were much more likely to have an abortion or a nonmarital birth than they were to have a marital birth. Likewise, those older than their first partner or 2-7 years younger were less likely than teenagers with a same-age partner to have an abortion than a live birth.
A second article, by Ann Evans [go to article], uses data from an Australian case-control study of young women who either gave birth or obtained an abortion as teenagers to study who most influenced them in their decision-making, and how. Partners had a strong influence; for example, teenagers who said their partner influenced them toward abortion were 10 times as likely as the others to have had an abortion. Parents had little direct influence, but mothers' "indirect" influence--by example rather than by argument--was strong: Young women whose mother had had an adolescent birth were significantly less likely to choose abortion over delivery, while those whose mother had had an abortion as a teenager were more likely to have an abortion.
Elsewhere in the issue, two articles study sexual risk behavior and what affects it. In analyzing data from the 1992 Youth Risk Behavior Survey, John Santelli and colleagues [go to article] find that recent substance use and substance use at last intercourse were strongly related to the odds that adolescents had had two or more partners in the previous three months. They did not affect whether teenagers used a condom at last intercourse, however. In contrast, a high level of lifetime substance use significantly lessened the likelihood that a teenager used a condom at last intercourse, but had no impact on number of partners. Becoming disinhibited or being exposed to social situations where substances are used may be more influential in partner selection than in condom use, while a failure to use condoms may be an expression of a general risk-taking mentality.
Susan Hillis and coauthors [go to article] find that women exposed during childhood to a large number of adverse or dangerous conditions are more likely to engage in risky sexual behavior later in life. Information from the Adverse Childhood Experiences Study shows that increased exposure to physical, emotional and sexual abuse during childhood raises women's chances of having had sex by age 15, of perceiving themselves as being at risk of HIV and AIDS, and of having had 30 or more partners. Such behavior might represent a search for intimacy and affection that was missing during childhood, they argue.
S. Marie Harvey and coauthors [go to article] examine factors affecting women's choice of and satisfaction with medical abortion using methotrexate. Women's choice of medical or surgical abortion depended on which types of attributes they valued more highly: privacy and naturalness, or swift resolution and avoidance of pain. Educators and counselors need to be able to communicate the details of both medical and surgical abortion and help women understand how their own values and perceptions interact with the abortion method's characteristics.
The role of race and ethnicity in family-building during cohabitation is the subject of an analysis by Wendy Manning [go to article]. Using data from the 1995 NSFG, Manning finds fundamental racial and ethnic differences in fertility during cohabitation: Hispanic women are 77% more likely than white women to conceive while cohabiting, and black women are 69% more likely. Moreover, among women who become pregnant while cohabiting, Hispanics are almost twice as likely and blacks are three times as likely as whites to remain cohabiting with their partner after childbirth.
Finally, Willard Cates, Jr., [go to article] outlines the findings of the controversial condom report released recently by the National Institutes of Health and the divergent reactions to it. Cates argues that, instead of the picture portrayed by condom detractors, the report clearly shows that the "glass is 90% full" (i.e., that condoms are largely effective) and "only 10% empty" (i.e., that data are inadequate).