Dimensions of Reproductive Attitudes and Knowledge Related to Unintended Childbearing Among U.S. Adolescents and Young Adults

What predicts willingness to participate in a follow-up panel study among respondents to a national web/mail survey?

The American Family Health Study (AFHS) collected family health and fertility data from a national probability sample of persons aged 18-49 between September 2021 and May 2022, using web and mail exclusively. In July 2022, we surveyed AFHS respondents and gauged their willingness to become part of a national web panel that would create novel longitudinal data on these topics. We focus on predictors of willingness to participate, identifying the potential selection bias that this type of approach may introduce. We found that efforts of this type to create a national web panel may introduce potential selection bias in estimates based on the panel respondents, with individuals having higher socio-economic status being more cooperative. Thus, alternative recruitment strategies and re-weighting of the subsample may be needed to further reduce selection bias. We present methodological implications of our results, limitations of our approach, and suggestions for further research on this topic.

The relationship between fertility knowledge and unintended pregnancy: a survey among women of reproductive age in Shiraz, Iran

Unintended pregnancy poses significant health risks for mothers, often leading to induced abortions. Understanding fertility is crucial when it comes to predicting the likelihood of unintended pregnancy. This study employed a quantitative research approach, utilizing a survey method. The survey was conducted in 2022 and involved 1065 married women aged 15-49 residing in Shiraz. The data collection process involved the administration of a standardized questionnaire. The sampling process utilized a combination of multi-stage classification and systematic random methods. The analysis of variable associations demonstrated a significant positive correlation between fertility knowledge, age, husband's age, duration of marriage, and monthly income variables with the proportion of unintended pregnancies. It was observed that higher levels of education among both women and their husbands were associated with a lower proportion of unintended pregnancies. Additionally, employed women exhibited a significantly lower proportion of unintended pregnancies compared to non-employed women. The logistic regression analysis further confirmed that fertility knowledge and monthly income exerted a significant reverse influence on the likelihood of experiencing an unintended pregnancy. Lack of awareness regarding fertility knowledge among women can contribute to the occurrence of unintended pregnancies. Unintended pregnancies, in turn, can pose potential health risks for women.

Understanding sexual and reproductive health from the perspective of late adolescents in Northern Thailand: a phenomenological study

BACKGROUND

Worldwide, Sexual Reproductive Health (SRH) issues comprise a third of health problems for women aged 15-44. SRH education equips people with knowledge of concepts around sexuality and reproduction, and the skills help to make informed decisions to prevent sexual and reproductive ill-health, including unplanned pregnancy and HIV/AIDS, and other sexually transmitted infections (STIs). The aim of this study was to explore the experiences of late adolescents relating to SRH, examining their attitudes toward sex and contraception, and to identify the gaps in knowledge pertiaing to decision-making around risk-taking behaviour.

METHODS

A qualitative phenomenological study was undertaken with 30 adolescents aged 18-19, purposively and snowball sampled from a university in Northern Thailand. Data collaction took place from July 2020 to January 2021. In-depth individual interviews were conducted until data saturation was reached. Data were recorded, transcribed, and analysed in ATLAS.ti version 9, using Modified Interpretative Phenomenological Analysis to identify pertinent themes.

RESULTS

Participants revealed five key experiences of SRH related to sex and contraception: Keeping a secret; Seeking Freedom and Love; Having SRH education; Self-protection; Parental acceptance. All findings reflected the value and impact of SRH on the experiences of late adolescents.

CONCLUSIONS

This study provides detailed knowledge about adolescents' perspectives of SRH and rights in terms of accessing sexual and reproductive health care and information as well as autonomy in sexual and reproductive decision-making. Gaining SRH education can assist decision-making concerning contraceptive methods for family planning and STI prevention. The study recommends that SRH and rights-based education should be designed responsively and appropriately for female and male adolescents, their families, and society. The content of SRH should be informed and advocated by healthcare providers, educators, policy makers, and systems to empower adolescents in order to achieve effective SRH education.

Influences of parental monitoring and school connectedness on age at first sexual debut among unmarried female youth in Bedele town, Ethiopia: A survival analysis of timing using accelerated failure time model

Background

The age of first sexual debut among youth continues to attract interest as it marks the start of their exposure to a variety of sexual and reproductive health problems. Parental monitoring (PM) and school connectedness (SC) has been found to have an effect on this problem. Despite this fact, there is a dearth of literature on implications of PM and SC on age at first sexual debut in Ethiopia. Therefore, this paper examined the influences of PM and SC age at first sexual debut among female youth.

Methods

A retrospective follow-up study was conducted on 470 randomly selected female youth in Bedele town, Oromia regional state, southwest Ethiopia from February 1 to March 30, 2021. The age at first sexual debut was asked in full years for respondents who ever engaged in sexual debut at a time of data collection. Data were entered using Epi-Data version 4.6 and analyzed using Stata version 14. All variables at P-values less than 0.2 in bivariable analysis were exported to multivariable analysis. Multivariable Accelerated Failure Time (AFT) regression analyses using Weibull distribution were used to examine the association of age at first sexual debut with PM and SC at 5% level of significance.

Results

Overall, 132(28.1%) youths were begun sexual activities of which 79.54% was an early (vaginal penetrative sex before 18 years old). The incidence rate was 15.58/1000 PY with 95% CI of [13.14, 18.47]. The result shows that, female youth start first sexual debut as early as 10 year and mean age was 16.89±2.82. Only 27.97% of those who began sexual debut used contraception during first sex. Multivariable Weibull AFT regression analyses adjusted for different variables showed that high PM (Adjusted Time Ratio (ATR) 1.13: 95%CI; [1.04, 1.21]) and good SC (ATR: 1.14: 95% CI; [1.06, 1.22] significantly delays the age at first sexual debut.

Conclusions

Overall, four out of every five premarital sexual activities were early sexual debuts. High PM and high SC significantly decrease early sexual debut by delaying the age of sexual initiation. Therefore, family and school involvement focused on PM and SC of the youth is recommended as an important mechanism for preventing youths’ risky sexual behaviour, including early sexual debut.

Religiosity and Young Unmarried Women's Sexual and Contraceptive Behavior: New Evidence From a Longitudinal Panel of Young Adult Women

Drawing on weekly panel data from the Relationship Dynamics and Social Life study, we investigate the relationship between religiosity and young Christian women's premarital intercourse, hormonal contraceptive use, and condom use for a period of up to 2.5 years. Mediation analyses reveal what explains the relationship between baseline religiosity and young women's subsequent reproductive behaviors, with consideration for their normative environments, moral order and learned competencies, attitudes, and anticipated guilt after sex. Results indicate that the more religious a young woman is, the less likely she is to have intercourse and to use hormonal contraception in a given week. However, when having intercourse and not using a hormonal method, the more religious a young woman is, the more likely she is to use condoms. Religiosity's relationship to these behaviors operates largely through women's reproductive attitudes, anticipated feelings of guilt after sex, and past sexual or contraceptive behaviors. Together, these findings highlight the complex relationship between religiosity and premarital sex and contraceptive use, elucidate key pathways through which religiosity operates, and draw attention to the often overlooked role of sexual emotions.

Adolescent reproductive attitudes and knowledge effects on early adult unintended and nonmarital fertility across gender

Theory and evidence suggest strong short-term effects of attitudes toward, and knowledge about, reproduction on women's fertility. Adolescent attitudes and knowledge may also have longer-term implications about the contexts women perceive as appropriate for childbearing and their capacity to manage their preferences. Although previous research on men's fertility is limited, theory would suggest the links between adolescent attitudes and knowledge and subsequent fertility would also exist for men (though perhaps in different ways given the gendered meanings of sex, contraception, and reproduction). We analyze the relationship between reproductive attitudes and knowledge in adolescence and unintended and nonmarital first and second births in early adulthood, using the National Longitudinal Study of Adolescent to Adult Health (N = 9,431). Adolescent reproductive attitudes, especially life course consequences of early childbearing, predict the intendedness and marital status of first and second births. Adolescent reproductive knowledge is more often linked to the context of second births than first births. These associations vary by gender, but the overall results suggest that fertility schemas developed during adolescence predict behavior into early adulthood.

Do Adolescent Sexual and Reproductive Attitudes and Knowledge Predict Men and Women's Adult Sexual Partnerships?

PURPOSE

Adolescence is a key stage for forming knowledge and attitudes about sex and reproduction that may have long-term implications for adult sexual behaviors. Gender differences in experiences and socialization processes may affect the links between adolescent characteristics and adult behaviors.

METHODS

By following adolescent virgins aged 15 years and older from wave I through wave IV of the National Longitudinal Study of Adolescent to Adult Health (n = 4,152), we test whether adolescent boys' and girls' knowledge about, and attitudes toward, sex and reproduction influence the number of lifetime different-sex sexual partners and the likelihood of having concurrent sexual partners in adulthood, using negative binomial regression and logistic regression, respectively. Models are run separately by gender.

RESULTS

Men and women who reported greater physical benefits of sex as adolescents reported more lifetime different-sex sexual partners and were more likely to have concurrent sexual partners in adulthood. For women, adolescent perceptions of more social costs to sex were linked to fewer lifetime sexual partners, whereas greater birth control confidence was linked to more sexual partners. Women who more strongly felt that avoiding sexually transmitted infections was a hassle during adolescence were less likely to have concurrent sexual partners as adults, and men who were more knowledgeable about condoms during adolescence were more likely to have concurrent sexual partners.

CONCLUSIONS

Adolescent knowledge and attitudes about sex, contraception, and reproduction have implications for adult sexual behavior, but different aspects emerge as salient for men and women.

Unintended Childbearing and Marital Instability: An Emphasis on Couples' Intentions

The birth of a child can negatively impact relationship functioning, especially if one or both partners did not intend to have a child. As such, unintended or disagreed-upon births may elevate the risk of dissolution. In this paper, we use the National Survey of Family Growth to consider how married couples characterize the intendedness of their first birth and examine its linkage with dissolution. Nearly one-third of first marital births are unintended by at least one parent. When fathers do not intend the birth, regardless of whether or not mothers do, couples report an elevated risk of dissolution.

Adolescent Fertility Attitudes and Childbearing in Early Adulthood

Teens' attitudes about adolescent childbearing predict childbearing in the short term. If these attitudes reflect persistent goals and values, they may also be linked to later outcomes. To test long-term linkages, we analyze the association of adolescent fertility attitudes with actual and prospective fertility in adulthood using Waves I (1994-95) and IV (2007-08) of the National Longitudinal Study of Adolescent to Adult Health and focusing on men (N = 4,275) and women (N=4,418) without a teen birth. For women, we find that more negative teen attitudes predict lower hazards of a first birth up to around age 30 but that teens' attitudes are unrelated to planned childlessness among those who have not yet had children. Men's adolescent attitudes are unrelated to actual fertility or prospective intentions. For both men and women, more advantaged individuals are less likely to have had a child by around age 30; socioeconomic advantage is also related to postponement of childbearing rather than planned childlessness, though more so for women than men. We interpret the findings as evidence that, for girls, teens' attitudes toward adolescent childbearing capture an internalization of social schema about childbearing, childrearing, and sequencing with other life outcomes but do not reflect overall preferences about having children. More work is needed to understand the psychosocial factors that influence men's fertility.