Parents of teen girls are more ready to accept their daughters being offered birth control pills and condoms during doctor visits than other, more effective and long-acting contraceptive methods, according to a new study in the Journal of Adolescent Health. The study also shows that the more that a parent respects their daughter's autonomy, the more likely that parent is to accept a doctor offering their teen any contraceptive.
"Among U.S. adolescents, rates of unintended pregnancies and sexually transmitted infections remain high," said lead author Lauren Hartman, M.D., a clinical fellow in adolescent medicine at the University of California, San Francisco. "Despite increased use of contraceptives by adolescents in the last twenty years, effective methods are still underused and too many sexually active teens do not use condoms" to block transmission of sexually transmitted diseases (STDs).
Parents can help improve contraceptive use among teens, she said. This study explored parents' attitudes towards seven contraceptive methods their daughters might learn about during a confidential health care visit and examined the factors that influence a parent's acceptance of different methods.
For the study, 261 parents/caregivers with a daughter aged 12 to 17 completed a phone survey that determined their attitudes towards different contraceptive methods as well as their parenting beliefs. Birth control pills won greatest acceptance (59 percent). In decreasing order of acceptability were condoms (51 percent), injectable contraceptives (46 percent), emergency contraception, also known as the morning-after pill (45 percent), birth control patches (42 percent), implants (32 percent) and intrauterine devices or IUDs (18 percent).
"The strongest predictor of acceptability of all methods was parental recognition of their teens' autonomy," said Hartman. She added that clinicians can use these findings to educate parents about STDs and longer-acting methods, which are the most effective. One reason parents may not accept these methods, the researchers surmised, is that parents might associate long acting contraception, like IUDs, with an ongoing sexual relationship.
Cori Baill, M.D., a board-certified obstetrician-gynecologist and former member of the national medical committee for Planned Parenthood, noted that parents' disapproval of long-acting contraceptive methods may also reflect U.S. historical events around the Dalkon shield, which the paper didn't mention. The Dalkon shield was an aggressively marketed IUD with considerable safety problems.
"IUDs aren't accepted in the U.S. for many reasons, across all ages, concerning societal attitudes towards medicine and the memory of the Dalkon shield," said Baill. However, she commented, parents need to understand that the risk of pregnancy outweighs the risk of any contraceptive method, including the IUD.
Lauren B. Hartman, M.D., Mary-Ann Shafer, M.D., Lance M. Pollack, Ph.D., Charles Wibbelsman, M.D., Fay Changa, and Kathleen P. Tebb, Ph.D. (2012). Parental Acceptability of Contraceptive Methods Offered to Their Teen Duringa Confidential Health Care Visit, Journal of Adolescent Medicine, dx.doi.org/10.1016/j.jadohealth.2012.06.013