Parental Disapproval and Difficulties Accessing Routine Health Care Influence Contraceptive Choice and Pregnancy Outcomes

Background: Prescription birth control is more effective than over–the-counter (OTC) methods like condoms, but a need for secrecy or difficulties accessing medical care may contribute to the reasons teens more commonly use OTC birth control. Young women using OTC methods may be more likely to experience first pregnancies while still in adolescence than those using prescription methods.

Methods: Limited access to health care services and perceptions of disapproving parental attitudes toward sex and birth control use were examined as barriers to use of prescription birth control with 1,625 sexually active females who participated in National Longitudinal Study of Adolescent Health. Bivariate logistic regression was used to determine if these barriers affected the choice of birth control methods. Time from sexual initiation to first pregnancy was analyzed using Kaplan–Meier survival curves and Cox proportional hazards models. All analyses used self-report data from adolescents’ first sexual experience and the most recent sexual experiences reported at Wave I and II.

 

Results: Experiencing barriers to healthcare access and perceiving parent disapproval resulted in less frequent use of prescription birth control relative to OTC. Users of prescription methods reported a significantly longer time to first pregnancy.

Conclusion: These results indicate that increasing young women’s access to basic preventative medical care is likely to encourage use of prescription birth control, but that taking full advantage of these more effective methods is likely to depend on their ability to access them independent of parental consent.