Associations between parent-female adolescent sexual and reproductive health communication and first sexual and reproductive healthcare seeking experiences amongst low income women in suburban areas outside of Atlanta, Georgia. Open Access

Standish, Kathryn (Summer 2020)

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Adult and adolescent women’s autonomy over their sexual and reproductive health (SRH) care is vital to women and society’s overall wellbeing. Unintended teenage pregnancies can have short and long-term adverse health effects, as well as negative social and financial implications for the individual and the community (Nove, Matthews, Neal, & Cambacho, 2014; CDC, 2019a). Use of contraception, access to teen friendly SRH services and counseling can reduce teen pregnancies and influence other adolescent SRH outcomes (UNFPA, 2014). Non-use, as well as misuse of contraception is a large contributor to unintended teenage pregnancies (Bell, Gifford, Rashid, McDuffie, & Knight, 2020; Potter, et al., 2009, Manlove et al, 2004).Studies have shown parents play a significant role in reducing adolescent unintended pregnancies (Widman, et al., 2016; Flores & Barroso, 2016) and can also hold the greatest influence over a female adolescent’s SRH outcomes (Lantos, et al., 2019; Somers& Surman, 2004). This study aims to assess the impact of parent-female adolescent (parent-adolescent) SRH discussions on female adolescent’s first sexual and reproductive healthcare seeking experience amongst low income women in suburban areas outside of Atlanta, Georgia.

This study used secondary data to assess 25 Life History interviews using qualitative methods. This study found that parent-adolescent SRH discussion influenced adolescents’ first care seeking experience. Results are organized into three sections: 1) initiation of SRH discussions; 2) content of discussions; and 3) influence of discussions on participant’s care seeking experience. Most initiation of SRH discussions were prompted by a parent’s desire to prevent their child from experiencing negative SRH outcomes, the participant moving away from home, or when the participant may become sexually active. The content of these discussions were usually centered around contraception, SRH services, and protection of the adolescent’s physical health and future. Discussions influenced SRH care, and often impacted which providers participants sought out, the type of contraceptive method they received, and in some cases when they started use. Participants were also more likely to let their parents know when they were ready for SRH services if they had already received conversations regarding SRH care or contraceptive use. Parental guidance scheduling adolescents' first appointment in this new sector of the healthcare system may be important facilitating access. Current SRH guidelines for adolescents primarily concentrate on the types of contraceptive methods available to use. Parental guidelines that tell their teen what to expect logistically, financially, and emotionally may help alleviate some of the unfamiliarity and anxiety associated with first time use. More research is needed to explore the relationship between parent-adolescent discussions and its impact on adolescents’ SRH service use.

Table of Contents

Table of Contents

Chapter 1: Introduction 1-3

Context and Problem 1

Research Objectives 3

Chapter 2: Literature Review 4-24

Unintended Pregnancies 4

Teen Pregnancy and Reproductive Health Outcomes 7

Factors that Influence Adolescent Sexual and Reproductive Health Outcomes 8

Parent-Adolescent Communication 11

Sexual and Reproductive Health, Religion, and Legislation in the South 16

Justification for Research 23

Chapter 3: Project Content 25-30

Methods 25

Contributions 25

Setting and Population 25

Study Procedures 27

Ethical Considerations 28

Data Analysis 29

Results 31

Initiation of SRH Discussions 31-45

Content of SRH Discussions 35

Impact of Sexual and Reproductive Health Discussions on First Care Seeking Experience 38

Care-seeking Implications for Those who Received SRH Discussions 39

Implications of Lack of Sexual and Reproductive Health Discussions 42

Chapter 4: Discussion, Conclusion, and Recommendations 46-54

Discussion 46

Sexual and Reproductive Health Discussions 46

Did not Receive Sexual and Reproductive Health Discussions 48

Recommendations 49

Parents 49

Schools 51

Future Research 51

Limits and Strengths 52

Conclusion 54

Additional Pages 55-60

Literature Referenced 55

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