Parental influences on contraceptive autonomy among adolescents in the Southern USA.

Abstract

Research on contraceptive coercion among adolescent and young adult women in the USA focuses primarily on clinicians and male sexual partners. Less recognised is how parents may limit their daughters' autonomy to decide when and if to initiate or discontinue prescription-based contraception and to use their preferred method. This study used thematic content analysis of interviews conducted with 46 adolescent and young adult women living in the southern USA regarding their parents' efforts to control their contraceptive decision-making and use during adolescence. The analysis found that participants' parents constrained their contraceptive autonomy in three distinct ways. First, parents who prohibited their daughters' prescription contraceptive use in general were influenced by conservative religious beliefs and sexual stigma. Second, parents who insisted their daughters specifically not use hormonal contraception perceived it to be harmful. Third, parents who required their daughters' prescription contraceptive use insisted they use oral contraceptive pills or a hormonal IUD. Some parents who initially forbade their daughters from using prescription contraception later pressured them to initiate use once they reached the age of majority. The study findings indicate that efforts to enhance young women's contraceptive autonomy should engage parents in supporting their daughters' sexual and reproductive health and well-being.