A social learning model of adolescent contraceptive behavior

Central to an understanding of adolescent pregnancy and sexually transmitted disease prevention is the study of birth control use among teenagers. This paper critically reviews both recent research findings and dominant theories regarding adolescent contraceptive use. An alternative theoretical framework, one that relies on social learning theory, is offered. This framework uses three major components — environmental context, cognitive influences, and behavior execution constraints — as the foundation for understanding the learning and maintenance of contraceptive behaviors. First, environmental factors, such as the availability of role models, accurate sexuality education, and birth control services, are seen as supporting or inhibiting birth control use. Second, the importance of cognitive functions through which the external environment is viewed and which influence the adolescent's image of the consequences associated with contraceptive use are highlighted. Last, the actual behavioral skills teenagers need in order to use birth control successfully are considered.Received D.S.W. in Social Welfare from the University of California — Berkeley. Research interests are adolescent reproductive health, contraceptive use, and prevention of pregnancy and sexually transmitted diseases.     

Family change during an unwed teenage pregnancy

Sixteen white intact families with unwed teenage daughters completed Olson, Portner, and Bell's Family Adaptability and Cohesion Scales III of 1985 and Cervera's Family Alliance Questionnaire of 1989 at the sixth and eight months of the pregnancy and one month after the baby's birth. In the first interview, subjects also responded retrospectively to the questionnaires. The results suggest that on average the families became more cohesive and had improved family functioning over the pregnancy. However, individual families showed different patterns. The implications for practice are discussed in the paper.Received Ph.D. from New York University. Research interests include teenage pregnancy and infertility.     

Pregnancy in early and late adolescence

The degree to which adolescent pregnancy is viewed as a social problem varies with the age of the adolescent: the younger the adolescent, the greater the perceived risks and costs. The young adolescent has been found to be at greater risk medically; both the young adolescent and her infant are subject more frequently to prenatal and postpartum complications. A sample of 130 pregnant adolescents and adolescent mothers was surveyed to determine the factors that discriminate between girls who become pregnant in early years versus late adolescence. The younger group had begun dating and particularly steady dating at a significantly earlier age than the older group. The age discrepancy between the groups is even greater for the average age at which subjects began steady dating, that is, dating 1 boyfriend exclusively. While ages at which the adolescent began dating and particularly steady dating were found to be significantly related to early pregnancy, this vulnerability was increased by the subjects' lack of knowledge and use of birth control. Subjects in both groups reported that prior to pregnancy they desired quite frequently to leave their parents' home and be on their own. Early pregnancy appeared instead to have increased the adolescents' dependence upon her parents, especially the mother. The findings point to a need for instruction in reproduction and birth control to begin at an earlier age. Opportunity is needed for guided discussion among peers about their feelings regarding the costs and benefits of relationships and how one might deal with potential problems.     

Family life education for young inner-city teens: Identifying needs

Sexual decision making, perceptions of responsibility for birth control and pregnancy, and knowledge of contraception and the consequences of teenage pregnancy were assessed among 251 high-risk seventh- and eighth-grade black, inner-city adolescents to determine these young peoples' need for information. Survey results indicated that these adolescents were aware of contraceptive methods, but lacked practical information about requirements for obtaining them or method effectiveness. Many students were uninformed about the circumstances under which pregnancy can occur. Males indicated a willingness to have intercourse, regardless of the contraceptives used, if any, and believed responsibility for use of a birth control method belonged to females. Females believed themselves to be responsible for contraceptive utilization and preferred intercourse with adequate protection. Both genders endorsed the notion of mutual responsibility for an unplanned pregnancy and related decisions. Implications for school-based family life education programs for young adolescents are discussed.This research was supported by grants from the Illinois Department of Children and Family Services and the Pittway Charitable Trust, to the Center for Health Services and Policy Research of Northwestern University; the project was administered by the Ounce of Prevention Fund. Portions of this paper were presented at the 112th annual meeting of the American Public Health Association at Anaheim, California, November 1984. Conclusions or opinions expressed in this article are those of the authors and do not necessarily reflect the views of the Center for Population Options, Northwestern University, or the State University of New York at Buffalo.Received Ph.D. from Loyola University of Chicago. Major interests include policy analysis and maternal and child health care.Received Ph.D. from the State University of New York at Buffalo. Major interests include evaluation of the effectiveness of maternal and child health services.     

Always More Than Two: Vibrations,the Foetus,and the Pregnant Person in Childbirth Singing Practices

The goal of this article is to expand the theoretical approaches in feminist research that have explored the relationship between the pregnant person and the foetus in terms of constitutive relationality. I examine new ways of understanding and conceptualizing such a relationship, which may be enabled by the concept of vibration, by focusing on a childbirth-singing method developed and taught by Finnish music educator Hilkka-Liisa Vuori. This article is based on ethnographic fieldwork; I participated in a course on childbirth singing taught by Vuori and interviewed women who had used singing and vocalizing during pregnancy and labour. With the help of new feminist materialisms and feminisms inspired by Gilles Deleuze and Felix Guattari’s thinking, I suggest that sound and music as vibrations are agential matter that allow us to rethink the dyad between the pregnant person and the foetus. I argue that when the foetus–pregnant person dyad is approached as a constitutive relationality, more than two bodies are always involved.     

Pregnancy in the single adolescent girl: The role of cognitive functions

Interviews were conducted with 211 single adolescent girls, free of known psychiatric disturbance, who had undergone an elective abortion at a metropolitan municipal hospital. Besides providing help for the possible emotional stress connected with their situation, it was learned to what extent they were acquainted with birth control methods and had actually attempted to avoid their pregnancy. Similar data relating to birth control were obtained in interviews with a group of 200 single adolescents pregnant for the first time, and from 50 girls serving as controls who had effectively practiced birth control for at least 6 months. The great majority of the girls came from the same socioeconomic background, close to the subsistence level. The results indicate that about three-fourths of the pregnancies were unintended. Besides the implied external difficulty involved in finding a congenial low-cost birth control clinic, three psychological cognitive mechanisms were uncovered which virtually block the conversion of birth control knowledge into its successful practice. This finding suggests that adolescent out-of-wedlock pregnancies do not exclusively arise from motivational factors.Received M.A. and Ph.D. in sociology from Columbia University, New York. Associated with René A. Spitz, M.D. (Denver), for many years. Collaborated on latter's book,The First Year of Life, International Universities Press, New York, 1965. Current interests are in psychology of adolescence and infancy; prenatal psychological phenomena.     

Caesareans and Cyborgs

This paper argues that cyborg perspectives offer real possibilities for the debate around enforced caesareans and the search for a language to encompass embodied maternal subjectivity. It is suggested, with reference to the fictional narrative of Star Trek, that cyborg figures have the power to disrupt the liberal subject and the body in legal discourse, not least because the plethora of cyborgs challenges simple conceptions of connections/disconnections between bodies. Feminist readings of case law relating to enforced caesarean sections have raised questions about the notion of autonomy at the heart of liberal legalism, have argued that law is complicit with white male techno-medicine's approach to childbirth and focused upon the pregnant woman's lived experience of pregnancy. The recent Court of Appeal decision in St George's Healthcare N.H.S Trust v. S., Regina v. Collins and Others, ex parte S., where the pregnant woman's self-determination was upheld, provides a good opportunity to confront both the liberal story and the idea of connectedness between mother and unborn child. This revised version was published online in August 2006 with corrections to the Cover Date.     

Substance use by hispanic and white non-hispanic pregnant adolescents: A preliminary survey

White non-Hispanic and Hispanic adolescents aged 17 years and under n= 81) who delivered in San Jose, California area hospitals during a 6-week period were interviewed within 24 hours concerning their use of cigarettes, marijuana, and alcohol during pregnancy, and a number of background, social support, and psychosocial factors. Before 12–16 weeks of pregnancy, each of the substances studied was used by over 50% of this population, with 53% smoking cigarettes, 51% smoking marijuana, and 58% consuming beer or wine. Most substance use ceased after 12–16 weeks of pregnancy. There were no significant differences between ethnic groups in substance use. Multiple regression analyses showed that cigarette smoking decreased when social support was provided by the adolescent's partner and it was higher if parents smoked and/or used alcohol p<.001. Parental substance use, combined with lack of social support, was also associated significantly with marijuana use p<.001, explaining 30% of the variance. Use of birth control prior to pregnancy was related to beer and wine consumption p<.05, explaining 16% of the variance. Active inclusion of members of the adolescent's support network in pregnancy care, and initiative by educators and clinicians in discussing substance use, may accelerate its cessation. Ethnicityrelated behavior change strategies may be of little relevance to adolescent substance use during pregnancy.This study was funded by grant no. MCR-060466-01-0 from the Maternal and Child Health and Crippled Children's Services Research Program, Bureau of Health Care Delivery and Assistance, DHHS, to the Department of Gynecology and Obstetrics, Stanford University School of Medicine. The first author is supported by a fellowship from the Pew Memorial Trust.Received Ph.D. from Stanford University. Main interest is adolescent pregnancy and health of Latino populations.Received M.D. and Ph.D. from the University of Kansas. Main interest is perinatology.     

The First Sexual Experience Among Adolescent Girls With and Without Disabilities

First sexual intercourse is an important experience in the young adult life course. While previous research has examined racial, gender, and socioeconomic differences in the characteristics of first sexual intercourse, less is known about differences by disability status. Using a racially diverse (27% Black, 20% Hispanic, and 53% non-Hispanic white) sample of 2,729 adolescent girls aged 12–24 at first sexual intercourse from the National Longitudinal Survey of Youth 1997, this article examines the association between disability and type of first sexual relationship, degree of discussion about birth control, and pregnancy wantedness. Regression analyses indicate that girls with mild or learning or emotional disabilities experience first sexual intercourse in different types of relationships than girls without disabilities. Adolescents with learning or emotional conditions have greater levels of discussion about birth control with their first sexual partners than those without disabilities. In addition, among those who do not use birth control at first sexual intercourse, girls with multiple or seriously limiting conditions are more likely to want a pregnancy—versus not want a pregnancy—at first sexual intercourse. Findings indicate that disability status is important to consider when examining adolescent sexuality; however, not all youth with disabilities have equal experiences.     

Pregnancy dismissals and theWebb litigation

Conclusion It is generally accepted that women have the right to participate in the workplace, although only if replicating the traditional male mode of working. To this extent, the right to formal equality with men is generally agreed to be a legitimate goal for legislation. However, where the limitations of such assimilation to a male norm come into sharp focus, as they do in the context of pregnancy, the restrictions placed on improving the position of women are evident. The courts seek to accept the arguments of employers that some limitation on the rights of women to participate fully in the workplace is necessary, with the unarticulated assumption that pregnancy constitutes a real difference between the sexes, incompatible with their notion of (formal) equality. Thus, it is argued, that the advances so far gained in the relation to pregnancy dismissals do not represent a cultural shift in attitudes towards accommodating pregnant women and women with children into the workplace. They have been adopted only reluctantly by the UK courts and legislature, with limitations still being placed on their effect particularly in respect of dismissals on account of pregnancy-related illness. The rights of women not to be discriminated against solely on the basis of their biological ability to give birth must continue to be advocated and given attention; complacency will likely see those rights progressively restricted.     

What role does gender have in shaping knowledge that underpins the practice of midwifery?

Midwifery is an ancient profession that continues to be practiced almost exclusively by women. This paper explores the role that millennia of gender exclusivity has had in shaping the knowledge that informs the profession. Prior to the Renaissance this knowledge was exclusively female, largely oral, tacit and intuitive whilst recognising childbearing as an important transformative period in a woman’s lifecycle. Male scientific enquiry in the seventeenth century into human anatomy extended to women’s bodies and childbirth and disrupted the female ways of knowing. Their positivist ontology focussing on the mechanics of childbirth created an opportunity for intervening in a normal process and receiving payment for it. The perceived structural superiority of a male obstetric ontology of childbirth has posed an existential threat to the midwifery profession. This paper concludes by discussing how 20^th century professional regulation of midwifery has encouraged midwives to use patriarchal structures and frameworks of knowledge to co-exist within the hegemonic biomedical model advocated by the majority of their obstetric colleagues.     

‘The Woman was a Stranger’: childbirth and community in eighteenth-century England*

On 17 December 1766 James Field stood accused at the Old Bailey of the ‘wilful murder of a new born child, by casting it into a tub of water’. The case was exceptional in many ways—not only was the accused male but he and his family had removed themselves from the network of neighbourly interactions that characterised lower status life in this period. As a result, the court's deposition statements record ideas of belonging and community with unusual clarity. Using Field as a case study, this article explores the involvement of the local community in the experience of childbirth in the eighteenth century. It will argue that childbirth had an active role in the creation of neighbourhood, and momentarily captured shifting eighteenth-century understandings of community.     

Contraceptive behavior in adolescence: A decision-making perspective

The contraceptive behavior of adolescent girls was viewed from a decision-making perspective. A semistructured interview protocol was used in interviewing 120 girls aged 12–19 in three clinics (Teen Family Planning, Prenatal, Pediatric Acute Care) at Michael Reese Hospital and Medical Center on (1) demographic in formation; (2) sexual and obstetric history; (3) contraceptive and sexual knowledge, attitudes, and practices; (4) environmental pressures; (5) personality factors; and (6) decision-making style. We found that the girls were generally poor contraceptors. They viewed the costs of contraception (in terms of safety) to be high; and they positively valued physical intimacy, opportunities for which come up unexpectedly and sporadically. These factors, along with their ambivalent views toward pregnancy and childbearing seemed to encourage their risk-taking behavior. Once pregnancy occurred, it was carried to term because of the strong internal and external pressures they felt to have and keep the baby. The peer-led intervention program that we are developing based on the survey findings will focus on (1) the teenagers' lack of accurate and complete knowledge about birth control and conception, (2) their limited sense of options concerning birth control and pregnancy outcomes, and (3) their poor understanding of and lack of insight into what motivates their behavior.This study is part of the investigation being conducted by the YADMAC (Young Adult and Adolescent Decision Making About Contraception) Project at Michael Reese Hospital and Medical Center, 2959 South Cottage Grove, Chicago, Illinois 60616. The authors are all members of the YADMAC research team.Received Ph.D. from the University of Chicago. Current interests are human sexuality and reproductive behavior. Currently at Department of Psychology, St. Xavier College.Received M.D. from the University of Michigan. Current interests are liaison child psychiatry and adolescent sexuality.Received Ph.D. from the University of Chicago. Current interests are early adolescent development issues.Current interests are puberty and sex differences.B. A. candidate in social work, Roosevelt University. Current interests are adolescent sexuality and contraceptive behavior.     

From Sancitity to Screening: Genetic Disabilities, Risk and Rhetorical Strategies in Wrongful Birth and Wrongful Conception Cases

This analysis scrutinises the rhetorical strategies used by judges in wrongful life and wrongful birth actions as evidence for the assertion that the judicial reading of public policy in such cases has undergone a significant shift which is likely to accelerate as genetic knowledge grows and health care resources shrink. The implications of the predicted move towards increased genetic testing of prospective parents are traversed in relation to feminist analyses of the impact of genetics on reproductive technology. These are viewed as forming a nexus with the current social constructions of disability and the contemporary cultural preoccupation with risk, in a context of the increasing commercial importance of genetic information. It is argued that women cannot make free and informed choices about genetic testing and pregnancy unless legal and social mechanisms which protect those choices are in place. This revised version was published online in August 2006 with corrections to the Cover Date.     

"Sort of part of the women's movement. But different": mothers' organisations and Australian feminism

In spite of the ‘maternal turn’ in feminist theory, at the level of policy and practice feminism has neglected the politics of motherhood. This article explores the ambivalent relationship between the Australian women's movement and mothers' organisations formed to contest the management of childbirth and lactation. It argues that the advent of a ‘politics of difference’ allows greater acceptance of seemingly non-feminist positions on maternity and recognition of the role played by childbirth reformers in effecting social change. It examines Australian feminist attitudes to motherhood before discussing the response to feminism of women's groups which saw themselves as possibly part of a wider women's movement, but ‘different’ from mainstream feminism. A strong familial orientation was often contradicted by the everyday lives of activist women, who gained new skills and self-confidence in a significant challenge to medicalised reproduction.     

Louise Bourgeois,ageing, and maternal bodies

This article explores late works by contemporary artist Louise Bourgeois that illuminate current concerns about ageing maternal bodies and the ambivalent responses of fear and loathing that they provoke. In 2003, Louise Bourgeois made an installation for the Freud Museum in Vienna entitled The Reticent Child, on the subject of her own earlier pregnancy and birth of her son, one of several works featuring maternity and fertility which Bourgeois has created in old age. In Nature Study 2007, made at the age of 96 years, she depicts carnal couples and pregnant and birthing figures embodied in brilliant pinks and scarlet reds. Bourgeois represents women as the powerful agents of the maternal function, marking a return to motherhood as a central topic of her earlier work. Edward Said posited sources of cultural meaning as ‘the whole notion of beginning, the moment of birth and origin … reproductive generation, maturity’, and ‘the last great problematic … the last and late period of life, the decay of the body’ (Said, 2006: 4–6). What does it mean for Bourgeois to return to the theme of birth in her nineties and how does it resonate with contemporary anxieties about the ageing maternal body? If the space of the gallery is a safe arena for a woman artist to present sexuality and maternity in old age, how are older women who break codes of fertility represented elsewhere? In a culture which is hostile to the conjunction of ageing women with motherhood, I shall argue that Bourgeois’ late maternal works can help to undo the taboo on older mothers.     

人口再生产价值视角的女性生育和劳动权益保障

近年来,我国生育政策进行了几次调整,体现了国家对人口再生产在社会发展中重要性的认同,但是生育率未能得到有效提升,而女性在劳动力市场遭受歧视的现象依然广泛存在.研究认为,生育与工作家庭的冲突是我国生育现状的主要影响因素,而"全面三孩"政策可能加剧这种冲突.研究建议:应以人口再生产与物质生产理论为基础,重新审视人口再生产在...     

frailty and debility

Drawing on empirical research from two focus groups, this article investigates the narratives and discourses that emerged around pregnancy, technology, birth and motherhood. In so doing, the article engages in some long-standing debates within feminism around embodied and maternal subjectivity, agency and identity. Seen here, the focus groups serve initially to remind us of the pervasiveness of gender inequality and the continual ambiguity of, and anxieties around, maternal subjectivity. The focus groups reconfigure these issues through a technological lens, which in turn seems to offer new spaces where agency can be (momentarily, problematically) claimed. This in turn extends existing debates in new directions through the particular framework of technology that is variously figured here as an object, as information and as imaginary digital space. All of these constructions, however, become problematic as they—despite their promises—nevertheless ultimately and profoundly return the women to an emplaced, embodied subjectivity that has been at the heart of feminist debate for so long.     

Male adolescent birth control behavior: The importance of developmental factors and sex differences

A survey of sex and birth control behavior of 51 male adolescents aged 15–17 was conducted utilizing a structured interview protocol. The purpose of the study was to describe male adolescent birth control behavior incorporating developmental issues, and to interpret the findings in light of what is known about female birth control behavior. Based on research with teenage females, three social influences were examined for their possible impact on male birth control behavior. A new operational definition ofmale effective birth control usage involving the effectiveness of the method and the consistency of its usage was developed. Findings similar to those obtained from research on females suggest that adolescent sexual partners may be the only direct social influence on adolescents' birth control usage. Results indicating differences from research with females suggest that in general: male birth control behavior is primarily self-oriented, males are more likely to be effective contraceptors with casual partners than with girl friends, males are more likely to communicate about sex and birth control with similar age peers than with family members and/or other adults, and that teen males view sex and birth control decisions as female decisions.He also conducts private psychotherapy, specializing in marital and family therapy. His doctorate from the University of Pennsylvania is from a unique joint program in marital/family therapy and sex education. His interests include sex roles and their impact on intimate relationships, adolescent development, and male sexuality. This article is based on his doctoral dissertation.faculty member in the Human Sexuality Program. Dr. Rose served as supervisor on Dr. Cohen's doctoral dissertation.     

YouTube: a new space for birth?

Birth, in many societies, is considered to be a private affair. Although health and medical professionals usually assist, the only other people who share the birth process with mothers are their nearest and dearest. With the rise of information communication technologies, however, birth is no longer an exclusively private event. Some women are now sharing their birthing experiences with millions of viewers who are part of the online video ‘community’ YouTube Broadcast Yourself. Searching the word ‘birth’ on YouTube results in close to one million ‘hits’. This article is based on a small-scale, qualitative research project, which involved viewing and making notes on several hundred online videos of birth on YouTube and the accompanying posts and commentaries about the videos. These data were analysed through a feminist, poststructuralist and geographical lens. Throughout the article the term ‘cyber/space’ is used to highlight the mutually constituted nature of ‘real’ and virtual spaces. The article concludes that although YouTube has the potential to open up new windows on birth, this potential is not yet being realized. YouTube does not overcome or render insignificant material expressions of power, instead it typically privileges US experiences of birth, reiterates discourses of ‘good’ mothering and censors particular (mainly vaginal) representations of birth.