In the past, we have seen a rise in adolescent pregnancies and an increase in raising awareness about teen pregnancies. There were/are shows (Teen Mom on MTV, Unexpected on TLC, or My Teen is Pregnant and So am I, also on TLC) made about the journey of being a teen mom. Adolescents (ages 10-19) have the lowest level of contraceptive knowledge and use (Todd & Black, 2020). An important part of reducing adolescent pregnancies was safe and effective contraception campaigns targeted towards young people under 16 years of age (Bierley & Larcher, 2014). Ethical problems come into play though, when considering a person's age and their autonomy, as there have been pregnancies reported at as young as 12 years old (Bierley & Larcher, 2014). Compared to adults, young people may not be given the right to their own autonomy because they are perceived as “not mature enough” and vulnerable to coercive influences. But, as they reach an age of making their own choices of sexual behavior, and understanding the consequences of their actions, not being granted contraceptive advice seems to further take away that individual autonomy. Individuals should be given all relevant information, regardless of their age, capacity, etc., in order to empower them to make a choice that is right for them (Bierley & Larcher, 2014). Additionally, health care providers may also act as a barrier, affecting the autonomy of the individual. Their own personal morals or beliefs, and unconscious biases may be applied to the way they proceed with the treatment of the adolescent (i.e. waiting until the next menses or until STI screening results are available or by erroneously insisting on a Pap smear prior to starting contraception) (Todd & Black, 2020). All three articles suggest that supporting adolescents’ health should include access to confidential sexual and reproductive health care and medically accurate contraceptive information, while also receiving counseling that is appropriate to the age group. Furthermore, health care providers should acknowledge the way in which they provide treatment, and that it is not perceived as directive or coercive (Bierley & Larcher, 2014, Lindberg et al., 2018 and Todd & Black, 2020). Overall, the big issue here seems to be autonomy, and the ability of this age group to make informed decisions. So, as future health care providers, in what ways could we continue to make sure they still receive the care they need while keeping their autonomy?
References:
Brierley, J., & Larcher, V. (2014). Clinical trials of contraceptive agents in those under 16 years of age: are they necessary, ethical or legal?. Archives of disease in childhood, 99(12), 1070–1073. https://doi.org/10.1136/archdischild-2014-306854
Lindberg, L. D., Santelli, J. S., Desai, S. (2018). Changing patterns of contraceptive use and the decline in rates of pregnancy and birth among U.S. adolescents, 2007–2014. Journal of Adolescent Health, 63(2), 253–256. https://doi.org/10.1016/j.jadohealth.2018.05.017
Todd, N., & Black, A. (2020). Contraception for Adolescents. Journal of clinical research in pediatric endocrinology, 12(Suppl 1), 28–40. https://doi.org/10.4274/jcrpe.galenos.2019.2019.S0003
Hi Kayla!
ReplyDeleteVery interesting post, as someone who comes from a background of strict parents and a culture that sees the topics of sex and birth control taboo, I have seen the measures and obstacles that many young women attempt to overcome to get birth control. For many, birth control is not for reproductive measures but rather for menstrual regulation. In not allowing young girls with the autonomy to elect this form of treatment due to their age and potentially not being “mature enough” to make an informed decision, we are immediately creating an environment and image in their head of the healthcare field in which we are not valuing their opinion and voice, two very important skills to develop at a young age. I found an article that was looking at contraceptive use in Kenya and developing a more adolescent marketing tactic for young people to feel comfortable and educated on the topic. The article discussed that many were embarrassed to talk about the subject as well as the biased input of their parents and health care providers (Chandra and Akwara, 2020). I agree with you on how we should provide young women with all of the necessary information and tools to allow them to make informed decisions about the use of contraceptives. As aspiring health professionals, we ought to provide all necessary tools and resources and materials ideally free of charge to empower young people and their autonomy of their body.
Reference: Chandra-Mouli, V., & Akwara, E. (2020). Improving access to and use of contraception by adolescents: What progress has been made, what lessons have been learnt, and what are the implications for action? Best Practice & Research Clinical Obstetrics & Gynaecology, 66, 107–118. https://doi.org/10.1016/j.bpobgyn.2020.04.003
This is an important topic to cover, Kayla! I agree with the statement preventing adolescent girls from access to contraceptives can impede autonomy. With our evolving world, young girls have access to more information now than ever before through the internet. HIPPA’s confidentiality laws are so important for protecting young girls’ access to adequate healthcare. Each state’s laws vary regarding confidentiality for medical records of minors. In 29 states, all minors are able to consent to prenatal care without permission of a parent (Guttmacher Report, 2021). Legalities of this law vary greatly between states. In some states, the physician can inform the parent during the second and third trimester of pregnancy, and in other states the parent can be notified if the physician believes this would be in the best interest of the patient (2021). The variations of this law go on, but I believe inhibiting adolescent access for contraceptives and adequate healthcare will only make the issue worse.
ReplyDeleteReferences:
Guttmacher Institute. (2021, November 10). Minors' access to prenatal care. Guttmacher Institute. Retrieved November 29, 2021, from https://www.guttmacher.org/state-policy/explore/minors-access-prenatal-care.