Childbearing Motivations and Desires, Fertility Beliefs, and Contraceptive Use among Urban African-American Adolescents and Young Adults with STI Histories

Assessing Parenting Attitudes Among Adolescents Seeking Healthcare with a Brief Pregnancy and Parenting Attitudes Questionnaire

PURPOSE

To use modified Parenthood/Pregnancy Attitude, Timing and How important is pregnancy prevention (PATH) questions to assess parenting attitudes and reproductive desires in adolescents and young adults (AYAs).

METHODS

Between November 2020 and January 2022, we recruited participants 13-22 years old via a convenience sample from an Adolescent Medicine outpatient clinic at an urban children's hospital to participate in a cross-sectional survey. The survey was self-administered on a tablet and was adapted from the original PATH questions.

RESULTS

300 adolescents completed the survey. Median age 17 years, 87.3% identified their assigned sex at birth as female, 43.0% identified as Black, and 55.3% had public insurance. 61.3% reported ever being sexually active. 62.7% reported a desire for future children, 70.2% listed a time frame or specific age when they would like children. Those who had ever had sexual activity were more likely to desire future children. Most participants (68.5%) reported pregnancy prevention was very important or important.

CONCLUSIONS

To our knowledge, this is the first study assessing parenting attitudes and reproductive desires of AYA patients assigned sex female at birth and assigned sex male at birth in a clinical setting. Most AYAs reported they were sexually active, had a desire for future children, had a certain time frame in mind for having children, and would want to prevent pregnancy until that time. Assessing AYA's parenting attitudes and reproductive desires supports the use of shared decision making and the provision of reproductive health counseling aligned with patients' preferences and priorities.

Female or Male Fertility Motivation? Which One Determines the Number of Children? (A Comparative Study)

Background

In the last three decades, childbearing in Iran has decreased more than many countries in the world. The aim of this study was to explore the fertility motivation of Working women and their husbands and discover which one determines the number of children.

Materials and Methods

This correlational study was conducted on 540 employed, married women and their husbands (270 couples) living in Mashhad, Iran, during 2017-2018. The participants were selected through multistage cluster sampling. Then, a random number table was used. Subsequently, questionnaires were distributed and completed at home, and collected after 24 h. Data were collected using a demographic characteristics form and the Childbearing Questionnaire (CBQ).

Results

The mean(SD) positive motivation scores of men and women differed significantly [92.77 (13.04) Vs. 92.22 (13.51) df = 4; p = 0.001;]. The mean (SD) negative motivation scores of men and women also differed significantly 55.42 (10.94) Vs. 56.78 (10.57) df = 4; p = 0.001;].

Conclusions

According to the scores obtained for the positive and negative fertility motivations of working women and their husbands, women were more in favor of having children and had an ambivalent motivation to bear children. Moreover, the working women's spouses were more indifferent to fertility. The results of this study can help reproductive health policymakers in childbearing.

"Having a Child Meant I had a Real Life": Reproductive Coercion and Childbearing Motivations Among Young Black Men Living in Baltimore

Despite disproportionate health outcome disparities experienced by Black women, reproductive coercion (RC), a range of behaviors to promote unwanted pregnancy and childbearing motivations among poor young Black men are underexamined in current empirical literature. We aimed to describe perceptions of RC behaviors and childbearing motivations among poor young Black men in Baltimore City. We recruited a convenience sample of young Black men aged 18 to 25 (N = 25). Data were collected using semi-structured interviews and demographic surveys. Thematic analysis was guided by Miller's Traits-Desires-Intentions-Behaviors (TDIB) framework. According to survey data (N = 23), mean age was 22 (2.1). Majority of participants reported sexual relationships with one person (74%; n = 17), almost half (48%; n = 12) were biological fathers, and six (26%) participants reported using RC toward an intimate partner; three (13%) reported experiencing RC behaviors from a female partner. According to qualitative interviews (N = 25), participants described perceived women-partner motivations for RC as entrapment. Childbearing motivations were influenced by (a) legacies and bonding and (b) escaping/correcting the past. Childbearing desires included (a) love feelings and intimacy and (b) good father. Childbearing intentions included (a) resistance to medical interventions and (b) preparation. Perceptions of RC and childbearing motivations reflected desires from participants to fulfill cultural expectations for conventional masculinity and enhance personal dreams for fatherhood. Although some perceptions and behavior patterns aligned with previous studies, RC was relatively rare in this sample. Findings demonstrated nuanced antithesis to stereotypical notions of young Black men and fatherhood. Provision of reproductive care for young men and their sexual partners should include discussions about RC, pregnancy motivations, and healthy sexual communication strategies.

Childbearing Motivation Questionnaire

O presente artigo objetiva descrever os procedimentos de adaptação e evidências iniciais de validade do Childbearing Motivation Questionnaire (CBQ) para o Brasil. O CBQ está constituído por duas escalas: a primeira avalia as motivações positivas para ter filhos (PCM) e a segunda, as motivações negativas (NCM). A adaptação foi realizada em cinco etapas: 1) tradução do instrumento; 2) síntese das versões traduzidas; 3) avaliação por juízes experts; 4) avaliação pelo público-alvo e 5) tradução reversa. Para a avaliação da estrutura fatorial realizou-se análises fatoriais exploratórias e confirmatórias em uma amostra de 1894 brasileiros de 18 a 68 anos de 25 estados do Brasil. A escala PCM apresentou uma solução fatorial de segunda ordem similar à proposta pelo autor enquanto a NCM apresentou uma estrutura unifatorial com boas propriedades psicométricas. Os resultados mostram o CBQ como um instrumento válido para a mensuração das motivações para ter filhos na população brasileira.

The Effects of Trauma, Violence, and Stress on Sexual Health Outcomes Among Female Clinic Clients in a Small Northeastern U.S. Urban Center

Background: Threats to sexual health can emerge across one's life span and are influenced by individual and interpersonal experiences, as well as certain environmental exposures. Although previous research has recognized the importance of ecological frameworks to understand the complexity of health and behaviors in marginalized communities, there continues to be a dearth of research that truly utilizes this perspective to gain insight into the multifaceted factors that can concurrently influence threats to sexual health among women. Methods: A sample of 279 ethnoracially diverse women were recruited from a U.S. northeastern small urban center health clinic to participate in a parent study on trauma and immunity. A hierarchical block analysis was conducted to investigate associations between women's experiences of trauma, stress and violence (i.e., childhood trauma (CHT), intimate partner violence (IPV), neighborhood stressors), and sexual health outcomes and behaviors (i.e., lifetime sexually transmitted infection [STI] diagnosis, concurrent partnerships, and lifetime sex trading). Results: In the full hierarchical model, IPV and life stress trauma were associated with lifetime sex trading and partner concurrency. Also in the full model, sexual CHT was associated with lifetime STI acquisition and partner concurrency, while emotional CHT was associated with lifetime sex trading. Lastly, as neighborhood disorder increased, so did the number of lifetime sex trading partners. Conclusion: Sexual health assessments in clinical and community settings require a holistic, comprehensive, and meaningful approach to inform person-centered health promotion intervention. Prevention and treatment interventions require a focus on parents and families, and should assist adolescents and young adults to adopt therapies for healing from these experiences of trauma, violence, and stress. Interventions to enhance sexual health promotion must also include the following: advocacy for safe environments, social policy that addresses lifelong impacts of CHT, and fiscal policy that addresses economic vulnerability among women and threatens sexual health. Further recommendations are discussed.