What Do Youth Think about Birth Control Methods?

A few years back, the Department of Health asked the ACT COE to gather young people’s perspectives on family planning services. With the help of CAPP and PREP providers, we were able to speak with 336 youth in 36 focus groups all over New York State. What we found was, for the most part, not surprising: Many had confidentiality concerns centered around the fear that parents would find out or people would know their business. Youth were afraid of being judged by clinicians and other staff; talking about sex and contraception felt awkward; and clinics did not always seem friendly to youth. There were also fears about getting bad news at a clinic visit.

No surprises there. But to me, one finding did stand out: the overwhelming negative beliefs and attitudes that youth expressed about birth control methods.

Participants were asked to name contraceptive methods that they were aware of and briefly discuss each method. Our researchers counted the number of negative vs. positive remarks made about each contraceptive method – and in nearly every case, the negative comments far outweighed the positive comments.

Negative comments most often referred to side effects they had heard about, as well as perceived lack of reliability. Emergency contraception in particular was considered dangerous – and had five times as many negative comments as positive. The only method where the good edged out the bad? Abstinence. Abstinence was not mentioned as frequently as other methods, but youth clearly understood that it is the most effective way to prevent pregnancy. (It was also largely seen as unrealistic.)

This study is several years old. More recently, researchers in South Carolina* conducted a small focus group study with black and Latina/o youth in two counties. They found many of the same themes: young people expressed the need for private, confidential services in an environment that is friendly to teens. And again, negative feelings about birth control surfaced – especially with respect to side effects. As one teen put it when talking of contraception commercials, “I hate it when they say side effects may include dizziness, drowsiness, heart disease…I say no thank you.”

We know we need to work on the perception and reality of confidential services for youth. At the same time, let’s make sure youth are getting positive messages about birth control. The good news is, they’ve received positive messages about abstinence, and these messages appear to be getting through. How can we present other methods in a positive light as well? Teens who are now or will soon be sexually active do need to know the side effects of any method they are considering, but are they also hearing about convenience, effectiveness, ease of use, and accessibility?

What are your thoughts? Do you have strategies to share? Let us know in the comments.

Karen Schantz– Karen

*Galloway, C. T., Duffy, J. L., Dixon, R. P., & Fuller, T. R. (2017). Exploring African-American and Latino Teens’ Perceptions of Contraception and Access to Reproductive Health Care Services. Journal of Adolescent Health, 60(3, Supplement), S57–S62. https://doi.org/10.1016/j.jadohealth.2016.12.006

You can find more on the ACT for Youth study here: Youth and Family Planning: Findings from a Focus Group Study (PDF)


Author: Karen Schantz

Communications Coordinator, ACT for Youth

8 thoughts on “What Do Youth Think about Birth Control Methods?”

  1. Christine Roos – Staten Island University Hospital

    We definitely hear the negative comments about E.C. and many youth refuse to believe that it is safe even after we spend time discussing it. It does seem, however, that youth are relieved to hear they can access E.C. for free at our clinic or their School Based Health Center, leading me to believe if they needed it they would seek it out. We also hear very negative things about LARC, especially IUDs. Most youth we speak to seem comfortable with OCPs and Depo, – their biggest fear is that it will “make them fat”.

  2. The negative comments about birth control are not surprising. One major, consistent negative comment about birth control I heard often from teen women, was their concern with weight gain while taking BC.

  3. I believe this article is referencing hormonal birth control methods specifically (Pill, IUD, Ring, Shot, Patch, Implant), but does not reference barrier methods like external and internal condoms. I have a feeling that youth who are also questioned about condom usage as a form of protection, may have a different reaction than those of hormonal methods.

    During contraceptive education workshops, I let youth know as much information as possible (even passing around models for tactile learners). The discussions are usually structured in 2 categories by method: 1. Why would someone use this? and 2. Why would someone choose not to use this? This permits open dialogue to make talking about contraceptives with youth “less awkward”, while providing benefits and side-effects in a less scary way. By stating all the side-effects at once, it can seem overwhelming for a young person, and then they begin to see the side-effects as negatives that will happen instead of things that can happen, but may not happen to everyone. Although there are risks with all forms of birth control, it’s important to mention that every body is different. Some people may experience side effects on one type of hormonal method, but not on another. Also, it’s okay for a young person to not be on hormonal birth control if they don’t want to be. They should feel empowered to advocate for themselves. As a health educator we can help young people determine other methods that meet their specific needs, like condom usage to prevent pregnancy and STIs.

    1. In our focus groups, even condoms generated more negative than positive remarks. Thanks for sharing your process — I imagine that would be empowering at a number of levels.

  4. I disagree with your characterization of youth attitudes toward abstinence as positive. Knowing that something is effective but considering it unrealistic adds up to a negative. By your reasoning we would consider attitudes toward flossing positive. Most adults know that flossing prevents gum disease, but they still don’t do it. Where’s the positive in that? Knowledge alone doesn’t equal behavior change. What young people need is the opportunity to explore their beliefs while processing new information and then practicing new behavior. This is best done as a supplement to the scripted curriculum (which is fine, but not sufficient) individually or in small groups run by a trained professional, where discussion can flow from the needs and questions of the youth. Unfortunately this is not realistic, given the limitations of funding. What is more likely to be doable is to give youth a time a place to process the information they are receiving in the EBC with the facilitator. Listen to their concerns and resist the impulse to repeat information they’ve already heard. Instead, acknowledge that making decisions about sexuality can be scary, let them know that their feelings, fears and decisions are ok, and that life is an ongoing process of learning and changing, which they’ll get better at the more they practice. Be patient and take the time they need to work through their negative attitudes. Fears of side effects or long term consequences like infertility often mask feelings of guilt and the expectation of punishment. If you can acknowledge this it can go a long way toward helping them integrate the information you’re giving. NYC high schools have condom resource rooms where CAPP-contracted staff might be able to see students who need the extra follow-up.

    1. I appreciate your comments. Absolutely, information does not necessarily (or even often) translate to behavior change — that’s why EBPs include skill-building activities. And yes, I may have been looking a little too hard for something positive to say about those findings!

    2. I agree with you that a comfortable, confidential conversation with young people would be best. The condom availability program/condom resource room in NYC schools sounds like a great opportunity to have this conversation. I am wondering though how many young people are using it. And it is not always CAPP staff, is it? The timing might be right to take a look at that this Friday during the workshop on sexuality education in NYC schools with staff from NYC DOE and DOH. Many CAPP and PREP providers will be there.

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