Questions to ask young male patients about Reproductive Life Plan & Pregnancy Prevention/Preconception Care

Overview

The United States consistently has one of the highest teen pregnancy rates among industrialized countries, despite the fact that the pregnancy rate has declined dramatically over the past 40 years.  About 7% of teenagers ages 15-19 get pregnant each year, according to the Centers for Disease Control and Prevention (CDC).  Each year, costs related to adolescent pregnancy and its complications are estimated to be $9 billion.^{1,2 (as cited in 3)}

The discrepancy in continuous and correct use of condoms likely doesn’t stem from a lack of education. According to the National Survey on Family Growth, 97% of male teenagers report having had formal sex education before they turned 18.

Beyond education, however, resources for male adolescents are lacking.  For example, teen males are vastly underrepresented in Title X Family Planning, a federal program that supports services to assist in pregnancy prevention and planning. Title X clinics provide education and counseling, condoms, STI testing and treatment, HIV testing and in some cases, vasectomy services to males.⁴

While 9% of those served by Title X clinics are males, only about a third are adolescents.⁵  Adolescent pregnancy prevention focuses on girls; however, males (frequently adolescent boys) are clearly causal participants in pregnancies, and fatherhood has an impact on their lives as well as on the lives of girls.⁶

A recent review of adolescent fatherhood highlights the developmental implications of early fatherhood. Contrary to common belief, most adolescent fathers would like to remain involved with their child; however, these young men face multiple stressors, including the need to provide financially for their child, having limited parenting skills and a limited knowledge of child development, and, frequently, having limited emotional support and resources.⁷  Unfortunately, because the responsible fatherhood movement is relatively new, rigorous evaluations on teen fatherhood programs are currently limited and only a handful of program evaluations currently exist.⁸

Young sexually active men should be coached in the correct use and reliability of condoms and spermicidal agents. Myths about withdrawal techniques and the difficulties inherent in natural family planning strategies for birth control may need to be discussed.⁹