Avoidance, awareness, or acceptance: Parental communication about sexual and reproductive health and college women's contraceptive behaviors

Emerging adulthood is characterized by heightened risks to unwanted sexual and reproductive health (SRH) outcomes, particularly for young women. In the U.S., school-based sexual education programs often prioritize abstinence, leaving youth without comprehensive information on avoiding pregnancy and sexually transmitted infections. In this context, parental communication about SRH is vital to increase SRH knowledge and contraceptive autonomy. However, we lack information about how parental beliefs and parent-child communication about SRH during adolescence may influence young women’s contraceptive behaviors during emerging adulthood. Therefore, we analyze 57 in-depth interviews with women attending a midwestern U.S. university to document parental SRH communication strategies, the beliefs or logics underlying these strategies, parental provision of contraception during high school, and the implications for women’s contraceptive behaviors in college. In the avoidance strategy, parents avoided discussing SRH and did not provide contraceptive access largely due to religious beliefs. In the awareness strategy, parents indirectly communicated about SRH and often put daughters on contraception to address menstruation-related symptoms. Logics in this group varied from religious opposition to practical support. In the acceptance strategy, parents talked openly about SRH, used a practical support logic, and provided access to birth control for pregnancy prevention. College women in the avoidance category were more likely than others to have unprotected sex, rely on less-effective methods, and use emergency contraception. Discussing SRH issues and providing daughters access to contraception when needed is an important way parents can ensure daughters have the knowledge and tools to avoid unwanted SRH outcomes during emerging adulthood.