Beyond the "Birds and the Bees" - What Adults Know (or don't know) About Reproductive Health

I recently read an article about research into adults’ knowledge of reproductive health. The research itself focused on adults’ perceived level of knowledge and their actual ability to correctly answer questions related to risks or health benefits of birth control methods, abortion and pregnancy. The research also recorded demographic information to learn more about whether one’s social position on abortion may be related to one’s actual knowledge-base. For example, one of the questions asked participants to determine whether first trimester abortion or childbirth was riskier to a woman’s health. Only thirty percent (30%) chose the correct answer, which was that childbirth is riskier than a first trimester abortion. That leaves the majority of adults who believe childbirth and first trimester abortion are equally risky or who believe that childbirth is safer.

A question related to use of birth control asked participants to determine which percentage of women used some form of birth control at some point in their lives, with the correct answer being ninety-nine percent (99%). Only sixteen percent (16%) of respondents selected this as their answer. More than half answered that just three-fourths of women use birth control at some point. While the study does not specifically state what constitutes birth control, participants’ responses can be seen as indicating that many people are either not aware of women’s use of birth control and/or have different views about what constitutes birth control. Birth control, in the broadest sense, is anything done to prevent or otherwise deter pregnancy from taking place. This would include the rhythm method and withdrawal, and even the morning after pill, which is not an abortive and will not prevent implantation (according to the latest research) or otherwise abort a fertilized egg. For the record, the morning after pill has no effect on a fertilized egg. It’s only benefit is to delay or stop ovulation. If ovulation has already occurred, a woman has just as much chance of getting pregnant as she would if she did not take the morning after pill.

Knowledge of the benefits of oral contraceptives is lacking. Twenty-seven percent (27%) of respondents correctly answered that oral contraceptives are believed to be protective against ovarian cancer. Twenty-eight percent (28%) claimed this was not true and forty-seven percent (47%) were unsure as to whether birth control pills conveyed any health benefits for ovarian cancer. Not only has birth control pill research backed this up, but also other research into the age of first menstruation, the age of menopause and the number of pregnancies has all supported the idea that fewer cycles of ovulation are protective against the risk of developing ovarian cancer. Considering the survey results, I will be clear and state that the reason pregnancy conveys protection is because ovulation is suppressed during gestation, and if a woman breastfeeds, ovulation can be further delayed for sometimes up to a year after childbirth.

The most disturbing part of the survey was that women who had an abortion were more likely to answer incorrectly about the risks associated with abortion where future pregnancy is concerned, and where the actual risk of the procedure is concerned. The second most disturbing result was that eighty-one (81%) of survey participants claimed they believed their general knowledge base of reproductive health was high. The third most disturbing result, yet not surprising either, is that respondents who want to limit or eliminate abortion are more likely to answer the questions about birth control and abortion incorrectly. This may indicate that their beliefs are distorted by misinformation. Another surprising result was that men more often answered correctly than women where questions around the risks of abortion and childbirth were explored by the researchers. Of course, this may not necessarily mean that men are actually more knowledgeable than women about the risks of abortion and childbirth, but rather may indicate that men view anything to do with women’s reproductive health as inherently risky.

The article I read was addressed to a professional audience of physicians and other healthcare workers who interact with women around reproductive health care as a call to never assume a level of knowledge or understanding. The author instead advocated for providing information, even if a patient indicated she already knew about birth control, oral contraceptives, abortion, pregnancy and childbirth or whatever reproductive health issue being discussed and/or treated. I’m writing this article to remind women and men to be informed. Maybe you don’t have a need right now to run out and get the latest issue of “Our Bodies, Ourselves,” or another text on women’s health. However, before you make decisions about reproductive healthcare, make sure you get reputable, scientifically supported information and education about all options. Most of us have a health class in sixth-grade about puberty. We then are fortunate if we get a class in high school that goes beyond abstinence-only information. After that, while we might scan the internet for information, or ask friends, we’re typically embarrassed to ask our physicians questions or to verify information. Speak up! Visit reputable websites—not those with scare tactics, and know your options. Your health depends on it.