One big question that many Americans still have following the 2024 election is: "What will the re-election of Donald Trump as the 47th president mean for women and their reproductive health?"
Even if no new restrictions are put in place that further limit reproductive freedoms, women today do not have the same options as those of prior generations. But there are grave concerns that the new administration will implement additional restrictions, particularly around abortion access, including a national abortion ban or restricting access to abortion pills.
These concerns have led both women and men to take measures to ensure that they have agency in determining when is the best time for them to have children. Since the election, there has been a surge in the purchase of emergency contraception as well as appointments for long-acting reversible contraception and vasectomies. Some women are even electing to replace still-effective IUDs to ensure that they will have access to long-term birth control irrespective of potential changes.
Our new political landscape has led to an even greater focus on preventing unplanned pregnancy in the first place. One important strategy to do this is for health care providers to begin prioritizing conversations about sex with patients during routine visits, especially with teens.
Adolescence is the time when young people begin thinking about engaging in sex. And over 30 percent of high school students have had sex, but 48 percent did not use a condom the last time they had sex making them vulnerable to experiencing the unintended consequences of sex, including unplanned pregnancy.
Unplanned pregnancy is common among young people. While overall rates have declined in recent years, 71 percent of all pregnancies among women aged 15 to 19 are unintended. Many adolescents would consider ending their pregnancy on their own if access to abortion services was not an option.
Sex education in schools varies widely across and within states, including the specific content that is covered (abstinence-only versus comprehensive sex education) and the amount of time devoted to covering it. And since the Dobbs decision overturned the federal right to abortion, there have been calls for more restrictive sex education. Communication about sex between parents and teens also varies from one-time events to continuous conversations.
While comprehensive sex education may not be available to many young Americans at school or home, health care providers are well positioned to have these conversations with teen patients especially since adolescents see them as experts on sexual and reproductive health and care.
National guidelines recommend clinicians provide confidential, age-appropriate, and medically accurate sexual and reproductive health education and counseling to adolescent patients. These interactions are a prime opportunity to talk with young people about the basics of sex and pregnancy, assess pregnancy intentions, share information about contraception methods including the best options for them based on personal and relationship needs, discuss how to talk about desires and intentions around sex and pregnancy with romantic partners, and provide reproductive services like contraception, although consent to access these services may vary by state.
Many providers are already having these talks with adolescent patients—but many are not. And even for those who do, such conversations are not always prioritized during routine health visits, with providers spending only 36 seconds holding these discussions.
Even though providers have limited time with patients, they need to prioritize these talks. One strategy to help with this is to better integrate sexual and reproductive health in medical and nursing education.
Formal education and training in sexual and reproductive health is not a requirement in all medical and nursing school programs and there is no standardized curriculum in this area. But sexual and reproductive health education that is thoughtfully and intentionally woven throughout the curriculum—including stand-alone courses in this area, like the class I developed for nursing students—can improve health care professionals' overall understanding of sexual and reproductive health, help them recognize the importance and value of talking with patients about it, and prepare them to have these conversations. Increasing their comfort, confidence, and ability to talk about sexual and reproductive health topics with patients is key, as these remain major barriers to providers actually initiating and engaging in these conversations.
Training health care providers across specialties in sexual and reproductive health is essential because it increases the opportunities in which these conversations can be had. This is particularly important since many adolescents, particularly those from minoritized communities, do not always have consistent access to a pediatrician or primary care provider. Thus, any interaction that adolescents have with the health care system, such as emergency room visits, can be an important touchpoint for engaging in these conversations.
Talking to teens about sex has always been important. But in our current political landscape, it is imperative that health care providers routinely prioritize these conversations with adolescent patients as one important approach to preventing unplanned pregnancy.
Yzette Lanier is a developmental psychologist and an assistant professor at the Rory Meyers School of Nursing at New York University and a Public Voices fellow with The OpEd Project.
The views expressed in this article are the writer's own.
English (US) ·