Preparing Daughters: The Context of Rurality on Mothers' Role in Contraception

ABSTRACT:  Context: The United States continues to have the highest rate of adolescent childbearing among developed countries. Lack of access and disadvantage contribute to this problem, which disproportionately impacts rural women. Given the increased difficulty rural young women face regarding contraceptive access, parental communication and support play an even more vital role in assisting them to navigate decisions about and access to contraception. Purpose: To examine rural women's perspectives on how living in a rural area impacts issues surrounding pregnancy prevention for their daughters and parent-child communication regarding pregnancy prevention. Methods: Open-ended interviews were conducted with 30 mothers of adolescent women in 3 rural counties in southern Oregon. Thematic analysis within and across interviews using constant comparative analysis was used to explore barriers, facilitators and strategies mothers identified in talking with their daughters about contraception. Findings: Specific themes found that related to the rural environment included (1) conservatism, (2) isolation, (3) lack of privacy, (4) stigma, (5) the paradox of the rural environment, and (6) the uniqueness of rural life. Conclusions: The context of living in a rural environment may present unique barriers to facilitate parent-child communication when discussing intimate topics. The design of interventions needs to take into consideration these issues, particularly when attempting to serve hard-to-reach populations.