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The Connection Between Sexual Abuse and Teenage pregnancy Sarah Dubicki SW 3810 Wednesday Wayne State University

2 Introduction The article chosen for this critique is Teenage Pregnancy and Associated Risk Behaviors Among Sexually Abused Adolescents. This article, written by Elizabeth M Saewyc, Lara Leanne Magee, and Sandra E. Pettingell The purpose of this study is to establish a connection between those who were sexually abused and their chances of either getting pregnant or getting someone else pregnant. There were three hypotheses tested in this study. The first states that teenagers who have reported a history of sexual abuse are more likely than their peers to admit and report pregnancy involvement. Secondly Saewyc, Magee and Pettingell hypothesized that those who were sexually abused would be more likely to have risky behavior in regards to their sexual practices. This includes unprotected sex and sex with multiple partners. Finally, they hypothesized that although the relationships will be similar, the strengths of the relationships will vary by gender and type of abuse. (Saewyc, Magee, & Pettingell, 2004) The researchers found that although there is a history of studying the connection between sexual abuse, there was nothing that compared the types of abuse and their relevance to risky sexual behaviors. They admit that without these studies previously being done previously, that they could not predict the specific kind of abuse that would most greatly affect the chances of teenage pregnancy. The researchers also admitted that they would be unable to predict if the relationship between abuse and pregnancy would be stronger with males or females. There was simply little or no research to compare males and females

3 (at least, until this study had been done.) Therefore, no hypothesis was given for this facet of study. Methods For this study, the chosen method was to use a survey system. The researchers used surveys from the Minnesota School District from the years 1992 & 1998. These surveys were anonymous. They looked at the health and risk behavior issues among 9th & 12th graders. The reason that the researchers chose to use years that were so far apart was so that there were independent cohorts. They wanted no contamination or people repeating the survey. Not only did the students have to give their assent in taking the survey, but parental consent was obtained before the surveys were given. Over 99% of the school districts in Minnesota participated in the study, and of those schools over 75% of the 9th and 12th graders took part in the surveys. In the surveys, students were asked the following two questions pertaining to sexual intercourse and pregnancy. 1) Have you ever had sexual intercourse (gone all the way) and 2) how many times have you gotten pregnant or gotten someone pregnant (Saewyc, Magee, & Pettingell, 2004). The wording for these questions was specifically chosen to acknowledge the fact that some students could have gotten pregnant from rape, which they may not have considered sexual intercourse. The measures used to evaluate sexual abuse in this study were relatively comprehensive of sexual abuse. Both years that the surveys were given, teenagers were asked has any older or stronger member of your family

4 ever touched you sexually or had you touch them sexually and has any adult or older person outside the family ever touched you sexually against your wishes or forced you to touch them sexually? The responses were then further grouped into one of four categories which included: no abuse, incest only, nonfamilial abuse only, or both (Saewyc, Magee, & Pettingell, 2004). The measures used to assess pregnancy came from the students response to the question of how many times have you been pregnant or gotten someone pregnant. If the student answered anything other than zero, or answered with a response of not sure, they were considered to have pregnancy involvement. Also included in the surveys were questions about sexual behavior. These questions included: number of opposite-gender partners in the last year, condom use at last intercourse, and how often the individual used birth control and/or condoms. Responses to the above questions were separated into always, often, sometimes, rarely and never. However, since rarely and never came out to be a low number, results from those answers were combined (Saewyc, Magee, & Pettingell, 2004). Finally, in the 1992 survey, Saewyc, Magee, & Pettingell asked questions that had connection to what is considered risky sexual behavior. These questions included: frequency of drug or alcohol use before intercourse and if the student had ever received an STD diagnosis. The answers once again ranged from always to never. Those questions were repeated in 1998, with the addition of have you ever run from home in the pasty year and whether or not the student was currently living out of home.

5 Results When evaluating the results, the information was split between males and females, as it was a general assumption that females would be more willing to admit to sexual assault than males. The information was presented in the format of a table as well as a Pearson chi-square test. The hope was to differentiate between the four groups. In 1992, it was found that 27% of the female students who were sexually experienced had and 6% of the male students had suffered abuse. In 1998, it was found that 22% of the females, and 9% of the males had suffered abuse. (Saewyc, Magee, & Pettingell, 2004) The majority of abuse types were nonfamilial, in both years that the survey was given. Incest only was found to be the smallest percentage of abuse. Both years that the survey was given, females who admitted to being abused had a high connection to females becoming pregnant. However, females who reported experiencing both incest and nonfamilial abuse were the highest percentage of those females who reported pregnancy involvement. Males shared this pattern, as those who experienced abuse were more likely to report the possibility of having gotten someone pregnant. They also shared the characteristic with females that those who had been abused both incestuously and in a nonfamilial setting were more likely to report having gotten someone pregnant. When it came to risk factors, females who did experience both types of abuse were substantially more likely to report partaking in this behavior. Condom

6 use was less prevalent than birth control use, but both methods of contraception were less prevalent in females who had been abused than in the females who had not. The number of abused females who admitted to having a history of STDs was double that of the number of females who were not abused. In males, the findings were extremely similar to the findings in females, however with more pronounced differences. In regards to having more than one sexual partner in the last year, 54-60% of males who experienced incest only reported having more than one partner. This is comported to 58-73% of males who experienced nonfamilial abuse, and 81-82% of males who went through both types of abuse. When it came to risky behaviors, males who had been abused in both ways reported not using condoms during their last intercourse, and they were also statistically more likely to have had alcohol or drugs before their last intercourse, and were not found to be not living at home. STDs were twice as common in males who had experienced nonfamilial abuse than in males who had not suffered abuse. However, males who had suffered both types of abuse were more than seven times more likely to report having an STD (Saewyc, Magee, & Pettingell, 2004). Discussion This study was a complex study, that had quite a few different factors taken into account (such as type of abuse, risky behaviors, pregnancy, etc.) The article states that only students who were in two sets of 9th and 12th grade were used in this study. The participants had parental permission and assent from the students themselves.

7 When it came to students who were sexually experienced Saewyc, Magee, & Pettingell, found that those who had been sexually abused at some point were more likely to become pregnant and to partake in risky behavior. It was determined that if they had suffered incest, they were more likely than their nonabused peers to partake in these behaviors, but they were less likely that their peers who suffered both incestuous abuse and nonfamilial abuse. Females were found to be more likely to report abuse, however abused males were found to be more likely to partake in risky behaviors or pregnancy involvement. One of the strengths of this study was the authors ability to point out the shortcomings of the information they had. They acknowledged that even though the survey was anonymous, certain people (males in particular) might not admit to being sexually abused. They also acknowledged that although a person could have been abused by more than one person in the family, they would still be listed as incestuous abuse only and the same for those people who had been abused by multiple nonfamilial members. The data does not take into account for this, however. It was found that those who had been abused both incestuously and nonfamilial were most likely to report risky behaviors, and this could also be the case for those people who had more than one situation of abuse, but under the same type of abuse. It was concluded that there is indeed a connection between sexual abuse and the risk of pregnancy. It is also concluded that there is a higher risk of sexual risky behaviors in those who were abused. It was found that students who had

8 been abused both by family members, and non family members were more likely to show the risky behavior explained in the article.

9 References

Saewyc, E. M., Magee, L. L., & Pettingell, S. E. (2004). Teenage Pregnancy and Associated Risk Behaviors Among Sexually Abused Adolescents. Perspectives on Sexual and Reproductive Health, 98-105.

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