The Article in Brief

Perspectives on Confidential Care for Adolescent Girls

By M. Diane McKee, MD, MS, and colleagues

Background Adolescent girls who live in poor urban areas are at much higher risk for health problems related to sexual activity than girls in other areas, yet they don't often seek confidential reproductive health care on their own. This study looked at the role that mothers play in encouraging appropriate and timely gynecologic care for adolescent girls.

What This Study Found Mothers want to protect their daughters against early sexual activity, pregnancy, and sexually transmitted infection, and believe they will be responsible for dealing with the results of such problems. Many mothers believe that a daughter's private visit to the doctor would promote risky behavior and challenge the mother-daughter bond. Mothers are willing to help their daughters receive gynecologic care, but only after the girls become sexually active. Mothers' awareness of sexual activity is low, and girls in this study worked hard to keep their sexual status private.

Implications

• Lack of trust in doctors and a mother's role as protector can be barriers to reproductive health care for adolescent girls.
• New approaches are needed to help prepare mothers and daughters for the adolescent's transition to independent health care. Doctors could try setting aside a portion of visits as confidential when girls are in early adolescence as a way to encourage this transition.
• Doctors need to build skills to communicate about confidential care, while respecting the mothers' role as champion of her family's health care and protector of her adolescent's well being.