Adolescents, contraception and confidentiality: a national survey of obstetrician--gynecologists.

BACKGROUND Given recent legislative efforts to require parental notification for the provision of reproductive health care to minors, we sought to assess how obstetrician-gynecologists (Ob/Gyns) respond to requests for confidential contraceptive services. STUDY DESIGN Mailed survey of 1800 US Ob/Gyns, utilizing a vignette where a 17-year-old college freshman requests birth control pills and does not want her parents to know. Criterion variables were the likelihood of encouraging her to abstain from sexual activity until she is older, persuading her to involve her parents in this decision and prescribing contraceptives without notifying her parents. Covariates included physicians' religious, demographic and clinical characteristics. RESULTS Response rate 66%. Most (94%) would provide contraceptives without notifying her parents. Half (47%) would encourage her to involve a parent, and half (54%) would advise abstinence until she is older. Physicians who frequently attend religious services were more likely to encourage her to involve her parents (OR 1.9), and to abstain from sex until she is older (OR 4.4) but equally likely to provide the contraceptives. CONCLUSIONS Most obstetrician-gynecologists will provide adolescents with contraceptives without notifying their parents.