Youth and Family Planning: Findings from a Focus Group Study

Research Facts and Findings, November 2013

A publication of the Act for Youth Center of Excellence


by Mary Maley

About the Author

Mary Maley is an extension associate at the Bronfenbrenner Center for Translational Research, College of Human Ecology, Cornell University.


Young women's use of sexual and reproductive health services has declined since its recent peak in 2002 (Hall et al., 2012). To further our understanding of the reasons youth might stay away from these services, the ACT for Youth Center of Excellence conducted 36 focus groups involving over 300 young people in high need communities across New York State. In this article, we share the results of the 2012 focus group study, including implications for practice to improve young people's access to and use of family planning services.


This focus group study was prompted by the need to understand the nearly 13% decline in adolescent (under 18) use of publicly funded family planning services between 2005 and 2010 nationally (Fowler et al., 2011), and an 8% decline in adolescent use of those services in New York State between 1999 and 2009 (Popkin et al., 2010). This trend is disconcerting, given that there is a clear need for youth to utilize these services. According to the 2011 Youth Risk Behavior Survey (YRBS) data for New York State, 42% of students in grades 9-12 have had sexual intercourse, and among those who were sexually active, 37% did not use a condom at last intercourse and 80% did not use effective birth control methods (CDC, 2012). In addition, rates of sexually transmitted infections are highest among young people age 15-24 (CDC, 2013).

Broad questions that we sought to answer through the study included: What do adolescents think about family planning? What are their experiences, beliefs, and feelings about different methods of birth control? What are the barriers to young people's use of family planning services?

Whose opinions are represented?

This study was based on a convenience sample of youth who were largely recruited by Comprehensive Adolescent Pregnancy Program (CAPP) grantees who work with young people across New York State. The Act for Youth Center of Excellence extends our gratitude both to the CAPP agency staff who supported the study, and to the many youth who were willing to share their experiences and opinions on a sensitive topic.

Key findings: General views of family planning

Understanding terms

To get a sense of youth understanding of the terminology often used in health care settings, all groups were asked "What does 'family planning' mean to you?" Of the 142 answers provided, just over half (52%) identified that "family planning" was related to contraception and/or reproductive or sexual health. Of the remaining responses to this question, 43% of comments were incorrect and 5% didn't know (for example, "I've never heard of it," and "we don't use that term").

The most common incorrect responses were related to general life planning or financial assistance/social services. For example:

Pregnancy intentions

Adolescents in all 36 groups expressed an intention to prevent pregnancy until older:

Those who discussed good timing for having a baby noted the need for stable relationships, jobs, and education.

Key findings: Perceptions of contraceptive methods

Participants were asked to discuss methods of birth control with which they were familiar. The pill and the male condom were mentioned most often, followed by the IUD, Depo-Provera shot, female condoms, the ring, and the patch. For most methods, the number of negative comments was greater than the number of positive comments. Negative comments centered upon effectiveness, side effects, and lack of reliability; positive comments focused on effectiveness and ease of access and use. Abstinence was the only method that generated slightly more positive than negative comments; however, while it was described as a foolproof way to prevent pregnancy it was also typically characterized as unrealistic. Plan B was also mentioned, with negative comments outnumbering positive comments by about 5:1.

Positive and Negative Comments about Selected Birth Control Methods

The Pill

Negative comments (main themes):

Positive comments (main themes):

Male Condom

Negative comments (main themes):

Positive comments (main themes):

Plan B

Negative comments (main themes):

Positive comments (main themes):


Negative comments (main themes):

Positive comments (main themes):


Negative comments (main themes):

Positive comments (main themes):

Key findings: Family planning service barriers

In these conversations, discomfort and fear emerged as real barriers to use of family planning services. Youth described discomfort talking with parents and health care providers. They also expressed concerns about using clinics. Privacy was a major concern, closely connected to youths' sense of stigma and fear of disapproval.

While over half (55%) of respondents indicated that their parents had discussed pregnancy or pregnancy prevention with them, conversations with adults about family planning were characterized as "awkward" and "uncomfortable." The most common messages that adults conveyed to youth were caution (discussed in 34 groups), stories of personal experience (34 groups), abstinence (27 groups), fear-based warnings (17 groups), and support (13 groups).

Talking about family planning with parents was daunting because of possible reactions:

It was also often difficult for youth to talk to doctors:

When it came to clinics, privacy was cited as the most common concern, but youth also discussed safety, convenience, and fear of getting bad news:

Implications for practice: How can adults do better?

We asked youth, "What can adults do better?" Their answers focused on good listening skills, accurate information, and respect for privacy.

Results of this focus group study suggest that young people's utilization of family planning services can be improved by attending to five important areas:

Through this project, we have learned a great deal from youth in New York State. Adults who care about the well-being of young people can listen to these voices for insight as we work to break down barriers to family planning services.