GPs, schoolgirls and sex. A cross cultural background comparison of general practitioner attitudes towards contraceptive service provision for young adolescent females in Scotland

Abstract

No previous studies have examined the influences of cultural background on the provision of contraceptive services to females under 16 years of age. A research project was undertaken to investigate any differences between general practitioners trained in the United Kingdom and those trained in the Indian sub-continent in relation to contraceptive service provision to females under 16 years of age. A self-completion postal questionnaire survey was distributed to 230 unrestricted principal general practitioners across Scotland. Subjects were identified from the Medical Register. Half of the sample consisted of all those working in Scotland who had been trained in the Indian sub-continent. The other half were a comparable group that had been trained in the United Kingdom and were selected by quasi-random quota sampling. The response rate was 57 per cent (131/230). General practitioners in the study who had trained in the Indian sub-continent were found to be significantly less likely to provide contraceptive services to a female under 16 years of age than those who had trained in the United Kingdom. Cultural background may be influential in general practitioner provision of contraceptive services to females below the legal age of consent for sexual intercourse. In order to obtain more conclusive evidence a larger study is necessary. Such investigations must be undertaken with appropriate sensitivity and social awareness.

PIP: In the UK, women must be at least 16 years old to give their legal consent to have sexual intercourse with a man. However, despite the legal proscriptions against women under age 16 legally having sex with men, women in that age group in England and Wales had 24,844 conceptions during 1989-91, a rate of 9.6/1000 females aged 13-15 years, and the highest level since statistics began being recorded in 1969. Approximately half of these pregnancies to young teenage women ended in abortion. The pregnancy rate in 1993 among under-16-year-olds in Scotland was 8.7/1000. 206 male and 24 female unrestricted principal general practitioners (GPs) across Scotland were sent a self-completion postal survey in a study to identify the differences between general practitioners trained in the UK and those trained on the Indian subcontinent in relation to the provision of contraceptive services to women under age 16 years. Half of the sample was comprised of GPs working in Scotland who had been trained in India, while the other GPs had been trained in the UK. 131 of the GPs responded, 29% of those trained in India and 85% of those trained in the UK. While 128 were willing to provide contraceptive advice, only 104 would provide contraceptive treatment. GPs trained in India were significantly less likely to provide contraceptive services to women under age 16 years. A larger study should be conducted to obtain more conclusive evidence.