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One CU researcher decodes a frequent explanation for unprotected sex

When asked why they didn’t use contraception or took other contraceptive risks, women in a �鶹ӰԺ study overwhelmingly replied that they just weren’t thinking. What they meant by that varied widely.

CU-�鶹ӰԺ Ph.D. candidate Laurie James-Hawkins conducted an original study on the CU-�鶹ӰԺ campus focusing on the underlying reasons for risky contraceptive behavior among college women.

Published in March in the Journal of Midwifery and Women’s Health, her research was based on interviews with women who initially self-reported having taken contraceptive risks. This research has implications for how clinicians can help reduce risky behavior and consequent unintended pregnancies.

Fifty-one percent of all pregnancies in the United States are unintended, and James-Hawkins says college-aged women (18 to 25) account for a large percentage of these accidental pregnancies. Not all the women she interviewed had become pregnant, but all had taken contraceptive risks at one time or another.

Before coming to CU �鶹ӰԺ, James-Hawkins had looked at third-party surveys that asked women why they took contraceptive risks. She was frustrated by the frequent reply, “I just wasn’t thinking.” She wanted more meaningful answers.

In one-on-one interviews, James-Hawkins asked her subjects why they had taken contraceptive risks. Of the 45 women interviewed, 91 percent spontaneously said, “I just wasn’t thinking.”

She asked each woman what she meant by this.

“Some women were vividly uncomfortable when I pushed them on the question,” James-Hawkins says. “I think they saw their [initial] answer as not being politically correct. In our culture, in the middle class, it’s the social norm to use contraceptives.”

Because sexual risk-taking is considered inappropriate and irresponsible, women were compelled to come up with answers to make their behavior seem less deliberate.

"Some women were vividly uncomfortable when I pushed them on the question. I think they saw their [initial] answer as not being politically correct. In our culture, in the middle class, it’s the social norm to use contraceptives.”

“To some extent, the ‘I just wasn’t thinking’ answer was impression-management, both for me and themselves,” James-Hawkins says.

She found that women have multiple meanings when they say they “weren’t thinking,” and they generally fall under four major themes.

“Almost all of the explanations were based on erroneous risk calculations that led the women to believe they were not likely to experience a pregnancy,” James-Hawkins says. “Only a small minority of women interviewed meant they had literally not thought about the possibility of pregnancy.”

One group of women assessed their risk and then consciously chose to ignore it.

A second group of women incorrectly assessed their cumulative risk of pregnancy.

“It is true that one single act of unprotected sex is unlikely to lead to pregnancy,” James-Hawkins says. “The problem is that after ‘getting away with it’ once, you feel invincible and safer doing it more.”

Some women decide they must be infertile or have no need for contraception, she says.

But with multiple risks, or continuing incidence of unprotected sex, cumulative risk of pregnancy increases.

Other women may have been on the birth control pill for two years, but missed a few days, James-Hawkins says. “They assume they are safe, but when you stop taking birth control, your protection stops…Consistency is really important.”

For a third group of women, alcohol played a major role in their decisions to have unprotected sex.

“Some women said, ‘Oh, I just wasn’t thinking because I was really drunk.’ Or they were realizing in the middle of sex that is was unprotected. Or they were having sex and not remembering it.”

James-Hawkins asked the women who attributed their risky behavior to alcohol whether they knew beforehand that they were going to have sex. She found that many “underestimate how much they drink and overestimate the agency they have while drunk.”

"Even if earlier in the interview they had decoded the answer for themselves, they would give themselves the benefit of the doubt, but then they attributed that same behavior to a character defect in others.”

A fourth group of women accepted the risk of pregnancy and chose to deal with it later. In some cases, women didn’t want to risk their relationship with their partner by delaying sex. This group also had knowledge of Plan B birth control.

At the end of each interview, James-Hawkins asked each woman what she thought other women meant when they attributed unprotected sex to “just not thinking.”

While most subjects explained their individual decisions as a one-time choice, their explanations of other women’s behavior included those women being stupid or dumb, being in love or not thinking about the future, and social norms discouraging women from carrying condoms.

“Even if earlier in the interview they had decoded the answer for themselves, they would give themselves the benefit of the doubt, but then they attributed that same behavior to a character defect in others,” James-Hawkins says.

She is interested in researching this double-standard in the future, but for now she wants to focus on what her research means.

“‘Just not thinking’ is a blanket term that represents [women’s] attempts to explain behavior with which they themselves are not comfortable and for which they often do not feel they have an adequate explanation,” James-Hawkins says.

She hopes her research will impact the way clinicians approach birth control and address reasons for contraceptive risk-taking with women.

“You can give someone the pill but you’re not there to make sure they take it every day,” James-Hawkins says. “If [a physician] delves into a woman’s needs for birth control and gets answers like the women gave in my survey, then the pill is probably not a good idea.”

Instead, she suggests that long-acting and reversible birth control like an IUD might fit some women’s needs better.

Lara Herrington Watson is a CU alumna (’07) and freelance writer who splits her time between Denver and Phoenix.