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PLoS One. 2020 Jan 23;15(1):e0228142. doi: 10.1371/journal.pone.0228142. eCollection 2020.

Young women's reproductive health conversations: Roles of maternal figures and clinical practices.

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Department of Family Medicine, State University of New York Upstate Medical University, Syracuse, New York, United States of America.
Department of Public Health and Preventive Medicine, State University of New York Upstate Medical University, Syracuse, New York, United States of America.
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
REACH CNY, Incorporated, Syracuse, New York, United States of America.
Department of Psychiatry, Upstate University Hospital, Syracuse, New York, United States of America.
Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York, United States of America.



To explore the role of clinical providers and mothers on young women's ability to have confidential, candid reproductive health conversations with their providers.


We conducted 14 focus groups with 48 women aged 15-28 years (n = 9), and 32 reproductive healthcare workers (n = 5). Focus groups were audio recorded and transcribed. Data were analyzed using inductive coding and thematic analyses. We examined findings through the lens of paternalism, a theory that illustrates adults' role in children's autonomy and wellbeing.


Mothers have a substantial impact on young women's health values, knowledge, and empowerment. Young women reported bringing information from their mothers into patient-provider health discussions. Clinical best practices included intermingled components of office policies, state laws, and clinical guidelines, which supported health workers' actions to have confidential conversations. There were variations in how health workers engaged young women in a confidential conversation within the exam room.


Both young women and health workers benefit from situations in which health workers firmly ask the parent to leave the exam room for a private conversation with the patient. Young women reported this improves their comfort in asking the questions they need to make the best decision for themselves. Clinic leadership needs to ensure that confidentiality surrounding young women's reproductive health is uniform throughout their practice and integrated into patient flow.

Conflict of interest statement

The authors have declared that no competing interests exist.

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