“The Buzz About the Birds and the Bees” Parental Reproductive Health Capital

Keywords: sex education, reproductive health knowledge, parenting, Pierre Bourdieu, cultural capital

Abstract

This mixed-method study examined the social field of sexuality education through an exploration of parental knowledge levels and sources of reproductive health information. A 414 respondent survey identified relevant demographic information and knowledge levels on various aspects of anatomy and conception, sexually transmitted diseases, and birth control—demographic characteristics of gender, education level, income, and religion all influence reproductive health knowledge capital. Ten open-ended depth interviews with mothers provided a contextual anatomy for parent-child reproductive health conversations. Through this, three Expanded Forms (Life Experience, Mass Media, and Religious Institutions) and two Restricted Forms (Medical Professionals and College Attainment) of reproductive health knowledge acquisition were identified. These results were analyzed through Pierre Bourdieu’s lens of cultural capital.

Over one’s life-course, a person encounters a variety of knowledge from any number of sources. As primary socializers, parents provide preliminary information on most topics children encounter, including playing a key role in disseminating reproductive health knowledge to children. Therefore, it makes sense to understand the information parents know and can therefore pass on. Moreover, an understanding of the origins of and influences on this knowledge is central to the discussion. Few would contradict the goal of providing youth with the highest quantities of the most verifiable information possible on most subjects; however, with the topic of reproductive health we remain uncharacteristically tight-lipped. Additionally, we have traditionally avoided the topic by saying such a private conversation belongs in the privacy of the home. But then researchers do not follow up on important aspects necessary for knowledge transmission, namely the nature of the knowledge being transmitted. The general moral climate surrounding sex and reproduction and our values regarding privacy and freedom help explain this avoidance.

Public discourse divides over whether schools should teach sex education. Some people do not want it taught in schools because they believe it is the parents’ responsibility. Others want sex-ed taught in the classroom because they believe schools, as formal institutions of learning, should also play a role. As a result of our relative respect for a parent’s rights to manage their children as they see fit, our understanding of reproductive health information transmission between parent and child remains sparse. Adolescent alcohol or drug use and prevention—a subject parallel to adolescent sexuality in many respects—draws much public discussion and often addresses the influences, actions, and roles of parents. Despite the similarities, the topic of reproductive health remains off-limits.

When the mere discussion of adolescent sexuality and sexual health draws passionate reactions from across the political continuum—evoking the quotation of scripture and calling for the separation of church and state—but eludes resolution, the field inspires inquiry. This research attempted to better understand the real factual knowledge of parents on certain topics of reproductive health and to delineate variances between groups. Additionally, this research sought to better understand the cultural capital of reproductive health and to begin mapping the social field of reproductive health education by tentatively ranking sources of reproductive health knowledge.

Literature Review

Research often contends that most of human knowledge about the world emerges through interaction with it. Studies examine the learning and socialization process of everything from basic skills such as speaking, reading, and writing to more complex activities such as whether and how to consume alcohol and drugs or practice unprotected sex. For example, in their study regarding parental approaches to the literary education process, Lynch et al. (2006) interviewed a number of parents and determined the value of both the skill-based application and the holistic inclusion of encouragement activities in teaching children reading and writing skills. This study not only identified the important role parents play in the education process, but also the unique value of positive and supportive message delivery. Furthermore, in their study of parent-child alcohol consumption, Yu and Perrine (1997) established that sons often emulate fathers’ drinking patterns and daughters often emulate mothers’ drinking patterns, showing parental influence on complex choices. Educational influences cross many topic areas, including the topics of reproductive health.

Research indicated that parents play an essential role in teaching children how to navigate sexual relationships and that parental involvement influences adolescent sexual behavior. For example, couples who engage in dialogue about sex before intercourse more consistently use ‘safe-sex practices’ (Biglan et al., 1990), and when parents communicate with adolescents about sexuality and sexual risks, the adolescent in question more often discusses condom use with his or her partner (Whitaker et al., 1999). Reproductive health conversations between parents and children affect adolescent sexual behavior, but only when parents communicate skillfully, clearly, comfortably, and openly about sexuality and the health consequences of sexual behavior (Whitaker et al., 1999). In one study, adolescents whose parents helped them with their sex education homework maintained stronger and more persistent intentions of sexual abstinence than those adolescents who completed the homework alone (Blake et al., 2001). A close relationship with the parents, particularly the mother (Nolin and Petersen, 1992), also correlated with adolescents delaying sexual intercourse; again, correlation of conversation and delayed sexual activity only occurred when parents discussed the subject matter frankly and openly (Abell, & Ey, 2008). Despite the potential for these conversations to decrease sexual activity and increase condom use (minimizing exposure to STDs and pregnancy), many sexual health topics remain absent from family discussions (Miller et al., 1998) because many parents feel uncomfortable talking about sex with their teenagers (Kirby, 1999). In accordance with previously mentioned research, Miller et al. (1998) also believed that adequate knowledge was an essential component of an open process of sexual communication.

While informed parent-child dialogue increased the likelihood that a young person would remain abstinent or use contraception when engaging in intercourse, more research is needed to explore the reproductive health knowledge of parents and the source of this information. One study by Levy et al. (1995) examined the AIDS-related attitudes and knowledge of parents in relation to their children’s knowledge before and after their children participated in an HIV/AIDS educational class. Although parents knew more relevant information compared to their children prior to their child’s involvement in the class, after the adolescent completed the class, the young people “knew more than their parents about HIV infection on two scales and had a similar level of knowledge on five [of seven] scales” (Levy et al., 1995: 9). The adolescents’ tolerance of those living with HIV/AIDS also grew significantly higher than their parents. This indicated that while parents retain some level of reproductive health knowledge, they may not continue receiving information after leaving the structures of formal education. Their information grows outdated over time, or they forget what they previously learned. In another study about parents’ belief about condoms and oral contraceptives, the researchers found that many parents underestimated the effectiveness of condoms at protecting against STDs and pregnancy and that they also underestimated the effectiveness and the safety of oral contraception (Eisenberg et al., 2004). They found that

These studies demonstrated not only gaps in knowledge but also gaps in research. In both studies, parents maintained outdated or flawed information about reproductive health. These studies also focused narrowly on very specific aspects of reproductive health, despite the varied and interconnected nature of the subject matter.

Previous research regarding where adults received reproductive health information indicates sporadic attainment from a variety of sources. According to a study regarding where young adult men received their information on AIDS, STDs, and condoms, researchers found that most adult men received their information primarily from media and informal social sources, rather than through formal instruction or medical advice (Bradner, Ku, & Lindberg, 2000). More specifically, 96.2 percent received information from media sources such as television, magazine, or radio; 50.8 percent from social sources such as asking a partner or a friend; 47.8 percent from instructional sources, though only 20.8 percent of this from lectures and the rest from pamphlets and handouts; and only 22.3 percent from medical consultation (Bradner, Ku, & Lindberg, 2000: 34). Evidently, young adult males largely received their reproductive health information from fairly informal means. This study also found a correlation between formal instruction on this topic and higher educational attainment. Reproductive health knowledge surveys exist for countries ranging from Turkey to Nigeria to Iran (Tavakol, Torabi, & Gibbons, 2003; Inandi, Tosun, & Guraksin, 2003; Mba, Obi, & Ozumba, 2007), but as with United States studies, many of these focused on adolescent knowledge. Research examining parental knowledge remains sparse, indicating a need for further research regarding parental knowledge levels and their sources of attainment for reproductive health.

Methodology

This study used quantitative and qualitative data collection methods. A survey asking knowledge questions about three different major topic areas under the umbrella of reproductive health constituted the quantitative piece. The first section included seven questions on anatomy and conception, the second section includes six questions about contraception, and the third section included six questions about STDs. The survey included a nine-point section seeking demographic information, as well as a space for participants to volunteer email addresses to participate in the qualitative interviews if interested. There was also a section for participants to offer comments and feedback to the researcher. These questions provided the necessary social context for the knowledge-based answers of the first three sections.

The knowledge-based portion of the survey employed questions adapted from handouts and testing materials administered in an effective (deemed such by lower than average STD and unintended pregnancy rates) curriculum of a comprehensive sexual education course. A high school health teacher, an Oregon Washington County reproductive health educator, and the Oregon Washington County health promotions coordinator vetted the questions. The choice to adapt questions from materials previously considered useful improved the reliability and validity of the questions (Fink, 2003; Miller, & Salkind, 2002). A study of pharmacy residents’ (recently graduated students) attitudes towards pharmaceutical industry promotion and its effects on practice and knowledge of residents exemplified this method of question adaptation. In this case, “questions were adapted from instruments used in studies of medical student or physician attitudes regarding the pharmaceutical industry” (Ashker, & Burkiewics, 2007: 1725).

The present study employed snowball sampling to recruit participants. This technique helped acquire responses from hard-to-reach, hard-to-identify, and interconnected populations (Chambliss, & Schutt, 2006: 101-102). As a student on a limited budget surrounded by few parents, parents represented difficult-to-contact participants for this researcher. The researcher sent a recruitment email to many personal contacts with a link to the survey on SurveyMonkey. The email encouraged contacts to continue forwarding the email to any known parents. Access to gatekeepers (Ibid: 173) aided in diversifying the sample by reaching different populations of parents. A minister at a church allowed the researcher to announce the study during the congregation and to collect contact information in the lobby. Parents, friends, and co-workers forwarded a recruitment email to parents. Finally, a contact at the Oreong Washington County Public Services Offices authorized the researcher to collect participants in the waiting rooms of the Washington County Woman, Infant, and Children (WIC) program and in the Washington County Public Clinic. This method of collecting participants from multiple locations reproduced a previously used method of diversifying samples and provided a vehicle for comparison (Geary et al., 2007; Davis et al., 2007).

The qualitative portion of this study comprised semi-structured interviews (Chambliss, & Schutt, 2006: 179-183) with ten mothers about their reproductive health knowledge and the source of the knowledge. The researcher obtained participants through availability (convenience) sampling (Ibid: 99) by emailing parents who indicated interest in further involvement in the study when taking the survey. Convenience samples are pervasive (Davis et al., 2007; Ryu, Kim, & Kwon, 2007; Ehlers, 2003), but researchers most commonly administer them through colleges (and sometimes high schools) to captive populations of students. A study on the effects of HIV/AIDS knowledge on condom use by Davis et al. (2007) administered in undergraduate social science classes exemplifies the method of convenience sampling. With a transcontinental range for the survey portion, the distance necessitated two methods of interviewing: telephone and in-person (Chambliss, & Schutt, 2006). In-person interviews represented a popular way of exploring beliefs and communication patterns regarding the topic of reproductive health (Whitaker et al., 1999; Gillmore et al., 2003). For example, in a study regarding men’s beliefs about different methods for preventing STD, the researchers asked thirty-one men open-ended questions about abstinence, mutual monogamy, use of male condoms and use of female condoms (Gillmore et al., 2003). While less common due to the sensitive nature of reproductive health, researchers also sometimes use phone interviews. In their study of parental beliefs regarding the safety and effectiveness of condoms and oral contraceptives, Eisenberg et al. (2004) spoke by telephone with over one thousand parents about their attitudes.

The researcher analyzed survey data from parents much in the same way Carrera et al. (2000) graded their test of sexual knowledge of underprivileged youth. This method allowed the study to test knowledge of parents in a similar format of accountability expected of youth when presented comparable information in a classroom setting. Similar to the study by Carrera et al. (2000), but different from traditional assessments of youth in schools, providing an “I do not know” option encouraged parents not to guess if they did not actually know the answer. This approach minimized a false positive indicating a parent knows more information than he or she actually did (Fink, 2003). This method also allowed for the uncertainty some participants might feel and helped prevent pressuring for the selection of an answer that was not comfortable (Schuman, & Presser, 1981). These compiled test scores then underwent comparisons through statistical regression tools against the demographic information provided by the parents. After determining the individual scores for each qualified person (a person with a child under the age of 18), the researcher compared the mean scores for different demographic categories. ANOVA tests in SPSS assured significant differences between categories, and then those demographics underwent further exploration.

The analysis of the semi-structured interviews followed a process of transcript coding by Glaser (1978). Initially open coding “generate[d] an emergent set of categories and their properties” (Glaser, 1978: 56) by applying new letter codes to discrete ideas and concepts. After completion of open coding, selective coding strategies—the limiting of “coding to only those variables that relate to the core variable in sufficiently significant ways to be used in a parsimonious theory” (Glaser, 1978: 61)—provided the necessary analytical framework.

Applied Theory

In his groundbreaking introduction to cultural capital, Pierre Bourdieu (1986) asserted that in addition to traditional monetary capital associated with economic production, social and cultural forms of capital also exist. One may trade these alternate forms of capital either directly or indirectly for economic benefit. Social capital refers to the interpersonal networks a person possesses through which potential for professional employment and advancement, and therefore prestige, occurs. Three subsets comprise cultural capital: the embodied state, the objectified state, and the institutionalized state.

Embodied cultural capital entails those characteristics benefiting an individual which one acquires through hard work and time, transforming a physical being. This form of cultural capital “cannot be transmitted instantaneously (unlike money, property rights, or event titles of nobility) by gift or bequest, purchase or exchange” (Bourdieu, 1986: 48). An intersection of social transmission and biological capacity occurs, as a person must not only obtain the means to learn the knowledge but also transfer of information may not exceed the “appropriating capacities of the individual agent” (Bourdieu, 1986: 48). Unless an extensive process of transmission occurs, one of similar breadth and depth as needed in first acquiring the knowledge or skills, capital associated with the embodied state “declines and dies with its bearer” (Bourdieu, 1986). Economic constraints exist regarding the acquisition of this capital:

In families where the resources exist to provide extended education on a useful skill or knowledge set, there will likely also exist a longer and more in-depth accumulation of embodied state cultural capital.

Objectified cultural capital represents a different, more material, and more easily transmitted form of cultural capital, such as writings, paintings, monuments, interments, etc. The properties of objectified capital are defined through a relationship with the embodied form of cultural capital. For example, a person may acquire a grand piano (objectified cultural capital), but never previously acquire the embodied cultural capital of learning to play.

Institutional capital constitutes the third form of cultural capital. A college degree exemplifies this form because “with academic qualification, a certificate of cultural competence which confers on its holder a conventional, constant, legally guaranteed value with respect to culture,” (Bourdieu, 1986: 50) an individual may more easily transfer to higher positions resulting in greater economic capital. Academic qualification also provides a method by which to compare different qualification holders, based on the prestige allotted to their distributing institution (Bourdieu, 1986: 50).

Bourdieu asserted that in a world based on capital accumulation and class, not all forms of capital rank equally. Less an explicit assertion of his theoretical framework and more a function of how he organized and analyzed data, Bourdieu often ranked various characteristics, tastes, and professions based on the weight and value assigned to them by other members of society (Bourdieu, 1979: 263, 452). The analysis of the present research occurred in a similar manner, with an exploration of how interviewees illuminated different levels of reproductive health knowledge capital within the broader field of reproductive health education. Additionally, Bourdieu’s inclusion of the Institutionalized State as a form of cultural capital (Bourdieu, 1986: 50-51) indicated the cultural significance placed on professional qualifications and helped explain the greater value assigned to the restricted forms of cultural capital discussed later. Finally, he theorized, “the measure of all equivalences, is nothing other than labor-time” (Bourdieu, 1986: 54). This may be taken to mean that the more work or capital required obtaining a particular form of capital, the more valuable it becomes.

Bourdieu’s concept of embodied cultural capital provided a valuable tool to understand the knowledge of reproductive health information possessed by parents. Those parents with an understanding of concepts related to sexual health and the prevention of pregnancy and STDs own part of the embodied capital necessary to prevent economically and socially detrimental consequences for their children. As the research showed, parents with greater knowledge and higher confidence communicate more effectively about reproductive health. Because this communication helped influence adolescents in making safer choices regarding sexuality this ‘knowledge capital’ could help prevent teenage pregnancy and STDs, both of which have significant financial and social costs. In the unique character of embodied capital, reproductive health knowledge only transmits through skilled teaching. Moreover, this transmission requires special tact and sensitivity due to its complicated nature, which on some level represents another form of embodied capital.

Bourdieu’s descriptions of “fields” and “habitus” provided necessary context for understanding cultural capital. Harker, Mahar, and Wilkes (1990) summarized the concept of fields and the social space as “a system of objective relations of power between social positions which correspond to a system of objective relations between symbolic points” (8) and the balance between these points. One of Bourdieu’s quintessential examples of fields is the system of higher education in France. Essentially, fields exist as distinct but overlapping arenas in which people compete for limited capital. An individual’s inclusion in different fields depends on existing cultural, social, and economic resources previously accumulated.

Bourdieu referred to habitus as the intersection between the social field and the individual. It is the dispositions “acquired in social positions within a field [which] imply a subjective adjustment to that position” (Harker, Mahar, & Wilkes, 1990: 10). A field necessitates a set of skills, mannerisms, and body language a person must learn in order to successfully navigate a given field. An individual develops this knowledge and understanding through interactions while at the same time the knowledge influences the field of performance. Bourdieu viewed agents of socialization, such as family, as a primary source of habitus. The social groups help the child develop a method of interacting appropriately in different social fields. As the social world constantly changes, there exists the necessity for constant reevaluation and adjustment in accordance with updated social rules of behavior. Habitus links to capital because the habitus of dominant cultural and social fields act as amplifiers of associated capital and in some cases as capital itself (Harker, Mahar, & Wilkes, 1990: 10-12). Habitus helps an individual use and apply different cultural capital in effective ways.

Bourdieu’s notions of cultural capital permeate sociological research. To begin, Bourdieu himself performed extensive research to support his theories. Sociology particularly acknowledges Bourdieu for his study of the field of higher education and how this field functions to produce and reproduce cultural capital (Harker, Mahar, & Wilkes, 1990: 86-108). The State Nobility is one of Bourdieu’s masterworks exploring how the reproduction of cultural capital occurs through elite institutes of higher education in France. Bourdieu (1996) agreed that “the highest academic titles are necessary but insufficient, possible but not inevitable, conditions for access to the establishment” (315). The educational form of institutional cultural capital, when taken in company with other forms of cultural and social capital as well as appropriate habitus, aids in advancing one’s social standing. Additionally, other researchers take Bourdieu’s outlines of cultural capital and use them to explore everything from the literary field to the sports field.

In his study of book ownership, leisure reading, and genre preference, Wright (2006) explored how social class influences different variables of individual experience within the literary field. The researcher found book culture involvement largely confined to individuals of higher professional occupations. Though book ownership and reading remained sequestered within the more prestigious professions, most individuals reported some level of reading activity through newspaper and magazine consumption. Literary genre preference correlated in several cases with education level. For example, those with higher education less commonly read ‘romance fiction’ and more commonly read ‘modern literature’ than those individuals with lower levels of education. The study concluded with the assertion that “tastes for reading are still concentrated within the better educated and within groups of relative socio-economic privilege” (Wright, 2006: 137).

Utilization of the concepts of cultural capital within analysis of sports and leisure activities occurs with surprising frequency in field of sociology (Light, & Kirk, 2001; Warde, 2006; Gayo-Cal, 2006). For example, in his study of the cultural capital associated with sports and fitness, Warde (2006) explored how different demographic variables correlated with exercise participation, sports participation and form of sport, as well as sports observed. Although Warde (2006) found that less correlation between different sports and class may exist than was previously suggested by Bourdieu, he believed evidence still shows “the most privileged people choose rare sports” (119). A strong correlation also exists between exercise/body maintenance regimens and class. The research also suggested that “high education and extensive physical activity for the purposes of body maintenance go together” (Warde, 2006: 120), indicating differing embodied capital associated with various social fields and classes. Warde (2006) did expand on Bourdieu by identifying that, in the case of sports, gender plays a key role in differentiation in sports participation (though not necessarily in exercise participation).

In the present research, the application of Bourdieu’s theory occurred first as an exploration of the distribution of cultural capital across selected demographic indicators such as gender, income, religion, and educational attainment. Following this, the theory of embodied cultural capital in expanded (lower, less prestigious, easier to obtain) and restricted (higher, more prestigious, harder to obtain) forms provided a framework for and an exploration of the sources where parents received their reproductive health knowledge.

Results and Analysis

The quantitative portion of this study tested parents’ knowledge levels of reproductive health information in three major categories and acquired demographic information. Gender, education level, income, and religion demonstrated significant differences in mean score levels between groups. Women showed higher reproductive health knowledge than men. Table 1 demonstrates this divide.

The greater responsibility and more personal involvement with the birthing process may create a greater sense of investment for women in this field, thereby motivating them to seek more information. Additionally, the variety of birth control available specifically for women possibly explained their greater contraceptive knowledge capital. Traditional responsibility for child rearing also played a part. Although Bourdieu spent some time exploring the impact of gender late in his career, most of his work did not address this topic. This research suggested, as the previously mentioned sports study did, gender played a role in capital accruement. On the issue of reproductive health knowledge a person’s gender alone provided women higher levels of cultural capital and indicated that researchers applying Bourdieu should inquire as to whether men or women possess more, or an advantage in obtaining, cultural capital in any given field. The small N for men in comparison to women posed a concern and an implication for further testing of fathers. In addition to the significant gender differences of reproductive health knowledge, differences also existed based on completed levels of education, as illustrated in Table 2.

The questionnaire established that respondents’ reproductive health knowledge ascended with greater levels of formal education. This correlation between reproductive health knowledge and educational attainment demonstrated that the higher education system acts as a source of restricted reproductive health cultural capital. Formal education options did not exist for everyone, but rather provided people with restricted and more accurate reproductive health information. This correlation between higher education and reproductive health capital also showed the interrelated structure of capital accumulation. High levels of capital in one instance may help increase levels of capital in another instance. Bourdieu explored the field of education extensively, and discussed how college degrees act as a form of institutional cultural capital. In the present case, however, college education functioned as a way to increase an embodied cultural capital of little or no relation to the formal institution. This sample over represented the higher education brackets due to the relative inaccessibility of those with lower education levels through typical sampling methods. In addition to gender and education, a significant knowledge division also arose based on income.

The variation in reproductive health knowledge across income level is outlined in Table 3. Although significant differences did not exist between income levels of $30,000-$135,000 plus, a division did exist below and above $30,000 with those making less than $30,000 a year demonstrating significantly less reproductive health knowledge. This suggested that high levels of monetary capital correlate with higher reproductive health capital, again showing the potential for capital concentration within the wealthier, more educated classes. These findings about knowledge concentration associated with class indicators may help explain the cyclical nature of adolescent pregnancy. Bourdieu discussed the ability to convert any form of capital into another form. These data implied the ability to change financial capital to embodied cultural capital in the form of reproductive health knowledge either directly or indirectly through sources like

higher education. Although these differences in knowledge level based on education and income might not come as much of a shock, people may not expect the notable division based on religious affiliation that is outlined in Table 4.

Those self-identifying as Nondenominational or as not religious exhibited significantly more reproductive health knowledge, with those identifying as Protestant and Jewish also ranks fairly high. Mormons and those of Islamic and Buddhist identification ranked fairly low with scores of around 50 percent. Some concern exists that the low n for these groups may influence the low scores. However, Pagans ranked quite a bit higher despite a low n. Regardless, those with looser religious affiliations tend to score higher than members of more conservative and rigidly organized religious. This indicates that although religious affiliation may provide members with reproductive health capital in some regard (such as a higher tendency towards abstinence), this does not necessarily increase their embodied cultural capital of reproductive health factual knowledge. The inverse relationship between religious affiliation and knowledge justifies the lower rank given to this source of information in relation to sources such as formal education. Further research should expand the sample of the less mainstream religions to determine whether these patterns persist.

When looking at these trends through Bourdieu’s lens of cultural capital, embodied cultural capital of reproductive health knowledge correlated with other forms of higher capital such as income and education. The lower level of knowledge capital based on religious affiliation indicated that some activities might actually lower one’s cultural capital of reproductive health knowledge. Although religious association may provide some levels of knowledge and correlates with a delay of first sexual activity (Meier, 2003:1032), it does not seem to improve parents’ basic knowledge of medical facts. Regarding whether parents generally possess high levels of reproductive health capital, the answer is no. After totaling scores, dividing by points possible, and then converting to percents, as the following table indicates, most parents failed.

Although these results possibly indicated that the researcher tested participants on information viewed as irrelevant to the reproductive health discussion, they still show parents did not know basic reproductive health facts. Therefore parents cannot pass these facts on to their children. This test illustrated through an objective measure that parents did not possess high levels of embodied cultural capital in the form of medically accurate reproductive health information. Bourdieu argued that cultural capital was necessary to compete within social fields. These results indicated, that with regard to the field of reproductive health, parents did not possess the levels of cultural capital they needed to educate child at the same levels the schools systems do. These results also indicated that those with higher education and higher income did possess greater cultural capital to compete within this particular social field. An exploration of the different methods through which parents acquire knowledge is provided in the next several sections.

Parents seemed to acquire their knowledge either through expanded or restricted means. The term “expanded” refers to the generally popular data sources available to most people such as life experience, mass media sources, and religious institutions. These sources, while instructive, provided somewhat ambiguous information, as characterized by the affect of religious affiliation on knowledge levels. The response of one mother in reference to where she received her information as “so kind of whatever, whenever” epitomizes this category. The term “restricted” refers to the selective sources such as medical professionals and college experience (both formal and informal) that provide substantial information (as demonstrated by the higher levels of reproductive health knowledge with extended educational participation) inaccessible to many people. In fact, some parents identifying these sources indicated aversion to expanded forms of knowledge, as demonstrated by a response from one mother, who said: “I don’t really pull anything off of the Internet. I would rather go directly to the people who are making and writing the literature rather than Wikipedia.” The interviews exposed these three expanded (life experience, media, and religion) and two restricted (medical professional and college) sources as the primary capital forms within the field of reproductive health education.

Expanded Forms

The cliché “live and learn” exists for a reason and many people credit personal experience or life experience as the teacher of important lessons. Life experience plays a significant role, not only in how adults approach future sexual relationships and sexual health for themselves but also what they teach their children about approaching sexual relationships. The following mother mentioned how her own experience as a young mother influences what she teaches her children:

This statement clearly demonstrated a mother learned valuable lessons from her own life experiences, and then used them to teach her children about sex. Most people at some time make choices about sex resulting in situations they view as less than desirable; the ability to reference this and provide concrete examples to one’s children may help them obtain a different result for their children.

Another mother similarly expressed how regrettable sexual activity influences the knowledge she wishes to pass to her daughters:

This regret of previous sexual activity repeatedly appeared in interviews, with parents wishing their children remained sexually abstinent after learning the pain of “giving oneself away” to another. After all, as one very young mother explained, “…every time you are with somebody else, you give a piece of yourself away to them. I just want them to have their whole selves to give away to one person.” Although this theme of a renewed value in abstinence and caution occurs most frequently, some parents also glean knowledge from health experiences. One mother recounted how her experiences with human papillomavirus (HPV) influenced her approach to educating her sons about reproductive health: “[h]aving been a person who got HPV before anybody really knew what HPV was, it’s even more important to me to let them know things happen, you’ve got to know how to protect yourself.” Parents not only derived knowledge about emotional impact and emotional growth from personal experience, but they also learned health-related consequences that affected the conversations with their children.

These life experiences exemplify a source of expanded cultural capital knowledge available to everyone, because all people learn from past transgressions and identify mistakes worthy of avoidance. Parents passing these life lessons on to their children show how embodied cultural capital earned over time by one person may transfer to another through conversation. As Bourdieu explained, unlike other forms of capital, embodied cultural capital may only pass from one individual to another with an investment of time and teaching. It is not known whether the adolescents choose to follow the advice suggested by their parents or whether the limiting factor of an individual’s ability to absorb and internalize the transmission of embodied cultural capital messages will prevail. Though life experience does provide valuable knowledge to parents about the consequences of sexual activity, the complete lack of restrictions and regulations as well as the entirely sporadic nature of the information makes it a less valuable and less coveted form of knowledge within the field of reproductive health. Additionally, the sacrificial nature of this knowledge source—needing to experience personal hardship and/or suffering in order to learn the lesson—further lessens the value. In fact, of all the five major information sources identified by parents, this stands alone as requiring a personal sacrifice (other than time or money) in the name of knowledge. This sacrifice coupled with the universal nature and the limited verifiability of this source earns life experience as one of the lowest rankings of cultural capital knowledge sources within the field of reproductive health education, but still a source of information nonetheless.

Although slightly less universal than the life experience ethic, the media also represent a primary and pervasive information source for parents. Most commonly, this takes the form of books and the Internet, but parents also mentioned both television and radio. As one mother stated: “I would probably get books or go onto the Internet to answer questions.” Some parents explicitly name particular books they read for information or provided for their children as a learning tool. One mother explained: “Well I’ve gotten information from “Our Bodies, Ourselves,” which is a book that I’ve had.” Some of these books circulate from generation to generation with parents offering books to their children they originally received as adolescents. This purposeful re-circulation of a source demonstrates that parents found the capital gained to be valuable and worthy of passing on and explains why book media earns a higher status ranking than other media forms.

Recently the Internet emerged as a supplement to these books, providing shocking amounts of information. However, the less regulated nature of this source may make it slightly less desirable to discerning parents. Many parents identified the Internet as a valuable place to find medical facts; one mother stated, “I definitely think I will turn to the Internet for more anatomy questions, just because it’s been a while since I’ve been in school.” This particular mother gave birth to her daughter while still in high school, never attended college, and therefore felt divorced from possible developments in the field. Here we see an acknowledgment of absent or outdated formal education regarding the subject and a supplement of information through the more expanded means of the Internet. Other parents point to educational television shows as a useful resource. One mother explained that

This demonstrated the inclination of parents to seek information wherever they may find it, as well as the wide and varied form that knowledge sources take. In addition to medical information, one mother acknowledged the potentially positive role media plays in educating the masses about the diverse nature of sexuality. She explained how she believed television might potentially decrease social judgment of certain groups:

This mother viewed mass media not only operating as a source for disseminating medical information but also as a tool influencing public opinion and potentially creating greater tolerance. This view, however, represented the minority opinion with most parents using the media as a tool demonstrating how not to act or to prompt discussions about responsibility and caution. As one mother stated:

I think that television has done a lot for people who do not necessarily start the conversation. I think it has done a lot for people as far as when a child sees something on TV that they don’t understand they can come to their parents and start a dialogue with them.

Another mentioned: “In fact, if something’s truly offensive to me – you’ll see them all rolling their eyes – but I’m going to talk about why that was so wrong.” These two comments implied two very different ways of utilizing the media to prompt discussions: either allowing the child to come to the parent with questions developed on their own after exposure or directly confronting what the children witness and providing context then and there. However, one might question the likelihood of a child approaching a parent on sexual topics. Regardless, these excerpts demonstrate how parents use mass media not only as a source to expand their personal knowledge of reproductive health information but to aid them in approaching a conversation that might otherwise be awkward, uncomfortable, or embarrassing to broach.

With the potential for misinformation associated with media sources such as the Internet and television, they may not seem effective sources for passing on reproductive health capital. However, the role they play in prompting a discussion improves the transmission process of embodied cultural capital. The first step in transmitting knowledge is simply having a conversation. Additionally, book media, which usually undergoes a more rigorous screening process, provides more reliable information for curious parents. Finally, although in western industrial countries—like the United States—most people have access to mass media such as television and Internet, many people still do without these resources, especially the Internet. This means that while mass media information represents an expanded cultural source of reproductive health capital, not everyone benefits from this information. Media and media information still acts as a precious commodity.

Within the field of reproductive health education, media sources carry less weight than many other sources. The negative reactions of most mothers when asked how media influences their discussions demonstrates that the abundance of overtly sexual images discolors the value most parents associate with media information, thereby decreasing the prestige associated with this cultural capital source. Parents do find value using the media as a discussion prompt, however, and sometimes find useful information embedded within otherwise offensive content. But generally parents assign less value to media information than other sources of knowledge. We see further status differentiations within the field of media because certain trusted books resurface as reproductive health classics, receiving certain levels of reliance and respect not yet granted sources like Wikipedia. Also, because the identification of how not to dress or act is the value parents normally derive from television, this specific source ranks where it does because it does not contribute to the stock of good knowledge but rather exemplifies what is bad. In some ways the media functions as a virtual form of self-sacrificing, a slightly less impactful version of the life experience ethic. Examples from the media provide parents the opportunity to note that a certain behavior does not end well and should therefore be avoided. Again, the less personal nature of media messages means the parent sacrifices less in acquiring the lesson but, as a result, the recipient of the message may not find it as powerful.

Religious Institution Affiliation

Although media sources represent the most pervasive outside source of parental information, the influences of religious institutions also merit note. Religious affiliation influences parental knowledge in three primary ways. First, many religions strongly emphasize abstinence until marriage as the best or only way of engaging in sexual activity. A scriptural emphasis on sex existing between a husband and wife in marriage finds its way into parents’ reproductive health discussions. Take the explanations from the following two mothers to a prompt asking whether religion affects their conversation:

These quotes demonstrate how involvement with religious institutions teaches parents the importance of delaying sexual activity until marriage. Although some might assume religious influence takes the form of a fire-and-brimstone approach to scare people about the sinful nature of sexual promiscuity, these specific excerpts highlight a gentler tactic. These mothers both talk about how religion teaches them the possible pleasure and beauty of sex—if it occurs within the institution of marriage. Religion teaches them of the potential for the body to express love and that therefore one should preserve his or her body for a truly special relationship.

Although oftentimes the religious approach to abstinence focuses more on the spiritual implications of premarital sex, abstinence does also present the most medically responsible choice. Abstinence from sex remains the only way to ensure 100 percent protection from pregnancy or STDs, so any source of knowledge that encourages abstinence and provides convincing reasons to maintain this life-style helps promotes sexual health. Additionally, parents also referred to the psychological and emotional burden of sex for those unprepared for the potential impact of sexual intercourse. Adolescents who approach sex from the perspective of these two mothers may fortify themselves against some of this turmoil. This represents a form of expanded cultural capital knowledge because of the wide availability of this influence and the potential for providing physical and emotional safeguards. However, the absence of specific and technical medical knowledge from the religious institution places it slightly lower in the social field than sources that do.

Although the focus on abstinence represents the primary infusion of religious cultural capital, some parents also referred to church officials themselves acting as a resource. One mother explained that “[T]he Bishop is there to answer every question under the sun.” This quote demonstrated how wholly those of religious faith trust the ability of church officials to provide them with needed information. Some viewed their church not only as a place of general teaching but also a place to seek the answers to difficult questions. Here we see how religions exists as more than a set of scriptures encouraging a certain behavior but also as an institution with individuals who may provide personal direction or guidance—in other words, a source of interactive knowledge. This poses a significant resource because not everyone maintains access to scientific experts they feel can advise them on difficult subjects. As with the religious teachings, access to the institutions themselves remains fairly open to anyone interested in seeking help, thereby exemplifying a source of an expanded version of the embodied cultural capital. Access to an expert in any form bolsters someone’s confidence and increases trust in the information. Additionally, many church officials act as counselors for their congregation and have experience in handling complex and potentially explosive subjects.

Though these represent interesting ways in which religion affects knowledge, a third potentially more controversial influence also exists: the influence of religion on knowledge about contraceptives. Most people acknowledge and understand the role religion plays in the abortion debate, with various sects discouraging this invasive form of birth control. Parents interviewed for this study also acknowledged religious education playing this role in their personal birth control choices. One mother explained why she would not use certain forms of contraception:

So while some parents seem to take religious teachings into consideration, they may “tell them what the…church party line is and the realities of the world as well,” thereby tempering the religious information with information acquired through other sources.

For some parents, however, religious education remains the primary and most influential source of knowledge, as demonstrated by this next mother’s comments:

Most parents interviewed expressed a desire for their children to remain abstinent until marriage, but believed that while religious teachings provide a nice guide they require supplements in order to deal with the realities of the world. This does, however, show an interesting case of how some parents rely heavily (and sometimes solely) on the expanded forms of knowledge as produced by the church, despite possible exposure to more restricted forms.

The cultural capital nature of religious affiliation rests with its ability to increase abstinence practices and provide parents a sense of reassurance, guidance, and confidence when approaching the subject. However, as demonstrated by the test results showing relatively lower knowledge levels among those with stronger religious affiliation, this may represent the extent of positive religious influence on this topic. The restrictions suggested by some religions on forms of birth control, and the justifications given for these restrictions likely decreases the medical knowledge of parents because it plays up the sinful nature of sex and contraception. The tempering of religious teachings with outside information also shows how most parents view this form of cultural capital as less influential and valuable than the more formal medical sources. In a culture currently following a medical model, other forms of information and advice will continue to occupy lower status within any field.

Restricted Forms

Although life experience, media, and religious institutions undeniably affect a parent’s reproductive knowledge, restricted forms of information sources such as the advice of medical professionals and college experiences also aid in the conversation.

As evidenced by the explosion in self-diagnosis, and the wild popularity of websites such as WebMD, we tend to trust doctors and those medically trained to evaluate the human body. Medical specialists exist for virtually every body part and every diagnosis, including family planning and reproductive health. One mother referred to advice she received from Planned Parenthood regarding how and what to discuss with her children:

As an established name in the reproductive health field, Planned Parenthood provides a level of reproductive health expertise absent from expanded forms of knowledge acquisition. Although the information still comes largely from books, the fact that they are suggested and explained, including instructions from a specialist, awards them a different level of value. Planned Parenthood does not restrict access, but only a minority of the population seeks services from them. In fact, the previous mother who relied so heavily on them acknowledges that without her previous employment with Planned Parenthood she would likely not utilize them as a resource: “I’m not sure how I would have learned about [the kits] otherwise…I think I would have gone to my public library, or…um…Googled stuff.” This demonstrates that despite the organization’s relative accessibility, even those who know and trust Planned Parenthood acknowledge possibly overlooking the services under slightly different circumstances. Interestingly, the fallback information source to this more restricted medical expertise was Google. Without access to experts in the field, this mother acknowledged a necessary reliance on expanded forms of cultural capital transmission such as mass media.

In addition to organizations specifically addressing family planning, parents also defer to their primary doctors for reproductive health information. One mother acknowledged that by “[G]oing to [her] own medical checkups and exams and physicals and paps” she learned a lot from her doctors about reproductive health. Parents also seek out reproduction-specific information from their doctors simply because of their general medical expertise, such as one mother who said: “[W]e also use our doctors a lot; they have medical training to deal with all of these kinds of issues . . . ” Even without a specific focus on reproductive health, the mother viewed her doctor as a valuable and knowledgeable source for receiving information. But the ability to consult a medical professional remains a restricted manner of obtaining cultural capital. With 45.7 million Americans or 15.3 percent of the population uninsured in 2006 (U.S. Census Bureau, 2008: paragraph 1), not everyone accesses this knowledge source with the same freedom as the forms discussed in the expanded section.

Within the field of reproductive health education the ability and tendency to consult medical professionals provides individuals the opportunity of obtaining information deemed a higher quality by our society. We trust that doctors, with their extensive understanding of the human body and natural world developed through ten years of formal scientific medical training, understand the specifics of pregnancy and STDs and therefore the best ways to prevent them. Parents trust that doctors, with their cool scientific approach, will present the information in a simple, straightforward, and appropriately detached manner. As evidenced by the earlier quote expressing a parent’s preference for the advice of highly educated medical professionals to dubious sources such as Wikipedia, this source draws greater respect within the field of reproductive health education. The inclination to consult doctors, rather than relying on personal knowledge gained through experience, shows the relative ranking of these sources. The cultural capital accrued by doctors in the form of institutional capital affords them greater legitimacy and a superior status within the field of knowledge.

With less than 28.8 percent of the population in 2007 receiving at least a four-year college degree (U.S. Census Bureau, 2009), college experience stands as a less direct form of reproductive health education. Its availability is even more restricted than individual assistance from a medical professional. Interviewees identified both formal and informal aspects of the college experience as significantly increasing their reproductive health knowledge and helped them discuss sexual health with their children. One mother joked how acquiring her degree in family therapy helped her in this regard:

Here a mother directly credited her college coursework and professional career as easing her sex-ed discussions. True, classes in certain fields likely provide greater benefit than others. As a professor and practitioner of family therapy, this specific mother received professional training in a subject uniquely close to the topic of this research. However, other parents also identified useful college coursework: “My husband and I both have science backgrounds so our understanding of biology is there. You know, we can explain things from a scientific perspective.” Evidently both social and natural science disciplines present potential opportunities for those with bachelors and advanced degrees to gain knowledge applicable to the reproductive health discussion.

In addition to the official class curricula, other formal college lectures and presentations often appear on college campuses. One mother recounted how her college reacted to the expanding AIDS epidemic:

Not only do specific coursework, classes, and topic areas take it upon themselves to educate the student body about reproductive health concerns, but Universities does as well. Many schools also sponsor condom fairs periodically. Pacific University hosts one every spring in conjunction with the Washington County Health Department. The final line of the proceeding quote: “it was just one of those school conversations,” indicated how entwined and even expected reproductive health discussions are in the college framework. These conversations just happen.

These conversations also happen outside of formal class work and lecture settings in a more informal sense. One mother currently enrolled in college remarked how involvement in the college atmosphere alone provided knowledge about reproductive health:

Although these informal college educational experiences do not meet the same academic standards of classroom curricula for biology and family therapy master’s coursework, it does indicate that the relatively open and frank discussions about sexuality and health permeating the world of academia provides useful information for parents.

With the relative taboo assigned to sex in the current cultural milieu, this opportunity for frank and open discussions about sexual health remains constricted to limited circles, making this a rare and privileged information source. Additionally, the high concentration of individuals with high institutional capital involved in the discussion also raises the value of the conversation. The extremely selective nature of the college institution, the high level of professionally qualified individuals, and the established correlation between this source and higher knowledge levels affords formal college instruction the highest prestige ranking of knowledge sources within the social field of sexuality education. Many also view college as a time of sexual experimentation and discovery so in a sense, very different from pure sexual health, sexual experience also grows creating a potentially richer life experience ethic as well. This tendency for higher cultural capital to beget further cultural capital exemplifies Bourdieu’s explanation of capital accumulation. This occurrence within the field of reproductive health education provides insights into the multi-disciplinary exploration of the widening division of class stratification.

Discussion

The interplay of various sources of knowledge characterizes the social field of reproductive health education. No parent receives information from only one source; instead, they tend to temper and modify knowledge from various arenas. Arenas referred to as expanded forms in this research, such as life experience, media, and religion interact, with more prestigious and restricted forms, such as college instruction or advice from medical professionals, to provide parents a more complete perspective. People award these restricted knowledge sources greater levels of legitimacy and worth and tend to value the advice of professionals at a higher level. The existence of expanded methods of information attainment does not cheapen the value of these more professional sources. Despite the pervasiveness of media influence, its quality and quantity of relevant factual information pales in comparison to the restricted forms. Thus the quantity of information available does not necessarily destroy the quality of the restricted forms of knowledge. Furthermore, although everyone potentially learns valuable lessons from life experience, the necessary sacrifice required for this knowledge raises the cost and lessens the value of that information, especially considering its relatively vague nature. Additionally, involvement with higher education systems and increased general knowledge levels expands the critical capacities of an individual and aids a person in extracting the valuable message present in expanded sources of knowledge, such as the media.

The application of Bourdieu’s analytical framework in this research illustrates how the embodied cultural capital of knowledge interacts with other forms of capital, such as institutional and financial capital. The strong influence of general educational attainment on a specific and somewhat unrelated form of knowledge demonstrates how this formal education provides more value than simply the award of a degree. Involvement in more elite fields exposes individuals to diverse, rewarding, and sometimes controversial forms of knowledge. In addition, the correlation between income and knowledge illustrates the potential of converting monetary capital into specific forms of knowledge either directly or indirectly. The natural and clear division between expanded and restricted embodied capital sources contributes to the understanding of the perpetuation of class divisions. Bourdieu’s explanation that other forms of capital exist—aside from financial capital—and that one may exchange these for financial gains, helps provide a nuanced understanding of the cliché “knowledge is power.” This understanding of knowledge as power extends to reproductive health knowledge, and the use of Bourdieu’s theoretical apparatus provides a rigorous vocabulary for discussion as well as a mode of comparison.

Overall, most parents seem to lack much of the reproductive health knowledge routinely outlined in comprehensive sex education curriculum. Eighty-two percent of the parents who completed the survey failed to achieve a passing grade.⁵ Although low performance may indicate that the survey was unfairly difficult, it still demonstrates an appallingly low knowledge level. Parents are generally not held formally accountable for this information, and this may help explain why they do not master it. Regarding where this knowledge comes from, both expanded and restricted forms of cultural capital attainment present themselves. Parents credit some widely available sources, such as personal life experience, mass media resources, and religious institutional teachings as providing them with most of their reproductive health information. In addition to these expanded sources of information, some parents also attribute capital acquisition to more restricted sources such as medical professionals and both formal and informal college experience. Aside from the general prestige typically awarded these sources, the higher knowledge level discovered in relation to higher educational attainment through the survey also helps classify college experience as a more elite source of knowledge. Thus, cultural capital of reproductive health knowledge correlates with more familiar forms of capital, higher income levels and higher educational attainment.

There are several implications for future research, including an examination of whether knowledge levels differ between group opposing and supporting comprehensive sexuality education in the schools. Also, further examination of the differences in knowledge levels between men and women, different religious groups, and different ethnic groups is required, due to some of the unequal representations within this sample. Interviews with these same underrepresented populations would also be worthwhile, since the researcher conducted interviews primarily with Caucasian mothers. Finally, those parents interviewed for this study all expressed a profound belief in the value of educating their children about sex and the belief that all parents should educate their children about this topic. But they believed that many parents do not do so because of discomfort. Because all parents volunteering for participation in this study wanted to, had, or planned to discuss reproductive health with their children, a study of parents who feel differently would be prudent. Surveying parents to identify who plans discussing this issue with their children and what the most common delivery methods are could provide further evidence about the nature of parents’ reproductive health capital. This sort of survey could allow for the exploration of parental approaches on more complicated topics, such as education about homosexuality and masturbation, which were beyond the scope of this study.

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1 ANOVA test confirmed this is a significant difference between Gender groups.

2 ANOVA test confirmed significant differences between Education Level groups.

3 ANOVA test confirmed significant differences between groups.

4 ANOVA test confirmed significant difference between different Religious Affiliation groups.

5 A, B, or C on the test

“The Buzz About the Birds and the Bees” Parental Reproductive Health Capital

Eulalie Laschever Pacific University, Mercer Island, WA

Abstract

Literature Review

Methodology