Percentage Teenage Pregnant Again Within Two Years
J Adolesc Wellness. Author manuscript; bachelor in PMC 2006 Oct 13.
Published in last edited form every bit:
PMCID: PMC1602042
NIHMSID: NIHMS2436
Boyish Pregnancy Intentions and Pregnancy Outcomes: A Longitudinal Examination
CYNTHIA ROSENGARD
From the Segmentation of General Internal Medicine, Section of Medicine, Rhode Island Hospital, Brownish University School of Medicine, Providence, Rhode Isle
MAUREEN K. PHIPPS
Departments of Obstetrics and Gynecology and Community Health, Women & Infants Hospital, Chocolate-brown University School of Medicine, Providence, Rhode Isle
NANCY E. ADLER
University of California, San Francisco, San Francisco, California
JONATHAN M. ELLEN
Division of General Pediatrics and Adolescent Medicine, Section of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
Abstract
Purpose
(a) To examine different methods of assessing pregnancy intention; (b) to identify psychosocial differences betwixt those who indicate pregnancy intentions and those who exercise not; and (c) to examine the relationship between pregnancy intentions and subsequent pregnancy at half-dozen-month follow-up in nonpregnant (at baseline), sexually experienced adolescent females.
Methods
Longitudinal cohort written report of 354 sexually experienced female adolescents attending either a STD clinic or HMO boyish medicine dispensary in northern California. Student's t-tests and regressions examined psychosocial differences between females who reported "any" and "no" pregnancy intentions. ANOVAs examined differences among different combinations of pregnancy plans/likelihood. Chi-square analyses assessed associations betwixt baseline pregnancy intentions and subsequent pregnancy.
Results
Adolescents' reports of their pregnancy plans and their assessments of pregnancy likelihood differed from one another (χ2 = 50.39, df = one, p < .001). Pregnancy attitudes and baseline contraceptive use differentiated those with inconsistent pregnancy intentions (Not Planning, but Likely) from those with clear pregnancy intentions (Planning and Likely, and Not Planning and Not Likely) (Pregnancy Attitudes: F [2,338] = 68.96, p < .0001; Contraceptive Use: F [2,308] = fourteen.87, p < .0001). Suspected pregnancies and positive pregnancy test results were associated with baseline pregnancy intentions (Suspected: χtwo = 19.08, df = two, p < .01; Positive Results: χtwo = eight.84, df = 2, p = .015).
Conclusions
To reduce adolescent childbearing nosotros must assess pregnancy intentions in multiple ways. Data/pedagogy might do good those female adolescents with inconsistent reports of pregnancy intentions.
Keywords: Pregnancy intentions, Adolescent females, Attitudes, Intentions, Contraceptive utilize
More than 880,000 adolescent girls between 15 and 19 years former became pregnant in the U.s. in 1996, representing 19% of sexually active girls in this age group [1,2]. More than 75% of teen pregnancies are considered unplanned or unintended and approximately 35% of all teen pregnancies end in ballgame [3]. For adolescents continuing a pregnancy, approximately 40% to threescore% of births are considered the result of unintended pregnancies [iii–7]. Fifty-vi percent of teen pregnancies result in alive births and i in iv teenage mothers has some other child inside 2 years [3,4,8].
The term "pregnancy intention" is widely used, and loosely interpreted. For instance, definitions of intention include degrees of "wantedness," "planning," "timing," and "happiness" regarding a pregnancy [vi,9–14]. To illustrate the differences betwixt these terms, often used interchangeably, a study of 110 women receiving prenatal care indicated that, whereas 35% of the pregnancies were considered "planned," 91% of them were "wanted" [15].
Oft, "intention" to be pregnant is measured during pregnancy or subsequently birth. The idea of pregnancy intention, yet, relates to a adult female'southward feelings before conception, whereas whether a adult female wants to have a baby may change and reverberate her emotional country during or after pregnancy, too equally beforehand [thirteen,16]. Because the thought of pregnancy intention attempts to capture a adult female's preconception attitude toward a pregnancy, it is important to recognize the timing of when these questions are asked. For example, after birth, a higher proportion country their pregnancies are wanted (interpreted equally intended) as compared with when questioned during pregnancy [17,eighteen]. This trend may reflect more than positive and socially accepted feelings almost having the child as the pregnancy continues [19,20]. Pregnancy intention has been studied retrospectively through interviews with women who are currently significant [4], who have recently given nascence [17], or who present for pregnancy testing [13]. Because prospective longitudinal studies investigating pregnancy intention in adolescents are scant, we do not know much nearly adolescents who intend to go pregnant earlier formulation or whether pregnancy intentions predict after pregnancy outcomes.
Understanding the process of adolescent pregnancy intention has pregnant clinical application. Adolescent pregnancies are ofttimes characterized by delayed initiation of prenatal care, poor prenatal wellness behaviors, and low birth weight infants [18,21,22]. Other research has shown a like increased chance of these outcomes among women with unintended pregnancies [10,23,24]. Contempo work also suggests that even healthy infants born to teenage mothers are at increased risk of postal service-neonatal death [25]. Clearly, understanding adolescents' motivations for pregnancy, the factors (i.e., attitudes, behavior, intentions) that characterize those adolescents who indicate a want for pregnancy, and how pregnancy intentions influence later pregnancy may aid in efforts to reduce the negative health consequences of teenage childbearing in the United States.
Nosotros examined adolescent pregnancy intentions (likelihood and planning) and pregnancy (at 6-month follow-up) to answer the post-obit research questions: (a) How do dissimilar means of measuring pregnancy intention (planning and likelihood assessments) differ from one some other, and is a combined measure a amend predictor of subsequent behavior and outcomes?; (b) How do nonpregnant boyish females who intend to get pregnant in the side by side 6 months differ in psychosocial variables from those who practice not intend to get significant?; (c) Do baseline pregnancy intentions predict the likelihood of pregnancy 6 months later? The findings from this written report may aid to broaden our understanding of pregnancy intentions among boyish females earlier conception and identify targets for intervention to prevent teenage pregnancies.
Methods
Participants and Recruitment
Ane hundred lxx-iv female adolescents from a municipal sexually transmitted disease (STD) clinic and 214 from a wellness maintenance organization (HMO) clinic in Northern California were recruited between June 1996 and June 1998 [26]. The study's protocol was approved past the Institutional Review Board at the University of California, San Francisco. For both clinics, adolescents were recruited in the waiting area before their clinician visit. Adolescents' reasons for seeking care ranged from suspected STDs and contraceptive services to annual concrete examinations. Eligibility criteria included: age = 14–xix years one-time, English language-speaking ability, vaginal or anal intercourse in the preceding 3 months, and residence within the local metropolitan area. Participants were contacted and re-interviewed half dozen months after. Over ninety% of those who participated at baseline completed the follow-upwards.
Administration of Measures
Data were collected every bit part of a larger study examining perceived take a chance of STDs, perceived risk of pregnancy, and sexual decision-making [27]. After obtaining written informed consent, a research assistant conducted a structured interview with each participant in a individual room and filled out corresponding questionnaires with the participants' answers to questions. The interview assessed demographics, perceived risk of STDs, attitudes toward condom use, perceived social norms regarding condom use, condom self-efficacy, and intentions to use a condom. The pregnancy attitudes/intention, oral contraceptive pill (OCP) attitudes, perceived take a chance of pregnancy, and abortion intentions items were included within this interview. Six-calendar month follow-up interviews were conducted at the clinics from which participants were recruited. Participants were offered compensation of $15.00 to participate in each interview.
Baseline Interviews
Option of psychosocial variables was guided by the Theory of Planned Behavior [28].
Demographics
Participants indicated their age, gender, cocky-identified racial/ethnic group, and mother's educational attainment.
Pregnancy attitudes and intention
Attitudes toward pregnancy and pregnancy intention were assessed past scales developed for the current study. Iii 5-point Likert scale items assessed: (a) how worried, (b) how upset, and (c) how happy an adolescent would exist if she got significant in the adjacent 6 months. A Total Pregnancy Attitudes Score was calculated past taking the mean of these three items (worried and upset items were reverse scored) (α = .82). College scores on this measure indicated more than positive attitudes toward pregnancy. Pregnancy intention was measured by ii items (one for likely and ane for planning) that assessed: (a) how likely she thought it was that she would get pregnant and (b) the caste to which she agreed that she planned to become pregnant in the next half-dozen months. Responses for these items were rated on five-point Likert scales (ranging from "Not at all Likely"/"Definitely No" to "Extremely Likely"/"Definitely Yeah"). All participants were asked if they were currently meaning (at baseline)—none reported a known pregnancy at that time.
An OCP attitudes scale was created from a set of items assessing possible outcomes of using oral contraceptive pills (OCPs), using composite expectancy-value items by multiplying the expectancy for each item (eastward.one thousand., " If y'all were taking the nascence control pill every day, how likely is it to affect your menstrual period?") with its corresponding value (east.g., "How adept or bad would it be if the pill afflicted your menstrual menstruum?") and summing the products (α = .55). College numbers indicate more positive attitudes toward oral contraceptive pills. OCP intentions were measured by request participants to bespeak how likely they were and how sure they were (dissever items) that they would utilize the oral contraceptive pill in the next 6 months (α = .96).
Nosotros measured perceptions of risk of pregnancy using newly developed items that included how probable participants thought they were to become pregnant in the next 6 months (a) if they used birth command pills every day, and (b) if they didn't employ any form of contraceptive at all.
Participants' abortion intentions were measured past request them to indicate how likely they were to have an abortion and how sure they were they would or would not have an abortion (divide items) if they became pregnant in the next 6 months (α = .97). Abortion intentions were included to measure their potential influence on pregnancy intentions among adolescents.
Participants were asked how frequently they had used contraceptive methods (including OCPs, Nor-plant/Depo-Provera®, diaphragms/cervical caps, vaginal suppositories, condoms, and withdrawal) in the by 6 months.
Six-month Follow-up Interviews
Half dozen months afterward participants were asked to indicate: (a) if during the previous 6 months they had ever thought they were pregnant ("Aye" or "No") (Suspected Pregnancy), and (b) if they had taken a pregnancy test, the results of the test (positive or negative) (Pregnancy Exam Results). If they reported a positive pregnancy test, participants were asked what they had decided to do about the pregnancy. Participants were again asked how frequently they had used contraceptive methods in the previous 6 months.
Information Analysis Plan
Responses to pregnancy plans and pregnancy likelihood items were dichotomized to contrast those who indicated "no intention to become pregnant" (not planning or not probable) from those who indicated "any intention to go meaning" (planning or likely) in the next 6 months. We initially chose to examine pregnancy plans separately from pregnancy likelihood to highlight the possible differences associated with assessing pregnancy intention using each of these questions. We then created combination pregnancy intention groups using cross-tabs of the dichotomized pregnancy intention (plan/probable) items ("Planning and Probable," "Not Planning, but Probable," "Planning, simply Not Likely," and "Non Planning and Not Likely"). However, because few females reported planning, just non likely, this group was dropped from farther analyses. Nosotros conducted a series of one-way analyses of variance (ANOVAs) to determine psychosocial variables that would differentiate the remaining three intention groups. To decide if there were significant differences in pregnancy outcomes (suspected pregnancy and pregnancy test results) amid the pregnancy intention groups, we conducted Chi-square analyses. All analyses were conducted using SPSS 10.0 software [29].
Results
Of the 388 females who provided baseline data, 354 (91.2%) returned for the vi-month follow-upward interview. The participants ranged in age from 14 to 19 years with an boilerplate age of 16.84 (SD = 1.37). Of the total, 97 (27 ½ %) were African-American; 72 (20.three%) were white; sixty (16.9%) were Latina/Hispanic; 57 (16.1%) were Asian American; and 68 (19.2%) were Mixed/Other race/ethnicity. One hundred forty-seven (44%) of the adolescents' mothers had graduated from high school or less, 164 (46%) had attended or graduated from college, vi (1.vii%) had obtained an advanced caste (masters or doctoral), and 30 (vii.5%) did not know their mother's educational attainment.
Comparing those adolescents who participated in the 6-month follow-up data with those who only provided baseline data yielded no significant differences in age, racial/ethnic composition, or maternal education. Of the 354 who provided 6-month follow-up data, 159 (45% of the follow-upwardly sample) had thought during the previous 6 months that they might be pregnant; 91 (25.7% of follow-upwardly sample and 57.2% of suspected pregnancies) had taken a pregnancy test, and 33 (nine.3% of sample and 36.3% of those who took a pregnancy test) had received positive pregnancy test results. Of those who reported a positive pregnancy exam, xi (33.iii%) had decided to proceed the pregnancy, xviii (54.v%) had decided to have an abortion, and 4 (12.2%) had experienced a miscarriage (Figure 1).
Menstruation chart of participant follow-up and pregnancy outcomes
Pregnancy Intentions
Although the majority of the sample (76.v%) indicated no plans to become significant in the next 6 months, 66% of the sample indicated that at that place was at least some likelihood that they would become pregnant in the next 6 months. We developed cantankerous-tabs and ran Chi-square analyses of participants' dichotomized responses to pregnancy program and pregnancy likelihood items. Nosotros constitute that the design of responses to these two items were significantly different from 1 another (χtwo = 50.39, df = 1, p < .001).
Determinants of Pregnancy Intentions
Program
A serial of Educatee'south t-tests were conducted to identify differences between those who indicated any pregnancy plans and those with no plans to be meaning in the side by side 6 months (Table one). There were ethnic group differences in planning; a larger per centum of African-American and Hispanic boyish females indicated any pregnancy plans as compared with white, Asian, or Mixed/Other groups (χii = 36.55, df = vi, p < .001). Those who indicated any plans to become meaning in the next six months demonstrated more than positive attitudes toward pregnancy, lower assessments of the adventure of pregnancy while using no contraceptives, weaker intentions to get an abortion, less contraceptive employ in the previous 6 months at baseline, and weaker contraceptive intentions than those who indicated no plans to become pregnant in the side by side half-dozen months (Tabular array 1).
Table one
Differences in Baseline Variables Between Those Who Intend (Program or Likely) to be Pregnant (Any) and Those Who Practise Non Intend (Program or Probable) to be Pregnant (None) in the Next Six Months (n = 355)
| Pregnancy Plans | Pregnancy Likelihood | |||
|---|---|---|---|---|
| None (280) | Any (75) | None (121) | Any (225) | |
| Demographics | ||||
| Age (mean years) | sixteen.86 (ane.4) | xvi.75 (one.iii) | 16.93 (ane.3) | 16.77 (1.4) |
| Race/Ethnicity | ||||
| African-American | 64 (22.ix%)** | 33 (44.0%) | 25 (20.7%) | lxx (31.1%) |
| White | 68 (24.3%) | iv (5.3%) | 29 (24.0%) | 41 (xviii.ii%) |
| Hispanic/Latino | 44 (15.vii%) | 16 (21.three%) | 21 (17.4%) | 36 (16.0%) |
| Asian | 53 (18.ix%) | ten (13.iii%) | 24 (19.8%) | 37 (16.four%) |
| Mixed/Other | 51 (18.2%) | 12 (16.0%) | 22 (18.2%) | 41 (18.2%) |
| SES (mother's educ.) (med.) | 4.0 | 3.0 | 4.0 | 4.0 |
| Individual variables | ||||
| Contraceptive attitudes | 8.53 (4.9) | 7.64 (four.6) | 8.72 (4.9) | 8.14 (4.9) |
| Pregnancy attitudesa | 2.11 (0.nine)** | 3.37 (0.9) | 1.88 (0.9)** | 2.sixty (i.1) |
| Perceived hazard of pregnancy | ||||
| Using OCPs | 2.38 (0.9) | ii.51 (0.9) | 2.29 (0.9) | 2.47 (0.viii) |
| No contraceptivesa | 4.69 (0.6)* | 4.49 (0.8) | 4.75 (0.6)* | iv.59 (0.vii) |
| Perceived take chances of STDs | 50.12 (31.6) | 47.33 (32.9) | 49.04 (33.v) | 49.54 (31.0) |
| Ballgame intentionsa | 3.60 (1.5)** | ii.18 (1.3) | 3.58 (1.half-dozen)* | iii.xv (1.6) |
| Behavioral variables | ||||
| Condom utilise | 3.58 (1.6) | 3.64 (ane.6) | 3.23 (1.7) | 3.84 (1.5) |
| Condom intentions | 3.09 (0.ix) | 2.90 (0.9) | 3.xx (0.8)* | ii.98 (0.9) |
| Contraceptive usea | 4.23 (1.one)** | iii.54 (i.four) | 4.51 (0.nine)** | 3.xc (1.3) |
| Contraceptive intentions | 3.13 (i.6)* | two.66 (i.5) | 3.19 (1.7) | 2.94 (1.6) |
Likelihood
As with those who had at least some plans to become significant, those who perceived any likelihood of becoming pregnant in the next 6 months differed from those who reported no likelihood of becoming pregnant in the next 6 months on pregnancy attitudes, perceived risk of pregnancy without using contraceptives, ballgame intentions, and contraceptive use. Additionally, those who perceived whatever likelihood of condign pregnant report weaker intentions to use condoms in the future than those who reported no likelihood of becoming pregnant in the adjacent 6 months (Table 1). In that location were no ethnic grouping differences associated with perceived likelihood of pregnancy.
Combinations of Plan/Likelihood
To determine the interplay between pregnancy plans and pregnancy likelihood, we created pregnancy intentions groups, based on the combination of the dichotomized answers to intention items. The resulting groups were: (a) those who indicated that they were planning and likely to go pregnant ("Planning and Likely," north = 69/xix.4%), (b) those who were non planning, merely probable to get pregnant ("Non Planning, but Probable," north = 156/43.ix%), and (c) those who were not planning and not probable to get pregnant ("Not Planning and Non Probable," n = 117/33%). The group who was planning, simply not probable to get pregnant (northward = 13/iii.vii%) was too pocket-size to include in the analyses. In a series of one-way ANOVAs we compared psychosocial variables that might differentiate the pregnancy intentions groups. There were meaning differences in pregnancy attitudes, perceived run a risk of pregnancy using no contraceptives besides as ballgame intentions and contraceptive use (Table two).
Table 2
Baseline Comparisons Amidst Programme and Likelihood Combination Groups
| M (SD) or n (%) | |||
|---|---|---|---|
| Planning and Likely (northward = 69) | Not Planning, But Likely (n = 156) | Not Planning and Not Likely (north = 117) | |
| Age (years) | 16.75 (1.30) | 16.77 (one.40) | sixteen.92 (1.29) |
| Race/ethnicity | |||
| African-Americana,b | 31 (44.9) | 39 (25.0) | 23 (nineteen.seven) |
| Whitea,b | 4 (five.8) | 37 (23.7) | 29 (24.8) |
| Hispanic/Latino | 14 (xx.3) | 22 (14.1) | 20 (17.1) |
| Asian | nine (thirteen.0) | 28 (17.nine) | 24 (20.6) |
| Mixed/Other | 11 (15.ix) | xxx (19.2) | 21 (18.0) |
| SES (parents' pedagogy) (median) | 3.00 | 4.00 | four.00 |
| Contraceptive attitudes | seven.75 (iv.62) | 8.31 (iv.95) | 8.82 (four.94) |
| Pregnancy attitudesa,b,c | 3.43 (0.93) | 2.24 (0.89) | one.87 (0.85) |
| Perceived risk of STDs | 46.65 (33.27) | 50.81 (29.98) | 48.60 (33.53) |
| Perceived take a chance of pregnancy | |||
| With OCPs | ii.52 (0.85) | 2.44 (0.79) | 2.30 (0.96) |
| With no contraceptivesb | 4.46 (0.78) | 4.64 (0.64) | iv.74 (0.lx) |
| Abortion intentionsa,b | ii.20 (1.34) | 3.57 (1.46) | 3.63 (one.54) |
| Prophylactic use | three.57 (ane.63) | 3.98 (1.49) | 3.18 (1.71) |
| Condom intentions | 2.87 (0.87) | iii.02 (0.85) | 3.19 (0.84) |
| Contraceptive employa,b,c | 3.53 (1.45) | 4.07 (1.18) | 4.52 (0.86) |
| Contraceptive intentions | two.68 (1.49) | iii.06 (ane.58) | 3.22 (1.71) |
In particular, information technology is interesting to note how those with inconsistent reports of pregnancy intentions ("Not Planning, but Likely") differed from those with clear pregnancy intentions ("Planning and Likely" and "Non Planning and Non Probable"). Those with inconsistent reports of pregnancy intentions were less likely to be African-Americans and more than likely to be white, reported less positive attitudes toward pregnancy, college ballgame intentions, and used contraceptives more those who clearly intended to become pregnant. Notwithstanding, those with inconsistent pregnancy intentions also indicated more positive attitudes toward pregnancy, and less contraceptive utilise than those who clearly indicated no pregnancy intentions (Tabular array 2).
Pregnancy Intention and Pregnancy Outcomes
To determine if those adolescents who indicated different combinations of pregnancy plans/likelihood at baseline differed in their experiences of suspected pregnancy and/or positive pregnancy test results at 6-month follow-upwardly, we ran Chi-square analyses (Tabular array three). Those who clearly indicated a desire for pregnancy ("Planning and Likely") were more likely to have a suspected pregnancy and a positive pregnancy test results than those who indicated inconsistent pregnancy intentions ("Not Planning, only Likely") and those who clearly indicated no pregnancy intentions ("Not Planning and Non Likely"). Additionally, those who indicated inconsistent pregnancy intentions ("Not Planning, simply Likely") were more probable to have positive pregnancy test results than those who clearly indicated no pregnancy intentions ("Not Planning and Not Likely"). Well-nigh a third of those who indicated inconsistent pregnancy intentions (30.2%) reported positive pregnancy test results in the past vi months. Importantly, nigh twoscore% of those with inconsistent pregnancy intentions reported not using contraceptives every fourth dimension they had sex. Additionally, more 75% of those who reported positive pregnancy test results reported that they would be terminating or had already terminated the pregnancy (data not shown).
Table three
Comparisons Among Baseline Pregnancy Plan/Likelihood Combination Groups and Pregnancy Outcomes (Suspected Pregnancy and Pregnancy Test Results)
| Planning and Likely | Not Planning, Simply Likely | Not Planning and Not Probable | |
|---|---|---|---|
| Pregnancy suspicionsa | |||
| n | 69 | 156 | 117 |
| No | 25 (36.two%) | 81 (51.ix%) | 80 (68.4%) |
| Yes | 44 (63.eight%) | 75 (48.ane%) | 37 (31.vi%) |
| Pregnancy exam resultsb | |||
| northward | thirty | 43 | 16 |
| Negative | xiv (46.7%) | 30 (69.viii%) | 14 (87.v%) |
| Positive | 16 (53.3%) | thirteen (xxx.2%) | 2 (12.5%) |
Discussion
This longitudinal study of sexually active adolescents gives u.s.a. a unique perspective on adolescent beliefs, attitudes, values, intentions and behaviors surrounding the complex upshot of pregnancy intention. Pregnancy intention has been studied retrospectively through interviews with women who are currently pregnant [4], who have recently given birth [17], or who nowadays for pregnancy testing [thirteen]. The value of the electric current study is that nonpregnant adolescents were interviewed at baseline about their plans and likelihood of becoming pregnant and they were prospectively followed for a 6-month period to assess whether they suspected that they might exist pregnant, whether they took a pregnancy test and the results of that test. The analysis helps to estimate the value of pregnancy intention (characterized by pregnancy plans and likelihood) in predicting actual pregnancy. In the relatively short study follow-upwardly interval, 45% of the female person adolescents sampled reported they suspected they might be pregnant during the past 6 months, 26% were suspicious enough to take a pregnancy test, and almost ten% had a positive pregnancy exam in the 6-month catamenia.
Despite a bulk of the teens expressing no plans to become significant in the next 6 months, there was tremendous variability in their assessments of the likelihood that they would become pregnant in the next vi months. Although both planning and likelihood have been considered means by which pregnancy "intentions" are measured [six,8,eleven], information technology is clear that they do non represent unitary constructs to boyish females before formulation. It is possible that questions regarding female adolescents' plans for pregnancy reflect their sense of internal control regarding their reproductive intentions, whereas questions of adolescents' assessments of likelihood of becoming pregnant reverberate their perceptions of external forces' influence on their firsthand reproductive futures. One study of adolescents' judgments of vulnerability to pregnancy institute that locus of command acted as a moderator of such judgments [30].
Some other possibility is that those who signal a disjuncture between their pregnancy plans and pregnancy likelihood are more ambivalent about their pregnancy intentions and are more comfortable indicating that it is likely to occur than that they are planning to become pregnant [31]. A recent study plant that adolescents' ambivalent pregnancy "attitudes" were associated with subsequent occurrence of a pregnancy i year subsequently [32]. An alternative view is that inconsistency in responses betwixt planning for pregnancy and likelihood of pregnancy does not reflect ambivalence about getting pregnant only most what is required to foreclose pregnancy. In this view, the "inconsistent" adolescents are not necessarily wanting to get pregnant more than than the "no planning, no likelihood" group, just are cognizant that they may not exist every bit likely to employ contraception for a multifariousness of reasons. Thus, the same beliefs (non using contraception effectively) may reverberate lack of motivation to avoid pregnancy or lack of commitment to using contraception. Additionally, in that location were differences in reported pregnancy plans among those from various indigenous/racial groups with African-American and Latino/Hispanic adolescent girls reporting more pregnancy plans than Whites and Asian Americans. It is possible that these differences reflect cultural expectations for taking on adult roles and the unlike perceived time to come options for adolescents in these groups [33].
The variables that distinguished those who indicated pregnancy intentions from those who indicated no such intentions can exist considered "markers" of stronger pregnancy intentions among boyish females who are non currently pregnant and may stand for targets of intervention.
Prediction of Pregnancy Outcomes
Using the combined measure out of pregnancy intention (plans and likelihood) revealed differences in the intention groups on the outcomes of suspected pregnancies and positive pregnancy test results in predictable means. Those who indicated clear pregnancy intentions ("Planning and Likely") were more likely to written report suspected pregnancies and positive test results than those with inconsistent pregnancy intentions ("Not Planning, but Probable"). Those with inconsistent pregnancy intentions ("Not Planning, simply Likely") were, in plow, more likely to report these pregnancy outcomes than those who clearly indicated no intention to become pregnant ("Not Planning and Not Likely"). Importantly, more than two-thirds of those with positive pregnancy exam results, who reported inconsistent pregnancy intentions at baseline, indicated during the six-month follow-up interview that they planned to, or had already aborted their pregnancy.
Limitations
Estimation of our findings should accept into account a number of limitations. We relied on self-study information that can be influenced by social desirability. In item, the outcomes of interest (suspected pregnancy and positive pregnancy test results) may have been underestimates owing to self-written report biases. Additionally, because our report sample was a sexually experienced adolescent group who attended an urban STD clinic or adolescent medicine clinic in an AIDS-epicenter, our results may non generalize to other adolescent populations who are not withal sexually active or who live in other geographical areas. Finally, because the original aims of the larger study did not include a focus on pregnancy intentions, per se, we were non able to characterize the adolescents in our sample with respect to all of the issues that might have influenced their pregnancy intentions (due east.g., past experiences with pregnancy and/or abortion).
Conclusions
Given that the responses to questions of pregnancy plan and pregnancy likelihood were not always the same, assessing pregnancy intentions using a number of questions is important to capture the meaning of these unlike concepts for boyish girls who are not notwithstanding pregnant, but at run a risk for pregnancy. Clearly, if clinicians or counselors but ask boyish girls if they are planning to become meaning, they are probable to be missing of import aspects of pregnancy intentions that might be captured in too assessing their perceptions of likelihood regarding pregnancy.
Considering those adolescents with inconsistent pregnancy intentions (i.e., not planning, just likely to become pregnant) written report more than suspected pregnancies and more positive pregnancy test results than those with articulate intentions to avert pregnancy, it is of import to consider and arbitrate with this "at take a chance" sub-grouping of adolescent females, especially with respect to issues of the need for available emergency contraception, consideration of pregnancy termination, and/or preparation for a healthy pregnancy, delivery and infant. Adolescents who suspect they may have been pregnant in the past 6 months are at chance for becoming meaning. Therefore, discussions regarding pregnancy plans and pregnancy likelihood may help focus counseling and educational efforts directed at these young women. Pregnancy likelihood and lower apply of contraceptives at follow-up were strong predictors of positive pregnancy examination results, suggesting a counseling intervention focused on adolescents' perceptions of the life circumstances that influence conception and contraceptive use may be beneficial.
Interventions to modify pregnancy intentions ought to focus peculiarly on the modifiable influences on pregnancy plans (i.east., attitudes toward condoms and pregnancy) and on assessments of pregnancy likelihood (i.e., self-efficacy to use condoms and attitudes toward pregnancy). Interventions aimed at enhancing condom and contraceptive self-efficacy and attitudes, providing more realistic views of the realities of pregnancy and childbearing, and encouraging greater contraceptive apply in sexually experienced adolescent females could to reduce the occurrence of boyish pregnancy.
Footnotes
The research was supported by the National Institute of Allergy and Infectious Diseases (Grant# AI36986) and the Maternal and Kid Health Bureau Preparation Grant (Grant# MCJ000978A).
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1602042/
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