Objective: In this study we attempted to learn why childbearing adolescents failed to use contraceptives prior to conception. We hypothesized that among adolescents who elect to bear their children, positive and/or ambivalent feelings about having a baby are the most frequently cited reasons for not having used contraceptives.
Study design: This is a cross-sectional, clinic-based survey of a racially and ethnically diverse group of 200 consecutively enrolled, poor, pregnant, 13-18-year-old patients in an adolescent-oriented maternity program. The participants completed a self-administered questionnaire which elicited information about environmental and personal risk factors for inconsistent use of contraceptives and information about the reasons they had not used contraceptives consistently prior to conception. Student's t-tests, Chi-square, and logistic regression analyses were used.
Results: The most frequently cited reasons for not using contraceptives prior to conception were: "I didn't mind getting pregnant" (20%) and "I wanted to get pregnant" (17.5%), followed by "I was using birth control but it didn't work (broke)" (12%), "I thought there was something wrong with me and I couldn't get pregnant" (9%) and "I just didn't get around to it" (9%). Teenagers who cited positive and/or ambivalent attitudes toward childbearing as their primary reason for not using contraceptives at the time of conception did not differ from others with regard to age, Medicaid status, gravidity, parity, frequency of living with parents, partner's age, depressive symptoms, or perceived family support. They were, however, more likely to have known the father of the baby for more than 6 months at the time of conception [odds ratio (OR) 2.53; 95% confidence interval (CI) 1.22-5.26) and to have dropped out of school (OR) 2.15; 95% CI 1.10-4.26].
Conclusions: The study hypothesis was supported. The absence of negative attitudes toward having babies rather than negative attitudes toward contraceptives is the most commonly cited reason for nonuse of contraceptives among childbearing adolescents. The results of this study may enable health care and social service providers to design more effective programs for preventing first and subsequent adolescent pregnancies.
PIP: A cross-sectional, clinic-based study was performed to test the hypothesis that childbearing adolescents fail to use contraceptives prior to conception because they have positive and/or ambivalent feelings about having a baby. The Colorado study sample consisted of 200 consecutively enrolled, poor, predominantly nulliparous (83.5%), unmarried (93%), pregnant adolescents who were racially and ethnically diverse. Data were collected during the third trimester through self-administered questionnaires that elicited the reasons for not using contraceptives, sociodemographic and psychosocial information, and sexual and reproductive history. Statistical analysis of the data supported the hypothesis by revealing that the most frequently cited reasons for not using contraception were "I didn't mind getting pregnant" (20%) and "I wanted to get pregnant" (17.5%). The young women who responded in this fashion were more likely to be White, to have dropped out of school, to have known the baby's father for more than 6 months at the time of conception, to remain involved with the baby's father, and to abuse substances. Despite the possibility that postconception rationalization may have influenced these findings, they indicate that early childbearing is becoming more popular in the US because the costs of childbearing are less than the costs of avoiding a pregnancy. Thus, young people must be motivated to avoid pregnancy.