Desire for pregnancy among adolescents in an antenatal clinic

BACKGROUND: Adolescent pregnancies in Canada have increased to 42.7/1000/ yr in 1997 with birth rates of 20/1000/yr. The delay between the initiation of sexual activity and the initiation of consistent use of contraception has been seen as one of the most important obstacles to the prevention of adolescent pregnancy. Efforts to decrease teen pregnancy rates through increasing education and access to contraception assume that adolescent pregnancies are unplanned, unintended, and unwanted. OBJECTIVE: The aim of this plot study was to retrospectively determine what percentage of Canadian adolescents presenting for antenatal care truly desired pregnancy. Our hypothesis was that a significant proportion of young women intended or attempted to conceive and thus would not benefit from current approaches to teen pregnancy prevention. METHODS: All teens presenting to a multidisciplinary adolescent obstetric clinic between March 1999/ December 2000 were asked to complete an anonymous mini questionnaire about pregnancy wantedness at their initial visit. Seventy-eight new patients were seen over that time frame and 58 responded to two questions concerning: 1) Their desire for pregnancy prior to conceiving and 2) their feelings about the pregnancy now. RESULTS: In response to question #1, 22/58 adolescents had “sort of” or “really” wanted to be pregnant and 32/58 “had not wanted” to be pregnant and 4/58 “had not cared” if they were pregnant. In response to question #2, 42/58 were happy that they were pregnant and 16/58 were not sure how they felt about being pregnant. CONCLUSIONS: Efforts to promote awareness and avail-ability of contraception would not likely have prevented 1/3 of the adolescent pregnancies in this small Canadian cohort of soon-to-be teen mothers. This sample is not representative of the entire pregnant teenage population; approximately half of adolescent pregnancies are terminated and this may explain why there were no teenagers in our cohort who did not want to be pregnant. Public health initiatives directed at reduction of teen pregnancies must also take into account adolescent attitudes toward pregnancy.