Paradoxical adolescent reproductive decisions

Objective To determine why teenagers who say they do not plan to parent if they become pregnant fail to use contraceptives consistently enough to avoid conceiving by default. Methods A racially diverse group of 333 inadequately contracepting, nulligravida teens, 45 (13.5%) of whom did not plan to parent if they became pregnant was studied. Participants completed scales assessing traditional teen pregnancy risk factors, deterrents to contraceptive use, expectations about the effect of pregnancy, the desire to remain non-pregnant, and sexual behavior. Results Teens who said they would not parent if pregnant were less apt to report boyfriends who wanted them to conceive (RR = 0.7; 95% CI = 0.5–0.9) and deterrents to contraceptive use (RRs around: 0.6; 95% CI: 0.3–0.9) and more apt to anticipate that childbearing would negatively impact their lives (RR: 1.9; 95% CI: 1.6–2.2), to want to remain non-pregnant (RR: 2.2; 95% CI: 1.8–2.4), and to have used contraception at last sexual intercourse (RR: 1.8; 95% CI: 1.3–2.4). In the group that did not intend to parent the only difference between those who had and had not used contraception at last intercourse was their willingness to plan for sexual activity (OR: 4.6; 95% CI: 1.3–16.7). Conclusion This study suggests that further progress toward preventing unwanted teen pregnancies might be made by dispelling the notion that for young, unmarried women, unplanned sexual intercourse is preferable to planned sexual intercourse.