Adolescent Girls' Attitudes Toward Pregnancy

Journal of Family Practice, July, 2001 by Carol Cowley, Tillman Farley

When boyfriend characteristics and attitudes were added to the analysis, all subject characteristics ceased to be significant, leaving the perception of the boyfriends' desire for pregnancy as the only significant variable.

DISCUSSION

We found the strongest predictor of an adolescent girl's attitude toward pregnancy was her stated belief about whether her boyfriend wanted a baby. In light of the powerful influence of the girl's perception of her boyfriend's attitude toward pregnancy, no other factors are significantly associated with her own attitude toward pregnancy. This finding suggests that family physicians and other health care providers working with teenaged girls should include the boyfriend in any discussions aimed at delaying pregnancy.

Girls ambivalent about pregnancy are markedly similar to those desiring it, differing only in the degree to which they believe their boyfriends want a baby. It may be that some of the ambivalence about pregnancy arises from a difference of opinion between the girl and her boyfriend. Girls ambivalent about pregnancy were least likely to know their boyfriend's opinion on the subject. It may be that young girls who are ambivalent about pregnancy are also those with more limited interpersonal communication skills, making it difficult for them to discuss critical reproductive health issues with their partners. Health care providers may have a role in facilitating improved communication between girls and their partners by specifically addressing partner communication when seeing girls individually, as well as by inviting their partners to be present and more actively involved in clinic visits. Interventions focused solely on providing information about and access to contraception are unlikely to be sufficient in strengthening a girl's motivation to delay pregnancy. More appropriate and effective interventions may be those that explore the extent to which her partner's attitudes shape her own critical reproductive health decisions, and encourage greater dialogue between a girl and her partner with respect to contraceptive and childbearing decisions.

Although several studies have been done on the contraceptive behavior of adolescent girls, to our knowledge no other studies have focused on evaluating the influence of the boyfriend's perceived attitude toward childbearing on nonpregnant adolescent girls' desire for a child. Our study did not support other studies' findings showing that girls desiring pregnancy are more likely to have older boyfriends.[22] In our study population, neither boyfriend age nor the age difference between the girl and her boyfriend were significantly associated with the girl's desire to become pregnant.

Limitations

Our study has several limitations. We did not talk with the boyfriends themselves, but instead were limited to what the girls reported about their boyfriends. The girls' perceptions of their boyfriends' attitudes toward pregnancy may be more a reflection of the girls' own desires. Also, we do not know what the girls really thought about pregnancy, only what they reported to us. It may be that more girls desired pregnancy, but were not willing to admit it. Our study did not use a previously validated questionnaire to determine "intendedness" of pregnancy. Because of the difficulty in ascribing motivations to adolescent behavior and reported attitudes, the entire concept of intendedness of pregnancy may not be relevant when discussing adolescent pregnancies.[18,23] However, the semistructured interview used in our study elicited a rich and detailed explanation of attitudes toward such topics as birth control, pregnancy, and influences of family and boyfriend.