Pregnancy intentions among expectant adolescent couples

Reproductive Justice as an Alternative to the Pregnancy Planning Paradigm for Teens

In this critical commentary, we describe the many limitations of the pregnancy planning paradigm as applied to pregnant and parenting teens. We describe how this paradigm, in characterizing pregnancies as intended or unintended, has shaped campaigns to prevent teen pregnancy and remains largely embedded in formal sex education and family planning programs in the United States. We argue that a paradigm shift is long overdue and describe how the reproductive justice framework addresses the limitations of the pregnancy planning paradigm. Although reproductive justice is endorsed by a growing number of organizations, recommended policies face formidable obstacles given that comprehensive sex education, contraception, and legal abortion are increasingly at risk in a post-Dobbs world.

Pregnancy (im)possibilities: identifying factors that influence sexual minority women's pregnancy desires

Sexual minority women (SMW) face both increased risk for unintended pregnancy and barriers to achieving wanted pregnancy, but little research investigates SMW's pregnancy desires. To fill this gap, we conducted five focus groups and 11 in-depth interviews with 20-30-year-old SMW in three US cities. Findings highlight that the heteronormative pregnancy planning paradigm lacks salience for SMW. While some SMW clearly wish to avoid pregnancy, many others are unsure, and factors influencing this uncertainty include relationship context, anticipating logistical barriers, and discord between queer identity and pregnancy.

The Role of Pregnancy Concerns in the Relationship between Substance Use and Unprotected Sex among Adolescents

BACKGROUND

Substance use and unprotected sex are prevalent among adolescents. The link between substance use and unprotected sex is well-established. Research has also highlighted how adolescents' attitudes and risk perceptions regarding unprotected sex, including concerns about pregnancy ("Getting pregnant would force me to grow up too fast"), are associated with unprotected sex and unplanned pregnancy. However, less research has examined the potential relationship between pregnancy concerns and substance use among adolescents.

OBJECTIVES

The study prospectively examined (1) differences in pregnancy concerns across patterns of substance use and (2) whether pregnancy concerns mediate the relationship between substance use and later unprotected sex among a sample of middle and high school students.

METHOD

98 adolescents [M(SD) age = 14.28(1.68), 59.4% female, 59.4% black/African American] completed self-report measures of marijuana and alcohol use, pregnancy concerns, and unprotected sex across three time points over 6 months (T1-T3).

RESULTS

Substance users (alcohol/marijuana) reported fewer pregnancy concerns compared to non-substance users (t = 2.99, p = .04). Pregnancy concerns at T2 mediated the relationship between T1 lifetime substance use and later unprotected sex (T3) (indirect effect: b = 0.10, CI[.01-.41]; direct effect: b = 0.15, p = .32), controlling for gender, age, and race. More frequent substance use (T1) was related to fewer pregnancy concerns at T2 (b = -0.10, p = .04); fewer pregnancy concerns were related to increased likelihood of later unprotected sex (b = -1.02, p = .02).

CONCLUSIONS

Findings offer new insight into associations between substance use and unprotected sex and suggest that substance use and sexual health interventions should target pregnancy concerns.

Perceived responsibility for pregnancy and sexually transmitted infection prevention among young African American men: An exploratory focus group study

Poor reproductive health outcomes, including unplanned pregnancies and sexually transmitted infections, continue to disproportionately affect African American teenaged populations. Interventions largely focus on young women, yet young men may play an important role in mitigating these reproductive health outcomes. This study aims to understand African American male teenagers' views on pregnancy prevention responsibility by qualitatively exploring their attitudes around contraception and condom responsibility. We conducted exploratory qualitative focus groups on perceived contraceptive and condom responsibility with 24 African American male high school students, ages 14-19, enrolled in charter schools in the South Side of Chicago. Research domains included relationship type, communication with female partners, perceived responsibility for pregnancy prevention, condom and contraceptive behaviors, and contraceptive knowledge. Data were coded using content analysis revealing several themes: Young men view condom use as important, but actual use of condoms is modified by relationship factors and perception of risk of STIs; Responsibility to prevent pregnancy is a shared- or female-responsibility; and male teenagers had greatest awareness of male-controlled contraceptive methods and limited knowledge or comfort with other non-condom forms of contraception. These adolescents weigh many factors when determining whether to use condoms and/or contraception. Building upon widespread endorsement for condom use and STI prevention offer the most hope for further gains.

Perceptions of Adolescent Pregnancy Among Teenage Girls in Rakai, Uganda

The leading causes of death and disability among Ugandan female adolescents aged 15 to 19 years are pregnancy complications, unsafe abortions, and childbirth. Despite these statistics, our understanding of how girls perceive adolescent pregnancy is limited. This qualitative study explored the social and contextual factors shaping the perceptions of adolescent pregnancy and childbirth among a sample of 12 currently pregnant and 14 never pregnant girls living in the rural Rakai District of Uganda. Interviews were conducted to elicit perceived risk factors for pregnancy, associated community attitudes, and personal opinions on adolescent pregnancy. Findings indicate that notions of adolescent pregnancy are primarily influenced by perceptions of control over getting pregnant and readiness for childbearing. Premarital pregnancy was perceived as negative whereas postmarital pregnancy was regarded as positive. Greater understanding of the individual and contextual factors influencing perceptions can aid in development of salient, culturally appropriate policies and programs to mitigate unintended adolescent pregnancies.