Adolescent pregnancy: do expectations affect intentions?

Abstract

Objective To establish the relationship between expectations about the effects of childbearing on specific aspects of life and the strength of the desire to remain nonpregnant during adolescence. We hypothesized that the absence of negative childbearing expectations is associated with an increase in the odds that sexually active, inadequately contracepting teenage girls are cognitively susceptible to conception. Method A racially and ethnically diverse group of 351 nulligravida, inadequately contracepting teenagers was studied. Participants responded to 60 items that asked about their expectation about the effects of becoming pregnant and not doing so. Analyses were performed to determine the factorial structure of the childbearing expectations items and their relationship to cognitive susceptibility to conception, defined as the lack of desire to remain nonpregnant. Results The analysis yielded a 9-factor solution for the childbearing expectations items. All 9 sub-scales exhibited acceptable reliability coefficients, stable factor patterns, and correlated significantly with the desire to remain nonpregnant. A dose-dependent relationship suggestive of causality was also apparent. In stepwise regression the sub-scales that assessed the anticipated effect of childbearing on future plans, self-esteem, and boyfriend relations remained significant and accounted for 56% of the variance in the desire to remain nonpregnant. The lengthy research instrument was reduced to an 8-item screening tool without loss of psychometric integrity or explanatory power. Conclusions Childbearing expectations reflect distinct concepts and account for a significant portion of the variance in the desire to remain nonpregnant during adolescence. Thus the 8-item screening tool we validated might be used to formulate a differential diagnosis for the enigmatic behavior of teens who say they do not “want” to become pregnant but do not “mind” doing so enough to try to avoid conceiving by default.