Interrompre ou poursuivre la grossesse à l’adolescence : facteurs de risque psychosociaux

Abstract

IntroductionTeenage pregnancy arouses lots of questions and remains a worldwide social and public health problem. This phenomenon is problematic because it is often associated with socio-economic, family and psychological difficulties. ObjectiveOur study aims to identify the individual and environmental factors that influence the teenager's decision whether to keep her child or not. MethodA sample of fourteen girls between 16 and 21years old was recruited who had been or were pregnant. The girls were divided into 2 groups: seven who decided to continue with their pregnancy and seven others who decided to have an abortion. This group was compared to girls who had never been pregnant (n=18). An interview was carried out and structured questionnaires were administered in order to evaluate individual and environmental characteristics as the age of menarche and the first sexual intercourse, the emotional and sexual education, the social and family support, the socio-cultural background and the socio-economic environment. Different other dimensions were analyzed: individual characteristics (Temperament and Character Inventory Junior, Impulsive Behaviour Scale, Coopersmith Self-Esteem Inventory) and family characteristics (Adverse Childhood Experiences) such as childhood family strengths and adverse childhood experiences. Results and conclusionsOur study findings showed that a precarious socio-economic environment, a lack of support and affection in the family, emotional deprivations, a restricted social network, low self-esteem and school disinvestments would effectively predict the continuation of a pregnancy. Childhood family strengths seem to be strongly protective against early sexual intercourse, adolescent pregnancy and long-term psychosocial consequences. On the other hand, no particular personality feature was demonstrated. Individual characteristics would thus have less impact on premature pregnancies than environmental characteristics. Prevention programs must stretch beyond the use of contraception, i.e. tend toward an intervention for psycho-socially and socio-economically at risk families, so as to support them in their educational and affective role with their children. Psychological help could also be brought to young girls who have had experiences of maltreatment, to favour self-esteem and raise their awareness of the consequences of sexual risk behaviour. Finally, there should be specific help for the girls during the decision-making period. Counselling during this period should be attentive to the resources and the motivations of the adolescent and to the circumstances of the pregnancy.