Narratives on Sex and Contraception From Pregnant Adolescent Women in a Northern Province in Thailand: A Phenomenological Study.

Panitsara Leekuan,Panpimol Sukwong,Ros Kane

doi:10.1177/00469580211056219

Abstract

Gaps in understanding, a lack of awareness of contraceptive use and a lack of control, related to gender dynamics, may influence the demand for contraception among adolescents and their decision-making around pregnancy prevention. This study explored the experiences of pregnant adolescents at the time of pregnancy and prior to becoming pregnant, examining attitudes toward sex and contraception. An interpretive phenomenological study guided by Heideggerian philosophy, analysed data from 30 in-depth interviews conducted with purposively selected consenting pregnant adolescents aged 15–19. Interviews were audio-recorded and transcribed verbatim and were analysed using a modified interpretative phenomenological approach. Participants exposed 5 key findings or experiences associated with sex and contraception: ‘Premarital cohabitation and sex’, ‘Staying in the relationship’, ‘Unforeseen future’, ‘Parental conformity’, and ‘Male command’. These findings can have far-reaching implications for the holistic understanding of the needs of adolescents in Thailand. They can be used to inform the development of appropriate and responsive interventions to support female and male adolescents, their families, and society. This includes interventions around reproductive health rights and sex education from health care providers, educators providing counselling to facilitate adolescents’ decision-making in order to reduce unintended adolescent pregnancy.

Highlights

Pregnancy during adolescence in modern societies has a significant impact on adolescents and their babies, families and communities, with significant economic social, health and cultural implications.[1]
The pregnant adolescents were recruited from 3 hospitals in 3 districts within Northern Thailand which has the highest rate of adolescent pregnancy in the country and where the rate has been increasing continuously since 2010
Reflected the phenomenological interpretation of participants’ experiences of ‘Premarital cohabitation and sex’, ‘Staying in the relationship’, ‘Unforeseen future’, ‘Parental conformity’, and ‘Male command’. These themes illustrated accounts of sex and contraception and appeared throughout the narrated experiences associated with adolescent pregnancy, manifesting researcher and participant co-creation in new ways of understanding the researched phenomena

Summary

Introduction

Pregnancy during adolescence in modern societies has a significant impact on adolescents and their babies, families and communities, with significant economic social, health and cultural implications.[1]. Adolescents explore the world around them, and many engage in sexual relationships, placing them at risk of sexually transmitted infections (STIs) and unplanned and potentially unwanted pregnancy. Sexual activity places adolescents at increased risk of adolescent pregnancy,[2] those who have unmet needs for, or reasons not to use contraception. It is recognised that sexual relationships commonly result in pregnancy between adult couples, but for adolescents this is an initial entrance to the world of adulthood and potentially motherhood. Adolescents face several barriers to positive reproductive and sexual health, including limited contraceptive access, unmet information needs and lack of negotiating power, which can put them at risk.[3]

Results

Discussion

Conclusion