Predictors of sexual intercourse and rapid‐repeat pregnancy among teenage mothers: an Australian prospective longitudinal study

Abstract

To examine the determinants of pregnancy within 2years of a teenager giving birth for the first time (rapid-repeat pregnancy [RRP]) and resumption of sexual intercourse after the birth. Prospective cohort study between June 2004and September 2006at the sole tertiary obstetric hospital in Western Australia involving teenagers who gave birth for the first time. Data were collected using questionnaires at recruitment, 6weeks and 3-monthly intervals for up to 2years postpartum. RRP and time to a return to sexual intercourse after giving birth. Of the 147participants, 49(33%) experienced an RRP. Sexual intercourse was independently significantly associated with using an oral contraceptive (odds ratio [OR], 2.83; 95% CI, 1.38-5.82); living with the birth father (OR, 8.43; 95% CI, 5.12-13.86); intending to become pregnant (OR, 3.20; 95% CI, 1.53-6.65); smoking marijuana (OR, 2.60; 95% CI, 1.38-4.79); and using alcohol (OR, 1.93; 95% CI, 1.17-3.20). Use of long-acting contraceptives was associated with reduced odds of RRP (OR, 0.27; 95% CI, 0.12-0.62), while teenagers who used an oral contraceptive had a similar risk of RRP compared with those using barrier methods or no contraception. Other factors predicting RRP were: being sexually active for more than 3months (OR, 8.96; 95% CI, 1.97-40.74); intending to become pregnant (OR, 2.39; 95% CI, 1.62-4.93); and being an Indigenous Australian (OR, 2.38; 95% CI, 1.38-4.11). There are two options available to health care providers for reducing the rate of RRP: to facilitate teenage mothers' access to long-acting contraceptives; and to gain clear understanding of their intention with regard to repeat pregnancy and to provide appropriate support.