Abstract

Sexual minority women are more likely than heterosexual peers to have a teen pregnancy, though little is known about origins of this disparity. Our objective was to describe teen pregnancy experiences among sexual minority women and elucidate potential risk factors. As a part of the SexuaL Orientation, Gender Identity, and Pregnancy Experiences (SLOPE) study, in-depth semistructured interviews and surveys were conducted. Across the United States. Interviews were conducted with 10 sexual minority cisgender women, ages 21-66years, who experienced a teen pregnancy. Interview transcripts were analyzed using immersion/crystallization and template organizing style approaches. The themes were contextualized using survey data and organized into a conceptual model. Participants first became pregnant between ages 12 and 19years; all pregnancies were described as unintentional. Half of the pregnancies resulted from sexual assault. Most of the remaining pregnancies resulted from consensual sex with a boyfriend or regular partner with whom the participant reported inconsistent or no contraceptive use. Five primary themes emerged from participants' interviews: (1) sexuality; (2) life history and contextual factors before pregnancy; (3) abuse and assault; (4) reactions to the pregnancy; and (5) pregnancy outcomes. Future research should assess each theme to explore its contribution to the higher burden of teen pregnancies among sexual minority compared with heterosexual women; such data can inform public health prevention campaigns and evidenced-based curricula for health care providers who care for adolescents.

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