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Contraceptive experiences among adolescents who experience unintended birth

      Abstract

      Background

      Adolescents are at high risk of unintended pregnancy due to contraceptive nonuse and inconsistent use.

      Study Design

      We examined associations between contraception and mistimed/unwanted birth among adolescents. For contraceptive nonusers, we analyzed factors contributing to unintended birth.

      Results

      Half of adolescents with unintended births did not use contraception at conception. Those ambivalent about pregnancy reported fewer unwanted [relative risk (RR)=0.06] compared to wanted births. Amongst contraceptive nonusers, difficulty accessing birth control was the only factor associated with more unwanted birth (RR=3.05). For Black adolescents, concerns of side effects (RR=7.03), access issues (RR=10.95) and perceived sterility (RR=3.20) were associated with unwanted birth. For younger teens, falsely perceived subfertility increased unwanted birth (RR=2.74), whereas access issues were significant for older teens (RR=3.97).

      Conclusions

      Access issues and misconceptions around contraceptive side effects and fertility place adolescents at higher risk for unintended pregnancy, especially among younger and Black teens. Ambivalence represents an additional area for intervention.

      Keywords

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      References

      1. Duncan GJ, Hoffman SD. Teenage welfare receipt and subsequent dependence among black adolescent mothers. Fam Plann Perspect 1990;22:16���20, 35.

        • Coley R.
        • Chase-Lansdale P.
        Adolescent pregnancy and parenthood. Recent evidence and future directions.
        Am Psychol. 1998; 53: 152-166
        • Fergusson D.M.
        • Boden J.M.
        • Horwood L.J.
        Abortion among young women and subsequent life outcomes.
        Perspect Sex Reprod Health. 2007; 39: 6-12
      2. Maynard R. Kids having kids: a Robin Hood Foundation special report on the costs of adolescent childbearing. The Robin Hood Foundation, New York City (NY)1996 (p. 1-20. Available at: http://www.robinhood.org/media/7490/khk.pdf. Accessed April 4, 2011.)
        • Goerge R.M.
        • Harden A.W.
        • Lee B.J.
        Consequences of teen childbearing for child abuse, neglect, and foster care placement.
        in: Maynard R. Hoffman S. Kids having kids. 2nd ed. The Urban Insitute Press, Washington, DC2008: 257-288
        • Hoffman S.D.
        • Scher L.S.
        Consequences of teen childbearing for the life chances of children, 1979-2002.
        in: Maynard R. Hoffman S. Kids having kids. 2nd ed. The Urban Institute Press, Washington, DC2008: 342-358
        • Scher L.S.
        • Hoffman S.D.
        Incarceration-related costs of early childbearing: updated estimates.
        in: Maynard R. Hoffman S. Kids having kids, revised edition. The Urban Institute Press, Washington, DC2010
        • Hoffman S.
        By the numbers: the public costs of teen childbearing.
        National Campaign to Prevent Teen Pregnancy, Washington, DC2006
      3. Vital signs: teen pregnancy -- United States, 1991-2009.
        MMWR Morb Mortal Wkly Rep. 2011; 60: 414-420
        • Finer L.
        • Henshaw S.
        Disparities in rates of unintended pregnancy in the United States, 1994 and 2001.
        Perspect Sex Reprod Health. 2006; 38: 90-96
        • D'Angelo D.V.
        • Gilbert B.C.
        • Rochat R.W.
        • Santelli J.S.
        • Herold J.M.
        Differences between mistimed and unwanted pregnancies among women who have live births.
        Perspect Sex Reprod Health. 2004; 36: 192-197
        • Santelli J.
        • Rochat R.
        • Hatfield-Timajchy K.
        • et al.
        The measurement and meaning of unintended pregnancy.
        Perspect Sex Reprod Health. 2003; 35: 94-101
        • Kost K.
        • Landry D.J.
        • Darroch J.E.
        The effects of pregnancy planning status on birth outcomes and infant care.
        Fam Plann Perspect. 1998; 30: 223-230
      4. Baydar N. Consequences for children of their birth planning status. Fam Plann Perspect 1995;27:228���34, 245.

        • Pulley L.
        • Klerman L.
        • Tang H.
        • Baker B.
        The extent of pregnancy mistiming and its association with maternal characteristics and behaviors and pregnancy outcomes.
        Perspect Sex Reprod Health. 2002; 34: 206-211
        • Frost J.J.
        • Darroch J.E.
        Factors associated with contraceptive choice and inconsistent method use, United States, 2004.
        Perspect Sex Reprod Health. 2008; 40: 94-104
        • Nettleman M.D.
        • Brewer J.
        • Ayoola A.
        Why women risk unintended pregnancy.
        J Fam Pract. 2009; 58: E1-E5
        • Nettleman M.D.
        • Chung H.
        • Brewer J.
        • Ayoola A.
        • Reed P.L.
        Reasons for unprotected intercourse: analysis of the PRAMS survey.
        Contraception. 2007; 75: 361-366
        • Stevens-Simon C.
        • Kelly L.
        • Singer D.
        • Cox A.
        Why pregnant adolescents say they did not use contraceptives prior to conception.
        J Adolesc Health. 1996; 19 ([discussion 54���5]): 48-53
        • Sheeder J.
        • Tocce K.
        • Stevens-Simon C.
        Reasons for ineffective contraceptive use antedating adolescent pregnancies, part 1: an indicator of gaps in family planning services.
        Matern Child Health J. 2009; 13: 295-305
        • Stevens-Simon C.
        • Sheeder J.
        • Harter S.
        Teen contraceptive decisions: childbearing intentions are the tip of the iceberg.
        Women Health. 2005; 42: 55-73
        • Burnhill M.
        Contraceptive use: the US perspective.
        Int J Gynaecol Obstet. 1998; 62: S17-S23
        • Santelli J.
        • Orr M.
        • Lindberg L.D.
        Pregnancy intentions, contraceptive use at the time of conception, and pregnancy-related behaviors among adolescents.
        J Adolesc Health. 2010; 46: S53
        • Jumping-Eagle S.
        • Sheeder J.
        • Kelly L.S.
        • Stevens-Simon C.
        Association of conventional goals and perceptions of pregnancy with female teenagers' pregnancy avoidance behavior and attitudes.
        Perspect Sex Reprod Health. 2008; 40: 74-80
        • Bartz D.
        • Shew M.
        • Ofner S.
        • Fortenberry J.D.
        Pregnancy intentions and contraceptive behaviors among adolescent women: a coital event level analysis.
        J Adolesc Health. 2007; 41: 271-276
      5. Centers for Disease Control and Prevention. Pregnancy Risk Assessment Monitoring System (PRAMS): methodology.
        (Available at:) (Accessed March 9, 2011)
        • Gilliam M.L.
        • Davis S.D.
        • Neustadt A.B.
        • Levey E.J.
        Contraceptive attitudes among inner-city African American female adolescents: barriers to effective hormonal contraceptive use.
        J Pediatr Adolesc Gynecol. 2009; 22: 97-104
        • Clark L.R.
        Will the pill make me sterile? Addressing reproductive health concerns and strategies to improve adherence to hormonal contraceptive regimens in adolescent girls.
        J Pediatr Adolesc Gynecol. 2001; 14: 153-162
        • Wetherill R.R.
        • Fromme K.
        Alcohol use, sexual activity, and perceived risk in high school athletes and non-athletes.
        J Adolesc Health. 2007; 41: 294-301
        • Zabin L.S.
        • Astone N.M.
        • Emerson M.R.
        Do adolescents want babies? The relationship between attitudes and behavior.
        J Res Adolesc. 1993; 3: 67-86
        • Bruckner H.
        • Martin A.
        • Bearman P.S.
        Ambivalence and pregnancy: adolescents' attitudes, contraceptive use and pregnancy.
        Perspect Sex Reprod Health. 2004; 36: 248-257
        • Dietz P.
        • Adams M.
        • Spitz A.
        • Morris L.
        • Johnson C.
        Live births resulting from unintended pregnancies: is there variation among states?.
        Fam Plann Perspect. 1999; 31: 132-136
        • Shulman H.
        • Gilbert B.
        • Msphbrenda C.
        • Lansky A.
        The Pregnancy Risk Assessment Monitoring System (PRAMS): current methods and evaluation of 2001 response rates.
        Public Health Rep. 2006; 121: 74-83
        • Joyce T.
        • Kaestner R.
        • Korenman S.
        On the validity of retrospective assessments of pregnancy intention.
        Demography. 2002; 39: 199-213