To be rather than not to be--that is the problem with the questions we ask adolescents about their childbearing intentions.
OBJECTIVE
To demonstrate that rephrasing the questions used to assess childbearing intentions to quantify the strength of the intent to remain nonpregnant, rather than the strength of the intent to become pregnant, would make teenagers' responses more useful to health care providers, family planning counselors, and health policy makers.


METHODS
Examples from the teen pregnancy prevention literature are used to support the recommendations for change.


RESULTS
Teenagers rarely plan their pregnancies. However, because those who are having sexual intercourse must actively try not to become pregnant or they will likely conceive, teenagers often become pregnant because they lack a firm commitment not to do so. Thus, to accurately profile the antecedents of adolescent pregnancy, (1) the questions used to assess childbearing intentions must be rephrased so that teenagers who intend to remain nonpregnant can be distinguished from those who do not and (2) separate differential diagnoses must be developed for inconsistent contraceptive use within these 2 groups of teenagers who are at risk for unintended pregnancy.


CONCLUSIONS
Asking sexually active teenagers about the strength of their intent to remain nonpregnant will make the results of office interviews and national surveys more useful because the responses such questions elicit will enable health care providers and policy makers to target common, modifiable antecedents of inconsistent contraceptive use for interventions.
Stevens-Simon
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Division of Adolescent Medicine, Department of Pediatrics, University of Colorado Health Sciences Center, The Children's Hospital, 1056 E 19th Ave, Denver, CO 80218, USA.
Beach
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Klerman
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D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D003268:Contraception Behavior / Q000523:psychology; D005260:Female; D006801:Humans; D009042:Motivation; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000523:psychology*; D012660:Semantics; D012725:Sexual Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires