Ambivalence and pregnancy: adolescents' attitudes, contraceptive use and pregnancy.
BACKGROUND
It is often argued that adolescents who become pregnant do not sufficiently appreciate the negative consequences, and that prevention programs should target participants' attitudes toward pregnancy.


METHODS
Data from the first two waves of the National Longitudinal Study of Adolescent Health were used to examine whether 15-19-year-old females' attitudes toward pregnancy influence their contraceptive consistency and their risk of pregnancy. Characteristics and attitudes associated with pregnancy and contraceptive use were assessed using bivariate and multivariate analysis.


RESULTS
Twenty percent of female adolescents were defined as having antipregnancy attitudes, 8% as having propregnancy attitudes and 14% as being ambivalent toward pregnancy; the remainder were considered to have mainstream attitudes. Among sexually experienced adolescents, having an attitude toward pregnancy was not associated with risk of pregnancy. However, those who were ambivalent about pregnancy had reduced odds of using contraceptives consistently and inconsistently rather than not practicing contraception at all (odds ratios, 0.5 and 0.4, respectively). Antipregnancy respondents did not differ from proprepregancy respondents in terms of their contraceptive consistency. However, having a positive attitude toward contraception was associated with increased likelihood of inconsistent and consistent contraceptive use compared with nonuse (1.6 and 2.1, respectively).


CONCLUSIONS
Programs designed to prevent pregnancy need to give young women information about pregnancy and opportunities to discuss the topic so that they form opinions. Furthermore, programs should emphasize positive attitudes toward contraception, because effective contraceptive use is shaped by such attitudes and is strongly associated with reduction of pregnancy risk.
Bruckner
Hannah
H
Department of Sociology, Yale University, New Haven, CT, USA. hannah.brueckner@yale.edu
Martin
Anne
A
Bearman
Peter S
PS
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology / Q000523:psychology*; D000328:Adult; D003268:Contraception Behavior / Q000208:ethnology / Q000523:psychology*; D003270:Contraceptive Agents / Q000627:therapeutic use; D003273:Contraceptive Devices / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology*; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology*; D014481:United States; D047568:Unsafe Sex / Q000208:ethnology / Q000706:statistics & numerical data
D003270:Contraceptive Agents