title: Unintended Pregnancy in the Native Hawaiian Community: Key Informants' Perspectives.
abstract: BACKGROUND
  Native Hawaiians experience the highest reported rate of unintended pregnancy of any ethnic group in Hawaii. Understanding the context in which they make decisions that influence pregnancy and pregnancy planning is essential to reducing this rate.
  
  
  METHODS
  A qualitative study was carried out in partnership with a community health center serving a large Native Hawaiian population to explore how Native Hawaiians conceptualize pregnancy and pregnancy planning. Between August and October 2013, semistructured interviews were conducted with 10 diverse key informants from the Hawaiian community. Content analysis was used to identify themes and patterns that emerged from the interviews.
  
  
  RESULTS
  Core Hawaiian values of children and family strongly affect how Native Hawaiians view pregnancy, pregnancy planning and unintended pregnancies. 'Ohana (families) are large and characterized by tremendous support, which is perceived to lessen the burden of an unintended pregnancy. Pregnancies, whether planned or not, are seen as blessings because children are highly valued. Because of these concepts, there is an expectation for women to continue unplanned pregnancies. Although Hawaiians ascribe value to planning pregnancies and hope that children are born under what they identify as ideal circumstances, they acknowledge that these circumstances are not necessary and often do not occur.
  
  
  CONCLUSIONS
  The concepts of family and children serve as core values to Native Hawaiians and are linked to the ways in which they view pregnancy and pregnancy planning.
authors.affiliation: Assistant professor, Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu. rsoon@hawaii.edu.
authors.forename: Reni
authors.initials: R
authors.lastname: Soon
authors.affiliation: Junior researcher, Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Elia
authors.affiliation: Medical student, Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu.
authors.forename: Nina
authors.initials: N
authors.lastname: Beckwith
authors.affiliation: Associate professor, Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii, Honolulu.
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
authors.affiliation: Professor, Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY.
authors.forename: Timothy
authors.initials: T
authors.lastname: Dye
mesh_terms: D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior / Q000523:psychology; D005191:Family Characteristics / Q000208:ethnology; D005193:Family Planning Services; D005195:Family Relations / Q000208:ethnology / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006254:Hawaii / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D044468:Native Hawaiian or Pacific Islander / Q000523:psychology* / Q000706:statistics & numerical data; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000208:ethnology / Q000523:psychology*; D036301:Qualitative Research; D012111:Residence Characteristics; D012944:Social Support; D012945:Social Values / Q000208:ethnology*; D055815:Young Adult