title: The Enigma of Rapid Repeat Pregnancy: A Qualitative Study of Teen Mothers.
abstract: OBJECTIVE
  Rapid repeat pregnancy accounts for 18% of teen pregnancies and leads to adverse health, economic, and developmental outcomes for teen mothers and their children. Few interventions have been successful in reducing rapid repeat pregnancy. In this qualitative study we examined adolescent mothers' perceptions of their decision-making and behaviors that helped prevent or promote a rapid repeat pregnancy. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Semistructured interviews were conducted with 31 adolescent mothers, aged 16-21 years; 15 of these subjects experienced a repeat pregnancy within a year of their first child's birth and 16 had not. Two researchers used a grounded, inductive technique to identify emergent themes; interviews were subsequently coded accordingly. Counts were tabulated of the number of times themes were endorsed among those with or without a repeat pregnancy.
  
  
  RESULTS
  Four overarching themes emerged from the interviews: intentionality regarding pregnancy planning, patients' degree of independence in making contraceptive choices, sense of control over life experience, and barriers to follow-through on contraceptive planning. Teens who had not experienced a rapid repeat pregnancy more often endorsed themes of intentionality in preventing or promoting a pregnancy, independence in decision-making, and feelings of control over their experience. Ambivalence and lack of decision-making about seeking another pregnancy were frequently endorsed by mothers who had experienced a second pregnancy.
  
  
  CONCLUSIONS
  Decision-making regarding seeking or preventing a rapid repeat pregnancy is complex for teen mothers; techniques to help support decision-making or to delay pregnancy until decision-repeat making is complete might be important in reducing rapid pregnancy.
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: K N
authors.initials: KN
authors.lastname: Conroy
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts. Electronic address: talia.engelhart@childrens.harvard.edu.
authors.forename: T G
authors.initials: TG
authors.lastname: Engelhart
authors.affiliation: Dana Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Y
authors.initials: Y
authors.lastname: Martins
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: N L
authors.initials: NL
authors.lastname: Huntington
authors.affiliation: Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida.
authors.forename: A F
authors.initials: AF
authors.lastname: Snyder
authors.affiliation: Department of Pediatrics, Johns Hopkins University Hospital, Baltimore, Maryland.
authors.forename: K D
authors.initials: KD
authors.lastname: Coletti
authors.affiliation: Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: J E
authors.initials: JE
authors.lastname: Cox
mesh_terms: D000293:Adolescent; D003268:Contraception Behavior / Q000523:psychology; D003657:Decision Making; D005260:Female; D020073:Gravidity; D066296:Grounded Theory; D006801:Humans; D008016:Life Change Events; D009035:Mothers / Q000523:psychology*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000523:psychology*; D036301:Qualitative Research; D013997:Time Factors; D055815:Young Adult
keywords: Pregnancy in adolescence; Rapid repeat pregnancy; Sexual behavior; Unplanned pregnancy