Influential life contexts and environments for out-of-home pregnant adolescents.

This focused ethnography explored influential life experiences and environmental contexts associated with pregnancy among "out-of-home" pregnant adolescent women in Seattle (i.e., not living in stable settings or with parents). Methods adapted from feminist anthropology guided ethnographic interviewing and participant observation. Key informants (N = 8) included 5 White, 1 American Indian, and 2 African American women 17-19 years, plus expectant fathers and street friends. Narrative and domain analysis focused on life events and current experiences that participants linked to their pregnancy decisions. Participants organized their narratives primarily around relationships: conflict-laden family relationships, violence and sexual abuse in childhood, mental health and substance abuse problems, and life-long patterns of housing instability. Economic challenges, disconnection to school, and spiritual change were important in their current circumstances. For most, out-of-home status preceded pregnancy, and during pregnancy, housing options improved slightly. For others, pregnancy occurred within a relationship that offered them relatively more stable housing arrangements.