Teenage pregnancy experiences in rural Kenya.

This community-based survey describes the socio-economic determinants of teenage pregnancy, experiences of health problems during pregnancy, and health care utilization patterns among adolescents (12-19 years old) in rural Kenya. Characteristics of adolescents with repeated pregnancy experiences were compared with first-time pregnancies. The survey covered 3,132 households from 32 randomly selected communities and 1,247 adolescents were interviewed. Data were collected retrospectively through quantitative and qualitative methods. Results showed that 572 (45.9%) adolescents had had sexual intercourse in the past, and of these, 245 (42.8%) had been pregnant at least once. A significant majority of adolescents who had been pregnant were not attending school during the survey period. Fifty-six percent of the first pregnancies occurred while the girl was single. Compared with repeat pregnancies, first pregnancies were more likely to be reported as unwanted (OR = 2.4; 95% CI = 1.1, 5.3). Antenatal care attendance, place of delivery and pregnancy outcomes were not significantly different for first-time and repeat pregnancies. Adolescents' reports on health problems during pregnancy, labour and in the post-partum period were not associated with parity or with age (< 16 years old). A lower proportion of younger primigravidae sought medical attention for health problems that arose during pregnancy (OR = 2.3; 95% CI = 1.1, 4.8) and labor (OR = 3.6; 95% CI = 1.5, 8.7). In conclusion, the study highlighted major unmet reproductive health needs of adolescents in this region. Age and gravida influenced health care seeking which could increase the chances of serious life threatening complications among young primigravidae.