Repeat pregnancy in adolescence: intentions and decision making.

PURPOSE: To determine the perceptions of young mothers concerning their intentions about repeat pregnancy and to determine shared meanings concerning intentionality and decision making about sexual activity and use of birth control. DESIGN AND METHODS: Ethnographic, descriptive study with interviews of a purposive sample of young mothers with a repeat pregnancy. Iterative methods, recursive data sifting, and Ethnograph 5.0 were used in data analysis.
RESULTS: All of the mothers stated that their repeat pregnancies were unintended. Regarding decision making about sexual activity, some mothers discussed a conscious, rational decision-making process before sexual activity, whereas others talked about a more impulsive, spontaneous participation in unprotected sexual activity. A key finding in this study was that although mothers did not intend to get pregnant, they also did not intend to prevent pregnancy. Many discussed feeling pressured to have sex, coerced into not using birth control, unable to implement safe sex behaviors, or just "doing it." CLINICAL IMPLICATIONS: These data suggest that much of teen sexual activity is spontaneous, unplanned, and sometimes involuntary. As such, interventions must be created that take the nature of this sexual activity into account. Consideration of young mothers' thought processes, intentions, and perspectives is integral in the design and implementation of programs and policies to prevent or delay repeat pregnancy during the adolescent years.