Psychosocial Variables Associated with Teenage Pregnancy
Morgan, Carole, Chapar, George N., Fisher, Martin, Adolescence
Over one million adolescents between the ages of 15 and 19 become pregnant each year, a number that has remained relatively stable since 1973 (Henshaw, Kenney, Somberg, & Van Wort, 1989; Carrera & Dempsey, 1988). Research into the phenomenon of teenage pregnancy has come from diverse disciplines. Epidemiologic studies have yielded important information about pregnancy rates and risk factors. Being poor and being black have been identified as major risk factors for adolescent pregnancy (Zelnick & Kantner, 1978). Studies arising from developmental and psychiatric perspectives have investigated the role of premorbid psychopathology and cognitive and emotional immaturity in adolescents who become pregnant. This literature has identified a regressive relationship with the mother, cognitive immaturity, inability to plan for the future, and impulsiveness in those adolescents who become pregnant (Group for the Advancement of Psychiatry (GAP), 1986; Cobliner, 1974; Hart & Hilton, 1988; Hatcher, 1973; Schaffer & Pine, 1972).
The present study was designed to examine the role of selected psychological and sociocultural factors in placing suburban, white, middle-class adolescents at risk for becoming pregnant. These variables include the personality factors of self-esteem and health locus of control, negative life events during the past year perceived by the teenager as stressful, and selected demographic variables. Self-esteem and locus of control have been identified as salient variables in understanding a wide range of adolescent health behaviors (Neel, Jay, & Litt, 1988) including contraceptive behavior and pregnancy (Visher, 1987), and they are important contributors to the maintenance of a stable self-concept under conditions of stress during adolescence. Negative life events during the past year which are perceived by the teenager as stressful also warrant exploration since adolescence is a time of rapid change with built-in biological and developmental challenges (Peterson & Spiga, 1982; Jessor, 1984).
A great deal of public attention to teenage pregnancy involves concern with teenage childbearing, particularly among poor and minority groups. Teenage pregnancy, however, is not confined to these high-risk groups. Among middle-class adolescents, who are becoming pregnant in increasing numbers, abortion rather than childbearing is more frequently the option of choice. Approximately 43% of all teenage pregnancies end in abortion (Furstenberg, Brooks-Gunn, & Chase-Lansdale, 1989; Henshaw & Van Wort, 1987; Dryfoos, 1982). Within our study population of suburban adolescents, 92% of pregnant teenagers resolve their pregnancies by abortion rather than childbearing (Fisher, Marks, & Trieller, 1988).
The primary hypothesis of this study was that suburban middle-class adolescents who became pregnant differ from their sexually active peers who do not become pregnant on the selected psychological variables of self-esteem, health locus of control, and impact of negative life events. A secondary hypothesis was that a difference exists on selected sociodemographic variables.
Both these hypotheses were examined in two ways. In comparison A, sexually active but never pregnant adolescents (group 1) were compared to adolescents who came to the clinic for a pregnancy test, one subgroup having positive tests, i.e., pregnant (group 2) and the other subgroup having negative tests, i.e., not pregnant (group 3). This three-group comparison is referred to as the pregnancy-test grouping. In comparison B, sexually active but never pregnant adolescents (group 1) were compared to adolescents who were now or had ever been pregnant (group 2). This two-group comparison is referred to as the history of pregnancy grouping.
Subjects for the study were female adolescents between the ages of 15 and 21 who attended North Shore University Hospital's Five Towns Adolescent Health Service, a general health facility for teenagers located in suburban Long Island, New York, between February and August, 1989. …