Three Cases of Adolescent Childbearing Decision-Making: The Importance of Ambivalence

Article excerpt

INTRODUCTION

Making a decision is often assumed to be a rational process. However, when it comes to more difficult and personal decisions, the process may involve less rationality. The decision to have an abortion or carry a baby to term is very complex and more so for the adolescent who is still growing up and is dependent on others. Models of decisionmaking are often referred to as rational models since they assume that individuals weigh the costs and benefits and then make the choice that is of greatest benefit to them. In order to make a rational decision, individuals need accurate information about the alternatives, potential consequences of each, the likelihood of each consequence occurring, and the harm or benefit involved. Adler and Rosengard (1996) pointed out that these models are not considered of much benefit when it comes to highly personal and complex decisions, like preventing or not preventing pregnancy. This is because people may not have enough information regarding the choices or outcomes, or they may not be able to predict the benefits or costs of the outcome. There could be cognitive limitations as well as limitations in processing information in the decision-making. Janis and Mann (1977) developed the conflict theory which is focused on more difficult decision-making and Bracken, Klerman & Bracken (1978) and Bracken and Kasl (1975) extended that theory in order to develop a theoretical model of decision-making regarding unwanted pregnancy. The model by Bracken and coworkers consists of five stages (see Table 1). These are: acknowledgement of pregnancy, formulation of alternative outcomes, consideration of available options (abortion, adoption, motherhood), commitment to one choice, and adhering to the decision. The first stage is about the perception of the risk of pregnancy, the reaction to pregnancy and how to cope. Denial can be present at this stage. The second stage is formulating alternative outcomes regarding abortion, adoption, and motherhood. It is considered to be a brief stage. It involves classifying the options according to their importance to the individual and precluding those not desired. The third stage is to consider the options by exploring their positive and negative sides. The more factors considered the better, since less regret is likely to be experienced subsequently. Considerable indecision is possible at this stage. The fourth stage is a commitment to once choice, i.e., the choice which the individual finds better than others. The woman may want to let others know about her plan. She may start to collect information about her choice. The rejected option may receive negative reinforcement and the chosen option defended. The fifth stage is when the woman is adhering to her decision although negative feedback about the choice is received. New information may shift the decision, and the individual may go back to stage two or three. During these stages the individual is likely to be influenced by others. No study has been found that has explored the applicability of this model to the experiences of young expectant adolescents. The majority of studies have focused on decision-making about sexual behavior or abortion but not the decision to carry to term (Husfeldt, Hansen, Lyngberg, Noddebo, & Peterson, 1995; Keller, Duerst, & Zimmerman, 1996). The few studies found about the decision to carry to term are based primarily on quantitative methods (Blum & Resnick, 1982; Bracken et al., 1978; Frost & Oslak, 1999; Gordon, 1996). A further limitation of these studies is their focus on socioeconomic characteristics (Soderberg, Andersson, Janzon, & Sjoberg, 1997). Some of these studies have explored the future perspectives of aborters and teenage mothers and how these young women see themselves in charge of their lives or being influenced by others. Other studies have focused on the costs (losses) and benefits (gains) of the childbearing decision. The benefits of childbearing that have been identified are, for example, becoming more mature (self-improvement) and stable, leaving home, becoming independent, having a family and love, avoiding loneliness, taking greater responsibility, having a better relationship with the baby's father, receiving gifts and attention and love from the baby. …