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Women Health. 2005;42(1):55-73.

Teen contraceptive decisions: childbearing intentions are the tip of the iceberg.

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Dept. of Pediatrics, Division of Adolescent Medicine, University of Colorado Health Sciences Center, Denver, CO 80218, USA.



To validate a model we developed while trying to understand why pregnant teens so often report that they did not want to become pregnant and could have obtained contraceptives before they conceived.


The study enrolled a racially/ethnically diverse group of 351 teenagers. Participants completed a questionnaire that asked about teen pregnancy risk factors, the expected effects of childbearing, the desire to remain non-pregnant, deterrents to contraceptive use, and contraceptive plans.


Most participants were capable of using contraceptives but at high risk for unintended conception because they exhibited numerous sociodemographic risk factors, were unsure that pregnancy would affect their lives adversely, and were ambivalent about remaining non-pregnant. Believing a boyfriend wanted a baby and the anticipated effect of childbearing on 5 specific aspects of life explained 63% of the variance in the desire to remain non-pregnant, which, in conjunction with fears about using contraceptives, explained 20.5% of the variance in future contraceptive plans.


Our new findings that expectations about the effect of childbearing explain the desire to remain non-pregnant may well help providers determine why teenagers who do not plan to conceive are often willing to allow themselves to do so by default. Further research is needed, as the model did not explain contraceptive decision-making adequately.

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