Repeat pregnancy among adolescent mothers: a review of the literature

Abstract

Repeat pregnancy among adolescent mothers is a major problem facing healthcare providers today. Adolescents who experience multiple pregnancies often are subjected to overwhelming physical, social, economic, and psychological outcomes. Research is needed to investigate the problem of repeat pregnancy and provide empirical support for intervention programs developed to reduce the incidence. This paper is a review of previous research. Major factors related to repeat pregnancy are examined. In addition, recommendations for future research are discussed.

PIP: A review of data concerning repeat pregnancies among adolescent mothers summarizes significant findings, identifies major contributing variables, and suggests areas for further research. The major variables associated with multiple pregnancies are inconsistent contraceptive practices, marital status, level of educational achievement, and weak parental relationships. The variables associated with first pregnancy are poverty, limited parent-child interactions, single-parent homes, peer relationships, psychological factors, limited decision-making skills, and degree of education. The seriousness of the problem has escalated because of the high incidence of repeat pregnancies (RP), i.e., 50% within 32 months of delivery in general and within 24 months of delivery for Blacks. As a consequence of RPs, there is also higher infant mortality, a decreased likelihood of completing school, welfare dependency, and increased unemployment rates. There has been much speculation about the antecedents of repeaters, but studies by Furstenberg in 1976 and Zelnick and Kantner in 1977 indicate that those returning to school had lower repeat rates. Conversely those lacking an orientation to the future and an awareness of pregnancy risks have the highest risk of RPs. Adolescents were unable to use contraceptives effectively, and knowledge alone was not sufficient to maintain birth control continuation. Most adolescents, and Black adolescents in particular, who became pregnant do not use contraceptives afterwards. Marriage has also been found to contribute to a RP, but the reverse is not true. Education is a consistently strong predictor of effective contraceptive use and avoidance of RPs. Academic achievement may provide incentives to delay another pregnancy. In a study of familial relationships, the pregnant group received less love, fewer demands, greater rejection, and experienced more casualness in the mother-daughter relationship. Having a father in the home reduced risk. The implications for research are that methodological problems need to be overcome, i.e., a longitudinal and experimental design is needed with a larger sample of subgroups in the adolescent first-time pregnant population.