Pregnancy Intentions and Contraceptive Behaviors Among Adolescent Women: A Coital Event Level Analysis

PurposeMeasuring pregnancy intentions has been difficult. This study examines questions regarding pregnancy intentions and their association with adolescents’ sexual and contraceptive behaviors longitudinally.MethodsAdolescent women completed an interview about pregnancy intentions followed by a 3-month daily diary period reporting coital activity and contraception use. Interviews assessed pregnancy intentions with: “Are you trying to get pregnant now?,” “Are you trying to keep from getting pregnant now?,” and “I’m very committed to not getting pregnant at this time in my life.” The measured outcome was the occurrence of contraceptive protected versus non-protected coitus collected from diary data. Logistic regression was used to assess this relationship.ResultsA total of 289 women completed 677 face-to-face interviews and subsequent 3 months of diary collection. In all, 194 reported having sex during diary collection. Women trying to keep from getting pregnant (n = 265) had 51.8% of 2533 coital events covered by contraception, whereas 13.1% of 818 coital events were protected in those women who were not trying to keep from getting pregnant (OR = 9.2, 95% CI = 6.0, 13.9). Women who agreed that they were committed to not getting pregnant were more likely to have coital events protected (50.5% of 2574 events) than those who disagreed (21.2% of 576 events) (OR = 9.8, 95% CI = 5.5, 17.3).ConclusionsAdolescents’ contraceptive behaviors were associated with reported intentions. However, approximately one half of coital events were not protected in women who agreed that they were committed to not getting pregnant. These women may represent a group at risk for unintended pregnancy.