Ambivalent Childbearing Motivations: Predicting Condom Use by Urban, African-American, Female Youth

Study ObjectiveTo describe a model of how interactions between positive and negative childbearing motivations affect the use of condoms for contraceptive purposes and test hypotheses based on that model.DesignPsychological and behavioral data were collected during a study that sampled randomly selected census block groups.SettingRespondents were household residents of Baltimore City, Maryland, between 2004 and 2007.ParticipantsEnglish-speaking, sexually active African-American women between the ages of 15 and 24 who had completed a reliable and valid measure of both positive and negative childbearing motivations.Main Outcome MeasuresRegularity of condom use during the past 90 days and contraceptive method at last sex.ResultsThe results of regression analyses with the total sample confirm that antinatal childbearing motivations predicted more regular condom use and that ambivalent, pronatal, and indifferent childbearing motivations acting together each predicted less regular condom use. The results with a subgroup using condom and not hormonal contraception confirmed that ambivalent childbearing motivation alone predicted less regular condom use.ConclusionsOur findings demonstrate how positive and negative childbearing motivations interact to create a dynamic effect on contraceptive behavior that transcends the effect of either positive or negative motivation acting alone. We conclude that the dynamics of these motivational interactions have important implications for further research on contraceptive decision-making, for augmenting the understanding of caretakers and providers, and for the formation of new policies that focus on the prevention of unplanned pregnancy among youth.