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To Be Rather Than Not To Be—That Is the Problem With the Questions We Ask Adolescents About Their Childbearing Intentions
Catherine Stevens-Simon, MD;
Roberta K. Beach, MD, MPH;
Lorraine V. Klerman, DrPH
Arch Pediatr Adolesc Med. 2001;155:1298-1300.
Objective To demonstrate that rephrasing the questions used to assess childbearing
intentions to quantify the strength of the intent to remain nonpregnant, rather
than the strength of the intent to become pregnant, would make teenagers'
responses more useful to health care providers, family planning counselors,
and health policy makers.
Methods Examples from the teen pregnancy prevention literature are used to support
the recommendations for change.
Results Teenagers rarely plan their pregnancies. However, because those who
are having sexual intercourse must actively try not to become pregnant or
they will likely conceive, teenagers often become pregnant because they lack
a firm commitment not to do so. Thus, to accurately profile the antecedents
of adolescent pregnancy, (1) the questions used to assess childbearing intentions
must be rephrased so that teenagers who intend to remain nonpregnant can be
distinguished from those who do not and (2) separate differential diagnoses
must be developed for inconsistent contraceptive use within these 2 groups
of teenagers who are at risk for unintended pregnancy.
Conclusion Asking sexually active teenagers about the strength of their intent
to remain nonpregnant will make the results of office interviews and national
surveys more useful because the responses such questions elicit will enable
health care providers and policy makers to target common, modifiable antecedents
of inconsistent contraceptive use for interventions.
From the Division of Adolescent Medicine, Department of Pediatrics,
University of Colorado Health Sciences (Dr Stevens-Simon); and the Division
of Adolescent Medicine, Department of Community Health Services, Denver Health
Authority (Dr Beach), Denver, Colo; and the Department of Maternal and Child
Health, University of Alabama at Birmingham (Dr Klerman).
Corresponding author: Catherine Stevens-Simon, MD, Division of Adolescent
Medicine, Department of Pediatrics, University of Colorado Health Sciences
Center, The Children's Hospital, 1056 E 19th Ave, Denver, CO 80218.
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