Saturday, December 09, 2006

Pregnant Teens Thought They Might Be Infertile

I'm back! After being out of town 2 1/2 weeks of the last month, moving into my first house, and *finally* getting the internet connection set up, I have a lot of catching up to do.

First up: A paper appears in the current [see citation] issue of the journal Obstetrics and Gynecology, "Fear of Inability to Conceive in Pregnant Adolescents" [See abstract]. The researchers surveyed "pregnant adolescents attending their first prenatal visit about their pregnancy intentions, including whether they had fears about not being able to conceive before their current pregnancy."

The 300 pregnant adolescents surveyed were from one women's primary care center and recruited during their first prenatal visit. They were included in the study if their estimated delivery date was prior to their 20th birthday, they agreed to review of their medical records, were able to give informed consent, and and able to speak and read English.

30 minute interviews were conducted with each participating teen, including "questions regarding the teenager’s demographic background, life plans, social supports, family and peer relationships, financial status, health history, and behavioral risks." Demographic results were: "The study participants were 48% Hispanic, 18% white, and 19% African American. Forty-two percent of the participants were 18 or 19 years old and 53% were currently enrolled in high school (Table 1). Eighty-three percent of the participants were less than 20 weeks of gestation during the interview."

126 (42%) of the surveyed teens reporting have been afraid that they were not able to get pregnant, without significant differences between younger and older teens. There was also no significant difference in reported sexually transmitted infections between the groups that were and were not afraid they could not get pregnant, and age at first intercourse was similar. There was a significant difference in length of sexual activity, averaging 2.6 years in those who were afraid they could not get pregnant vs 2.0 years in those who were not. There were no differences when comparing previous pregnancy terminations or live births, although those with past spontaneous abortion were more likely to fear not being able to conceive.

There was no significant difference in contraception use between those who were afraid they were unable to conceive (17%) and those who weren't (26%). According to the authors, "A significantly higher proportion of teenagers with the fear of not being able to conceive agreed with the following statements, “I wanted to get pregnant,” “I didn’t think I could get pregnant,” “I didn’t want to use birth control,” and “my partner didn’t want to use birth control.” The two groups had similar proportions agree that they experienced side effects from birth control or that they didn’t think they were going to have sex." Regarding thinking they could not get pregnant, 61% of those who had "fertility fears" agreed that they thought they could not get pregnant, while only 19% of those without "fertility fears" agreed.

What does it all mean?
This is an interesting study, because when we think about how adolescent girls think about sex, we tend to think they are worried about getting pregnant. It may be less common for discussions of teen sexuality to address the actual fertility of these girls, to address their worries about not being able to conceive or perception that birth control is not needed because they can't get pregnant. This may be one new piece of the puzzle in educating teens about the risks of their sexual activity choices.

The cranky anti-abstinence only sex ed part of me questions whether this is related to that policy - if you hear repeatedly that there is no such thing as safe sex and contraceptives fail (which they do, but we're talking fear and emotions here, not statistics), yet you have sex repeatedly without getting pregnant, might you worry that you are not able to become pregnant? And thus not take proper precautions or cease sexual activity? The girls with fears of not being able to get pregnant were not that statistically different from those without the fears, except that they had been having sex for longer on average. Regardless of the cause, however, this is a health fear/concern that some young girls have which I think has not been adequately discussed.

Citation: White E, Rosengard C, Weitzen S, Meers A, Phipps MG. Fear of inability to conceive in pregnant adolescents. Obstet Gynecol. 2006 Dec;108(6):1411-6.

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MeSH Tags: Fertility AND Adolescent; Pregnancy in Adolescence


Anonymous Anonymous said...

this article was really important for me. I don't want to get pregnant at this time, however just have that instinct of wanting to be a mother in the future. I did not use birth control consistently with my BF for about six months and fear I am infertal, but this article gave me some hope.
Thank you,

9:20 AM  

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