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Doctoral
Thesis: Psychosocial
predictors of pregnancy risk-taking, pregnancy, and
childbearing in Australian youth.
Supervisors: Associate
Professor Tracey Wade & Professor Christina Lee.
University: Flinders
University, Adelaide.
The
purpose of this research was to gain a greater understanding
of why some young people risk pregnancy when others
do not. This project expanded on previous research by
conducting a series of longitudinal, multivariate, theoretically-informed
studies which examined the predictors of pregnancy,
childbearing, and pregnancy risk-taking (i.e., non-optimal
use of contraception) in “emerging adults"
and adolescents. A comprehensive Pregnancy Risk-Taking
Questionnaire was designed for the purposes of this
research which took into account frequency of sexual
activity, the types of contraception used, contraceptive
consistency, and contraceptive compliance. Use of this
questionnaire with several hundred heterosexually-experienced
Australian young people (aged 15 to 24) indicated that
it provided several appropriate measures of pregnancy
risk-taking, and that inconsistent and incorrect contraceptive
use was common in this group.
This research applied components of Erikson’s
psychosocial developmental theory to youth reproductive
behaviours, and suggested four groups of developmental
risk factors which were relevant to reproductive behaviour
in youth:1)
socio-demographic factors, 2) perceived competence or
industry factors, 3) psychosocial well-being factors,
and 4) aspirations or identity factors.
Three
longitudinal studies examined the influence of these
predictors. The first investigated the psychosocial
predictors of subsequent pregnancy and childbearing
in emerging adult young women from the Australian Longitudinal
study of Women’s Health (n= 1647, aged 18-20 at
Survey 1 and 22-24 at Survey 2), and the second examined
predictors of pregnancy risk-taking in a sub-sample
of these emerging adults (n= 90, aged 24 when pregnancy
risk-taking was measured). The final longitudinal study
investigated psychosocial predictors of pregnancy risk-taking
and early sexual initiation over a 6-month period in
male and female adolescent high school and technical
college students (n=288, aged 14-18).
The
results of these three studies indicated that poor psychological
well-being was a strong and robust risk factor for subsequent
pregnancy, childbearing, and pregnancy risk-taking in
emerging adult young women, and pregnancy risk-taking
in adolescents. Industry-related variables (unemployment
and industry achievement) were also frequently found
to be predictive of youth reproductive behaviours, with
poorer industry achievement a risk factor for measures
of pregnancy risk-taking in adolescents, and greater
experience with unemployment a risk factor for pregnancy
and childbearing (but not pregnancy risk-taking) in
emerging adult young women. Mediational analyses indicated
that poorer industry was associated with poorer psychological
well-being, which in turn predicted subsequent pregnancy
risk-taking, pregnancy, and childbearing in these young
people. Other risk factors identified for early pregnancy
and childbearing in the emerging adults were greater
family aspirations combined with lower job aspirations,
and for pregnancy only, greater alcohol use and stress.
In the adolescent sample, having more positive attitudes
and intentions towards early parenthood, experiencing
sexual coercion, receiving less comprehensive sex education,
and being male were predictors of exhibiting greater
pregnancy risk-taking. Other socio-demographic factors
played a relatively minor role. The risk-factor findings
from these quantitative studies corresponded well with
results from a qualitative focus group conducted with
7 young mothers.
Overall,
the findings suggested that the picture of the adolescent
and the emerging adult who is at risk of early pregnancy
and childbearing is not an overly positive one. As expected
based on the propositions of the Eriksonian psychosocial
developmental model, those young people who were the
least emotionally and competently equipped to cope with
the difficulties of early parenthood were the ones more
likely to risk pregnancy, and subsequently to become
pregnant and give birth. These results suggest that
enhancing competence and psychological well-being in
conjunction with providing comprehensive sex education
may be a worthwhile approach to the prevention of early
pregnancy in Australian youth.
To
contact Lauren:
Dr
Lauren Miller-Lewis
Research and Evaluation Unit
Women's and Children's Hospital
72 King William Road
North Adelaide SA 5006
Australia
Email:
lauren.millerlewis@adelaide.edu.au
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