Dr Lauren Miller-Lewis: Psychosocial predictors of pregnancy risk-taking, pregnancy, and childbearing in Australian youth.

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