Exeter and North Devon Health Authority, Dean Clarke House, Southemhay East, ..... The project was funded by the South Western Regional. Health Authority ...
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE
Volume 88
July 1995
comparative study of teenagers choosing termination of pregnancy or antenatal care
CZ) Teenage C41M
pregnancy: a
V A H Pearson MRCGP MFPHM M R Owen MD FFPHM D R Phillips BScEcon PhD D J Pereira Gray MA FRCGP M N Marshall MSc MRCGP
OMM4 J R Soc Med 1995;88:384-388
Keywords: *os
SUMMARY A comparative study of 167 pregnant teenagers in Devon attending either antenatal booking clinics or for National Health Service (NHS) termination of pregnancy was carried out to determine differences in their characteristics, use and experience of local family planning services. Teenagers presenting for termination of pregnancy were younger and more likely to say that they had wished to avoid getting pregnant. Whether the teenager was in a stable relationship was strongly associated with the outcome of the pregnancy, with single girls being more likely to choose a termination of pregnancy. The termination of pregnancy group were also more likely to be condom users, and to have learned about their method of contraception from school rather than from health care professionals. Teenagers' frequency of contact with family planning services suggested that teenagers choosing a termination were less likely than antenatal attenders to have attended regularly. This was mainly due to differences in behaviour among teenagers attending their general practitioner (GP) for contraceptive advice: teenagers having a termination were more likely to describe their visit to their GP as embarrassing. These findings have implications for local family planning services attempting to reduce the number of unwanted teenage pregnancies.
INTRODUCTION
METHOD
Unwanted teenage pregnancy may be catastrophic for the individuals involved, and a burden on society and health services. Despite the high profile of pregnancy in under16s as a Health of the Nation key area for prevention1, relatively little is known about the most effective way to prevent unwanted pregnancies in teenagers2'3. Few casecontrol studies have been done examining the characteristics and experiences of women choosing termination of their pregnancy-6. One of the aims of this study was to establish any differences in the characteristics of teenagers opting for a termination of pregnancy, or those choosing to continue with their pregnancy, particularly with regard to their experience and use of local family planning services.
This comparative study collected information directly from teenagers (those having terminations of pregnancy and those proceeding with their pregnancy) by face-to-face interview, using a structured questionnaire with a combination of open and dosed questions. Teenagers (those aged 13-19 years inclusive) were selected by sequential sample in each of the four district health authorities. In order to make the two groups as comparable as possible with regard to recalling their experience of contraceptive services, teenagers were interviewed when attending for booking at antenatal clinics (usually 16-17 weeks pregnant) or when attending for termination of pregnancy (usually 8-12 weeks pregnant). Ethics committee approval was granted from the four (prior to April 1993) district health authorities in Devon, and the informed consent of the teenager was sought prior to their participation in the study. After a small pilot study to refine the questionnaire, the interviews took place over an 18-month period from August 1992 to January 1994. The sampling frame for each district health authority consisted of the provider unit day surgery units (which carry out uncomplicated terminations of pregnancy in young people) and the maternity hospitals' antenatal clinics (which see teenagers at their booking appointment). In addition to one of the authors (VP), four
Exeter and North Devon Health Authority, Dean Clarke House, Southemhay East, Exeter EX1 1 PQ, Institute of Population Studies, University of Exeter, Hoopem House, Pennsylvania Road, Exeter EX4 6DT and Institute of General Practice, University of Exeter, Postgraduate Medical School, Barrack Road, Exeter EX2 5DW, UK
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Correspondence to: Dr VAH Pearson, Exeter and North Devon Health Authority, Dean Clarke House, Southemhay East, Exeter EXI 1 PQ, England, UK
JOURNAL OF THE ROYAL SOCIETY OF MEDICINE
other female interviewers were used who had experience in talking to teenage girls and also of family planning or obstetrics and gynaecology. Data from questionnaires were analysed using EPI-INFO 5.
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Table 2 Reported intention to avoid current pregnancy at time of conception. Odds ratio=0.10(95% confidence interval 0.04-0.26); x2 test with Yates' correction=32.14, df=1, P
