Grounded theory principles were systematically employed to reveal key differences in pregnancy risk and underlying disparities in contraceptive use in (a) never-pregnant (b) pregnant-terminated and (c) pregnant-continued teenagers. Analysis of 69 semistructured interviews revealed a bicausal model of pregnancy protection that accounted for variation in contraceptive use across the sample. Diverging pregnancy/childbearing desires and risk perceptions were conceptualized into three behavioral patterns that represented higher and lower levels of commitment to prevent pregnancy. The various ways that teenagers made sense of their behavior highlight the importance of acknowledging and respecting diversity in perspectives and experiences and provide a useful framework for educational and practitioner-delivered interventions with greater relevance and impact.

Abma, J., Martinez, G., Mosher, W., Dawson, B. (2004). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2002. Vital and Health Statistics, 23, 1-48.
Google Scholar
Agius, P. A., Dyson, S., Pitts, M. K., Mitchell, A., Smith, A. M. A. (2006). Two steps forward and one step back? Australian secondary students’ sexual health knowledge and behaviors 1992-2002. Journal of Adolescent Health, 38, 247-252.
Google Scholar | Crossref | Medline | ISI
Alan Guttmacher Institute . (1994). Sex and America’s teenagers. New York, NY: Author.
Google Scholar
Allen, J. P., Philliber, S., Herrling, S., Kuperminc, G. P. (1997). Preventing teen pregnancy and academic failure: Experimental evaluation of a developmentally based approach. Child Development, 68, 729-742.
Google Scholar | Crossref | ISI
Anderson, J. E., Santelli, J. S., Morrow, B. (2006). Trends in adolescent contraceptive use, unprotected and poorly protected sex, 1991-2003. Journal of Adolescent Health, 38, 734-739.
Google Scholar | Crossref | Medline | ISI
Bearinger, L. H., Sieving, R. E., Ferguson, J., Sharma, V. (2007). Global perspectives on the sexual and reproductive health of adolescents: Patterns, prevention, and potential. Lancet, 369, 1220-1231.
Google Scholar | Crossref | Medline | ISI
Blumer, H. (1969). Symbolic interactionism. Englewood Cliffs, NJ: Prentice-Hall.
Google Scholar
Brazzell, J., Acock, A. (1988). Influence of attitudes, significant others and aspirations on how adolescents intend to resolve a premarital pregnancy. Journal of Marriage and the Family, 50, 413-425.
Google Scholar | Crossref | ISI
Brindis, C. D. (2006). A public health success: Understanding policy changes related to teen sexual activity and pregnancy. Annual Review of Public Health, 27, 277-295.
Google Scholar | Crossref | Medline | ISI
Bruckner, H., Martin, A., Bearman, P. S. (2004). Ambivalence and pregnancy: Adolescents’ attitudes, contraceptive use and pregnancy. Perspectives on Sexual and Reproductive Health, 36, 248-257.
Google Scholar | Crossref | Medline | ISI
Card, J. J. (1999). Teen pregnancy prevention: Do any programs work? Annual Review of Public Health, 20, 257-287.
Google Scholar | Crossref | Medline | ISI
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: SAGE.
Google Scholar
Crosby, R., DiClemente, R., Wingood, G., Davies, S., Harrington, K. (2002). Adolescents’ ambivalence about becoming pregnant predicts infrequent contraceptive use: A prospective analysis of nonpregnant African American females. American Journal of Obstetrics and Gynecology, 186, 251-252.
Google Scholar | Crossref | Medline | ISI
Davies, S. L., DiClemente, R. J., Wingood, G. M., Person, S. D., Dix, E. S., Harrington, K., . . . Oh, M. K. (2006). Predictors of inconsistent contraceptive use among adolescent girls: Findings from a prospective study. Journal of Adolescent Health, 39, 43-49.
Google Scholar | Crossref | Medline | ISI
Evans, A. (2004). Education and the resolution of teenage pregnancy in Australia. Health Sociology Review, 13, 27-42.
Google Scholar | Crossref
Feldman, E. E. (2006). Contraceptive care for the adolescent. Primary Care, 33, 405-431.
Google Scholar | Crossref | Medline | ISI
Flanagan, P. J., Kokotailo, P. (1999). Adolescent pregnancy and substance use. Clinical Perinatol, 26, 185-200.
Google Scholar | Crossref | Medline | ISI
Free, C., Ogden, J., Lee, R. (2005). Young women’s contraception use as a contextual and dynamic behaviour: A qualitative study. Psychology & Health, 20, 673-690.
Google Scholar | Crossref | ISI
Gerrard, M., Luus, C. A. E. (1995). Judgments of vulnerability to pregnancy: The role of risk factors and individual differences. Personality and Social Psychology Bulletin, 21, 160-171.
Google Scholar | SAGE Journals | ISI
Gibbons, F. X., Gerrard, M., Ouellette, J. A., Burzette, R. (1998). Cognitive antecedents to adolescent health risk: Discriminating between behavioral intention and behavioral willingness. Psychology & Health, 13, 319-339.
Google Scholar | Crossref | ISI
Glaser, B. (1978). Theoretical sensitivity: Advances in the methodology of grounded theory. Mill Valley, CA: Sociology Press.
Google Scholar
Glaser, B. (1998). Doing grounded theory: Issues and discussions. Mill Valley, CA: Sociology Press.
Google Scholar
Glaser, B. G. (1992). Basics of grounded theory analysis. Mill Valley, CA: Sociological Press.
Google Scholar
Harlap, S., Kost, K., Forrest, J. (1991). Preventing pregnancy, protecting health: A new look at birth control choices in the United States. New York, NY: Alan Guttmacher Institute.
Google Scholar
Herrman, J. (2008). Adolescent perceptions of teen births. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 37, 42-50.
Google Scholar | Crossref | Medline | ISI
Hillard, P. J. (2005). Contraceptive behaviors in adolescents. Pediatric Annals, 34, 794-802.
Google Scholar | Crossref | Medline | ISI
Jaccard, J., Dodge, T., Dittus, P. (2003). Do adolescents want to avoid pregnancy? Attitudes toward pregnancy as predictors of pregnancy. Journal of Adolescent Health, 33, 79-83.
Google Scholar | Crossref | Medline | ISI
Jackson, L., Marentette, H., McCleave, H. (2000). Teenage moms living in Nova Scotia, Canada: A exploration of influences on their decision to become a mother. International Quarterly of Community Health Education, 20, 17-38.
Google Scholar | SAGE Journals
Janz, N. K., Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11, 1-47.
Google Scholar | SAGE Journals | ISI
Jewell, D., Tacchi, J., Donovan, J. (2000). Teenage pregnancy: Whose problem is it? Family Practice, 17, 522-528.
Google Scholar | Crossref | Medline | ISI
Jones, R. K., Darroch, J. E., Henshaw, S. K. (2002). Contraceptive use among U.S. women having abortions in 2000-2001. Perspectives on Sexual and Reproductive Health, 34, 294-303.
Google Scholar | Crossref | Medline | ISI
Kegler, M. C., Bird, S. T., Kyle-Moon, K., Rodine, S. (2001). Understanding teen pregnancy from the perspective of young adolescents in Oklahoma City. Health Promotion Practice, 2, 242-254.
Google Scholar | SAGE Journals
Kirby, D., Crosby, R. A., Santelli, J. S., DiClemente, R. J. (2009). Interventions to prevent pregnancy and sexually transmitted diseases, including HIV infection. In DiClemente, R. J., Santelli, J. S., Crosby, R. A. (Eds.), Adolescent health: Understanding and preventing risk behaviors (pp. 303-338). San Francisco, CA: Jossey-Bass.
Google Scholar
Klein, J. D. (2005). Adolescent pregnancy: Current trends and issues. Pediatrics, 116, 281-286.
Google Scholar | Crossref | Medline | ISI
Lonczak, H. S., Abbott, R. D., Hawkins, J. D., Kosterman, R., Catalano, R. F. (2002). Effects of the Seattle Social Development Project on sexual behavior, pregnancy, birth, and sexually transmitted disease outcomes by age 21 years. Archives of Pediatrics and Adolescent Medicine, 156, 438-447.
Google Scholar | Crossref | Medline
Manlove, J., Ryan, S., Franzetta, K. (2003). Patterns of contraceptive use within teenagers’ first sexual relationships. Perspectives on Sexual and Reproductive Health, 35, 246-255.
Google Scholar | Crossref | Medline | ISI
Manlove, J., Ryan, S., Franzetta, K. (2004). Contraceptive use and consistency in U.S. teenagers’ most recent sexual relationships. Perspectives on Sexual and Reproductive Health, 36, 265-275.
Google Scholar | Crossref | Medline | ISI
Manlove, J., Terry-Humen, E. (2007). Contraceptive use patterns within females’ first sexual relationships: The role of relationships, partners, and methods. Journal of Sex Research, 44, 3-16.
Google Scholar | Crossref | Medline | ISI
Marston, C., King, E. (2006). Factors that shape young people’s sexual behaviour: A systematic review. Lancet, 368, 1581-1586.
Google Scholar | Crossref | Medline | ISI
Meade, C. S., Ickovics, J. R. (2005). Systematic review of sexual risk among pregnant and mothering teens in the USA: Pregnancy as an opportunity for integrated prevention of STD and repeat pregnancy. Social Science and Medicine, 60, 661-678.
Google Scholar | Crossref | Medline | ISI
Meade, C. S., Kershaw, T. S., Ickovics, J. R. (2008). The intergenerational cycle of teenage motherhood: An ecological approach. Health Psychology, 27, 419-429.
Google Scholar | Crossref | Medline | ISI
Merrick, E. N. (1995). Adolescent childbearing as career “choice”: Perspective from an ecological context. Journal of Counseling and Development, 73, 288-295.
Google Scholar | Crossref | ISI
Mersky, J. P., Reynolds, A. J. (2007). Predictors of early childbearing: Evidence from the Chicago longitudinal study. Children and Youth Services Review, 29, 35-52.
Google Scholar | Crossref | ISI
Miller-Johnson, S., Winn, D.-M., Coie, J., Maumary-Gremaud, A., Hyman, C., Terry, R., Lochman, J. (2000). Motherhood during the teen years: A developmental perspective on risk factors for childbearing. Development and Psychopathology, 11, 85-100.
Google Scholar | Crossref | ISI
Nelson, A. (2002). Contraception. In Neinstein, L. (Ed.), Adolescent health care: A practical guide (pp. 834-856). Philadelphia, PA: Lippincott Williams and Wilkins.
Google Scholar
Philliber, S., Kaye, J., Herring, S., West, E. (2002). Preventing teen pregnancy and improving health care for teens: An evaluation of the Children’s AID Society Carrera Program. Perspectives on Sexual and Reproductive Health, 34, 244-251.
Google Scholar | Crossref | Medline | ISI
Quinlivan, J. A., Tan, L. H., Steele, A., Black, K. (2004). Impact of demographic factors, early family relationships and depressive symptomatology in teenage pregnancy. Australian & New Zealand Journal of Psychiatry, 38, 197-203.
Google Scholar | SAGE Journals | ISI
Rogers, R. W. (1983). Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation. In Cacioppo, J., Petty, R. (Eds.), Social psychophysiology (pp. 153-176). New York, NY: Guilford.
Google Scholar
Rosengard, C., Phipps, M. G., Adler, N. E., Ellen, J. M. (2004). Adolescent pregnancy intentions and pregnancy outcomes: A longitudinal examination. Journal of Adolescent Health, 35, 453-461.
Google Scholar | Crossref | Medline | ISI
Sanci, L. A., Sawyer, S. M., Weller, P. J., Bond, L. M., Patton, G. C. (2004). Youth health research ethics: Time for a mature-minor clause? Medical Journal of Australia, 180, 336-338.
Google Scholar | Medline | ISI
Santelli, J., Lindberg, L., Finer, L., Singh, S. (2007). Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use. American Journal of Public Health, 97, 150-156.
Google Scholar | Crossref | Medline | ISI
Santelli, J. S., Marrow, B., Anderson, J., Lindberg, L. D. (2006). Contraceptive use and pregnancy risk among U.S. high school students, 1991-2003. Perspectives on Sexual and Reproductive Health, 38, 106-111.
Google Scholar | Crossref | Medline | ISI
Santelli, J. S., Orr, M., Lindberg, L. D., Diaz, D. C. (2009). Changing behavioral risk for pregnancy among high school students in the United States, 1991-2007. Journal of Adolescent Health, 45, 25-32.
Google Scholar | Crossref | Medline | ISI
Seamark, C., Lings, P. (2004). Positive experiences of teenage motherhood: A qualitative study. British Journal of General Practice, 54, 813-818.
Google Scholar | Medline | ISI
Sjöberg, L. (2003). Neglecting the risks: The irrationality of health behavior and the quest for la dolce vita. European Psychologist, 8, 266-278.
Google Scholar | Crossref | ISI
Smith, A., Agius, P., Mitchell, A., Barrett, C., Pitts, M. (2009). Secondary Students and Sexual Health 2008. Melbourne: Australian Research Centre in Sex, Health & Society, La Trobe University.
Google Scholar
Smith-Battle, L. (2000). The vulnerabilities of teenage mothers: Challenging prevailing assumptions. Advances in Nursing Science, 23, 29-40.
Google Scholar | Crossref | Medline | ISI
Spear, H. J., Lock, S. (2003). Qualitative research on adolescent pregnancy: A descriptive review and analysis. Journal of Pediatric Nursing, 18, 397-408.
Google Scholar | Crossref | Medline
Unger, J. B., Molina, G. B., Teran, L. (2000). Perceived consequences of teenage childbearing among adolescent girls in an urban sample. Journal of Adolescent Health, 26, 205-212.
Google Scholar | Crossref | Medline | ISI
van der Pligt, J., Richard, R. (1994). Changing adolescents’ sexual behaviour: Perceived risk, self-efficacy and anticipated regret. Patient Education and Counseling, 23, 187-196.
Google Scholar | Crossref | Medline | ISI
Weinstein, N. D. (1980). Unrealistic optimism about future life events. Journal of Personality and Social Psychology, 39, 806-820.
Google Scholar | Crossref | ISI
Weinstein, N. D. (1982). Unrealistic optimism about susceptibility to health problems. Journal of Behavioral Medicine, 5, 441-460.
Google Scholar | Crossref | Medline | ISI
Weinstein, N. D. (1988). The precaution adoption process. Health Psychology, 7, 355-386.
Google Scholar | Crossref | Medline | ISI
Weinstein, N. D., Klein, W. M. (1995). Resistance of personal risk perceptions to debiasing interventions. Health Psychology, 14, 132-140.
Google Scholar | Crossref | Medline | ISI
Weinstein, N. D., Lachendro, E. (1982). Egocentrism as a source of unrealistic optimism. Personality and Social Psychology Bulletin, 8, 195-200.
Google Scholar | SAGE Journals | ISI
Weinstein, N. D., Lyon, J. E., Sandman, P. M., Cuite, C. L. (1998). Experimental evidence for stages of health behavior change: The precaution adoption process model applied to home radon testing. Health Psychology, 17, 445-453.
Google Scholar | Crossref | Medline | ISI
Zabin, L. S., Astone, N. M., Emerson, M. R. (1993). Do adolescents want babies? The relationship between attitudes and behavior. Journal of Research on Adolescence, 3, 67-86.
Google Scholar | Crossref | Medline
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