Factors influencing decision-making regarding contraception and pregnancy among nursing students

The current nursing shortage, now referred to as a 'global crisis', is having a widespread impact on health systems around the world. In view of the international nursing shortage, the retention and matriculation of nursing students who gain entry to nursing programs is a vital facet of nursing education that has broad ramifications. Although enrollment in higher institutions in the United States has increased in the last two decades; graduation rates have not increased at the same rate. Yet the impact of pregnancy on the progression and matriculation of what remains a female dominated nursing student population in her child bearing years has not been adequately addressed. This exploratory study used grounded theory methodology to identify and describe the decision-making processes and coping of African American nursing students who become pregnant. Five interrelated themes emerged from the data. Participants reported inconsistent use of contraceptives but experienced discovery of the pregnancy as highly traumatic. Participants also described the decision to keep the pregnancy as conflict-ridden and difficult as a result of family values and religious beliefs and ultimately driven by maternal support. Maternal and faculty support was central to successful coping and matriculation while in nursing school. With the changing profile of the nursing student, it is important for educational institutions to become more pregnancy friendly in their endeavors to retain and matriculate nursing students.