'You just have to learn to keep moving on': young women's experiences with unplanned pregnancy in the Cook Islands

The Cook Islands is one of several countries in the Pacific region that has high rates of teenage pregnancy and birth. While the social determinants of pregnancy and early motherhood are well established in the global context, little is known about how Cook Islands young women who become pregnant before age 20 make sense of their experiences. Drawing on individual interviews with a purposive sample of 10 young mothers, this paper examines the phenomenology of early pregnancy from their perspectives. Structural, cultural and individual factors emerged as salient themes in participants' accounts. Qualitative analysis revealed that nearly all the pregnancies were unplanned and every participant reacted negatively when she learned she was pregnant. While some participants wanted to terminate their pregnancies, lack of access to safe, legal and affordable abortion care limited their options. Ultimately, while nearly all participants wished they had been able to delay motherhood, they expressed happiness and pride about their new-found status as mothers. These findings allow for a fuller understanding of factors shaping young women's experiences of pregnancy in the Cook Islands, which have policy implications for reproductive health and rights.