A Developmentally-Informed Model of Adolescent Decision-Making Around Pregnancy: A Qualitative Study.

Area of Science:

• Reproductive Health
• Adolescent and Young Adult (AYA) Health
• Decision-Making Models

Background:

• Adolescents and young adults (AYAs) face complex decisions regarding unintended pregnancies.
• Understanding the decision-making process is crucial for providing effective support.

Purpose of the Study:

• To formulate a model of the decision-making process for adolescents and young adults (AYAs) facing pregnancy.
• To identify factors influencing AYA pregnancy decisions and outcomes.

Main Methods:

• Qualitative analysis of semi-structured phone interviews with 50 US-based participants (aged 18-35) who experienced pregnancy under age 20.
• Exploration of emotions, disclosures, and decision-making processes across parenting, adoption, and abortion outcomes.

Main Results:

• Development of the Pregnancy Decision-making and Outcome Trajectories (PDOT) model with four stages: Initial Reactions, Intention Analysis, Planning, and Action/Inaction.
• PDOT highlights AYA potential for uncertainty or certainty, engagement in research, support-seeking, and cost-benefit analysis.
• Identified barriers and facilitators impacting AYAs' ability to achieve desired pregnancy outcomes.

Conclusions:

• Pregnant AYAs encounter difficulties in making and executing decisions regarding pregnancy outcomes.
• The PDOT model provides a framework for healthcare providers and support systems to offer targeted assistance, enhancing AYA agency in pregnancy decision-making and action.