1. A Qualitative Approach to Understanding Pregnancy Among Adolescent Females in Allentown, PA Alexis Burgess, Valerie Lewis, MD, MPH, Jessica Adams-Skinner Ed.D., M.P.H., Michelle Flores R.N., John Dumnich, Nancy Taylor University of Scranton, Lehigh Valley Health Network Department of Community Health and Health Studies METHODS Participants  Pregnant females who intend to maintain their pregnancy, give birth and raise their child(ren), and/or females who are currently parenting a child to whom they have given birth  13 to 18 years of age  Residents of Allentown, PA  Ability to speak English fluently  No cognitive impairment that prevents participation in an ongoing dialogue about the research topic Data Collection  After informed consent was obtained, semi-structured face-to-face qualitative interviews were audio taped, then transcribed and coded. LIMITATIONS  To date only three participants have taken part in this study, limiting the generalizability of the findings.  Given the limited sample size not all emergent themes may have been captured.  A parenting adolescent, whose perspectives may differ from a pregnant one, was not represented in this study sample.  Recruitment challenges were addressed by disseminating flyers and information packets to a variety of community organizations that serve pregnant or parenting adolescents. CONCLUSIONS  Overall, participants had support from the father of the baby as well as their family members.  Participants were not fully aware of different birth control methods  Partner’s negative HIV/ STI status was an important factor in choosing not to continue or start a birth control method.  Participants lacked appropriate sex education, especially from their parents.  Participants perceived that they were viewed negatively and judged by the members of their church communities. BACKGROUND  Adolescent pregnancy is a gestation occurring in anyone 19 years old or younger.  Based on the National Vital Statistics Reports,from 1991 to 2011 the adolescent birth rate declined from 61.8 to 31.3 per 1,000 adolescents in the United States.¹ (see Table 1.)  Although the overall adolescent birth rate has declined, rates are still highest among African Americans and Hispanics.¹  In 2007, of all the births in the City of Allentown, 16.33% were to mothers 19 years of age or under compared to 9.32% in Pennsylvania as a whole. 21.44% of the births were to Hispanics in Allentown as compared to 18.19% for PA.² MY EXPERIENCE During my time as a Research Scholar I have had the opportunity to review the literature about adolescent pregnancy. I have gained a better understanding about adolescent pregnancy and the associated risks and resilience factors. Although this study had a small sample size, the emergent themes were consistent with the themes from similar studies. I participated in an interview with an adolescent mother and performed the debriefing at the end of the interview. I contacted different local agencies and distributed flyers to the various locations in order to increase knowledge of and enrollment in the study. Additionally, I learned the skill of coding and analyzing qualitative data. PURPOSE The purpose of this study is to explore and better understand the factors that influence adolescents’ choices to maintain their pregnancies. Demographicsn (%) Age 15-17 yrs3(100%) Attending or graduated high school 3(100%) Racial and Ethic Background Hispanic2(66%) Black/ African American1(33%) Medical insurance Yes No 2(66%) 1(33%) Unintended Pregnancy3(100%) RESULTS: MAJOR THEMES Views on Pregnancy & Abortion  The participants viewed pregnancy as a positive experience; there was a sense of happiness; the pregnancy made them feel more mature, strengthened relationships with parents, offered new perspectives, provided motivation to continue school, and resulted in a strong support system.  The participants believed that abortion and adoption were not options. They all believed that babies are a blessing, that the pregnancy is their responsibility, and that they are willing to provide the best for their children. “Only certain reasons as to why you should have an abortion. Like if you get raped or something like that. And nothing happened to me.” “Abortion isn’t really an option, just because of the fact that there is people out there that cant have kids, and it’s not really that child’s fault.” “I don’t want nobody else raising my baby when its really supposed to be my job.”  Although the participants saw the positives in their pregnancy they did realize that some sacrifices must be made such as a reduction in time spent with friends and participating in certain school activities and events. The change in body appearance was also a commonly expressed concern. Relationships with the Father of the Baby  All of the participants were in long-term relationships (> one year in duration) at the time of conception.  The fathers of the babies (FOB’s) were supportive of the pregnancy and relationships with the FOB’s were continued during the pregnancy.  One participant was engaged to be married to the FOB; all of the participants had a desire to marry the FOB in the future.  The participants expressed that adolescent fathers “complicated” things by worrying about providing for the baby and giving up their current lifestyle.  These expectant mothers felt that the FOB’s were not judged as harshly as they were for childbearing during adolescence. Views of Church  One participant had a positive view of church and felt accepted and was excited to bring her child to church.  Two participants expressed insecurities and lack of motivation to attend church during the pregnancy. “Everybody stares at you. You’re underage. You’re not married and you’re pregnant, you know… they don’t say it, but I’m pretty sure they think it… I just think it feels uncomfortable.” Views on Birth Control  All of the participants discussed birth control options with their partner. Only 2 of the 3 (66%) participants received HIV/STI testing together. After negative HIV/STI results, these 2 participants were less likely to use a birth control method. “Like in the beginning we used condoms…He got checked. So I don’t have to worry about no diseases or anything. The baby part was the last thing on my mind.”  Only one participant chose condoms as her birth control method. “Mainly him buying it, it was him using it, him throwing it away… it wouldn’t involve me as such.”  None of the participants discussed birth control methods with their parents prior to their pregnancy. “She [participant’s mother] probably would have said no, don’t have sex and kept me trapped. That’s why I didn’t come to her about it.” “I didn’t want to try taking birth control and her finding pills or me going to the doctor and needing my parents’ signature of something like that.” Relationships with Family Members  There was no history of adolescent pregnancy in two of the participants’ families; these two participants were raised in single mother households.  All the mothers of the participants expressed some disapproval of adolescent pregnancy, however, were eventually supportive of the participants and their decisions.  Extended family members had mixed feelings about the pregnancy; some were not as accepting and others were excited and involved in preparing for the birth. References 1. Hamilton BE, Martin JA, Ventura SJ. Births: Preliminary data for 2011. National Vital Statistics Reports. 2012;61(5). Table 2.. 2. PA Department of Health, Birth Statisticshttp://www.portal.state.pa.us/portal/server.pt?open=514&objID=809799&mode=2 Table 1. Adolescent Birth Rates in the City of Allentown vs. Pennsylvania PA 19 and under % 19 and underAllentown* 19 and under % 19 and under Total Births150322140069.32222336316.33 Hispanic13731249818.19115224721.44 % Hispanic9.13 51.82 Data Source : PA Department of Health, Birth Statistics * This was calculated using geocoded birth data