Why don't teenagers use contraception? A qualitative interview study

Abstract

Objectives To investigate the causes of unintended pregnancies and, in particular, reasons for non-use of contraception among young women attending a day unit for surgical abortion.

Methods Women between the ages of 16 and 20 attending a day unit at a hospital in the north of England who were due to have, or had recently had, a surgical abortion were interviewed about their knowledge of and views on contraception, sex education, and sexual health services. Twenty-four young women were interviewed, 22 on the day unit, one in her home and one over the phone, after the abortion. Interviews were recorded with the consent of the interviewees and fully transcribed. Transcripts were analysed using a grounded theory approach.

Results The most common reasons for non-use of contraception related to forgetting or ‘not thinking’, being ‘in the moment’ (i.e., being ‘in the mood’, not wishing to ‘break a spell’), the influence of alcohol, and pressure from young men not to use condoms. Lack of knowledge was rarely cited as a reason.

Conclusions Young people are aware of the need to use contraception, and knowledgeable about its availability; however, they often do not think about using it, especially where sex is unplanned. Alcohol and being ‘in the moment’ are key factors which diminish the likelihood of contraceptive use.

KEY WORDS:

• Contraception
• Teenagers
• Pregnancy
• Abortion
• Qualitative

Acknowledgements

The authors acknowledge the assistance of Ms Gail Teasdale and Mrs Helen Thornton-Jones in the design of this study. We also thank the nurses on the GDU and the young women who took part for their contributions. The study was funded by the Teenage Pregnancy Unit, Hull City Council.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.