Important but far away: adolescents’ beliefs, awareness and experiences of fertility and preconception health

Figures & data

Figure 1. Flowchart of recruitment process.

Table 1. Examples of the analytical process.

Interview transcript	Initial coding	Sub-category	Category	Theme
That’s a bit tough because you … I’ve actually thought about this. You study … first, you go to high school, then maybe you want to have a year before university. I don’t know, to travel and such. Then you study a little longer. I don’t know how long I want to study. If you are going to be a doctor, it will take a really long time. And then you have to get a job. If you are pregnant then too … you have to be home for a year; there is no real end. (FG 6)	First travel, study for a long time and work before having children	Live life and be ready before starting a family	1: Starting a family far down on the list	Important but far away
It’s a bit hard to say, because we don’t know what we don’t know. (FG4)	Difficult to say what is needed as we don’t know what we don’t know	Want to know ‘everything’/what we need to know	2: High awareness but patchy knowledge of fertility and preconception health
It’s hard for girls if they want to get pregnant while they are studying. Exactly. But it’s easier for boys: they can just keep on working, watch the child as it grows up; then they are on parental leave for, like, 6 months. It’s not exactly the same thing, right? A woman is gone from the job for almost 2 years. (FG6)	Building a family is tougher for girls than for boys; women are away from their jobs for longer compared with men	Different conditions for boys and girls	3: Gender roles influence beliefs about fertility and preconception health
Yes, it’s unnecessary to close a door that you might really want to keep open. (FG7)	Unnecessary to close a door that you want to keep open	Why information and planning ahead are important	4: Wish to preserve fertility and preconception health in order to keep the door to procreation open
But it’s kind of like when you go to middle school, and when you become 15, 16, then maybe it’s good … Maybe it’s good to know about risks, since the older you become … That you split it up, so you don’t get it all at once. It feels like some stuff you don’t need to know when you are 15 years old. It could be better if you knew that later on; otherwise, you would just forget it. (FG2)	Adapt the information according to age; separate the information so it is not all provided at once; some information is better given later, otherwise it is forgotten	Wishes for age-appropriate and repetitive information	5: No panacea – early and continuous education about fertility and preconception health

FG: focus group.

Table 2. Characteristics of and background knowledge regarding fertility and preconception health among participating students (n = 47).

Characteristic	n
Age in years, mean (SD)	17.6 (1.0)
Sex
Female, n (%)	17 (36.2)
Male, n (%)	30 (63.8)
Educational programme
University preparatory programme, n (%)	22 (46.8)
Vocational preparatory programme, n (%)	25 (53.2)
Country of birth
Born in Sweden, n (%)	41 (87.2)
Born outside Sweden, n (%)	6 (12.8)
Background knowledge of fertility and preconception health
How long does an ovum live?
1 day, n (%)^a	5 (10.6)
3 days, n (%)	32 (68.1)
5 days, n (%)	10 (21.3)
How long can sperm survive in the woman’s body after intercourse?
12 h, n (%)	11 (23.4)
1 day, n (%)	22 (46.8)
5 days, n (%)^a	14 (29.8)
At what age is there a marked decline in a woman’s ability to become pregnant?
30 years, n (%)	0 (0)
35 years, n (%)^a	17 (36.2)
40 years, n (%)	30 (63.8)
When should one start taking folic acid if planning a pregnancy?
At least 1 month before pregnancy, n (%)^a	31 (66.0)
At conception, n (%)	7 (14.9)
1 month into the pregnancy, n (%)	9 (19.1)
Which factor has an irreversible effect on fertility?
Smoking, n (%)	17 (36.2)
Weight, n (%)	2 (4.3)
Age, n (%)^a	28 (59.6)
What was the average age of mothers at the birth of their first child in Sweden in 2011?
26 years, n (%)	12 (25.5)
29 years, n (%)^a	31 (66.0)
32 years, n (%)	4 (8.5)
What is the chance of having a child with one attempt at IVF?
0–5%, n (%)	2 (4.3)
25–30%, n (%)^a	29 (61.7)
55–60%, n (%)	16 (34.0)
Desired number of children
0, n (%)	2 (4.3)
1–2, n (%)	31 (66.0)
3 or more, n (%)	14 (29.8)

IVF: in vitro fertilisation.

^aCorrect alternative.

Figure 2. Overview of the theme and categories.