Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Trace Kershaw

Second Advisor

Megan Smith

Abstract

Objective

Adolescent mothers are at high risk of repeat pregnancy and repeat birth with short birth intervals. Perceived stress is known to affect young women's use of contraception, and therefore risk of unintended pregnancy. The primary aim of the study was to examine how stress, stressful life events, discrimination and economic hardship affect adolescent mothers' risk for repeat pregnancy. Secondary aims included examining if the association between stress and repeat pregnancy was mediated by contraception use, if the stress experienced by the mother's partner was associated with risk of pregnancy and if the association between stress and repeat pregnancy was mediated by social support and family functioning.

Methods

Data was obtained from a subset of participants from a longitudinal study of pregnant adolescent females and their partners. Couples completed individual structured interviews via audio computer-assisted self-interview (ACASI) during pregnancy and at six and twelve months postpartum. The association between the predictors and repeat pregnancy was examined using logistic regression.

Results

Stressful life events (OR: 1.52, 95% CI: 1.13, 2.03) and discrimination (OR: 2.35, 95% CI: 1.16, 4.76) were associated with greater risk of repeat pregnancy. Contraception use did not mediate the association between the predictors and repeat pregnancy.

Conclusions

The results of this study suggest that adolescent mothers that experience mental distress, and specifically stressful life events and discrimination, are at a greater risk of repeat pregnancy. The results support the need for postpartum services that address the physical health as well as the mental health of adolescent mothers to help them avoid a repeat pregnancy.

Comments

This is an Open Access Thesis.

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