Adolescent men’s attitudes and decision-making in relation to an unplanned pregnancy. Responses to an interactive video drama
Highlights
► An interactive video drama was used to elicit hypothetical pregnancy-related decisions of young male adolescents. ► Adolescent men were more likely to choose to keep the baby in preference to abortion or adoption. ► Keeping the baby was related to expected abortion regret, perceived positive response of own mother and levels of religiosity.
Introduction
Understanding adolescent pregnancy has been a key focus in scientific research and public policy priorities across western developed nations for almost three decades. What is clear, however, in all of this immense research is the relative absence of research in relation to adolescent men and adolescent pregnancy and, particularly, in relation to adolescent men’s involvement in pregnancy resolution decisions. The aim of this study was to explore adolescent men’s decisions in relation to resolving a hypothetical unplanned pregnancy in their lives and to deepen understanding of the psychological and sociological determinants of their hypothetical decisions. A greater understanding of adolescent men’s views on adolescent pregnancy and pregnancy resolution would re-frame adolescent pregnancy as an issue for adolescent men as well as adolescent women and would inform gender inclusive pregnancy prevention and counselling programmes (Lohan, Cruise, O’Halloran, Alderdice, & Hyde, 2010).
The social context of the study is noteworthy. In the Republic of Ireland, it is illegal to have an abortion except where there is a real and substantial risk to the life (as distinct from the health) of the mother. Women living in Ireland who decide on abortion/termination as a resolution to pregnancy travel outside of the country (usually to Great Britain) to clinics or hospitals offering such services (Layte et al., 2006). The pregnancy rate for under twenty-year olds was 26.1 per thousand in 1980 and has steadily declined to 19.8 in 2009. The rate of abortion has not similarly dropped over time. In 1980, the rate of abortion was 3.1 per thousand rising to a peak of 6.0 in 2001 while falling back to 3.5 in 2009 (M. O’Brien, Crisis Pregnancy Programme (CPP) personal communication, November 12th, 2010). There is no evidence to suggest a trend of illegal abortion. Ireland’s proximity to the UK and the accessibility of its abortion services may have prevented a trend in illegal abortions occurring in Ireland. In 2009, the Irish Customs Authority, working in partnership with the Irish Medicine’s Board, detected 62 cases (or packages) of importation of abortion-inducing substances. While purchasing abortion pills may develop as a trend into the future, at present the numbers are very low (M. O’Brien, CPP, personal communication, 8th December, 2010).
A systematic review of the extant literature on adolescent men and pregnancy resolution (Lohan et al., 2010) suggests that, in common with the study reported here, two previous studies used a role-play or vignette, combined with a questionnaire, to probe adolescent men’s hypothetical decisions and decision-making processes. In a US-based study that presented adolescent men with a hypothetical scenario of an unplanned pregnancy in an ongoing relationship, adolescent men were more likely to choose to keep the baby and least likely to choose abortion (Marsiglio, 1988, Marsiglio, 1989, Marsiglio and Menaghan, 1990). In a similar Australian study, adolescent men were somewhat more likely to choose abortion (39%) over ‘keep the baby’ (30%) or ‘leave it up to her’ (30.9%) (Condon, Corkindale, Russell, & Quinlivan, 2006). There is also a small body of literature that describes accounts of adolescent men’s actual pregnancy decision-making experiences (Buston, 2010, Cater and Coleman, 2006, Holmberg and Wahlberg, 2000, Redmond, 1985, Vaz et al., 1983). Beyond these studies, there is a larger body of literature on adolescent men’s attitudes to abortion, with particular reference to men’s right to be involved in pregnancy termination decision-making. This literature has been almost exclusively conducted in the United States (hereafter US) (Boggess and Bradner, 2000, Ku et al., 1998, Marsiglio and Shehan, 1993) (for exceptions see Agostino and Wahlberg, 1991, Hooke et al., 2000) and, in particular, amongst small and convenience samples of college men in the US (Coleman and Nelson, 1999, Esposito and Basow, 1995, Jones, 2006, Nelson et al., 1997, Ryan and Dunn, 1983). We begin by elaborating our hypotheses in the context of the current literature relating to adolescent men.
Section snippets
Background literature
Explanations of adolescent men’s attitudes to an adolescent pregnancy and pregnancy outcome choices are principally derived from a social constructivist model of human actions, incorporating variables that reflect adolescent men’s social context (such as social class) and underlying values (such as religiosity). We refer to these as distal variables. In addition, the Theory of Planned Behaviour (Ajzen, 1988, Ajzen and Madden, 1986) suggests that a person’s attitudes towards a behaviour
Research design
The data come from a cross-sectional survey of adolescent men attending secondary schools in the Republic of Ireland between September 2008 and September 2009. The study was approved by the School of Nursing and Midwifery Research Ethics Committee at Queen’s University Belfast.
Participants
We divided the country into four regions of equal size. Within each region, we wished to recruit schools that represented variation in terms of the following criteria: socio-economic advantage/disadvantage, urban/rural,
Descriptive analysis
The socio-demographic profile of the sample suggests a reasonable cross-section of the adolescent male population in high schools in Ireland. The modal age of participants was 15 years and most participants (75.3%) were aged 15 or 16 years old. In relation to social class, 43% were of professional and managerial classes (work that requires degree level qualifications) and 57% were from lower middle class, skilled and unskilled working class and other (including never worked). In relation to
Discussion
The results of our study suggest that the choice to keep the baby is the preferred choice – almost half (46.7%) of adolescent men would choose to keep the baby. Abortion was the next most preferred choice (18.9%). Thus, these Irish male adolescents show similar pregnancy outcome choices to the comparable US study (Marsiglio, 1989, Marsiglio and Menaghan, 1990), but were much less likely to choose abortion than respondents in the Australian study (Condon et al., 2006).
How might we explain
Limitations
The hypothetical nature of our data does not permit us to draw conclusions about adolescent men’s actual experiences of an unplanned pregnancy or the negotiated process of pregnancy decision-making. Further limitations are that we did not differentiate in our analysis those who were sexually active and those who were not, those who had experienced an unintended pregnancy and those who had not and between those who identify as heterosexual and those who do not (we perceived that the inclusion of
Acknowledgements
Funding for this study was obtained from the Health Services Executive Crisis Pregnancy Programme (Ireland). The paper represents the views of the authors and not that of the funding organisation. The authors are grateful to all the schools and adolescent men who participated in the study and to Drs John Garry and Chris Cardwell, Queen’s University Belfast, for statistical advice.
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