Adolescent men’s attitudes and decision-making in relation to an unplanned pregnancy. Responses to an interactive video drama

Abstract

This study confronts a gender bias in research on adolescent pregnancy by exploring adolescent men’s decisions relating to a hypothetical unplanned pregnancy. A cross-sectional survey was conducted with adolescent men (N = 360) aged between 14 and 18 years attending schools in the Republic of Ireland. The study, the first of its kind in Europe, extends the small body of evidence on adolescent men and pregnancy decision-making by developing and examining reactions to an interactive video drama used in a comparable study in Australia. In addition, we tested a more comprehensive range of sociological and psychological determinants of adolescent men’s decisions regarding an unplanned pregnancy. Results showed that adolescent men were more likely to choose to keep the baby in preference to abortion or adoption. Adolescent men’s choice to continue the pregnancy (keep or adopt) in preference to abortion was significantly associated with anticipated feelings of regret in relation to abortion, perceived positive attitudes of own mother to keeping the baby and a feeling that a part of them might want a baby. Religiosity was also shown to underlie adolescent men’s views on the perceived consequences of an abortion in their lives.

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.