Raquel Pires

Preventing Adolescent Pregnancy: Biological, Social, Cultural, and Political Influences on Age at First Sexual Intercourse

Age at first sexual intercourse (AFSI) is the initial factor related to adolescents’ sexual life that may increase the risk of adolescent pregnancy. We explored the biological, social, cultural, and political predictors of AFSI addressing several gaps that prevent us from generalizing the results of past research to adolescent pregnancy prevention. We also explored the moderating effects of cultural variables on the links between social and political predictors and AFSI. Our sample consisted of 889 Portuguese female adolescents aged 12–19. Earlier age at menarche, non-intact family structure, maternal history of adolescent pregnancy, lower maternal emotional warmth, absence of religious involvement, and living in Portugal’s mainland and in a legal context penalizing abortion predicted earlier AFSI. School attendance predicted earlier AFSI among adolescents of European ethnic origin; adolescents of non-European ethnic origin presented the opposite, but non-significant, pattern. These findings suggest that, in addition to isolated characteristics, factors from different ecological contexts should be considered when planning interventions designed to foster healthy and informed transitions to sexual initiation and prevent the related risks of unwanted outcomes. We discuss implications for future research and practice.

Psychosocial adjustment after induced abortion and its explanatory factors among adolescent and adult women

Abstract Objective: To compare the depressive symptoms and quality of life (QoL) among adolescents (<20 years) and adult women who have had an abortion and to explore individual, social, relational and decision-making explanatory factors for (mal)adjustment in each group. Background: International findings are not consistent regarding the presence of negative psychosocial outcomes after abortion or about the explanatory factors for occurrence among adolescents and adult women. Methods: In this cross-sectional study, 177 adolescents (65.1%) and 95 adult women (34.9%) who underwent abortion were recruited. Data on individual, social, relational and decision-making characteristics, depressive symptoms (Edinburgh Postnatal Depression Scale) and QoL (EUROHIS-QOL-8) were collected through self-report questionnaires at 16 healthcare services that provide abortion. Results: Although adolescents are not at greater risk of maladjustment than adult women, abortion may be an emotionally significant event for both age groups. Regarding adolescents, feelings of being pressured into abortion and lower satisfaction with the abortion decision were significantly associated with depressive symptoms and lower QoL. Lower support from the mother was also associated with lower QoL. With regard to adult women, lower satisfaction with the abortion decision was significantly associated with depressive symptoms. None of variables was significantly associated with QoL. Conclusion: Our results suggest that adolescents are not at greater risk of psychosocial maladjustment than are adult women. Factors from different ecological contexts and specific factors depending on age group should be considered in preventive interventions for (mal)adjustment after abortion.

Sociodemographic, sexual, reproductive and relationship characteristics of adolescents having an abortion in Portugal: a homogeneous or a heterogeneous group?

Abstract Objectives: The aims of the study were to describe the sociodemographic, sexual, reproductive and relational characteristics of adolescents having an abortion in Portugal and to explore the differences between three adolescent age groups. Methods: We recruited a nationally representative sample of 224 adolescents (<16 years, n =  18; 16–17 years, n =  103; 18–19 years, n =  103) who had an abortion. Data were collected from 16 health care services that provide abortion. Results: The adolescents were predominantly single, were from non-nuclear families, had low-socioeconomic status and were students. Mean age at first sexual intercourse was 15 years and mean gynaecological age was 5 years. Most had had multiple sexual partners, and for most it was their first pregnancy. At conception, the majority were involved in a long-term romantic relationship, were using contraception but did not identify the contraceptive failure that led to the pregnancy. Significant age group differences were found. Compared with the younger age groups, the 18–19 year age group was more frequently married or living with a partner, had finished school, had attained a higher educational level (as had their partner), intended to go to university, and had a greater number of sexual partners. Compared with the other groups, those under 16 years of age reported earlier age at menarche and at first sexual intercourse, and had a lower gynaecological age. Conclusions: Our study characterises the life contexts of Portuguese adolescents who had an abortion. It highlights the need to recognise the heterogeneity of this group according to age. The findings have important implications for the development of age-appropriate guidelines to prevent unplanned pregnancy.

The Impact Of Gynecological Cancer On Reproductive Issues And Pregnancy: Psychological Implications

Gynecological cancer is the fourth most common form of cancer among women. Over the past few decades, the growing number of survivors has been forced to cope with the consequences of the disease. Of these consequences, the impact of cancer on reproduction has been receiving increasing attention. Research shows that the health care of these women poses challenges other than medical ones. Although the inclusion of psychologists in health care teams has been particularly valued, studies focusing on the psychological implications of the impact of gynecological cancer on reproduction are scarce. Therefore, the first aim of this review is to critically reflect on the psychological implications of infertility, decision-making regarding childbirth, and pregnancy in the context of gynecological cancer. The second purpose of this review is to provide practice guidelines that account for the specificities and demands of these patients. Our findings suggest that gynecological cancer entails specific emotional and decisional challenges regarding reproductive issues, highlighting the importance of specialized psychological interventions with patients and their families. Providing emotional support and education about sexual and reproductive difficulties, supporting decision-making about fertility preservation and childbirth, promoting adjustment to cancer during pregnancy and supporting transition to motherhood are the main areas of intervention suggested. A

Reproductive and relational trajectories leading to pregnancy: Differences between adolescents and adult women who had an abortion

OBJECTIVES The literature has been conceptualizing pregnancy occurrence as a multiphase event. However, the different combinations of decisions and behaviors leading to pregnancy that end in abortion remain unexplored in the literature. The aims of the study were to describe the reproductive and relational trajectories leading to pregnancy in women who decide to abort and to explore the differences in this process according to womens age [adolescents (<20 years old) vs. adults]. STUDY DESIGN In this cross-sectional study, 426 women [246 adolescents (58.4%), 177 adults (41.6%)] who chose abortion were recruited. Data on reproductive and relational characteristics were collected through a self-report questionnaire at 16 healthcare services that provide abortion. The variables were introduced in trajectories according to the criterion of temporal sequence between them: age at first sexual intercourse, relationship type, pregnancy planning, use of contraception, identification of contraceptive failure, and occurrence of pregnancy. RESULTS Seven trajectories leading to pregnancy were identified. The most frequent trajectory (30.8%) included women who 1) were involved in a long-term romantic relationship, 2) did not plan the pregnancy, 3) were using contraception, and 4) did not identify the contraceptive failure that led to pregnancy. Although this was the most frequent trajectory for both age groups, the remaining trajectories showed a different distribution. Compared to adolescents, adult womens trajectories more frequently included casual relationships with non-use of contraception, or contraceptive use with no contraceptive failure identification. CONCLUSION Our study highlights the need to recognize the multiplicity of reproductive and relational trajectories leading to pregnancies that end in abortion and their specificities according to womens age. These findings have important implications for abortion counselling and for the development of age-appropriate guidelines for preventive interventions, by drawing attention to prioritization of different contexts of intervention according womens age.