Pregnancy intentions, contraceptive use, and subsequent births among adolescent and adult mothers

A two year period between births is recommended (Healthy People 2010); however, this is not met by a large percentage of women, especially teenagers and women of color, with potentially major adverse child consequences (Klerman, 2004). We explore whether (1) pregnancy spacing intentions, after a first birth, predicted contraceptive use (2) spacing intentions predicted actual spacing of births and (3) any differences in expected direction in the average time to second deliveries between mothers occurred during the 36 months postpartum in a landmark NICHD 4-site longitudinal study of 682 first-time mothers (396 adolescent; 162 adult mothers matched in ethnicity and resources; 124 matched in ethnicity but with higher resources); 65% African American, 19% European American, 14% Hispanic/Latina. Findings: (1) 49% of adolescent and 47% of adult low resource mothers did not ever want to get pregnant again; (2) about 2/3 of mothers reported using any contraceptive; (3) 39% of adolescent mothers and 24% of adult low resource mothers were pregnant before their first child was two years; (4) of those who did not want to get pregnant again, 37% of adolescent mothers versus 16% of adult low resource mothers were pregnant again within 2 years; (5) survival analyses indicate over a 3 year period, adolescent mothers began having children earlier, many within one year of the first birth, and by two years postpartum a much larger percentage of teenagers than either adult group had given birth. Health promotion recommendations for addressing the needs of first-time mothers in terms of clinical, research, and educational applications will be presented.