A Closer Look at Pregnancy Prevention among Adolescent Women in Jinotega, Nicaragua

Background: Young women in Nicaragua have the highest rate of teenage pregnancy within the Western Hemisphere. In Jinotega, Nicaragua, a staggering 36% of adolescent girls aged 15-19 are already mothers. Adolescent pregnancy adversely impacts physical and emotional health, and access to educational and economic opportunities. Methods: To identify factors that contribute to high rates of teenage pregnancy, 175 surveys were administered, and 2 focus groups were held with young women ages 13-19 in Jinotega. Preliminary findings reveal a majority of young women felt sex is best initiated between the ages of 18-20. Pregnancy prevention education and contraceptives are accessible and young women report the desire to prevent teenage pregnancy, however, most young women report not using contraceptives. Teenage Pregnancy is often socially unacceptable and can bring great shame to a young woman's family. Another significant finding indicated that there is a dramatic imbalance of power between men and women, as “machismo” carries excessive power and influence. This power dynamic leads to young women feeling pressured to initiate sex at an early age and contributes to an inability to negotiate condom use, as a way to further please their partners. These findings demonstrate the pressing need for the development of a peer support model that would allow older teens to facilitate discussions and skill building exercises with younger girls. The focus would be on pregnancy prevention through the lens of healthy relationships, assertive communication, self-exploration and self-esteem building.