Factors Related to Repeated Pregnancy in Adolescents, Phetchaburi Province - ปัจจัยที่มีผลต่อการตั้งครรภ์ซ้ำในแม่วัยรุ่น จังหวัดเพชรบุรี

บทคัดย่อ

           Repeated pregnancies in adolescent mothers have caused health-related, economic and social problems against adolescent mothers in respect of health, families, and the nation at large. This study aimed to explore factors affecting repeated pregnancies among adolescent mothers in Phetchaburi province. A mixed method study was designed to address the purpose of the study, whereby the quantitative research was in a case-control design. The samples were adolescent mothers who received antenatal care services at general hospital and all community hospitals in Phetchaburi province. There were 122 persons experiencing repeated pregnancies within 24 months and 202 persons with such experience within more than 24 months.

            The data were collected from these samples by using questionnaires. In-depth interview was conducted with 10 adolescent mothers with repeated pregnancies. Data analysis was conducted by using frequency, percentage, Chi-square, Fisher’s exact test, and binary logistic regression. It was found that the pregnancy history of adolescent mothers, attitudes towards pregnancy and motherhood, and birth control experiences were associated with repeat pregnancies in adolescent mothers. In this regard, adolescent mothers who had normal pregnancies were likely to have 56.1 times repeated pregnancies than those experiencing unusual pregnancies or complications during pregnancy and delivery. Mothers who had positive attitudes towards pregnancy and motherhood were likely to have repeated pregnancies by 1.1 times of those with negative attitudes. Adolescent mothers without contraception experiences were likely to have repeated pregnancies by 3.8 times of those regularly performing contraception behaviors (p<0.05). Based on the in-depth interview, it was found that repeat pregnancies were mostly caused by a failure to prevent pregnancy after delivery since adolescent mothers had no knowledge of contraception methods; and experienced complica tions from contraception use. Thus, they stopped contraception practice, and eventually experienced repeated pregnancies. The results of this study suggest that responsible administrators should promote policy implementation and strengthen coordination with public authorities, families, and educational institutes in the community. Public health personnel in health centers should provide knowledge on self-care and detect complications during pregnancy and antenatal period, and encourage pregnant adolescents to receive routine antenatal care services, as well as educate and suggest suitable contraception methods for each mother during a postnatal period, including the recommendation of permanent contraceptive methods for those who already have sufficient children. More efforts should be paid to develop programs for prevention of repeated pregnancies among high-risk adolescent mothers screened from their pregnancy history; contra ceptive practice, and intention to have another child during a postnatal period in order to ensure efficient surveillance and prevention of repeated pregnancies in adolescent mothers.

Key words: repeated pregnancies, adolescent  mothers