Adolescent sexual decision-making: contraception, pregnancy, abortion, motherhood.

A study was undertaken to define the contribution of developmental parameters to adolescent sexual decision making. Only 1 aspect was examined: once sexually active, what factors distinguish between those who are successful contraceptors and those who become pregnant. 206 sexually active adolescent females between ages 15-18 were studied. 29% were successful contraceptors, 24% were aborters, 24% were currently pregnant, and 23% were mothers at the time of the study. The study focuses on ego development, locus of control, future time perspective, moral development, sex role socialization, and irrational beliefs. Aborters were found to have the most developed future time perspective, lowest demand for external approval, and lowest dependency needs. Teen mothers were found to have the least developed conceptualization of the future, highest level of anxiety and rumination, most external locus of control, and had internalized the most traditional notion of female sex roles. Adolescence is a period of experimentation which becomes the substrate for cognitive growth. Through experimentation one begins to develop an internal locus of control and anticipates the impact that certain actions will have on others. Over time the sense of control and limits of influence are internalized and the need to continually validate it through experimentation is diminished. It would therefore be expected that those with a less internalized locus of control would be more likely not to use contraception. Throughout adolescent life one begins to understand time as an abstract concept and the adolescent begins to perceive herself as a being who will live in the future as well as in the present and past. The notion of prevention is predicated upon a personal conception of future; those adolescents who have the least developed future perspective are most at risk for unwanted pregnancy. In addition the adolescent must feel that the future promises something so that there is competition to the present reality of pregnancy and motherhood. Understanding these processes will enable physicians to guide the adolescent at an appropriate level.