Self-Reported Pregnancy and Access to Primary Health Care Among Sexually Experienced New Zealand High School Students

• Published in: Journal of adolescent health 2011-11, Vol.49 (5), p.518-524
• Main Authors: Copland, Rachel J., M.B.Ch.B, Denny, Simon J., M.P.H., F.R.A.C.P, Robinson, Elizabeth M., M.Sc, Crengle, Sue, Ph.D, Ameratunga, Shanthi, Ph.D, Dixon, Robyn, Ph.D
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior - psychology; Biological and medical sciences; Community Health Centers - statistics & numerical data; Confidentiality; Cross-Sectional Studies; Developmental psychology; Ethnic differences; Female; Fundamental and applied biological sciences. Psychology; Gynecology and obstetrics; Health care; Health services accessibility; Health Services Accessibility - statistics & numerical data; Health Services Research; Health surveys; High schools; Humans; Male; New Zealand; New Zealand - epidemiology; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Pediatrics; Pregnancy; Pregnancy in adolescence; Pregnancy in Adolescence - psychology; Pregnancy in Adolescence - statistics & numerical data; Pregnant adolescent girls; Primary health care; Primary Health Care - statistics & numerical data; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; School Health Services - statistics & numerical data; Sexual Behavior - statistics & numerical data; Students - psychology; Students - statistics & numerical data; Surveys and Questionnaires
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2011.04.002

Abstract Purpose To determine the prevalence of self-reported pregnancy among sexually experienced high school students, and the association between teenage pregnancy and access to primary health care. Methods Between March and October 2007, 96 high schools throughout New Zealand participated in Youth'07, a cross-sectional Health and Wellbeing survey. The dataset included 2,620 (1,217 females and 1,403 males) year 9 through 13 students who reported ever having sexual intercourse and responded to a question about whether they had ever been pregnant or ever caused a pregnancy. Results Nationwide, 10.6% of sexually experienced high school students self-reported that they had been pregnant (11.6%) or caused a pregnancy (9.9%). Māori (15.3%) and Pacific Island (14.1%) students had the highest self-reports of pregnancy. Foregone health care was reported by 24.2% of sexually experienced students. Students who self-reported pregnancy reported greater difficulty accessing health care (41.7% vs. 20.6%; odds ratio: 2.6); however, when they accessed care, the majority received confidential care (67.4%) as compared with pregnancy-inexperienced peers (51.6%). Concern about privacy was the most common reason for not accessing health care. Other barriers included uncertainty about how to access care and lack of transportation (all p values < .05). Conclusions Self-reported pregnancy among sexually active high school students in New Zealand is high and ethnic disparities exist. Being pregnant or causing a pregnancy is associated with difficulty accessing health care. Further research is needed to identify drivers for ethnic differences and determine what the cause-and-effect relationship between teenage pregnancy and access to health care looks like.