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Chapter 5: Findings about pregnancy
5.1 Suspecting or confirming pregnancy
A substantial proportion of the male and female callers who contacted ChildLine regarding pregnancy, stated that they knew themselves to be pregnant or that they had been informed that a female partner had become pregnant. Approximately a third of the young people whose pregnancy was confirmed indicated that they had had been seen by a health professional: family planning clinic, health centre, hospital or GP. A large number of other narratives stated simply that the caller had done a test and it was positive, suggesting that it was a home pregnancy test, although often this was not specified. However, a very large number of young women and a proportionately large number of young men stated that they thought that they or their girlfriend was pregnant, or that they were worried about the possibility of pregnancy. In many narratives it was indicated that the caller had not conducted a pregnancy test. In some narratives there were specific reasons for this, for example some callers described feeling too scared or nervous to have a test, some indicated that they did not want to get a test or were not sure if they wanted to, and others were phoning because they didn't know how or where to get tested, for example:
Had sex with boyfriend; didn't use protection; scared to do a pregnancy test; thinks mum will go mad. ( PREG, 2003, FC, 13 years)
The young people (all female callers) who did not know how or where to get a pregnancy test indicate a knowledge gap that could be addressed by sex and relationships education. However, some young women evidently had knowledge about where to get advice and information about pregnancy, but nonetheless also sought support, information and/or advice from the ChildLine service. The relatively few calls expressing concerns about confidentiality nevertheless highlight the importance of continuing to educate young people about services and their rights to confidentiality, as well as providing information about where to access services and what they offer.
5.2 Identifying pregnancy
Both those callers who suspected pregnancy and those who had had it confirmed by a test often described physical changes or symptoms that they believed might indicate pregnancy, and often it was these changes that had prompted them to have a test. Many callers described having experienced more than one change or symptom occurring at a time, most frequently, missed/late period, weight gain, morning sickness and stomach pain.
However, other than physical changes and symptoms, the other major reason given by a large proportion of callers for thinking that they were pregnant was that they had had unprotected sex. Some narratives did not describe any indications or symptoms of pregnancy, suggesting that callers' main or only reason for thinking they might be pregnant was that they had had unprotected sex. In many calls, though, physical changes and symptoms were discussed with reference to having had unprotected sex, therefore indicating that this combination of factors was creating the concern. The extent to which young people were worried about pregnancy following unprotected sex and in the absence of other indications of pregnancy, suggests that some of these young people perceived pregnancy to be a very likely or certain consequence of unprotected sex. This perception, coupled with the apparent distress and concern regarding pregnancy, is interesting as it suggests a desire not to be pregnant, and a clear awareness of the risk involved in unprotected sex, yet neither of these factors had prevented the young person from having unprotected sex.
5.3 Factors related to teenage pregnancy
In the majority of narratives the context in which the caller had had sex and become pregnant were not indicated. For example, it was not clear if the callers had the knowledge and skills to have safe sex, nor what ways in which the context might have led to their having unprotected sex. Nonetheless, many callers did describe salient contextual factors that had clearly contributed to their decision not to use protection. Most commonly, young people described sex that had happened when they were at a party, and/or when they had been drinking. In describing themselves as having been drunk or drinking when they had had sex it was apparent in most narratives that callers were indicating a loss of control which had led them to have sex. The suggestion from this, though not explicitly stated in the narratives, was that these young people did not think they would have had sex had they been sober, for example:
Was drunk and had sex with boy. Think I might be pregnant. Had sex last month, had one day heavy bleeding 3 weeks after sex. No pregnancy test. No condom. We were drunk. I am not drinking ever again. I am going to have an abortion if I am pregnant. ( PREG, 2004, FC, 14 years)
However, it is important to note that, whilst these factors were discussed in many narratives, it was much more common that callers indicated they had had sex with their partner, suggesting that sex, and perhaps unprotected sex, had been an ongoing facet of their partner relationship, for example:
14 year old caller thinks she is pregnant. Got drunk at party 1 month ago. Had sex with boyfriend. Was pressured by friends to drink alcohol. Known boyfriend for about 2 months. He is really nice. He is 15 years old. Didn't use condom. Was really drunk. ( PREG, 2004, FC, 14 years)
It is clear from these narratives that alcohol and parties are seen as contributing to unprotected sex and pregnancy by young people, particularly perhaps when in conjunction. From the facts of life data it was also apparent that perceptions of peer expectations could exert pressure on young people to have sex, in order to fit in and to avoid peer exclusion. The combination of an alcohol-induced lack of control with the party/peers context seems to be highlighted by callers as particularly conducive to risk of unprotected sex. These data suggest that there would be value in further research to explore these contexts with young people and how they contribute to decision-making regarding sex and protection. Education might also seek to explore the development of practical skills, such as carrying condoms to parties, as well as ways that young people can support each other at parties and in similar contexts where they are more at risk.
5.4 Emotional reaction
By far the most common emotions expressed about pregnancy by callers of all ages, male and female, were fear and worry. Many narratives simply stated that callers were afraid worried or upset because they were, or might have been pregnant. Callers who did not know if they were pregnant often expressed fear or worry that they would be, and many expressed fears about conducting a test. Very often, callers described feeling most afraid of how their parents would react, for example:
Pregnant - been to GP and now 5 months pregnant. Wants a termination before mum and dad find out. Does not want to hurt them. Worried and does not know where to turn. ( PREG, 2004, FC, 15 years)
Got girlfriend pregnant, feel scared. ( PREG, 2004, MC, 16 years)
Many callers also described feeling confused, often about their options and about trying to make a decision. Some were confused or conflicted in their feelings about the pregnancy, and described feeling both happy and sad or unsure what they felt about the pregnancy. Some expressed anger or shock and it was only in a small number of narratives that young women said that they were happy about being pregnant or expressed mixed emotions including feeling happy to some extent about it. All of the feelings outlined in this subsection highlight the enormous difficulty young people faced in dealing with pregnancy, make it potentially very difficult for them to think clearly about their options, and suggest the importance of having support and help.
5.5 Options and decision-making
A central concern in many narratives was what options were available to young women who were pregnant and their partners, and how to decide what to do. It is also evident from the analysis that there is considerable diversity amongst young people in terms of what options they favour, and why. Thinking about options and making decisions was a highly complex process, with young people often struggling with a number of considerations and difficulties beyond simply what they themselves wanted to do about the pregnancy. It seemed that many young people were using the ChildLine service, at least in part, to explore their options and facilitate their decision making. A large number of young women and, proportionately, many young men said that they did not know what to do about being pregnant, indicating a need for information and support, for example:
Has taken 2 pregnancy tests. One positive and one negative. Has not had a period for 4 moths. Does not want to have baby. No abortion because it is murder, caller is going to talk to GP about what he can do to help. ( PREG, 2003, FC, 14 years)
A large number of callers, both those who thought they might be pregnant and those who knew they were pregnant, stated that they did not want the baby. A very large proportion of the narratives from young women and men contained discussion about the option of abortion. Proportionately there were also many male callers who stated that they did not want the baby, for example:
I've got my girlfriend pregnant, want to know what options I have, I do not want to keep the baby, she isn't sure, feel as though I'm too young to be a father. ( PREG, 2003, MC, 17 years)
But there were many callers who said they wanted to keep the baby, for example:
Girlfriend pregnant. She wants an abortion and I want her to have the baby. 4 months pregnant, been to doctor. It will change life, a lot more responsibility. ( PREG, 2003, MC, 17 years)
The sense from most narratives was that young people were at least aware of the three options: to abort, adopt or keep the baby. However there was much less certainty about what these would entail, and how to go about making and then carrying through with these decisions. Consequently, many callers asked quite specific questions about their options. The majority of these questions were concerned with abortion, with many questions asked about how and where to get an abortion. Many questions were also asked about confidentially and consent issues. Such callers were concerned about whether decisions could be made without their parent's knowledge or consent; whether their parent(s) could force them to make a decision they did not want; and whether they could speak to services in confidence without their parent(s) being informed.
5.6 Conflicting wishes - parents, relatives and partners
In a large number of calls young people described conflict between their own wishes and those of their parents and, occasionally, other relatives. In many narratives young people had not yet informed their parent(s) of the pregnancy, and were therefore expressing concerns about what their parent(s) wishes might be. In other narratives the pregnancy had been disclosed and there was overt conflict between what the caller wanted and what their parent(s) thought they should do. Finally there were narratives in which young people expressed uncertainty about what they wanted, but whose parent(s) had clearly expressed their opinion or desire for what they should choose. These were central concerns for many young people. Conflicting wishes between callers and their partner or the father/mother of the baby was also described in many narratives, although, notably, less often than was conflict with parents. The conflict between partners was not clear cut; i.e. it was by no means always the case that young women wanted to keep the baby and young men did not.
In some narratives it was clear that young people were experiencing pressure from others to make a decision in a particular direction with regard to the pregnancy; i.e. pressure to have or not have an abortion, to adopt or to keep the baby. It was clear in some calls that this pressure was making it very difficult for the young person to decide what to do. Also evident was that many of these young people felt unsupported by the people close to them, primarily because of this conflict and pressure, for example:
Problems at home, pregnant (6 months), parents threatening me, say they will put baby up for adoption, I want to keep it, boyfriend wants to keep baby, sister understands, she had twins at 12, step dad giving me silent treatment, 2 brothers and younger sister. ( PREG, 2003, FC, 13 years)
5.7 Disclosure and support of pregnancy
There were many differences across narratives as to whether young people had disclosed their pregnancy, and if so to whom. Most young people indicated that they had told someone that they were pregnant or were concerned they might be pregnant. Disclosure was, however, strongly tied to relationships with peers, partners, parents, and other relatives, and often it revealed much about the quality of these relationships and the support that young people were receiving or expected to receive from the key people in their lives. Many young people expressed considerable fear or anxiety about what reactions from such key people might be.
The ratio of callers who indicated that they had not yet told their parents they were or might be pregnant, to those who had disclosed, was approximately 3:1. Therefore, for a very large proportion of callers, disclosing pregnancy to parents appeared to be as great or a greater concern than the pregnancy itself. This continued to be the case amongst many callers who had disclosed the pregnancy to their parents, depending upon how their parents had reacted and what degree of support the young person was receiving. Given that this data emerged from young people's disclosure to ChildLine, it seems likely that these young people were not without a need or desire for adult support and guidance.
The central reason for non disclosure given by a large proportion of callers was that they were frightened to tell their parents, and of these, many indicated that they were afraid of how their parents would react. Callers expressed these concerns at all ages. Most callers expressed concern that their parents would be very angry with them; sometimes callers expressed shame or embarrassment that they had let their parents down. There were also some young people who specified fears of very serious reactions or consequences, such as being thrown out of their home, or violence. Something of the range of fears about disclosure is illustrated below:
My girlfriend is pregnant. We had sex 2 weeks ago. She did a pregnancy test. I'm scared about having to tell my mum and scared of my girlfriend's parents. ( PREG, 2004, MC, 13 years)
Positive she's pregnant - tested herself - unprotected sex - scared what mum will say - she'll be disappointed - boyfriend 17 will stand by her. ( PREG, 2003, FC, 17 years)
Pregnant, been to doctor, blood tests and urine test. Told Gran and sister they will not tell mum and dad but will help. Mum and dad will throw her out. Threw sister out when she got pregnant. Sister lives with boyfriend. They will hit me if I tell them (PREG, 2003, FC, 13 years)
Of those callers who had not yet told their parents their concerns, there were many who stated that they did not know how to. Notably, some of these young people were clear that they wanted to tell their parent(s), and some were seeking advice from ChildLine about how to go about this. Moreover, it was evident in some narratives that young people wanted to tell their parent(s) because they needed their parent(s) support.
It is possible that many young people's fears were unfounded and parents might have ended up being supportive. However, in a large number of cases callers also spoke of problems in their home or family life of a serious nature, such as very poor relationships, bereavement, drug or alcohol problems, or abuse. Those young people whose fears had foundation clearly highlight the considerable importance of sources of support and advice available outside the family unit.
Although lack of parental support was a common concern across a substantial proportion of narratives, there were many other callers who indicated that their parents were providing support to them during the pregnancy. However, perhaps unsurprisingly given the nature of the ChildLine service, these were fewer than callers who were having problems. Nevertheless, amongst the young people who described their parents as being supportive were many whose parent(s) had initially been very angry or upset, but who they had calmed down and were now ok, for example:
Mum knows she is pregnant and has hit her and sent her to bed. Climbed out the window. Happened 2 days ago, mum now helping her but friends won't talk to her. ( PREG, 2004, FC, 15 years)
In a large number of narratives callers indicated receiving support and help from relatives other than their parents. Often this support was provided in the absence of parental support, and in many cases this was because parents had not been told of the pregnancy or pregnancy concerns. The relatives that young people described as receiving support were predominantly female: mostly sisters, but also aunts and grandmothers, and very occasionally uncles, brothers and grandfathers were mentioned.
Overwhelmingly, though, a major source of support for young women concerned about pregnancy came from their friends. As with relatives, the majority of these friends were female and in many cases, this support was indicated by young people phoning on behalf of their friend, or to express concerns about their friend. Only in a very few cases did callers express concern about how their friends would react to the pregnancy. Very few male callers, though, described support from their peers. However, for girls and young women, friends often provided support by accompanying callers to the doctor/clinic for a test or being with them to do a home test. They also kept their friend's confidence and offered advice or suggestions regarding how to handle the pregnancy. A key way that friends provided support was by providing young people with a place to stay when they did not want to stay at home or had been kicked out of home because of the pregnancy. Friends were therefore a crucial support mechanism during teenage pregnancy.
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