What Contributes to High Adolescent Pregnancy Rates in Ecuador? A Secondary Analysis of a Qualitative Study

Introduction: Ecuador has the second highest rates of adolescent pregnancy in South America. Adolescent pregnancy is associated with negative health implications, including miscarriage, neonatal and maternal demise, cephalopelvic disproportion, and illness throughout infancy. Additionally, adolescent pregnancy perpetuates the cycle of poverty and is associated with lower educational attainment and increased reliance on social services. Purpose: The purpose of this study was to describe experiences that contributed to unintended adolescent pregnancy of Ecuadorian women living in a low-resource community. Specifically, this work aimed to identify barriers to seeking or utilizing birth control in sexually active adolescents. The long-term goal of this study was to contribute to data to design programs to improve the health and socioeconomic status of Ecuadorian women and their children. Methods: This was a secondary analysis of a larger qualitative study of women of reproductive age. The focus of this study was on the experiences specific to women who reported an adolescent pregnancy. Participants included 11 women aged 22 to 38 who reported their first pregnancies between age 14 to 18. The semi-structured interviews were conducted in Spanish, transcribed in Spanish and translated into English for analysis. Data were analyzed using content analysis to identify codes and themes in an iterative process with peer review. Results: Four themes arose from data analysis: 1) Adolescents learned from experience, 2) Partner and peer pressure to have sex, 3) Limitation in provision of reproductive health care, 4) Lack of feasible options other than early motherhood. Conclusions: In order to reduce rates of unintended adolescent pregnancy in Ecuador, young women must be provided with tools to maintain reproductive autonomy. In order to accomplish this, public health nurses in Ecuador should push for more effective sexual education programs in schools, improved healthcare and contraceptive accessibility, and programs empowering young women emotionally and financially