Understanding adolescent pregnancy from the perspectives of pregnant adolescents in a Northern Thailand province: a phenomenological study

Background: Adolescent pregnancy is a global health issue in nursing, medical, and psychological literature, and a significant social and practical concern, particularly in the context of developing countries. Adolescent pregnancy is associated with severe medical health problems commonly affecting socially disadvantaged pregnant adolescents. Existing literature has investigated meanings, factors, and associated outcomes of adolescent pregnancy in order to increase knowledge of the causes of increasing adolescent pregnancy rates. However, few studies have allowed pregnant adolescent women to voice their experiences, express their feelings, and give their own meanings to their pregnancy, and their holistic experiential dimensions and care requirements remain under-researched. As a result of this research gap and the manifest need for improved care for this group, this study explores experiences of pregnant adolescents in Thailand in depth, engaging with a deep-seated interest in adolescent pregnancy issues and narratives, developing the understanding of the situation from the perspective of Thai pregnant adolescents. The aim of this study is to improve understanding and interpretation of pregnant adolescents’ perspectives associated with first-time pregnancy experiences in Northern Thailand. Methods: A qualitative study was conducted using a hermeneutic phenomenological approach, with purposive sampling recruitment of pregnant adolescents (aged between 15 and 19 years) from three hospitals in Northern Thailand. Data was collected using unstructured, in-depth, face-to-face interviews. A modified interpretive phenomenological analysis of 30 interviews was undertaken, incorporating translation into English using a cross-cultural translation technique. Findings: The key findings from this study illustrate that socio-cultural contexts in Thailand influence the adolescents’ lives prior to becoming pregnant, and during their first pregnancies, as well as coping strategies shaped within the context of lifestyles and values, gender roles, culture, religion, and socio-economic issues. Gender power imbalance played a key role in adolescents’ lives and created asymmetry of gender roles influencing the ability to demand the use of contraception. A lack of awareness of contraceptive use related to gender roles in Thai culture was a crucial influence in decision-making to prevent pregnancy. Identity and culture reflect the dual challenge of transition role from being an adolescent to becoming a mother. The sense of identity of motherhood reflects the duty and responsibility on women’s identity and development. In Thai culture, traditional beliefs and values as well as practices influence the health behavior and lifestyle. The meaning of family mirrors family support for pregnant adolescents through difficult times. Their own mothers were their pillars of strength and have provided both materials and emotion support. Transition to adulthood exposes numerous challenges that place extra demands not only the pregnant girls’ stage of adolescent development and journey to adulthood but also on their ability to fulfill the obligations of becoming mothers. Conclusion: These findings offer valuable insights into the significance of pregnancy for pregnant adolescents in Northern Thailand and have implications for health providers, educators, and policy makers’ encounters with adolescents during pregnancy, driving the move beyond biomedical care, identifying the need for support mechanisms and strategies, and offering guidance from multiple sources of support