Self-reported pregnancy and access to primary health care among sexually experienced New Zealand high school students

J Adolesc Health. 2011 Nov;49(5):518-24. doi: 10.1016/j.jadohealth.2011.04.002. Epub 2011 Jun 8.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Community Health Centers / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Research
  • Humans
  • Male
  • New Zealand / epidemiology
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Pregnancy
  • Pregnancy in Adolescence / psychology
  • Pregnancy in Adolescence / statistics & numerical data*
  • Primary Health Care / statistics & numerical data*
  • School Health Services / statistics & numerical data
  • Sexual Behavior / statistics & numerical data
  • Students / psychology
  • Students / statistics & numerical data*
  • Surveys and Questionnaires