PC2100: Adolescent Pregnancy in Nicaragua: An Emic Perspective of Structural Influences

Background: Adolescent girls in Nicaragua are at risk early pregnancy and motherhood and their infants are at greater risk for prematurity, low birth weight, child abuse and neglect, and poverty. There are few studies that specifically address the role cultural and societal values play in Latin America regarding adolescent pregnancy. However, researchers have identified critical cultural and social factors that were further explored in this study. Additionally, this study aimed to uncover new factors related to cultural values that may be important to the occurrence of adolescent pregnancy. The purposes of this qualitative study were to increase understanding of adolescent girls’ perspectives on motherhood and reveal perceived health determinants that contribute to adolescent pregnancy in Nicaragua.

Methods: Based in Jinotega, Nicaragua where the adolescent pregnancy rates are among the highest in the country, data were collected using three qualitative approaches: a visual ethnography with photovoice, semi-structured interviews, and participant observation. Purposeful sampling for the ethnographic photovoice groups yielded six adolescent, one with rural mothers 15-20 years old and a with rural, never pregnant 18-20 year olds. The interview sample included 25 rural pregnant adolescents ages 15-20 years at the Casa Materna in Jinotega, a facility for pregnant teens located near the hospital. Observations of places and events common in the lives of adolescent females occurred throughout the study with a focus on examples of machismo/marianismo, religion, and familismo. Data were analyzed for themes using a combined content analysis approach.

Results: Six themes were constructed from the data: (a) “la maternidad es amor” (motherhood is love) (b) “la maternidad es responsibilidad” (motherhood is responsibility) (c) machismo, (d) familismo, (e) personal agency, and (d) emotional isolation.

Conclusion: Findings from this study indicate that adolescent pregnancy is influenced by girls’ lack of power with men (machismo) and their families (familismo). However, the girls still find personal agency. They also experience emotional isolation while at the same time having social support. Finally, motherhood is thought to bring both happiness and love as well as responsibility. The results of this study may be used to inform future interventions designed to reduce the adolescent pregnancy rate, save and improve the lives of adolescent girls and their children in Nicaragua.