Causes and Perspectives on Repeat Pregnancy in Adolescent Pregnant Women: A Qualitative Systematic Review within the Context of Thailand

Abstract

This research is a systematic review aimed at investigating the causes and perspectives on repeat pregnancy in adolescent pregnant women. The data were sourced from CINAHL, EBSCOhost, PubMed, ScienceDirect, international theses from the University of Hull, ThaiLIS, the Digital Research Information Center, and ThaiJO. The samples were eight qualitative research regarding causes and perspectives on repeat pregnancy in adolescent pregnant women within the context of Thailand. These researches were published between 2013 and 2023 in Thai or English journals. The research instruments consisted of the JBI Critical Appraisal Checklist for Qualitative Research and the JBI Qualitative data extraction tool. The data collection was conducted through the systematic review methodology outlined by the Joanna Briggs Institute (JBI) from June to October 2024. Data were analyzed using frequency and content analysis.

The research results revealed that a total of thirty studies were identified based on the search criteria, of which eight met the inclusion and quality assessment criteria. The causes of repeat pregnancies consisted of 1) lack of awareness: adolescent pregnant women and their spouses lacked awareness about the likelihood of repeat pregnancies; 2) limited knowledge: inadequate understanding of various contraceptive methods in adolescent pregnant women and their spouses; 3) incomplete contraceptive counseling, particularly on methods suitable for adolescents, and did not tailor contraceptive advice to individual needs; 4) not receiving contraceptive services before being discharged from the hospital; 5) adolescent pregnant women experienced side effects from contraceptive methods, leading them to discontinue their use; 6) adolescent pregnant women and their families were unaware of the consequences of repeat pregnancies; 7) it was influenced by the desires of the husband and family; and 8) traditions, culture, and beliefs of adolescent pregnant women and their families. In addition, the perspectives on repeat pregnancies in these adolescent pregnant women included: 1) adolescent pregnant women viewed themselves as too young; 2) adolescent pregnant women who worked outside the home perceived that they could not fulfill their maternal roles; 3) perceived repeat pregnancy as a source of joy; and 4) repeat pregnancies or having more children was considered normal.

This research suggests that healthcare personnel should provide individualized contraceptive counseling to adolescent pregnant women and their families. Additionally, contraceptive services should be offered to postpartum adolescents before their discharge from the hospital. Furthermore, home visits by community network partners should be implemented to collaborate in preventing and addressing the issue of repeat pregnancies among adolescents.