Ambivalence about pregnancy and its association with symptoms of depression in adolescent females initiating contraception

Jenny Francis, Katherine Malbon, Debra Braun-Courville, Linares Oriana Lourdes, John Santelli

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Purpose To examine the association between symptoms of depression and ambivalence about pregnancy in an inner-city adolescent female population.

Methods This study analyzed data from 220 urban minority adolescent females (ages, 15-19 years) presenting for contraceptive initiation in a comprehensive, free-of-cost, adolescent health center in New York City. Cross-sectional baseline data were examined to define the relationship between participants' ambivalence toward pregnancy (defined by responses to items previously used in the National Longitudinal Study of Adolescent Health) and symptoms of depression (assessed by the Center for Epidemiological Studies-Depression scale). After controlling for covariates, multivariate logistic regression was used to identify the unique contribution of symptoms of depression on the pregnancy ambivalent group.

Results Over one third of adolescent females self-reported ambivalence about pregnancy (n = 73, 33%). In our sample, 20% (n = 45) reported mild and 14% (n = 30) reported moderate-to-severe symptoms of depression. After controlling for potentially confounding factors, adolescent females who reported mild symptoms of depression had increased odds of reporting pregnancy ambivalence (adjusted odds ratio, 3.53; confidence interval, 1.64-7.62; p =.001) compared with those with minimal symptoms of depression.

Conclusions A substantial number of adolescents, despite planning to initiate contraception, were ambivalent about pregnancy; those reporting ambivalence were more likely to report mild symptoms of depression. When counseling adolescents about contraception initiation, clinicians should be aware that mild symptoms of depression may contribute to ambivalence about pregnancy.

Original languageEnglish (US)
Pages (from-to)44-51
Number of pages8
JournalJournal of Adolescent Health
Issue number1
StatePublished - Jan 1 2015


  • Ambivalence about pregnancy
  • Birth control sabotage
  • Contraception
  • Depressive symptoms
  • Mental health
  • Pregnancy attitudes
  • Pregnancy intentions
  • Symptoms of depression

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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