Pregnancy, Contraception and Emergency Contraception: The Language of Urban Adolescent Young Women

Abstract Objective We sought to characterize how a group of urban adolescent females understands the domains of pregnancy, contraception, and emergency contraception (EC). Design We used the research strategy of freelisting as part of an in-depth interview study. Setting and Participants Urban adolescent females presenting to a Pediatric Emergency Department. Participants were enrolled using a purposive sampling strategy if they were black, English-speaking females, 15-19 years old, who resided in 1 of 11 zip codes surrounding the hospital. Main Outcome Measure Smith’s saliency score. Freelists were analyzed for the entire sample, as well as for subgroups. Results Thirty adolescents completed the interview. We found that this group of adolescents uses different words to characterize the domains of pregnancy, contraception, and EC. The only overlapping salient term was “abortion,” which appeared in the overall lists for pregnancy and EC and in the younger group’s list for contraception. In addition, lack of knowledge was cited as an important factor related to contraception. Conclusions Adolescent patients may not fully understand the concepts of contraception and EC. Providers should consider the potential need to provide an explanation for terms used, and they should consider explicitly differentiating between routine forms of contraception and EC, as well as between EC and abortion.