臺中市初產青少女避孕及再度懷孕初探

Contraception and Repeat Pregnancy among First-delivery Adolescent Mothers in Taichung City

青少女懷孕衍生諸多不良結果，而再度懷孕傷害尤深。為瞭解初產青少女於生產後二年內之避孕和再度懷孕之行為，利用台中市1999年1-12月出生通報資料，篩選年齡小於20歲且設籍於台中市之本國籍初產青少女141人為對象，透過各區衛生所公共衛生地段護士以研究者自行設計之問卷，於2001年10月至12月進行家戶訪視，共計完訪75份（完訪率53.2%），未完成問卷之主要原因為找不到研究對象（佔應訪人數之29.8%）。主要研究結果包括：(1)初產青少女之在學比例由懷孕時之24.0%至生產二年後降至2.7%。(2)初產青少女於生產後的二年內，每次都會避孕之比率為17.3%，最常用的避孕方式為保險套；再度懷孕的比率為70.7%，主要原因為意外懷孕(45.3%)；而再度懷孕後有22.6%會採取人工流產。(3)初產青少女之避孕行為與本身及嬰兒父親之年齡、教育程度、工作狀況、婚姻狀況、家庭狀況、生活費用、對避孕之態度及懷孕意向等因素間沒有顯著相關；本人及嬰兒父親反對「初產後二年內再生小孩」及不打算再生小孩者之再度懷孕比率顯著較低、終止懷孕比率顯著較高。本研究雖屬初探，但仍可偵測出國內婦幼衛生尚未落實之一環，此亦屬青少年保健的主要照護議題重點所在。

The consequences of repeat pregnancy are far-reaching for adolescents and for our society. The purpose of this study was to investigate methods of contraception and circumstances that led to repeat pregnancy among adolescent mothers delivering their first child. Information about sociodemographic data, family profiles, beliefs, attitudes, and behavior related to repeat pregnancy were collected by a cross-sectional interview survey. Information on primiparas was collected from the birth registration system in Taichung City. Study subjects were mothers younger than 20 years who delivered their first newborns in 1999 (n=141). The response rate was 53.2% (75 persons). The major reason for the low response rate was inability to contact the adolescent mothers. At the time of the study, the mothers' school attendance markedly declined, from 24.0% to 2.7%. Two years after the first delivery, the contraception rate, repeat pregnancy rate, and elective abortion rate of adolescent mother were: 17.3%, 70.8%, and 22.6%, respectively. Use of condoms was the most common contraceptive method. Repeat pregnancy could be associated with an adolescent mother's attitude toward repeated childbearing (p＜0.01). For first-delivery adolescent mothers, interventions should focus on attitudes toward repeat pregnancy through a monitoring and management system.