The background of adolescent pregnancies in Nicaragua: a qualitative approach.
A qualitative study of the complex social, economic, cultural, and psychological contexts of adolescent pregnancy in Nicaragua revealed close links to the problem of poverty. Data sources included in-depth interviews with 10 female adolescents, 5 adult women, and 5 adult men, and 2 focus groups of 12 teenage girls. Nicaragua's economic crisis, combined with a lack of political will to challenge traditional gender relations, has increased the rate of unwanted pregnancies. Moreover, the economic, political, and cultural situation fails to provide favorable conditions for women to gain power over their bodies and reproductive lives. Unwanted pregnancy was overwhelmingly associated with absent fathers, broken families, problematic stepfather relations, poor mother-daughter communication, economic dependence, romantic illusions, needs for emotional affection, and a lack of alternative opportunities. Machismo-based relations between men and women are consolidated by the Catholic religious tradition and the "Virgin Mary syndrome." Few respondents used contraception during their first sexual experience, despite awareness of available methods of protection, and the adult female respondents continued this pattern until they were unable to bear more children and underwent sterilization. Contraception, promoted only by nongovernmental organizations and women's groups, is widely considered to have severe negative health effects. Lacking is recognition of the close association between women's health and sexuality, reproduction, and contraception information and services.