Decision Making for Pregnant Adolescents: Applying Reasoned Action Theory to Research and Treatment
Original article authored by: Neil J. Cervera
This summary includes the following sections:
A pregnant teen faces many tough decisions, including whether or not to continue the pregnancy and, if so, whether or not to raise the baby herself or give the baby up for adoption. Many factors complicate her decision-making process: her own beliefs and values, her family's and partner's attitudes and support, and even hormonal changes as the pregnancy progresses.
In this article, the author suggests a theoretical framework — the Theory of Reasoned Action — to help explain and link the variables that affect a pregnant teenager's decision about whether or not to place a baby for adoption.
The Theory of Reasoned Action
First articulated by Fishbein and Ajzen in the 1970s,1 the Theory of Reasoned Action attempts to explain how (and whether) a particular behavioral intent translates into the behavior itself. What specific beliefs, attitudes, and norms influence the transition? Which play a key role, and which are sideline variables? How do they shift over time, and how can they be influenced? These are some of the questions the author applied to the issue of pregnant teen decision-making about adoption.
The first step in applying the Theory of Reasoned Action is to understand the universe of possible influences, so that they can, in turn, be linked and understood. The author conducted a literature review about pregnant adolescents in general and adoption decisions in particular to arrive at the following list of key determinants:
- The teen's and family members' beliefs about the pregnancy,
- Family support,
- Cognitive development,
- Caseworker assessment and intervention, and
- The adolescent weighing her options.
The author notes that although these variables are individually cited in the literature and some are linked, no one has fit them all together in a cohesive model of behavior. The Theory of Reasoned Action offers the potential to do so.
Applying the Theory of Reasoned Action
The developers of the Theory of Reasoned Action, Ajzen and Fishbein, have suggested that a person's intention to behave a certain way results from choosing among the available alternatives. At one level, the author notes, the alternatives for pregnant teens seem simple: to have the baby or not, and, if so, to raise the baby or place him or her for adoption. In fact, though, he suggests that the options are more complicated — and that a more specific description and understanding of options can in turn help teens and those who work with them explore their options more constructively. Instead of the either/or view, the author suggests these four choices once a teenager has decided to go ahead with a pregnancy:
- Keeping the child and raising it alone as a single mother,
- Keeping the child and raising him/her with the baby's father (through marriage or some other formal commitment), or
- Keeping the baby and raising him/her with the help of the teen's parents or other relatives.
Similarly, the author explains how important it is to understand how teens perceive the advantages and disadvantages of these alternatives, which are influenced (in the model) by attitudes and norms. The author envisions a scenario in which teens are guided through a set of questionnaires and discussions to explore their specific behavioral intent, attitudes, norms, and beliefs about consequences.
The author believes that the Theory of Reasoned Action will help professionals who work with teens understand the decision-making process that teens go through as they contemplate different pregnancy outcomes. Greater understanding and clarity about options, he maintains, will, in turn, lead to "better counseling strategies to ensure that choices are well thought out, realistic, reasonable, and consistent with the adolescents' overall future goals." The same process, the author adds, can reveal the adolescent's perceptions of major obstacles so that these can be addressed.
Pregnant teenagers facing such a difficult and life-altering decision deserve compassion and support as they take the "reasoned action" that best fits their unique situation.
1 Fishbein, M., and Ajzen, I. Beliefs, Attitudes, Intentions, and Behavior. New York: John Wiley, 1975.
Cervera, N.J. (June 1993). Decision Making for Pregnant Adolescents: Applying Reasoned Action Theory to Research and Treatment. Families in Society: The Journal of Contemporary Human Services. 355-365.