Prevention of unwanted pregnancy among teenagers.

A psychosocial constellation that appears to predispose many teenage girls to risk unwanted pregnancy includes hostility in the parents' marriage, alienation from the mother, and a seductive father-daughter relationship. The dynamics which lead into sexual acting out include attempts to (1) compensate for low self-esteem by seeking male approval and (2) reduce anxiety over sexual fantasies or behavior with the father by counterphobic coital contacts with other men. Provision of a contraceptive method alone is sometimes insufficient to protect a woman with these dynamics from unwanted pregnancy because her conflicts over dependency needs and sexuality may interfere with taking responsibility for reliable use of contraceptives. Supplementary intervention, either by the primary care physician, a psychiatrist, or other mental health professional, is recommended where the high risk family history is evident.