# ‘You may be a mother, but you’re also a child.’– the importance of unintended pregnancy of underaged women in Germany for sexual and reproductive health: a biographical narrative analysis

## TL;DR

This study explores how teenage girls in Germany experience unintended pregnancies, especially those with difficult childhoods or relationship violence, and highlights the need for better support and education.

## Contribution

The study identifies two distinct coping orientations among teenage girls with unintended pregnancies and emphasizes the need for gender-equitable sexual education and support services.

## Key findings

- Two contrasting orientations were identified in how adolescents cope with unintended pregnancies: subordinated/resigned and reflexive/pro-active.
- Adverse childhood experiences and teen dating violence strongly influence how teenagers manage unintended pregnancies and intimate relationships.
- Specialized support services are needed to empower young women and align with their complex family and partnership situations.

## Abstract

Adolescence is a formative period in which self-concept and sexual identity are developed. Unintended teenage pregnancies represent a sensitive and stigmatized issue, often associated with major psychosocial challenges. The aim of this study is to explore the lived experiences of women with unintended teenage pregnancies in Germany, with a particular focus on adverse childhood experiences (ACE) and Teen Dating Violence (TDV).

The analysis is based on five biographical narrative interviews conducted within the ELSA project (November 2020–April 2024), which aimed to investigate how unintended pregnancies are managed and to identify needs for counseling and care. Using the documentary method, we reconstructed the meaning of communicative and conjunctive knowledge in adolescents’ narratives and compared these orientations across four comparative dimensions: childhood biography, handling of the unintended pregnancy, construction of intimate relationships, and construction of minority.

Two contrasting orientation types were reconstructed across the dimensions, shaped by how adolescents processed external framings. Type 1 (subordinated, resigned orientation) was characterized by communicative deficit narratives and conjunctive patterns of resignation, dependency, and restricted agency. Type 2 (reflexive, pro-active orientation) demonstrated communicative acknowledgment of burdens but conjunctive practices of resilience, negotiation, and self-assertion. Unintended pregnancies were frequently constructed as existential crises, in which personal needs and emotions were suppressed. Minority status intensifies these challenges, while ACE -related patterns of behavior were reproduced in the context of pregnancy and intimate relationships.

The study provides valuable insights into the complex realities and decision-making processes of female adolescents with unintended pregnancies. The findings highlight the need for specific support services that strengthen girls’ empowerment and agency in order to promote sexual and reproductive health and rights. Outdated role models that ascribe contraceptive responsibility solely to women should be replaced by gender-equitable sexual education. In addition, legal regulations and counseling services should be better aligned with the often precarious family and partnership situations of young pregnant women.

The teenage years are an important time for young people to develop their identity and sexuality. Becoming pregnant at this age is often unintended and can be a sensitive and stigmatizing experience. It usually comes with major challenges. This study looks at how teenagers in Germany experience unintended pregnancies, especially when they have faced difficult experiences in childhood (known as Adverse Childhood Experiences, ACE) or violence in relationships (Teen Dating Violence, TDV).

Interviews were analyzed with five young women who experienced an unintended pregnancy as teenagers. These interviews were conducted as part of a larger research project called ELSA, which ran between 2020 and 2024.

The study shows that there are two main ways in which teenage girls deal with unintended pregnancy:

1. The subordinated, resigned type (basic type): These young women often feel powerless, controlled by their environment, and limited in their ability to act.

2. The reflexive, pro-active type (maximum contrast): These young women are able to reflect on their situation, make their own decisions, and act more independently.

The findings also show that traumatic childhood experiences strongly how teenagers cope with pregnancy and how they experience their relationships.

The study highlights the need for specialized support services for teenagers with unintended pregnancies. Such services should strengthen self-determination and agency, replace outdated role models with fairer and more gender-equitable sex education, and ensure that legal regulations and counseling take into account the often difficult family and partnership siuatons of young pregnant women.