RESUMO
CONTEXT: Native Hawaiians experience the highest reported rate of unintended pregnancy of any ethnic group in Hawaii. Understanding the context in which they make decisions that influence pregnancy and pregnancy planning is essential to reducing this rate. METHODS: A qualitative study was carried out in partnership with a community health center serving a large Native Hawaiian population to explore how Native Hawaiians conceptualize pregnancy and pregnancy planning. Between August and October 2013, semistructured interviews were conducted with 10 diverse key informants from the Hawaiian community. Content analysis was used to identify themes and patterns that emerged from the interviews. RESULTS: Core Hawaiian values of children and family strongly affect how Native Hawaiians view pregnancy, pregnancy planning and unintended pregnancies. 'Ohana (families) are large and characterized by tremendous support, which is perceived to lessen the burden of an unintended pregnancy. Pregnancies, whether planned or not, are seen as blessings because children are highly valued. Because of these concepts, there is an expectation for women to continue unplanned pregnancies. Although Hawaiians ascribe value to planning pregnancies and hope that children are born under what they identify as ideal circumstances, they acknowledge that these circumstances are not necessary and often do not occur. CONCLUSION: The concepts of family and children serve as core values to Native Hawaiians and are linked to the ways in which they view pregnancy and pregnancy planning.