Adolescent pregnancy has been considered a major public health problem, as well as a social, political, and economic problem. The adolescent pregnancy rate in the United States has been declining since 1991, and yet, this nation continues to have the greatest number of teen births in the industrialized world. The birth rate for African American adolescents is greater than twice the rate for white adolescents. Researchers have studied this complex and multifaceted phenomenon by examining individual factors, as well as familial, societal, and cultural influences. A growing number of researchers believe that many adolescent pregnancies are planned, or, at least, intentionally not prevented. Some suggestions for why adolescents desire pregnancy have been offered, yet there is none that provides a clear, evidence based explanation to why they want to be mothers.

The purpose of this hermeneutical interpretive phenomenology was to explore urban African American pregnancy from a unitary transformative worldview. Margaret Newman's theory of health as expanding consciousness (HEC) was the framework and research method chosen for this study. In tape-recorded interviews, nine female participants were asked to talk about the most significant people and events in their lives, and nine individual life patterns emerged. They are being cared for, wandering in a maze, longing to belong, going with the flow, living in the shadows, caring for others, adapting to change, establishing an identity, and living with consequences. The patterns indicate what has been important and meaningful in life, and reflect the pattern of the whole person. The individual patterns were examined according to Newman's correlates of consciousness: time, space, and movement. When the individual patterns were analyzed further, and compared with one another, dimensions of attachment, decision-making, and discovering meaning, were found in each. The individual patterns and the common dimensions contributed to the aggregate pattern—discovering meaning through attachment and decision-making. The aggregate pattern represents a comprehensive and holistic explanation of adolescent pregnancy among urban African Americans, and answers the research question what is the evolving pattern of urban African American adolescents.