Teen pregnancy

From UBC Wiki

CAUSES

Teen pregnancy can happen to any sexually active female who is fertile and under the age of 20, regardless of her socioeconomic status, place of origin, education level, sexuality, familial background, and race/ ethnicity. It can happen for a variety reasons such as a lack of sexual education, misuse of birth control, and no access to birth control or abortion services - all of which can contribute to unprotected sexual intercourse. Many public education systems still teach abstinence, which does not give adolescents the proper tools to know how to practice safe sex.

Low Socioeconomic Status

Young women who come from a lower socioeconomic status are much more likely to experience teenage pregnancies compared to their more affluent peers.[1] 95% of teen mothers that give birth each year are from developing nations.[2] Although contraceptive use has increased over time in all socioeconomic groups, teenage girls from middle class families are more likely to use contraceptives during intercourse due to having better financial accessibility compared to low-socioeconomic youth.[3] Amongst low-come youth, having a lack of opportunity creates low expectations for education and job market opportunities as a result of being economically disadvantaged, which acts as a "driving force" behind increased rates of teen pregnancy.[4] As a result of teen pregnancy, teenage mothers are less likely to complete their high school diploma, they are more lively to live in poverty and depend on social assistance/ welfare, and their children are more likely to suffer health issues and cognitive disadvantages.[5] This trend of low-socioeconomic teenage mothers having children is more likely to perpetuate this cycle of poverty, as well as increase the chances of teenage pregnancy occuring amongst their own children.[4]

Early Marriage

Due to an increase rate of early marriage in developing nations, teen pregnancies within a marital context are more common.[6] Early marriage, also known as Child Marriage, is a human rights violation in which girls under the age of 18 are married off to older men in developing countries as a result of persistent poverty, social norms surrounding gender inequality, and cultural norms.[7][8]As a result of girls getting married at a young age, this can lead to a "lifetime of disadvantages and deprivation" as a result of increased risks to domestic violence and sexual abuse, early abandonment of formal education, and becoming pregnant which can negatively impact the health of the mother and child.[7]

Sex Education and Contraception

A lack of sexual education is a major factor in teenage pregnancy. Many countries do not provide their youth with proper sex education, or lack access to contraception, either because contraception is not legally available, or it is expensive. Because of this, teens are likelier to not use contraception or to use it improperly.[9] In the United States, the government has spent over one billion dollars on supporting abstinence sexual health programs to educate teenagers in school, as a way to promote sex after marriage.[10] Abstinence only programs increase the risks of STIs (Sexually Transmitted Infections) and pregnancy amongst teenagers as they are not properly educated on the use of contraception.[10] There is no evidence to support the effectiveness of abstinence programs, but rather high rates of teen pregnancy and STIs among teenagers in the United States still remains to be an issue.[10] Highly effective sex education programs and HIV/STI prevention programs that educate teenagers on contraceptive usage are more likely to decrease the risks associated with unprotected sex, and they are not likely to increase the rates of sexual activity amongst teenagers. [10]

Lack of Discipline and Control of Alcohol and Drugs

Teen pregnancy can sometimes be as a result of intoxication from alcohol and/or drug use, leading to impaired decisions that may include risky sexual behaviour with improper use or no contraception.[11] Being under the influence of drugs or alcohol can limit a teenager's ability to control their urges, thus increasing their chances of engaging in risky sexual behaviour and having an unwanted pregnancy.[11] Continued alcohol or drug use during the duration of the pregnancy can lead to dangerous and even deadly health issues that can negatively affect the teenage mother and infant.[12] Affects of alcohol and drug use during teen pregnancy include a potential miscarriage or stillbirth, learning and developmental delays for the child, speech and hearing impairments for the child, physical birth defects, and behavioural problems with the child - the negative outcomes for the baby may fit under Fetal Alcohol Spectrum Disorders.[12]

Peer Pressure

The affects of peer pressure amongst adolescents can lead to an unwanted pregnancy as a result of peer influences to engage in early sexual activity.[11] In social environments, adolescents influence their peers by "modelling behaviours and setting social norms" which create pressures for individuals to fit in, in order to receive acceptance from their peers.[13] As teenagers are getting pressured by others to engage in sexual activity in order to fit in amongst their peers, teenage girls have a higher risk of having an unwanted pregnancy - especially if they do not have the appropriate knowledge of using contraceptives effectively.[13]

CONSEQUENCES

The consequences of teen pregnancy may vary depending on the person. The mother may have access to childcare and education or may be forced into poverty. There is a high rate of mothers who are left by their partners before or after the birth of their child, creating further social barriers for them.

Health

Teenage mothers under the age of 16 are more likely to experience complicated pregnancies and health problems during pregnancy, at about the same rate as mothers in their mid-40s [14] Babies born to these young teenage mothers are more likely to have health complications, and are much more likely to experience Sudden Infant Death Syndrome (SIDS), as compared to babies born to older mothers [15]

Abuse

Children born to teenage mothers are more likely to experience maltreatment. This is linked to the fact that teen mothers are usually lacking adequate emotional and social resources needed to raise their child. [16]

Education

Teen mothers are much less likely to earn their high school diploma compared to their childless peers. [17]

PREVENTION

Sexual Education Programs

Sexual education is key when attempting to reduce teen pregnancies. After education, access to contraceptives, abortion services and support are curtail to reducing teen pregnancies. Comprehensive sex education has proven to be more effective in preventing teen pregnancy than abstinence only education or no formal sexual education. [18]

  • Comprehensive sex education

Comprehensive sex education teaches student about birth control methods to avoid unwanted pregnancies, risks of STDs and HIV (AIDS) and how to prevent being infected. Although this type to education does have messages about abstinence, it is not their focus. Comprehensive sex education programs have been proved effective in reducing teenage pregnancies, and a reduced likelihood in becoming sexually active. [18]

  • Abstinence only Education

Abstinence only education teaches that sexual relations must be reserved for marriage, and does not discuss any form of birth control, other than commenting on its ineffectiveness. Although over the past several years, the US has been allocating increasing amounts of funding to abstinence only education, even though it has been proved ineffective. [18]

  • Abortion Counselling
  • Access to Contraceptives

Contraceptive Methods

98% of American women have used some form of contraceptive during their lifetime, and 62% of women in their reproductive stage are currently using contraceptives. Although many women may be using various methods of contraception, about 50% of pregnancies are unintended. This may be due to various reasons, including inconsistent use, incorrect use, or user error. [19]

Oral Hormonal Contraceptive

Also known as the birth control pill, or just the pill, this contraceptive is taken daily, interfering with fertilization, ovulation and implantation of the egg, which prevents pregnancy. It is currently the leading form of contraception in the United States, reaching 11 million women. This form of contraception requires commitment and patient compliance. [20]

Barrier Contraceptive

A type of device that physically blocks the sperm from entering the vaginal cavity, preventing it from reaching the ovum and achieving fertilization. [19] Examples include condoms, (male and female ones), cervical cap and diaphragm. Along with preventing unwanted pregnancies, condoms also limit the genital to genital contact, protecting against the transmission of sexually transmitted diseases. [19]

Intrauterine Devices (IUDs)

These are plastic devices that when inserted into the uterus, alter the uterine environment to prevent pregnancy. It is one of the most effective reversible long term forms of contraception. [19] Two types of IUDs are currently used in the United States: copper containing IUD and progestin releasing IUD. They both work by creating an inflammatory response in the uterus that interferes with sperm transportation. [19]

Surgical Contraceptive

Tubal ligation is a permanent procedure performed on females. The women's fallopian tubes are obstructed to prevent the sperm from reaching the ovum and achieving fertilization. Tubal ligation also decreases the risk of ovarian cancer. Failure rates are lower among women over 30, as their fecundability is lower. In men, the surgical procedure is called a vasectomy, where the sperm is blocked from being ejaculated, by surgically sealing the vas deferens.[21]

Emergency Contraceptive

When no preventative measures are taken, there are still options to prevent pregnancy after coitus. If an Intrauterine device is inserted within 5 days of sexual intercourse, the chance of implantation of the fertilized ovum is decreased. [19] There is also a hormonal option in which the woman ingests a pill containing either progestin only or estrogen and progestin, with the effectiveness being inertly related to the time since coitus. [19] Since this method is less effective than others available, it is not recommended to be used as a routine form of contraceptive.

New Solutions for Teen Pregnancy Prevention

(Edited by Kevin Lui):

In regards to the prevention of teen pregnancy, with the help of advanced technology, there are several new options for teen pregnancy prevention. They are OrthoEvra, NuvaRing, and Seasonale. These three new alternatives offer several significant improvement in the utilization of pregnancy prevention, such as: increased privacy, ease of use, low side effects, and last but not least, higher contraceptive efficacy (Kartoz, 2004).

OrthoEvra

OrthoEvra is a contraceptive patch that is utilized for prevention of pregnancy. It contains progestin as well as estrogen. However, OthoEvra does not prevent sexually transmitted diseases, and HIV (AIDS).

NuvaRing

NuvaRing is a birth control vaginal ring, that is small and flexible with 2 inches in diameter. Users can insert as well as remove it by themselves. NuvaRing has a duration of up to 3 continuous weeks.

Seasonale

Seasonale contains ethinyl estradiol as well as levonorgestrel, which includes a combination of female hormones that helps preventing ovulation. Therefore, it will prevent the release of egg from a woman's ovary. Seasonale also leads to changes in cervical mucus and uterine lining. This helps to block the sperm from reaching the uterus.

Kartoz, C. R. (2004). New Options for Teen Pregnancy Prevention. The American Journal of Maternal/Child Nursing, 29, 30-35.

Having a baby

If you cannot prevent the pregnancy there a certain facts that the future mother should know. If you decide to have the baby it is important to know how to have a healthy pregnancy: http://kidshealth.org/teen/your_mind/emotions/pregnancy.html

TEEN PREGNANCY IN TELEVISION

16 and Pregnant

16 and Pregnant is a reality documentary style show on MTV that follows various teenagers throughout their pregnancy, and up to the first few weeks of motherhood. It aired in 2009. It showcases their issues, such has possible adoption, religion, getting a job and sometimes marriage. It shows the sacrifices the soon-to-be parents have to make and the struggles they have to face in order to have the child. [22] According to a study on the impact of the show, the show caused a greater online search for birth control and abortions, which led to a reduction of 5.7% of teen births in the 18 months following its debut. [23]

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Teen Mom

Also a MTV reality documentary-style show but the focus is life during the first year with the new baby. The focus is on the challenges of motherhood and fighting to build a career and establish their own families. The 4 girls who star the show are Maci Bookout, Farrah Abraham, Catelynn Lowell and Amber Portwood, who were all previously on the show 16 & Pregnant. [24]

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REFERENCES

  1. Gillham, Bill (1998). The Facts About Teenage Pregnancies. London: Continuum International Publishing. pp 8
  2. U.N. Cites Teen Pregnancy's Harm to Developing Nations . Wall Street Journal. Oct 30, 2013. Retrieved Dec 1 2014.
  3. Besharov, Douglas J. and Gardiner, Karen N. (1997). "Trends in Teen Sexual Behavior". Children and Youth Services Review. 19 (5/6): 341–67. doi:10.1016/S0190-7409(97)00022-4.CS1 maint: multiple names: authors list (link)
  4. 4.0 4.1 "Gender and Poverty". Gender and Health. Gender & Health Collaborative Curriculum. Retrieved 1 April 2016.
  5. "Teen Pregnancy Prevention". National Conference of State Legislatures. National Conference of State Legislatures. Retrieved 1 April 2016.
  6. U.N. Cites Teen Pregnancy's Harm to Developing Nations . Wall Street Journal. Oct 30, 2013. Retrieved Dec 1 2014.
  7. 7.0 7.1 "Child Marriage". UNICEF. UNICEF. Retrieved 7 April 2016.
  8. "Child Marriage". United Nations Population Fund. United Nations Population Fund. Retrieved 8 April 2016.
  9. World Health Organization. Adolescent Pregnancy. Updated September 2014.
  10. 10.0 10.1 10.2 10.3 "Effective Sex Education". Advocates for Youth. Advocates for Youth. Retrieved 7 April 2016.
  11. 11.0 11.1 11.2 "What Are the Causes of Teenage Pregnancy". LIVESTRONG. LIVESTRONG. Retrieved 7 April 2016.
  12. 12.0 12.1 "Alcohol and Teen pregnancy". Teen Pregnancy Statistics. Teen Pregnancy Statistics. Retrieved 7 April 2016.
  13. 13.0 13.1 "Peer Effects on Adolescent Sexual Debut and Pregnancy: An Analysis of a National Survey of Adolescent Girls". Resource Centre for Adolescent Pregnancy prevention. Retrieved 7 April 2016.
  14. Gillham, Bill (1998). The Facts About Teenage Pregnancies. London: Continuum International Publishing. pp 14
  15. Gillham, Bill (1998). The Facts About Teenage Pregnancies. London: Continuum International Publishing. pp 19
  16. Gillham, Bill (1998). The Facts About Teenage Pregnancies. London: Continuum International Publishing. pp 23
  17. Centers for Disease Control and Prevention. About Teen Pregnancy. June 2014. Retrieved Dec 1 2014.
  18. 18.0 18.1 18.2 Kohler, Pamela; Lafferty, William (Apr 2008). "Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy". Journal of Adolescent Health. 42 (4): 344–351. doi:10.1016/j.jadohealth.2007.08.026. PMID 18346659. Unknown parameter |coauthors= ignored (|author= suggested) (help)
  19. 19.0 19.1 19.2 19.3 19.4 19.5 19.6 Neinstein, Lawrence (2008). Adolescent health care : a practical guide (5th ed. ed.). Philadelphia: Lippincott Williams & Wilkins. p. 624. ISBN 9780781792561.CS1 maint: extra text (link)
  20. Ammer, Christine (2009). "oral contraceptive". The encyclopedia of women's health (6th ed.). New York: Facts On File. pp. 312–315. ISBN 978-0-8160-7407-5.
  21. Hanson, S.J.; Burke, Anne E. (21 December 2010). "Fertility control: contraception, sterilization, and abortion". In Hurt, K. Joseph; Guile, Matthew W.; Bienstock, Jessica L.; Fox, Harold E.; Wallach, Edward E. (eds.). The Johns Hopkins manual of gynecology and obstetrics (4th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. pp. 382–395. ISBN 978-1-60547-433-5.
  22. 16 & Pregnant. 16 & Pregnant (TV Series). June 2014. Retrieved Dec 3 2014.
  23. "Media Influences on Social Outcomes: The Impact of MTV'S 16 And Pregnant on Teen Childbearing". National Bureau of Economic Research.
  24. Teen Mom. Teen Mom (TV Series). June 2014. Retrieved Dec 3 2014.