Adolescent pregnancy Health Article

Definition

Adolescent pregnancy is pregnancy in girls age 19 or younger.

Alternative Names

Teenage pregnancy; Pregnancy - teenage

Causes, incidence, and risk factors

The rate of adolescent pregnancy has steadily declined since reaching an all-time high in 1990, mostly due to an increase in the use of condoms. In fact, the birth rate among girls ages 10-14 has fallen to the lowest level in almost 50 years. 

Since no form of contraception is completely effective, abstinence (not having sexual intercourse) is the only sure way to prevent pregnancy. A sexually active teenager who does not use contraception has a 90% chance of becoming pregnant within a year. 

Why teenagers have sex, and do so without effective methods of contraception, is a topic of  debate. Suggested reasons include:

• Adolescents become sexually mature (and fertile) approximately 4-5 years before they reach emotional maturity.
• Adolescents today are growing up in a culture in which peers, TV and movies, music, and magazines transmit subtle and obvious messages that unmarried sexual relationships (specifically those involving teenagers) are common, accepted, and even expected.
• Education about responsible sexual behavior and specific, clear information about the consequences of sexual intercourse (including pregnancy, sexually transmitted diseases, and psychosocial effects) are frequently not offered. Therefore, much of the "sex education" that adolescents receive filters through misinformed or uninformed peers.

When compared with other industrialized nations, the United States has the highest rates of pregnancy, abortion, and childbirth among teenagers, despite similar or higher rates of sexual activity in the other countries.

Teens are more likely to become pregnant if they:

• Begin dating early (dating at age 12 is associated with a 91% chance of being sexually involved before age 19, and dating at age 13 is associated with a 56% probability of sexual involvement during adolescence)
• Use alcohol and/or other drugs, including tobacco products
• Drop out of school
• Have no support system or have few friends
• Lack involvement in school, family, or community activities
• Think they have little or no opportunity for success
• Live in a community or attend a school where early childbearing is common and viewed as normal rather than as a cause for concern
• Grow up in poverty
• Have been a victim of sexual abuse or assault
• Have a mother who was 19 or younger when she first gave birth

Symptoms

Pregnancy symptoms include:

• Missed period
• Fatigue
• Breast enlargement and breast tenderness
• Abdominal distention
• Nausea/vomiting
• Light-headedness or actual fainting

Signs and tests

The adolescent may or may not admit to being involved sexually. If the teen is pregnant, there are usually weight changes (usually a gain, but there may be a loss if nausea and vomiting are significant). Examination may show increased abdominal girth, and the fundus (the top of the enlarged uterus) may be palpable.

Pelvic examination may reveal bluish or purple coloration of vaginal walls, bluish or purple coloration and softening of the cervix, and softening and enlargement of the uterus.

• A pregnancy test of urine and/or serum HCG are usually positive.
• A pregnancy ultrasound may be done to confirm or check accurate dates for pregnancy.

Treatment

All options made available to the pregnant teen should be reviewed thoroughly.

Abortion is a potential option, but state laws vary regarding whether an unmarried teen can get an abortion legally without parental consent. In the case of married teens, the husband's consent may be required. Giving the infant up for adoption is another option.

The majority of pregnant teens choose to continue their pregnancies and keep their infants.

Early and adequate prenatal care, preferably through a program that specializes in teenage pregnancies, ensures a healthier baby. Smoking, alcohol use, and drug use should be strongly discouraged, and support should be offered to help the teen stop such behaviors.

Adequate nutrition must be encouraged through education and community resources. Appropriate exercise and adequate sleep should also be emphasized. Contraceptive information and services are important, following delivery, to deter teens from becoming pregnant again.

Pregnant teens and those who have recently given birth should be encouraged and helped to remain in school or reenter educational programs targeting skills that will enable them to provide for their child financially, emotionally, and with appropriate parenting. Accessible and affordable child care is an important factor in teen mothers continuing school or entering the work force.