Running head: TEEN PREGNANCY PREVENTION AND SUPPORT
TEEN PREGNANCY PREVENTION AND SUPPORT IN THE UNITED STATES
by
Jessica Firnhaber
A Senior Honors Project Presented to the
Honors College
East Carolina University
In Partial Fulfillment of the
Requirements for
Graduation with Honors
by
Jessica Firnhaber
Greenville, NC
May 2015
Approved by:
Dr. Martha Engelke
East Carolina University College of Nursing
1
Running head: TEEN PREGNANCY PREVENTION AND SUPPORT
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Teen pregnancy in the United States is a significant problem and one of the six
public health priorities of the Centers for Disease Control and Prevention (Centers for
Disease Control and Prevention (CDC), 2011). In 2009, a total of 409,840 infants were born
to teens between the ages of 15 and 19. In 2012, this number dropped to 305,388. This
decrease is a start but more change is necessary to improve the quality of life of young
people and communities throughout the United States (CDC, 2011). The adverse effects of
teen pregnancy have an impact on everyone; the teen, the baby and the community. A
pregnancy between ages 15 and 19 creates short-term and long-term difficulties in life
(CDC, 2011). School dropout rates are greatly influenced by pregnancy. Whether the teen
remains in, or ultimately returns to school, high school completion is frequently impacted.
Only about 50% of teen mothers earn a high school diploma by the age of 22, in comparison
to almost 90% in women who do not have children in their teenage years (CDC, 2011).
Not only does this lack of education negatively impact the teen, but also the child.
Uneducated teenage mothers have a higher probability of persistent economic and social
disadvantage throughout their lifetime. Children born to teenage mothers are less prepared
than their peers to begin kindergarten and are at greater risk for behavioral problems and
chronic medical conditions (CDC, 2011). As the children grow up they follow in their
mother’s footsteps, with a higher rate of dropping out of high school and having children at
younger ages. Compared to their peers, children from teenage mothers are more likely to
be incarcerated at some point during adolescence and struggle more with employment
throughout their lifetime (CDC, 2011). The entire United States is affected by teen
pregnancy rates, as the costs accrued to taxpayers from increased health care, foster care,
TEEN PREGNANCY PREVENTION AND SUPPORT
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and lost tax revenue from teen mothers with little education sum to approximately nine
billion dollars per year (CDC, 2011).
Programs are being implemented throughout the country to decrease the teen
pregnancy rate. Although widely adopted, abstinence-only sex educations have not
demonstrated impact in teen sexual activity or pregnancy rates. Other industrialized
countries have focused on comprehensive sex education and achieved success in lowering
rates of teen pregnancy (SmithBattle, 2006). Knowing the risks and potential outcomes of
teen sexual activity improves a teen’s ability to make educated decisions on their own.
Sexual health curricula have the potential to lower pregnancy rates.
Regardless of the effectiveness of programs aimed at lowering birth rates, teen
pregnancy will undoubtedly occur. As such, more focus is being placed on decreasing
adverse effects of teen pregnancy. In New Haven, Connecticut, a public school called The
McCabe Center serves pregnant and parenting adolescent women. Students attend McCabe
during their pregnancy and remain through the quarter in which their child is born
(SmithBattle, 2006). While at the school, pregnant teens follow the same curriculum as
their peers in their regular school, while also attending classes on prenatal health,
preparation for labor and infant growth and development (Meadows, Saddler, & Reitmeyer,
2000). While other studies have demonstrated a mere 59% school
continuation/completion rate, a study of girls attending the McCabe Center revealed a
promising outcome: approximately 80% of teen mothers who attended the school
continued and/or completed school (Meadows et al., 2000).
It is unclear if this resulted from the teens’ readiness for childbirth from the
additional classes, the support from other parenting teens, or other factors, regardless; it
TEEN PREGNANCY PREVENTION AND SUPPORT
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has proven to be an effective program. Another school specific to pregnant teens in
Baltimore, Maryland has shown similar results. A study comparing students receiving
office-based prenatal care with students receiving school-based prenatal care found that
those receiving school-based care missed fewer days of school during their pregnancy year.
The author suggested that some of the variation in absences may be due to those receiving
non-school-based care skipping a full day of school for their appointment rather than being
able to return to class (Barnet, Arroyo, Devoe, & Duggan, 2004). A main focus in almost all
pregnant teen support programs involves school retention rates and attainment of a high
school diploma or the equivalent.
Public schools specific for pregnant teens have proven their effectiveness yet many
areas do not build such schools, instead implementing other outreach programs. The
Minnesota Visiting Nurse Agency created the Pregnant and Parenting Teen Program, which
sends public health nurses to the homes of enrolled teens to offer support (Schaffer,
Goodhue, Stennes, & Lanigan, 2012). The visiting public health nurses work to “gain a
trusting relationship with the teen; provide help with outreach services to schools, clinics
and human service agencies; inform the teens of maternal health; and provide connections
to additional community support” (Schaffer et al., 2012). Within the Pregnant and
Parenting Teen Program, 76% of the teens receiving 10 or more visits, graduated or
continued school compared to 56% with 9 or fewer visits (Schaffer et al., 2012). The
positive retention results, along with feedback results that 74% of teens highly agree and
18% agree when asked if they would recommend the program to others, supports the
positive impact the program had on the teens (Schaffer et al., 2012). Within the same
program, another study was conducted to determine how the teens perceived the
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mentoring relationship they developed with the visiting public health nurse. All teens in the
study viewed the public health nurse as “an important part of their support network and
valued the positive feedback they received from the public health nurse” (Schaffer & Mbibi,
2014).
A study conducted by Saint Louis University interviewed teens six times, between
their third trimester to ten months postpartum, asking about their aspirations as students
(SmithBattle, 2006). Each student had gained a new appreciation for education with the
anticipation of motherhood. The teenage women, regardless of their prior status in school,
all seemed to reevaluate their priorities and goals in light of a brighter future for their
children. One teen explained how her pregnancy was the reason for her new interest in
attending college:
“I’m not even sure I would’ve wanted to go to college if I wouldn’t have been
pregnant… Without education, you can’t go nowhere in life. And if you don’t go
nowhere in life, you can’t raise a child. I’m raising a child by myself, so I have to
have an education” (SmithBattle, 2007, p. 356).
Another teen explained her reason for wanting to complete school is to “be a good mother
and have a good future” (SmithBattle, 2007, p. 356). It is crucial for teen mothers to
discover their goals in life and have the support to achieve them. Supporting a pregnant
teen and helping connect her to the resources she needs obviously makes a positive impact
in her life.
Programs are beginning to develop within public school systems to provide easy
access for the teen, eliminating additional time that must be set aside to meet with mentors
or to transfer to a different school. Within public school systems, school nurses play the
TEEN PREGNANCY PREVENTION AND SUPPORT
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lead role in sexual health and mentorships of pregnant teens (Perrin & Dorman, 2003).
Being involved in the school allows the school nurse to work with pregnant teens’ teachers
and coordinate absences and other issues resulting from pregnancy. The school nurse has a
unique role by using his/her education in health and communication while also being
compassionate and professional; their involvement in the school is beneficial yet their
position stands apart from the academic role of grading, judging, and writing
administrative reports (Perrin & Dorman, 2003). This allows the school nurse to actively
listen and connect with the teen, creating a trusting relationship, which has the potential to
lead to more positive outcomes. The National Association of School Nurses is confident that
the school nurse is in the prime position to support many health aspects of pregnant and
parenting teens (Davis-Aldritt et al., 2011). The school nurse is crucial in helping connect
the teen with the resources available in order for her to succeed both short-term and longterm. Each teen is unique and, as a mentor, the school nurse can specifically address each
individual while also identifying trends in order to help pregnant and parenting teens. By
identifying pregnancy rates and trends, the school nurse can also improve the sexual
education curriculum taught by the school in hopes of reducing the teen birth rate (Hoyt &
Broom, 2002).
Although teen pregnancy is currently a significant issue in the United States, many
initiatives are being undertaken to lower the prevalence. Realizing that abstinence-only sex
education has not proven to be effective has encouraged the teaching of a more wellrounded and inclusive curricula. Additionally, no matter how effective prevention
programs are, some teen pregnancies are inevitable and programs are being implemented
to focus on improving the outcomes of the teens and their children. The completion of
TEEN PREGNANCY PREVENTION AND SUPPORT
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school is a primary focus in order to improve the outcomes for the teen, her baby, and the
United States taxpayers. Studies of schools specific to pregnant and parenting teens have
shown positive impacts on the retention rates of the teenage women. Home visiting
programs utilizing public health nurses as mentors have also been effective in increasing
the educational attainment of teenage mothers. One of the most practical programs studied
is through the public school system; allowing the school nurse to mentor and provide
support for the pregnant and parenting teens. This type of program requires minimal time
and effort from the teen and the school nurse’s connections with the school allows them to
work closely with the teachers to maximize the teen mothers’ educational opportunities.
TEEN PREGNANCY PREVENTION AND SUPPORT
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References:
Barnet, B., Arroyo, C., Devoe, M., & Duggan, A. K. (2004). Reduced school dropout rates
among adolescent mothers receiving school-based prenatal care. Archives of
Pediatrics & Adolescent Medicine, 158(3), 262-268.
doi:10.1001/archpedi.158.3.262
Centers for Disease Control and Prevention, National Center for Chronic Disease
Prevention and Health Promotion, Division of Reproductive Health. (2011). Teen
pregnancy: Improving the lives of young people and strengthening communities by
reducing teen pregnancy: At a glance 2011. Retrieved from
http://www.cdc.gov/chronicdisease/resources/publications/aag/pdf/2011 /TeenPregnancy-AAG-2011_508.pdf
Davis-Alldritt, L., Bushmiaer, M., Desisto, M., Lambert, P., Murphy, M. K., Roland, S., . .
National Association of School Nurses. (2011). Pregnant and parenting
students--the role of the school nurse. position statement. revised. National
Association of School Nurses,
Hoyt, H. H., & Broom, B. L. (2002). School-based teen pregnancy prevention programs: A
review of the literature. The Journal of School Nursing, 18(1), 11-17.
doi:10.1177/10598405020180010401
Meadows, M., Sadler, L. S., & Reitmeyer, G. D. (2000). School-based support for urban
adolescent mothers. Journal of Pediatric Health, 14(5), 221-227.
doi:10.1016/S0891-5245(00)06909Perrin, K. M., & Dorman, K. A. (2003). Teen parents and academic success. The
Journal of School Nursing, 19(5), 288-293. doi:10.1177/10598405030190050701
TEEN PREGNANCY PREVENTION AND SUPPORT
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Schaffer, M. A., Goodhue, A., Stennes, K., & Lanigan, C. (2012). Evaluation of a public health
nurse visiting program for pregnant and parenting teens. Public Health Nursing
(Boston, Mass.), 29(3), 218-231. doi:10.1111/j.1525-1446.2011.01005.x
Schaffer, M. A., & Mbibi, N. (2014). Public health nurse mentorship of pregnant and
parenting adolescents. Public Health Nursing (Boston, Mass.), 31(5), 428-437.
doi:10.1111/phn.12109
SmithBattle, L. (2006). Helping teen mothers succeed. The Journal of School, 22(3), 130-135.
doi:10.1177/10598405060220030201
SmithBattle, L. (2007). "I wanna have a good future": Teen mothers' rise in educational
aspirations, competing demands, and limited school support. Youth & Society, 38(3),
348-371. doi:10.1177/0044118X0628796