Teen Pregnancy
Misty Thompson DO
August 19, 2011
Financial Disclosures

I do not have any financial or beneficial
relationship to disclose that may pose a conflict
of interest
Objectives
Review statistics regarding teen pregnancy
trends
 Discuss available options for pregnant teens
 Discuss maternal and neonatal morbidities as
they relate to teenage pregnancy
 Review how the media can affect teen
pregnancy
 Discuss the physician’s role in pregnancy
prevention, discussion of options, and prenatal
care.

Teen Pregnancy Statistics
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The US has the highest rates of teen pregnancy
and births in the western industrialized world
Teen pregnancy costs the world approx. $10
billion annually
34% of young women become pregnant before
the age of 20 (approx. 820,000/yr)
State Levels & Trends
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Between 2000-2005, teen pregnancy rates
declined in every state except North Dakota
States with the highest teenage birth rates are
MS, TX, NM, AR, AZ
The states with the lowest teenage birth rates are
NH, VT, MA, CT, NJ.
Facts on Teen Pregnancy
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Very few teens who become mothers plan on
doing so; 82% are unintended, and teens
account for 20% of unintended pregnancies
annually
Two-thirds of teen pregnancies occur among 1819 year olds
Accounts for 11% of all US births
Facts on Teen Pregnancy
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Out of all teen pregnancies, 57% end in birth
14% result in miscarriage
29% are terminated by abortion
US teen pregnancy rates are higher than those of
other developed countries
Teen Pregnancy Risk Factors

Teens becoming sexually active earlierpregnancy rates in among those under 15 years
of age are on the rise. A large portion of these
girls had an unwanted or non-voluntary
experience their first time, but were more likely
to go on to have more intercourse
Teen Pregnancy Risk Factors
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Among ethnic groups, African Americans and
Hispanic teens are more likely to become
sexually active earlier
Socioeconomic factors-Risky sexual behaviors in
teens are more likely to occur in poor families,
and among those with single parents. A study
found that teens girls whose fathers were not
present in the home were more likely to become
pregnant than those who had regular contact
and good relationships with their fathers .
Teen Pregnancy Risk Factors

Parents’ education levels-Those teenagers whose
parents have lower levels of education are more
likely to engage in risky sexual behavior, and
more likely to become pregnant.
Teen Pregnancy Risk Factors
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Teen religious involvement-Teenagers who have
a low occurrence involvement in religious
activities are more likely to experience teen
pregnancy. Involvement in religious activities is
one of the strongest factors related to delayed
sexual activity.
Teen Pregnancy Risk Factors
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Educational involvement-Teens that focus on
school activity are less likely to engage in
intercourse, and are more likely to use birth
control when they do.
Drug & alcohol use-Inhibition reducing drugs &
alcohol may encourage unintended sexual
activity (cannabis & amphetamines)
Teen Pregnancy Risk Factors

Age discrepancy in relationships-studies in the
US indicate that age discrepancy between the
teenage girls and the men who impregnate them
is an important contributing factor. Teenage
girls in relationships with older boys, and in
particular with adult men, are more likely to
become pregnant than teenage girls in
relationships with boys their own age.
Teen Pregnancy Risk Factors

Sexual abuse-between 11 and 20 percent of
pregnancies in teenagers are a result of rape,
while 60% of teenage mothers had unwanted
sexual experiences preceding their pregnancy.
Studies have found a strong link between
childhood sexual abuse and teen pregnancy. Up
to 70% of women who gave birth as a teen
report being molested as young girls.
Teen Pregnancy Risk Factors
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Dating violence-Studies show teens are often in
abusive relationships at the time of conception,
and the knowledge of their pregnancy intensifies
controlling or violent behaviors of their
boyfriends. 51% of teenage mothers have
experienced birth control sabotage, 21%
experienced school or work sabotage
Teen Pregnancy Prevention
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In the US, the topic of sex education is the
subject of much debate. “Abstinence-only”
education & virginity pledges are becoming
more popular in some schools. However, 88%
of those who pledge abstinence have premarital
sex anyway. Most public schools offer
abstinence education along with advice about
contraception.
Teen Pregnancy Prevention
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Relationships with inequalities tend to be
associated with lower contraceptive use &
consistency
Condom use is more frequent with casual sexual
partners
Consistent birth control use occurs in
relationships where partners have discussed
birth control prior to first having sex
Teen Pregnancy Prevention
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Discussions between sexual partners about
condoms and sexual histories are consistently
linked with improved condom use
The younger teenagers are at the time of sexual
encounters with their partners, the less likely
they are to use birth control.
Teen Pregnancy Prevention
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Family and individual characteristics such as
higher family socioeconomic status, living with
both biological parents, and receiving sex
education are associated with improved
contraceptive use and consistency.
Teens and Birth Control
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There are many reasons teens may not use birth
control, even if they do not want to have a baby.
They may:
Think they will not get pregnant
Be afraid to go to a health care provider or clinic
to ask for birth control
Not know how to get birth control or think they
cannot afford it
Teens and Birth Control
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Worry about their parents finding out
Be afraid of what their partner thinks about
birth control
Think that birth control might hurt their ability
to get pregnant in the future
Have sex that was not planned
Think they will not get pregnant the first time
they have sex
Teens and Birth Control
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In most states, minors (people younger than 18
years) have the right to make choices about birth
control without their parents’ permission.
Inform patients that if they use their parents’
health insurance to pay for birth control or a
provider’s visit, it may appear on a bill that the
parents receive
Teens and Birth Control
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Education about how pregnancy occurs will
help teens understand how the different
methods of birth control work
Discuss emergency birth control
Options for Pregnant Teens
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When a teen pregnancy occurs, the young
woman is faced with a decision as how to
proceed with the pregnancy and/or birth.
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There are three choices available: adoption,
abortion, and teen parenting.
Adoption
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Adoption is the least prevalent option among
pregnant teens.
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Only 1-2% of women place their children up for
adoption, and the number of teens who place their
babies for adoption has declined sharply over recent
decades.
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There are 3 adoption types: closed, semi-open, open
Closed Adoption
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A confidential adoption in which the adoptive
family and birth mother remain confidential, with
no contact prior to or after the placement of the
child. For many generations, it was common
practice to keep all adoptions closed. Some people
believe closed adoptions to be safer, mainly out of a
fear that if the birth parents know where the
adoptive family lives, that they will take back the
adopted child.
Semi-Open Adoption
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The adoptive family and birth parents usually
will know basic information about each other,
such as their first names and state of residence.
Complete contact information, such as phone
numbers and addresses, are not shared. While
adoptive families and birth parents may speak
to one another prior to the birth of the child,
some confidentiality is maintained.
Semi-Open Adoption
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Once the child has been placed with the
adoptive family, the birth parents may still
stay in contact with the family via letters and
pictures, however this correspondence is
handled by a third party, such as the adoption
agency.
Open Adoption
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Open adoption typically means that the birth
parents and the adoptive family speak prior to
and even after the child is born. This may
include phone calls and face-to-face visits.
Open Adoption
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Some adoptions of this nature are very open,
with the adoptive family and birth parents
exchanging contact information and agreeing to
periodic visits by the birth parents as the child
grows. It is also common in open adoptions for
the adoptive family to mail pictures and letters
to the birth parents.
Abortion
Of teenagers who become pregnant, 29%
choose to have an abortion rather than bear a
child.
 Many states have enacted laws that restrict
teenagers' access to abortion by requiring
parental involvement in the abortion decision.
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Abortion
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Parental notification laws-require medical
personnel to notify a minor's parent(s) of her
intention to obtain an abortion
Parental consent laws-require medical personnel to
obtain written permission from the parents before
providing an abortion
Almost all of the parental notification and consent
laws have judicial bypass options that allow a teen
who feels she cannot involve her parents to get a
judge's permission to proceed with her abortion.
Abortion
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Abortion providers encourage teenagers to tell a
parent or another important family member
about their plans. Even without state laws, one
or both parents of 61% of minors know about
their daughters' abortions. The younger the teen,
the higher the likelihood that she has told her
mother about the situation.
Abortion
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Those young women who do not or cannot tell their
parents often have important reasons such as a family
history of alcoholism, abuse, or incest. To involve
such parents could invite further abuse of the
teenager.
Rather than tell their parents, some teenagers resort
to unsafe, illegal abortions or try to perform the
abortion themselves. In doing so, they risk serious
injury, death, or criminal charges.
States Ranked by Rates of Teen
Abortion
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New Jersey (47)
New York (46)
Maryland (38)
Nevada (36)
California (36)
Hawaii (34)
Florida (33)
Delaware (31)
Connecticut (30)
Illinois (27)
Teen Parenting
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Over half of teen pregnancies end with the
woman choosing to deliver and rear the
child.
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Teen mothers are less likely to complete
high school or college than women who
delayed having children, and fewer than
1/3 of teen mothers complete high school.
Teen Parenting
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80% of teen mothers receive welfare at some point.
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25% of teen mothers have another child within two
years of their first birth.
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Teen pregnancy often creates a cycle of poverty, crime,
and further teen pregnancy.
Teen Parenting
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Sons of teen mothers are 2.7 times more
likely to go to prison than sons of women
that had children after the age of 20
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Children of teenage mothers are twice as
likely to be abused and neglected than
children born to women over the age of 20.
Pregnancy Complications
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There are special risks to a baby when the
mother is not fully mature. Because most
teenagers are not physically, emotionally, or
financially ready to carry and care for a child,
their babies tend to have LBW & are
predisposed to a variety of illnesses. A teen
mother will need the full support of her
family to live a healthy lifestyle for her and
her baby.
Pregnancy Complications
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Compared with older age groups, teen mothers
are at greater risk of having medical
complications.
Because the teenage mother is more likely to
receive little or no prenatal care, she often
becomes anemic
Teens are more likely to develop preeclampsia &
have preterm labor
Pregnancy Complications
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Vitamin deficiencies are more common
A teenage mother’s weight gain is likely to be
inadequate-since the mother is still growing
herself, she needs to eat properly not only for
her own growth but for normal growth of the
fetus.
Pregnancy Complications
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Pelvic bones do not reach their maximum size
until about the age of 18; therefore, the pelvis of
the teenage mother may not have grown enough
to allow vaginal delivery of a normal-size baby.
For this reason, the incidence of cesarean
section is higher in teenage mothers
Pregnancy Complications
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Babies born to teenage mothers are more likely
to die in the first year of life compared with
babies born to mothers older than 20 years of
age.
Since the teenage mother is less likely to eat
correctly during pregnancy, her baby often has a
low birth weight, making it more likely the baby
will become ill.
Teens are more likely to smoke, drink, or take
drugs during pregnancy
Pregnancy Complications
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The teenage mother should be encouraged to
seek prenatal care early in pregnancy, eat a
nutritious diet, take prenatal vitamins, and
engage in healthy physical activity. A supportive
family can help the teenage mother cope with
her new responsibilities, and social service
agencies may be needed to help find ways to
finish school and seek employment.
Children Born to Teen Mothers
Children born to teenage mothers are less
likely to receive proper nutrition, health care,
and cognitive and social stimulation. As a
result, they are at risk for lower academic
achievement.
 Children born to teenage mothers are at
increased risk for abuse and neglect.
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Children Born to Teen Mothers
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Babies born to women who do not have regular
prenatal care are 4 times more likely to die
before the age of 1 year.
Girls born to teenage mothers are 22% more
likely to become teenage mothers themselves.
Is the Media
Glamorizing Teen
Pregnancy?
Teen Pregnancy and the Media
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Teen pregnancy has gained significant attention
in the media in recent years (from MTV’s
popular shows 16 & Pregnant and Teen Mom to
recent cover stories in major magazines).
Some have criticized these efforts for
glamorizing teen pregnancy. New research
suggests that teens do not share that view.
Teen Pregnancy and the Media
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According to a poll by The National Campaign
to Prevent Teen and Unplanned Pregnancy,
most teens (79% of girls & 67% of boys) agree
that when a TV show or character they like deals
with teen pregnancy, it makes them think more
about their own risk of getting pregnant or
causing a pregnancy and how to avoid it.
Teen Pregnancy and the Media
Among those young people who have watched
MTV’s 16 and Pregnant, 82% think the show
helps teens better understand the challenges of
teen pregnancy and parenthood and how to
avoid it.
 76% of young people say that what they see in
the media about sex, love, and relationships
can be a good way to start conversations with
adults.
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Teen Pregnancy and the Media
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93% of those who had watched 16 & Pregnant
agreed with the statement: “I learned that teen
parenthood is harder than I imagined from these
episodes.”
About half (48%) say they have discussed these
topics with their parents because of something
they have seen in the media.
Conclusion
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The most important role of physicians is to be
proactive & ask all teenaged patients about
sexual activity and sexual health issues
Inquire about contraception use
Abortion counselling and referral should be
provided when needed
Conclusion
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Many adolescents have the emotional and
cognitive maturity to receive confidential health
services, but many are not aware that they are
entitled to patient confidentiality
If pregnant teens choose to carry to term,
exemplary care should be provided before,
during, and after delivery to help minimize the
risk of negative outcomes.
References
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womensissues.about.com/od/datingandsex/a/
TeenAbortRates.htm
www.solutionsforamerica.org/healthyfam/teen
age-pregnancy.html
www.advocatesforyouth.org/teen-pregnancyprevention
www.ncsl.org/IssuesResearch/Health/Abortion
Laws/tabid/14401/Default.aspx
References
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www. Pregnantteenhelp.org
www.thenationalcampaign.org
Pregnancy.adoption.com
www.livestrong.com/article/96985complications-teenage-pregnancy
www.cdc.gov/nchs/fastats/teenbrth.htm