Adolescent Pregnancy & Older Parenting
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Developmental Tasks of Adolescence
o Acceptance of and comfort with one’s body image
o Sexual identity development
o Development of personal value system
o Development of a sense of productivity
o Identification of a life’s work
o Achievement of a sense of independence
o Development of adult identity
o A major psychological risk to a pregnant teen is interruption in completing her developmental tasks
Factors Contributing to Adolescent Pregnancy
o Poverty
o Low educational achievement
o Age and family situations
o High Risk behaviors
o Knowledge deficit
o Emotional factors
Physiologic Risks Related to Adolescent Pregnancy
o Developmental level
o Not completed their own growth
o Not getting into early prenatal care
o Preterm labor, low birth wt, CPD, iron deficiency anemia, preeclampsia, IUGR
 The younger you are the more likely you are to develop preeclampsia, also if it’s your first baby
 140/90 can be an indicator of mild preeclampsia, also look for protein in the urine
o Increased risk STD’s
Sociologic Risk/Issues
o High drop out rate, disrupted education
o Dependence on parents
o Single parent status
o High divorce rates
o Teens live in the “here and now”
o Children of teen moms at risk for abuse and neglect
o Legal abortion = higher pregnancy rates
o Most teen pregnancies are unplanned
o Less adult supervision leads to a higher teen pregnancy rate
o Teens who participate in after school activities have lower pregnancy rates
o Teens with future goals tend to use birth control and will have more abortions if they get pregnant
o The younger the pregnant teen the higher the incidence for future teen pregnancies
o Familial tendency to have teen pregnancies
 Your mom had you as a teen, your sister got knocked up early, you’re more likely to get knocked up early
o Peer pressure high to become sexually active
o A lot of teens don’t use contraception and lack knowledge about contraception
Developmental Tasks and Considerations of an Early Adolescent <15 years
o Concrete thinker
o Usually has some degree of discomfort with normal body changes and body image
o Has a minimal ability to foresee the consequences of her behavior and see herself in the future
o Has an internal focus of control
o Turns to parents for help
o May not understand their habits affect the fetus, will need help problem solving
Developmental Tasks and Considerations of a Middle Adolescent 15-17 years
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Prone to experiment with drugs, alcohol and sex
 Many drugs cross the placenta, drugs with low molecular weight
 Cocaine is lipid soluble, so it can cross the placenta
 When baby is born they are born addicted to that drug, will need close care and supervision
o Seeks independence and frequently turns to her peer group for support.
o Pregnancy at this age can force a parental dependency and interfere with her striving for independence.
o Economic dependence on parents
o Capable of formal operational thought and abstract thinking, but may have difficulty anticipating the long term
implications of her actions.
o Can absorb more detailed information. May not have assertive communication skills
Developmental Tasks and Considerations of a Late Adolescent 17-19 years
o Is developing individuality
o Capable of thinking abstractly and anticipating consequences
o Capable of problem solving and decision making
o Can picture herself in control
o May have a relationship with child’s father
o Can handle complex information
Adolescent Fathers
o Developmental status
o Relationship with mother of child
o Needed support
o May be a source of emotional support for the teen mom
Reaction of Family Members
o Variation
o Can help with decision making
o Varied level of support
o Mother of teen mom more involved
o The younger the teen mom, the more support is needed from the family
o Teen pregnancy is more socially acceptable today
o Some teens may deliberately get pregnant to punish parents or to get out of the house
o Very young adolescent pregnancy could be a result of incest, sexual abuse or rape
o **So social service follow-up is necessary!
Planning Care for Adolescent
o Every teen pregnancy is a different situation
o Priority assessment> consider developmental level!
o Motivate teen to attend clinic appointments and to take an active role in her own care
o Focus on the present rather than the future > need concrete approach
o Early prenatal care and education is vital
o Ask these questions
 Are realistic role models available to her?
 How much does she know about child development?
 Can she resolve conflicts and manage anger?
 Does she need information about community resources?
o Care giver establish trust
o May attend another school for pregnant teens
o Teen specific childbirth classes the best
o Teen’s mom and teen father are usually involved, relationship will vary
o Teen can sign her own consents
o Address birth control to prevent another pregnancy soon
o Good birth control choices for teens > patch, vaginal ring or Depo provera injection
o IUD’s or diaphragms not recommended for teens
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Stuff from the bottom of the slide
 Patch – change every two weeks
 Vaginal ring – insert ring into vagina on or before the 5th day of menstrual period.Remove after 3 weeks.
Leave out one week then insert new ring.
 Depo Provera – Start on day 1-5 of menstrual cycle. Do not use until age 23 or for more than 2 years due
to bone loss. Take every 3 months.
 Norplant – this was 5 rods implanted under the skin. It has been off the market for approximately 3 years.
Long term use caused anovulatory cycles which is bleeding monthly but is not ovulating.
 IUD’s or diaphragm – Teens will not use diaphragm (too much trouble). IUD’s are not a good idea unless
the person is in a definite monogamous relationship. Risks of infections is very high.
Pregnancy Prevention Programs
o Teens are having sex, so need to address it
o But, conflict with local groups and educators about route to take regarding education > abstinence vs sex
education
Care of the Expectant Couple over Age 35
o Incidence—highest incidence in more than three decades
 More effective birth control methods
 Expanded roles and careers for women
 More women delaying parenthood for careers
 Delayed age for marrying and more second marriages
 More specialized fertilization methods
o Age-related medical risks
 Greater risk of maternal death
 More chronic illness in older women
 More low-birth-weight babies
 More preterm babies
 More placenta abnormalities
 More congenital abnormalities
 More macrosomia
 More spontaneous abortions
 More small-for-gestational-age infants and fetal mortality
 More cesarean births
 More Down syndrome
o Planning nursing care for the couple over 35
 Prenatal care
 Genetic screening
 Amniocentesis
 Quadruple screening
 Ultrasound—assessment of nuchal fold
 Special concerns
 Age
 Infertility
 Complex family constellation due to previous marriages and children