Adolescent
Pregnancy
A Global Perspective
Martha Gibson
HS 6423
Spring 2007
Worldwide
about 14
million
adolescent
girls give
birth, while
about 4.4
million have
abortions.
Source: People’s Daily (2007)
Implications of
Adolescent Pregnancy
 Social exclusion
 Greater
reproductive health
risks
 Increased risk of
poverty
 Increased risk of
maternal and infant
mortality
Source: Guttmacher Institute (2006)
Adolescent Pregnancy Contributes to the
Cycle of Poverty
According to Yampolskaya, Brown,
and Vargo (2004), “...approximately
60% of adolescent mothers live in
poverty at the time of the birth of
their babies, and approximately
73% go on welfare within 5 years
of giving birth.”
Associated Factors









Poverty
Unemployment
Failing Nuclear Families
Abuse
Early Menarche
Gang Activity
Domestic violence
Coercion
Early Marriage







Rape
Alcoholism
Substance Abuse
Social Pressures
Low Self Esteem
School Drop outs
Poor educational
opportunities
 Poor access to health care
 Influence of the media
Source: Data gathered from various cited resources (WHO, CDC,
Guttmacher Institute)
Higher Risk with Adolescent
Pregnancy, Birth and
Postpartum Complications




Hypertension
Eclampsia
Anemia
Difficult labor and childbirth as a result of
cephalopelvic disproportion
 Increased maternal mortality
 Low Birth Weight
Source: IRIN-Africa (2007)
It is a Global Issue
Most men have sex
before age 20.
% of men 20-24
100
80
60
40
20
0
11
13
15
18
20
Burkina Faso
Nigeria
Uganda
Zimbabwe
Brazil
Dominican Republic
Mexico
Peru
Italy
Japan
United States
Copyright: The Alan Guttmacher Institute
In Their Own Right- Worldwide
Approximate Pregnancy Rate
Per 1,000 girls < 20-years-old
350
Global
300
Latin America
250
South Africa
200
Netherlands
150
100
50
United States
Botswana
Russian Federation
Japan
Australia
France
Sweden
Canada
Great Britain
Ghana
0
Information in table was generated from data gathered from cited resources (Guttmacher Institute, WHO, CDC)
Worldwide, women
bear a greater
burden of sexual and
reproductive illhealth than men.
More than half a
million women die in
pregnancy and
childbirth in resource
constrained settings.
Source: WHO (2006)
Adolescent Pregnancy Leads
to Unsafe Abortions
 A study in Nigeria in the early 1990’s, that included
about 144 women (half of which were under 20 years
of age), reported many complications- including a 9%
death rate. Only 25% had no complications.
 In some urban areas unmarried adolescents represent
the majority of all abortion seekers.
 In developing countries, the risk of death following
unsafe abortions is several hundred times higher than
one performed professionally in safe conditions.
 Almost 14% of all unsafe abortions occur in
adolescents under the age of 20.
 The rate is higher in Africa than any other region.
Source: WHO (2004)
Chile
 More than 30,000 adolescents between the
ages of 15 and 19 give birth every year.
 From 1990 to 2003, the proportion of live births
to teenage mothers rose from 13.8 percent of
all births to 14.9 percent.
 In 2003, 17 of the 994 babies (1.7 percent)
born to mothers under age 15 died.
 335 of the 33,838 babies (1.0 percent) born to
mothers between the ages of 15 and 19 died.
Source: Health-Chile (2007)
Botswana
 In 1996, six out of 10 teenage girls had
been pregnant at least once, but only two
out of 10 in 2003.
 Among girls between the ages of 15 and
19 who have had sex, 40% have been
pregnant.
Source: Plus News Global (2007)
South Africa
 The number of pregnant school girls jumped from
1,169 in 2005 to 2,336 in 2006 in Gauteng.
 One in three girls has had a baby by the age of
20.
 16 percent of pregnant women under the age of
20 tested HIV positive.
 30 percent of girls in South Africa said "their first
sexual experience was forced or under threat of
force".
Source: IRIN Africa (2007)
Afghanistan
 57% of marriages are by girls under
the age of 16 years old which has
led to an increased maternal
mortality rate.
Source: Guttmacher Institute (2006)
Ghana
 More than half marry in their teens.
 12% aged 15-19 have had a child.
 25% report sexual coercion that leads to an
unintended pregnancy.
 39% aged 12-24 state that the last abortion
they were involved in took place at home.
The Alan Guttmacher Institute (2004)
United States
 One million teenagers become pregnant
annually.
 The United States has the highest rate of teen
pregnancy, childbirth and abortion among
developed countries
 63% give birth, and 22% have abortions.
Source: Adolescent Pregnancy and Childbirth in the U.S. (1999)
According to the Centers for Disease
Control (CDC), teenage pregnancy rates
nationally dropped 27 percent overall during
the years 1990-2000. Despite the decline,
the teenage pregnancy rate in the United
States is still the highest among
industrialized nations. Even with the drop,
35 percent of U.S. teenage girls become
pregnant at least once before age 20.
Source: Centers for Disease Control (CDC) (2004)
The 2005 Youth Pregnancy
Risk Behavior Survey
 47% of high school students had
sexual intercourse at least once.
 37% of sexually adolescent
students had not used a
condom.
Source: Branson (2006).
Adolescent Maternity
Threatens Achievement of the Millennium
Development Goals (MDGs) by 2015
 Since adolescent pregnancy leads to an
increased infant and maternal mortality rate,
achievement of the following goals will not be
met if current trends continue:
 Reduce by three-quarters the maternal mortality rate
 Reduce by two-thirds the under-five mortality rate
 Since in many parts of the world, pregnant girls
are not allowed to remain in school,
achievement of this goal will also not be met:
 Eliminate gender disparity in all levels of education
Source: Millennium Project (2005)
Healthy People 2010
 In an attempt to decrease adolescent
pregnancy, Healthy People 2010
recommended the goal of ….increasing the
“proportion of sexually active, unmarried
adolescents aged 15 to 17 years who use
contraception that both effectively prevents
pregnancy and provides barrier protection
against disease”
Source: Healthy People 2010
Recommendations
 Focus on women and girl’s reproductive
health and education outcomes.
 Provide Emergent obstetric care.
 The provision of reproductive health care
services to teens requires sensitivity to
the special needs of this age-group
including knowing about laws about
confidentiality and services for birth
control, pregnancy, abortion, and
adoption.
Source: Stanhope and Lancaster (2006)
 Thorough assessments are vital, because factors
such as a history of sexual victimization, family
dysfunction, substance use, and failure to use birth
control can influence whether a young girl becomes
pregnant.
 The pregnant teen will need support during and
after pregnancy from her family and friends and
from the father of the baby.
Source: Stanhope and Lancaster (2006)
Reforms
 In Chile, under the new regulations, public health services are
authorized to prescribe, and to provide free of charge, traditional and
emergency contraceptives to adolescents over 14, without the need
for parental consent.
 In Botswana, increased child support rules and daycare and
encouragement for teens to stay in school have led to decreased teen
pregnancy rates.
 In Ghana, Media Campaigns to encourage condom use among
sexually active youth are proving to be effective in reducing the
number of adolescent pregnancies.
Source: Health-Chile and Plus News Global

The “Young and Wise” campaign sponsored by Planned Parenthood in
Ghana is another good campaign to decrease the number of adolescent
pregnancies.

The African Youth Alliance is moving towards progress in reducing
adolescent pregnancy.

The “Stop Aids Love Life” program in Ghana is also an effective tool in
promoting self esteem leading to lower incidences of adolescent pregnancy.
Source: Plus News Global (2007)
Successful Pregnancy
Prevention Programs
 Include collaborative approaches by the
teens, their families, teachers, health
professionals, businesses, the faith
community, lawmakers, and other
community organizations.
Source: Brandis, Sattley, and Mamo (2005)
The Parent-Adolescent
Relationship Education
(PARE) Program
 The program provides a curriculum for prevention of
STDs and pregnancy in middle school youth and
focuses on strengthening family communication about
sexual issues and behaviors to help prevent teen
pregnancy.
 The National Campaign to Prevent Teen Pregnancy
advocates PARE and includes information about
reproduction, sex risks, and safe-sex behaviors
including contraception and abstinence.
 PARE emphasizes the importance of parental
involvement on the reduction of early pregnancies.
Source: Lederman, R.P., & Mian, T.S (2003).
Education is Key

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

Source: People's Daily (2007)
Education should be started before the age
of 14, when young people become sexually
active.
Information should be provided for
teenagers about avoiding unintended
pregnancies, including detailed information
about contraception and its side effects.
There should be better management and
training for nurses, so they can deal
sympathetically with teenagers requiring
contraception and provide the necessary
information and education campaigns that
take away the stigma of teenage sexuality,
so that adolescents are not afraid to ask for
contraception.
All teenagers should not just be allowed to
remain in school and to return to school
after birth, but they should be strongly
encouraged to do so.
Every minute, somewhere in the
world a young mother dies from
complications in pregnancy and
childbirth. Four million babies die
each year within their first 28 days
of life, and another 3.3 million are
stillborn. Millions of lives could be
saved using the knowledge we have
today, but the challenge is to
transform this knowledge into
action.
Source: World Health Organization (WHO) (2006)
References
Adolescent Pregnancy and Childbirth in the U.S. (1999) Retrieved March 10, 2007, from
http://www.prcdc.org/adolescent_pregnancy_and_childbearing_us.pdf.
Alan Guttmacher Institute (2004). Adolescents in Ghana: Sexual and reproductive health.
Retrieved March 10, 2007, from www.guttmacher.org
Alan Guttmacher Institute ( 2006). In their own right-Addressing the sexual and reproductive
health needs of men worldwide. Retrieved March 11, 2007, from www.guttmacher.org
Brandis, C. D., Sattley, D., & Mamo, L. (2005). Theory to action: Frameworks for
implementing community-wide adolescent pregnancy prevention strategies. Retrieved
October 27, 2006 from http://crhrp.ucsf.edu
Branson, B. (2006). Revised recommendations for HIV testing of adults, adolescents, and
pregnant women in health-care settings Retrieved March 5, 2007, from
www.cdc.gov/mmwR/preview/mmwrhtml/rr5514a1.htm
Centers for Disease Control and Prevention (CDC) (2004). National Center for Health
Statistics (NCHS) data on teenage pregnancy. Retrieved September 26, 2006 from
www.cdc.gov.
Guttmacher Institute (2006). Retrieved March 10, 2007, from http://www.guttmacher.org
Health-Chile (2007). Teen pregnancy bucks global downward trend. Retrieved March 14,
2007, from http://ipsnews.net/news.asp?idnews=36729
Healthy People 2010. Retrieved September 27, 2006 from www.healthypeople.gov
•
IRIN-Africa (2007). South Africa: Teenage pregnancy figures cause alarm. Retrieved March 14,
2007, from http://www.irinnews.org/Report.aspx?Reportid=70538

Lederman, R.P., & Mian, T.S. (2003). The parent-adolescent relationship education (PARE)
program: A curriculum for prevention of STDs and pregnancy in middle

Millennium Project (2005). Investing in development: A practical plan to achieve the millennium
development goals.

People’s Daily (2007). Health services grow to meet increase in teen pregnancy. Retrieved
March 9, 2007, from http://english.people.com

Plus News Global (2007). Botswana: Baby steps in bringing down teen pregnancy. Retrieved
March 14, 2007, from http://www.irinnews.org/Repoert.aspx?Reportid=39151

Stanhope, M. and Lancaster, J. (2006). Foundations of nursing in the community. Mosby. St
Louis.

WHO (2004). Unsafe abortion: Global and regional estimates of the incidence of unsafe
abortion and associated mortality. Retrieved March 8, 2007, from www.who.int/reproductive
health/publications/unsafe_abortion_estimates_04

WHO (2006). Sexual and reproductive health of women living with HIV/AIDS. Retrieved March
5, 2007, from http://www.who.int/hiv/en

Yampolaskaya, S., Brown, E. C., & Vargo, A. C. (2004). Assessment of teen pregnancy
prevention interventions among middle school youth. Child and Adolescent Social Work
Journal, 21, 69-83.