PREGNANCY IN ADOLESCENCE: INFORMATION FOR PARENTS AND EDUCATORS By Adena B. Meyers, PhDIllinois State University
The term adolescent pregnancy brings to mind a number of related issues such as adolescent
sexuality, premarital sex, birth control, abortion, adolescent childbearing, adolescent parenthood,unplanned pregnancy, unintended birth, out-of-wedlock birth, and single motherhood. Many of theseissues are highly controversial. Therefore, it may be difficult to consider adolescent pregnancy itself.
Though adolescent pregnancy is related in one way or another to all of these other issues, it is
important to keep in mind that it is distinct from each of them. Adolescent pregnancies, like adultpregnancies, may be planned or unplanned; may involve married couples or single individuals; and mayresult in miscarriages, abortions, or childbirth. Although adolescent sexual behavior may sometimesresult in pregnancy, usually it does not. Background
The idea that adolescent pregnancy is a problem, and one that should be prevented, is relatively new.
During the baby boom of the 1950s, more than 25% of all women had their first birth before age 20, yetthis was not considered worrisome. Not until the early 1970s, when pregnant and parenting teenagers wereless likely to be married, did adolescent pregnancy begin to seem a serious social problem.
In recent years U.S. rates of adolescent pregnancy, abortion, and childbirth have been steadily
declining. Between 1970 and 1990, more than 1 million adolescents in the United States becamepregnant each year, but by the late 1990s, the number had dropped to fewer than 900,000 per year. Similarly, 12% of all teenage women in the United States became pregnant in 1990, yet fewer than 9%became pregnant in 1999. Whereas about 4.5% of all teenage women had abortions each year duringthe mid 1980s, this rate has declined throughout the 1990s to 2.5% in 1999.
Research indicates that a variety of factors have contributed to these declines, including a small
drop in the rate of adolescent sexual behavior and a small increase in contraceptive use among sexuallyactive teens. In addition, state laws requiring minors to obtain parental consent or to notify their parentsbefore obtaining an abortion also may help explain trends in adolescent abortion.
However, the most important factor in the reduction in teen pregnancy, childbirth, and abortion
appears to be an increased use of more effective contraceptive methods. That is, more adolescents thanever before are using highly effective long-acting hormonal contraceptives such as Norplant and Depo-Provera. Although these methods of birth control do not stop the spread of sexually transmittedinfections such as HIV, they are extremely effective for pregnancy prevention. With hormonal implants orshots, adolescents do not have to remember to take a pill every day or know how to use condomsproperly to be protected against unwanted pregnancy.
Despite these trends, teenage pregnancy and childbearing are still occurring in the United States at
exceedingly high rates when compared to other developed countries. For example, recent statisticsindicate that adolescents become pregnant in the United States at nearly twice the rate of adolescentsin Great Britain and Canada, and at roughly four times the rate of those in France.
This is alarming because of the many negative consequences associated with adolescent pregnancy.
It is estimated that adolescent pregnancy costs society as much as $7 billion per year. Close to 80% ofadolescent pregnancies in the United States are unplanned, with about one-third ending in abortionsand more than 40% ending in unintended births. Today, most adolescents giving birth are not married(e.g., in 1996 fewer than one fourth of adolescents who gave birth were married), yet only a smallfraction of teen pregnancies result in adoption.
Moreover, adolescent childbearing appears to be associated with a variety of negative outcomes for
young mothers and their children. For example, adolescent mothers are more likely than their same-age peers
Helping Children at Home and School II: Handouts for Families and Educators
to drop out of school, rely on welfare, be unemployed, and
believe that families are the most appropriate providers
report high levels of psychological distress such as anxiety
of sexuality education and pregnancy prevention
and depression. Pregnant adolescents are less likely than
messages, and others prefer to leave the responsibility
older women to obtain adequate prenatal health services,
entirely in the hands of schools, effective prevention
and are more likely to deliver pre-term and low birth-weight
does involve the active participation of parents as well
babies. Ultimately, their children are at risk for a number of
developmental problems including cognitive delay, schoolfailure, and aggressive behavior.
What Schools Can Do
Many schools include some form of pregnancy
Teen Fathers? Not Necessarily
prevention within their health education curricula. Best
Research indicates that teenage fatherhood may
practice would suggest that any school-based attempts
not play as large a role as adult fatherhood in the
phenomenon of teenage pregnancy. It is estimated thatas many as two thirds of the fathers of children born to
Sexuality education: Effective prevention programs
school-age mothers are adults, and these adult fathers
usually include educational components that
are often at least four years older than the adolescent
provide accurate information about the risks
mothers of their babies. Having an adolescent father is
associated with unprotected intercourse and
not necessarily a disadvantage for the children of
methods to avoid these risks. A concern raised in
adolescent mothers. For example, older fathers are no
some communities is that teaching young people
more likely than younger fathers to be involved in their
about sex and birth control may convey the
children’s upbringing. Regardless of the father’s age,
message that it is suitable for teens to have sex.
fathers who are involved during adolescent pregnancy
The research data suggest this concern is
and childbirth are more likely to be involved during the
unfounded. Pregnancy prevention programs do not
significantly increase rates of sexual activity,
Problematic developmental outcomes have been
regardless of whether the programs emphasize
observed among teens who do become fathers.
Research suggests that teenage fathers have higher
Active learning: Effective programs tend to use
rates of school dropout, absenteeism, and legal conflict
active learning techniques to present sexuality
when compared to adolescent boys who are not fathers.
information. Examples include group discussions,
In addition, there is some evidence that being physically
role-playing, and live skill practice (e.g., going to
or sexually abused or exposed to domestic violence in
stores or clinics to practice accessing birth control).
childhood increases the odds that a boy will become
Access to birth control: Most effective pregnancy
involved in an adolescent pregnancy, either as a
contraceptive services, often through school-basedor school-linked clinics. Obviously, distributing birth
control in schools is highly controversial. However,
Although adolescent pregnancy occurs among all
research indicates that providing adolescents with
racial, cultural, and socioeconomic groups, some
access to contraception does not result in increased
adolescents are more likely than others to become
pregnant. Adolescents who experience some or all of the
Interpersonal skills: Many effective programs include
following are at greatest risk of becoming pregnant:
training in interpersonal skills such as decisionmaking, negotiation, communication, and refusal of
Low academic achievement and low career aspirations.
sexual advances. This training generally involves
modeling, instruction, and various types of skill
Socioeconomic disadvantage including poverty and
being raised in a single-parent home. Values: Effective programs take a clear stand
Early sexual behavior (i.e., before the age of 15).
regarding what is and is not appropriate, and are
Lack of parental monitoring and supervision.
designed to shape group norms. Many specificallyemphasize abstinence as the best way for teens to
avoid unwanted pregnancy. However, since birth
Adolescent pregnancy is both a private problem
control information and access are also important,
that occurs within families and a public problem that
many effective interventions teach that abstinence
affects entire communities. Although some people
is the best choice, but they also encourage
Pregnancy in Adolescence: Information for Parents and Educators
adolescents to practice safer sex should they chose
adolescents report that they have not discussed sex
with their parents. A one-time discussion about
Abstinence versus safer sex: The relative emphasis
pregnancy will be much less effective than an on-
placed on abstinence, as opposed to safer sex,
varies from program to program. Effective programs
Monitor your adolescent’s activities: Setting limits is
promote norms and values appropriate for the
an important part of a parent’s responsibility. These
specific populations they target. For example, an
limits change as children mature, but even with
intervention aimed at middle-school students who
adolescents, it is important to be aware of what your
have not yet become sexually active places the most
children are doing, where they are, and with whom.
emphasis on abstinence. In contrast, interventions
Seek out accurate information: It is fine if you do not
aimed at high-risk teens who are predominantly
know all the answers. Numerous resources are
sexually experienced stress condom use and other
available for those who are seeking information
Drop out prevention: Poor academic performanceand low career aspirations place adolescents at risk
for teen pregnancy. There is evidence that reducing
Meyers, A. B., & Landau, S. (2000). Preventing early
school drop out rates and helping struggling
sexual behaviors: Sociopolitical issues and the
students succeed in school, as well as plan their
design of empirically supportable school-based
future careers, actually lead to lower rates of teen
interventions. In K. Minke & G. Bear (Eds.),
Preventing school problems—Promoting schoolInvolvement of parents: Parents are likely to feel
success: Strategies and programs that work (pp.
more comfortable about school-based sexuality
299–336). Bethesda, MD: National Association of
education and pregnancy prevention if they are
School Psychologists. ISBN: 0-932955-89-4.
invited to participate in curriculum development.
Websites What Parents Can Do
Alan Guttmacher Institute—www.agi-usa.org
Parents can contribute to pregnancy prevention in a
Provides access to Fact Sheets and reports
summarizing recent statistics about adolescentsexuality and pregnancy. It also offers a full-text
Be involved: Learn what types of pregnancy
version of the current issue of Family Planning
prevention services are provided in your community
and at your child’s school. If possible, participate in
Centers for Disease Control and Prevention—
curriculum development. Know what is covered and
what is not, so that any discussions that you have
Information about health promotion, disease
with your child can complement the information
prevention, and epidemiological data.
Planned Parenthood Federation of America—
Be realistic: By the time adolescents graduate from
high school, some have not had sexual intercourse.
However, more than half have become sexually
active. Even if your adolescent is not sexually active,
developments (particularly regarding abortion laws
it is likely that some members of the peer group are
and policies), answers to frequently asked questions
sexually experienced. Many youngsters report that
about sexual health, and information targeted
they learn more about sex from their peers than
specifically at adolescents. It also provides a list of
Be brave: Even though discussions with your teen
Sexuality Information and Education Council of the
about sensitive subjects such as sex, relationships,
United States (SIECUS)—www.siecus.org
and birth control can be uncomfortable for many
Offers an array of comprehensive sexuality
parents, these conversations can be extremely
education resources for adolescents, parents,
important. For example, research indicates that
professional educators, and religious groups as well
teenagers who discuss condoms with their mothers
as information specifically relevant to adolescent
Be persistent: Nearly all parents report they have
discussed sex with their adolescents, but many
includes a detailed annotated bibliography, Sexuality
Helping Children at Home and School II: Handouts for Families and Educators
Education in the Home(www.siecus.org/pubs/biblio/bibs0011.html), thatdescribes more than 100 print, video, and on-lineresources available for families, parents, children,and adolescents and provides easy access to on-line
Psychologists (NASP) offers a widevariety of free or low cost onlineresources to parents, teachers, and others
Adena B. Meyers, PhD, is an Assistant Professor ofPsychology at Illinois State University.
the NASP website www.nasponline.org
and the NASP Center for Children & Families website
2004 National Association of School Psychologists, 4340 East West Highway,
www.naspcenter.org. Or use the direct links below to
Suite 402, Bethesda, MD 20814—(301) 657-0270.
access information that can help you improve outcomesfor the children and youth in your care.
About School Psychology—Downloadable brochures, FAQs, and facts about training, practice, and career choices for the profession. www.nasponline.org/about_nasp/spsych.html Crisis Resources—Handouts, fact sheets, and links regarding crisis prevention/intervention, coping with trauma, suicide prevention, and school safety. www.nasponline.org/crisisresources Culturally Competent Practice—Materials and resources promoting culturally competent assessment and intervention, minority recruitment, and issues related to cultural diversity and tolerance. www.nasponline.org/culturalcompetence En Español—Parent handouts and materials translated into Spanish. www.naspcenter.org/espanol/ IDEA Information—Information, resources, and advocacy tools regarding IDEA policy and practical implementation. www.nasponline.org/advocacy/IDEAinformation.html Information for Educators—Handouts, articles, and other resources on a variety of topics. www.naspcenter.org/teachers/teachers.html Information for Parents—Handouts and other resources a variety of topics. www.naspcenter.org/parents/parents.html Links to State Associations—Easy access to state association websites. www.nasponline.org/information/links_state_orgs.html NASP Books & Publications Store—Review tables of contents and chapters of NASP bestsellers. www.nasponline.org/bestsellers Order online. www.nasponline.org/store Position Papers—Official NASP policy positions on key issues. www.nasponline.org/information/position_paper.html Success in School/Skills for Life—Parent handouts that can be posted on your school’s website. www.naspcenter.org/resourcekit
Pregnancy in Adolescence: Information for Parents and Educators
BMJ 2013;346:f1 doi: 10.1136/bmj.f1 (Published 7 January 2013) EDITORIALS Drug-grapefruit juice interactions Two mechanisms are clear but individual responses varyMunir Pirmohamed professor of clinical pharmacology Wolfson Centre for Personalised Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool L69 3GL, UKGrapefruit juice, which is widely consumed for
JULIE EVANS (TVN) Abertawe Bro Morgannwg University Health Board, Rehab Engineering Unit, Morriston Hospital, Swansea, UK. email@example.com Introduction: Patients may succumb to infections from a variety of ÂopportunisticÊ bacteria as a result Table 1 -Sequence of intervention and associated wound response of concurrent co-morbidities. The Centers for Disease Cont