Adolescent pregnancy Discussion
Adolescent pregnancy is viewed as a high-risk situation because it poses serious health risks for the mother and the baby. Describe various risk factors or precursors to adolescent pregnancy. Research community and state resources devoted in adolescent pregnancy and describe at least two of these resources. Research the teen pregnancy rates for the last 10 years for your state and community. Has this rate increased or decreased? Discuss possible reasons for an increase or decrease.
Every year, an estimated 21 million girls aged 15 to 19 years and 2 million girls aged under 15 years become pregnant in developing regions (1) ,(2). Approximately 16 million girls aged 15 to 19 years and 2.5 million girls under age 16 years give birth in developing regions.2,3
The global adolescent birth rate has declined from 65 births per 1000 women in 1990 to 47 births per 1000 women in 2015 (6). Despite this overall progress, because the global population of adolescents continues to grow, projections indicate the number of adolescent pregnancies will increase globally by 2030, with the greatest proportional increases in West and Central Africa and Eastern and Southern Africa (7).
Additionally, regional differences reveal unequal progress: adolescent birth rates range from a high of 115 births per 1000 women in West Africa to 64 births per 1000 women in Latin America and the Caribbean to 45 births per 1000 women in South-Eastern Asia, to a low of 7 births per 1000 women in Eastern Asia (8). There are also up to three times more adolescent pregnancies in rural and indigenous populations than in urban populations (9).
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Adolescent pregnancies are a global problem that occurs in high, middle, and low income countries. Around the world, adolescent pregnancies are more likely to occur in marginalized communities, commonly driven by poverty and lack of education and employment opportunities (2).
For some adolescents, pregnancy and childbirth are planned and wanted. In some contexts, girls may face social pressure to marry and, once married, to have children. Each year, about 15 million girls are married before the age of 18 years, and 90% of births to girls aged 15 to 19 years occur within marriage (2), (10).
For many adolescents, pregnancy and childbirth are neither planned nor wanted. Twenty-three million girls aged 15 to 19 years in developing regions have an unmet need for modern contraception (1). As a result, half of pregnancies among girls aged 15 to 19 years in developing regions are estimated to be unintended (1).
Adolescents face barriers to accessing contraception including restrictive laws and policies regarding provision of contraceptive based on age or marital status, health worker bias and/or lack of willingness to acknowledge adolescents’ sexual health needs, and adolescents’ own inability to access contraceptives because of knowledge, transportation, and financial constraints. Additionally, adolescents face barriers that prevent use and/or consistent and correct use of contraception, even when adolescents are able to obtain contraceptives: pressure to have children; stigma surrounding non-marital sexual activity and/or contraceptive use; fear of side effects; lack of knowledge on correct use; and factors contributing to discontinuation (for example, hesitation to go back and seek contraceptives because of negative first experiences with health workers and health systems, changing reproductive needs, changing reproductive intentions).
In some situations, adolescent girls may be unable to refuse unwanted sex or resist coerced sex, which tends to be unprotected. Sexual violence is widespread and particularly affects adolescent girls: about 20% of girls around the world experience sexual abuse as children and adolescents (11). Inequitable gender norms and social norms that condone violence against women put girls at greater risk of unintended pregnancy.
Adolescent pregnancy remains a major contributor to maternal and child mortality, and to intergenerational cycles of ill-health and poverty. Pregnancy and childbirth complications are the leading cause of death among 15 to 19 year-old girls globally, with low and middle-income countries accounting for 99% of global maternal deaths of women ages 15 to 49 years (4), (12).
Adolescent mothers (ages 10 to 19 years) face higher risks of eclampsia, puerperal endometritis, and systemic infections than women aged 20 to 24 years (5). Additionally, some 3.9 million unsafe abortions among girls aged 15 to 19 years occur each year, contributing to maternal mortality and lasting health problems (1). Furthermore, the emotional, psychological and social needs of pregnant adolescent girls can be greater than those of other women.
Early childbearing can increase risks for newborns, as well as young mothers. In low- and middle-income countries, babies born to mothers under 20 years of age face higher risks of low birthweight, preterm delivery, and severe neonatal conditions (5). Newborns born to adolescent mothers are also at greater risk of having low birth weight, with long-term potential effects.5 In some settings, rapid repeat pregnancy is a concern for young mothers, which presents further risks for both the mother and child (13)
Adolescent pregnancy can also have negative social and economic effects on girls, their families and communities. Unmarried pregnant adolescents may face stigma or rejection by parents and peers and threats of violence. Similarly, girls who become pregnant before age 18 are more likely to experience violence within marriage or a partnership.7 With regards to education, school-leaving can be a choice when a girl perceives pregnancy to be a better option in her circumstances than continuing education, or can be a direct cause of pregnancy or early marriage. An estimated 5% to 33% of girls ages 15 to 24 years who drop out of school in some countries do so because of early pregnancy or marriage (14).
Based on their subsequent lower education attainment, may have fewer skills and opportunities for employment, often perpetuating cycles of poverty: child marriage reduces future earnings of girls by an estimated 9% (14). Nationally, this can also have an economic cost, with countries losing out on the annual income that young women would have earned over their lifetimes, if they had not had early pregnancies.
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