Adolescent pregnancy

• Illustrations
• Alternative names
• Definition
• Causes, incidence, and risk factors
• Symptoms
• Signs and tests

• Treatment
• Expectations (prognosis)
• Complications
• Calling your health care provider
• Prevention
• References

Alternative names    Return to top

Definition    Return to top

Adolescent pregnancy is pregnancy occurring in women aged 19 or younger.

Causes, incidence, and risk factors    Return to top

The incidence of adolescent pregnancy has steadily declined since reaching an all-time high in 1990, mostly due to an increase in the use of condoms. In fact, the birth rate among young girls aged 10 to 14 has fallen to the lowest level in almost 50 years. 

Since no form of contraception is completely effective, abstinence is the only sure way to prevent pregnancy. A sexually active teenager who does not use contraception has a 90% chance of becoming pregnant within a year. 

Why teenagers have sex, and do so without effective methods of contraception, is a topic of  debate. Suggested reasons follow:

• Adolescents become sexually mature (and fertile) approximately 4-5 years before they reach emotional maturity.
• Adolescents today are growing up in a culture in which peers, TV and motion pictures, music, and magazines often transmit either covert or overt messages that unmarried sexual relationships (specifically those involving teenagers) are common, accepted, and, at times, expected behaviors.
• Education about responsible sexual behavior and specific, clear information about the consequences of sexual intercourse (including pregnancy, sexually transmitted diseases, and psychosocial effects) are frequently not offered. Therefore, much of the "sex education" that adolescents receive filters through misinformed or uninformed peers.

When compared with other industrialized nations, the United States has the highest rates of pregnancy, abortion, and childbirth among teenagers, despite similar or higher rates of sexual activity in the other countries.

Teens are more likely to become pregnant if they:

• Begin dating early (dating at age 12 is associated with a 91% chance of being sexually involved before age 19, and dating at age 13 is associated with a 56% probability of sexual involvement during adolescence)
• Use alcohol and/or other drugs, including tobacco products
• Drop out of school
• Lack a support group or have few friends
• Lack involvement in school, family, or community activities
• Perceive little or no opportunity for success
• Livie in a community or attending a school where early childbearing is common and viewed as the norm rather than as a cause for concern
• Grow up under impoverished conditions
• Have been a victim of sexual abuse or assault
• Have a mother who was aged 19 or younger when she first gave birth

Symptoms    Return to top

Pregnancy symptoms include:

• Missed period
• Fatigue
• Breast enlargement and breast tenderness
• Abdominal distention
• Nausea/vomiting
• Light-headedness or actual fainting

Signs and tests    Return to top

The adolescent may or may not admit to being involved sexually. If the teen is pregnant, there are usually weight changes (usually a gain, but there may be a loss if nausea and vomiting are significant). Examination may show increased abdominal girth, and the fundus (the top of the enlarged uterus) may be palpable.

Pelvic examination may reveal bluish or purple coloration of vaginal walls, bluish or purple coloration and softening of the cervix, and softening and enlargement of the uterus.

• A pregnancy test of urine and/or serum HCG are usually positive.
• A pregnancy ultrasound may be done to confirm or check accurate dates for pregnancy.

Treatment    Return to top

Pregnancy options made available to the pregnant adolescent, and should be reviewed thoroughly. Abortion is a potential option, but state laws vary regarding an unmarried adolescent's ability to legally obtain this means of terminating a pregnancy without parental consent. In the case of married teens, consent of the husband may be required.

Giving up infants for adoption after delivery is another option, but the majority of pregnant teens choose to continue their pregnancies and keep their infants.

Early and adequate prenatal care, preferably through a program that specializes in teenage pregnancies, ensures a healthier baby. Smoking, alcohol use, and drug abuse should be strongly discouraged, and support methods should be offered to assist the pregnant teen in terminating such behaviors.

Adequate nutrition must be assured through both education and the availability of community resources. Appropriate exercise and adequate sleep should also be emphasized. Contraceptive information and services are important, following delivery, to deter adolescents from becoming pregnant again.

Pregnant teens and those who have recently given birth should be encouraged and helped to remain in school or reenter educational programs targeting skills that will enable them to provide for their child financially, emotionally, and with appropriate parenting. Accessible and affordable child care is an important factor in teen mothers continuing school or entering the work force.

Expectations (prognosis)    Return to top

Women having a first child during adolescence are more likely to have an increased overall rate of childbearing and more total births. They are less likely to receive child support from biological fathers, less likely to complete their education or work in some type of vocation, and less likely to establish independence and financial security adequate to provide for themselves and their children without outside resources.

Married teen mothers are more likely to experience divorce than those married women who postpone childbearing until their 20s.

Complications    Return to top

Adolescent pregnancy is associated with higher rates of illness and death for both the mother and infant.

Pregnant teens are at much higher risk of dying or having serious medical complications such as toxemia, pregnancy-induced hypertension, significant anemia, premature delivery, or placenta previa.

Infants born to teens are 2 to 6 times more likely to have low birth weight than those born to mothers age 20 or older. Prematurity plays the greatest role in this, but intrauterine growth retardation (inadequate growth of the fetus during pregnancy) is also a factor.

Teenage mothers are more likely to demonstrate unhealthy behaviors which may place the infant at greater risk for inadequate growth, infection, or chemical dependence. The younger a mother is below age 20, the greater the risk of her infant dying during the first year of life.

It is very important for pregnant teens to have early and adequate prenatal care.

Calling your health care provider    Return to top

Make an appointment with your health care provider if symptoms of pregnancy occur.

Your health care provider can also provide counseling regarding  birth control methods or pregnancy risk.

Prevention    Return to top

There are many different kids of adolescent pregnancy prevention programs.

Abstinence education programs encourage postponing sexual involvement until marriage or until a person is mature enough to handle sexual activity and a potential pregnancy in a responsible manner.

Knowledge-based programs focus on teaching adolescents about their bodies and normal functions as well as providing detailed information about contraceptives.

Clinic-focused programs provide easier access to information, counseling by health care providers, and contraceptive services. Many of these are through school-based clinics.

Peer counseling programs typically involve older and respected teens who encourage other teens to resist peer and social pressures to become sexually involved. These programs tend to take more of an experiential approach, helping teens to personalize risks. Peer counseling programs also provide, for those teens already involved in sexual activities, the skills to negotiate within relationships and the information needed to obtain and successfully use contraceptives.

References    Return to top

U.S. Teenage Pregnancy Statistics:Overall Trends, Trends by Race and Ethnicity and State-by-State Information. New York, NY: The Alan Guttmacher Institute; 2004