TEENAGE PREGNANC Y (A WIDESPREAD PROBLEM OF TEENAGE PREGNANCY

TEENAGE PREGNANCY (A WIDESPREAD PROBLEM OF TEENAGE PREGNANCY) Authors: Ghail Bas Teenage Pregnancy Case Study Introduction Teenage pregnancy is an important public health problem as it often occurs in the context of poor social support and maternal well-being. Some studies have suggested that first teenage pregnancies have a higher frequency of adverse perinatal outcomes. However, there is argument about whether this is an independent association or explained by confounding factors. In general, the risk of adverse outcomes is lower in second pregnancies. However, longitudinal studies comparing outcomes in first and second pregnancies in teenagers have produced inconsistent results. Cross sectional studies comparing the outcome of second births in teenagers and older women have observed increased rates of preterm birth, low birth weight, and perinatal death but have failed to adjust for potential confounding factors such as smoking and socioeconomic deprivation. Objectives This article examines trends in teenage pregnancy, focusing on induced abortions, live births and fetal loss among women aged 15 to 19. Analytical techniques Pregnancy rates, abortion rates, live birth rates and fetal loss rates are calculated using population counts of women in the age groups 15 to 17, 18 to 19, and 15 to 19. The percentages of pregnancies that ended in the three outcomes are also calculated for these years. Definition Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female under the age of 20. Pregnancy can occur with sexual intercourse after the start of ovulation, which can be before the first menstrual period (menarche) but usually occurs after the onset of periods. Pregnant teenagers face many of the same pregnancy related issues as other women. There are additional concerns for those under the age of 15 as they are less likely to be physically developed to sustain a healthy pregnancy or to give birth. For girls aged 15–19, risks are associated more with socioeconomic factors than with the biological effects of age. Risks of low birth weight, premature labor, anemia, and pre-eclampsia are connected to biological age, being observed in teen births even after controlling for other risk factors (such as accessing prenatal care etc.) Results from cumulative years of the National Demographic and Health Survey and the latest result of the 2011 Family Health Survey, shows that teenage pregnancy in the Philippines, measured as the proportion of women who have begun childbearing in their teen years, has been steadily rising over a 35-year period. These teenage mothers are predominantly poor, reside in rural areas and have low educational attainment. However, this paper observes a trend of increasing proportions of teenagers who are not poor, who have better education and are residents of urban areas, who have begun childbearing in their teens. Among the factors that could help explain this trend are the younger age at menarche, premarital sexual activity at a young age, the rise in cohabiting unions in this age group and the possible decrease in the stigma of out-of-wedlock pregnancy. Teenage pregnancies are associated with social issues, including lower educational levels and poverty. Teenage pregnancy in developed countries is usually outside of marriage and carries a social stigma. Teenage pregnancy in developing countries often occurs within marriage and half are planned. However, in these societies, early pregnancy may combine with malnutrition and poor health care to cause medical problems. When used in combination, educational interventions and access to birth control can reduce unintended teenage pregnancies. Philippine Statistics Authority – Source 2014 One in ten young Filipino women age 15-19 has begun childbearing: 8 percent are already mothers and another 2 percent are pregnant with their first child according to the results of the 2013 National Demographic and Health Survey (NDHS). Early pregnancy and motherhood varies by education, wealth quintile, and region. It is more common among young adult women age 15 to 24 with less education than among those with higher education (44 percent for women with elementary education versus 21 percent for women with college education). Early childbearing is also more common in Caraga (38 percent) and Cagayan Valley (37 percent) than other regions. The proportion of young adult women who have begun childbearing is higher among those classified as belonging to poor households than those in wealthier households (37 percent for young women in the lowest wealth quintile versus 13 percent for women in the highest wealth quintile). The survey also reveals that one in five (19 percent) young adult Filipino women age 18 to 24 years had initiated their sexual activity before age 18. Some of them would have had their first intimate sexual act before marriage. The survey reveals that 15 percent of young adult women age 20 to 24 had their first marriage or began living with their first spouse or partner by age 18. This proportion is lower than the proportion (19 percent) earlier cited regarding initiation by young women of an intimate sexual activity. Age at first marriage hardly changed over the years. A slightly higher proportion (17 percent) of older cohort of women (age group 40-49) had their first marriage at age 18. Initiation of sexual activity before age 18 is more common among young adult women with less education and those in poorer households. Over 40 percent of young adult women with some elementary education, compared with only 7 percent of those with college education, reported having their first intimate sexual act at age 18. Similarly, 36 percent of young adult women in the lowest wealth quintile, compared with only 10 percent of those in the highest wealth quintile, had their first intimate sexual act before age 18. Across regions, the proportion ranges from 11 percent in Cordillera Administrative Region to 27 percent in Davao. The proportion of young adult women reporting first intimate sexual act before age 18 is 22 percent for rural areas and 17 percent for urban areas. Among young women age 15 to 24, 2 percent reported initiating their sexual activity before turning 15. The 2013 NDHS is a nationally representative survey of almost 16,000 households and 19,000 women age 15-49. The survey was conducted from August 12 to October 16, 2013. The 2013 NDHS is designed to provide information on fertility, family planning, and health in the country. Other important findings of the 2013 NDHS will be presented in a data dissemination forum on September 2, 2014 at Crowne Plaza Manila Galleria, Ortigas Ave. cor. ADB Ave., Quezon City.  Abstract Teenager Being a young mother in a first world country can affect one's education. Teen mothers are more likely to drop out of high school. However, recent studies have found that many of these mothers had already dropped out of school before becoming pregnant, but those in schools at the time of their pregnancy were as likely to graduate as their peers. Young motherhood in an industrialized country can affect employment and social class. Less than one third of teenage mothers receive any form of child support, vastly increasing the likelihood of turning to the government for assistance. The correlation between earlier childbearing and failure to complete high school reduces career opportunities for many young women. One study found that, in 1988, 60% of teenage mothers were impoverished at the time of giving birth.  Additional research found that nearly 50% of all adolescent mothers sought social assistance within the first five years of their child's life. Child Early motherhood can affect the psychosocial development of the infant. The children of teen mothers are more likely to be born prematurely with a low birth weight, predisposing them to many other lifelong conditions. Children of teen mothers are at higher risk of intellectual, language, and socio-emotional delays. Developmental disabilities and behavioral issues are increased in children born to teen mothers. One study suggested that adolescent mothers are less likely to stimulate their infant through affectionate behaviors such as touch, smiling and verbal communication, or to be sensitive and accepting toward his or her needs.  Another found that those who had more social support were less likely to show anger toward their children or to rely upon punishment. Causes In developed countries however, teenage pregnancy is most often unintentional and due to a variety of different reasons. Drugs and Alcohol Low Socio-economic Status Peer Pressure and Sexual Abuse Media Influence Mothers Child Family and Peer Support Education/Knowledge These young females have not yet reached adulthood and the causes of teenage pregnancy vary greatly. Teenage pregnancy may be linked to things such as lack of education and information about reproduction, peer pressure and early engagement of sexual activity. Medicalities Teenage pregnancies have a number of problems. There is a higher risk that babies born from teenage mothers are born too early, or that they have a low weight at birth. The mothers may also encounter complications or difficulties at birth; they have a higher risk of anemia than mothers aged 20–24. A pregnancy is best followed by trained medical staff during its course. Teenage mothers are less likely to receive prenatal care, often seeking it in the third trimester, if at all. The Guttmacher Institute reports that one-third of pregnant teens receive insufficient prenatal care and that their children are more likely to suffer from health issues in childhood or be hospitalized than those born to older women. Like most other teenagers, teenage mothers may suffer from poor nutrition. This may lead to them having specific illnesses related to bad nutrition. Bad nutrition is a more marked problem of teenagers in developed countries. Up to 70,000 teen girls in developing countries die from complications during pregnancy each year. Young mothers and their babies are also at greater risk of contracting HIV. The World Health Organization estimates that the risk of death following pregnancy is twice as high for women between 15 and 19 years than for those between the ages of 20 and 24. The maternal mortality rate can be up to five times higher for girls aged between 10 and 14 than for women of about twenty years of age. Illegal abortion also holds many risks for teenage girls. Risk for complications is higher for girl 14 years or younger, because their pelvis has not yet developed fully; this may lead to problems with childbirth. Some of these problems can be dealt with using Cesarean section (C Section). This requires the services of a doctor, or a hospital, which is often unavailable. Where this is unavailable, eclampsia, obstetric fistula, infant mortality, or maternal death can result. For mothers in their late teens, age in itself is not a risk factor, and poor outcomes are associated more with socioeconomic factors rather than with biology. Social Problems other than the age of the mother, such as poverty and social support also affect the outcome. It is important that teenage mothers can rely on the family and the state to help them cope, and educate their child. Teenage parents who can rely on family and community support, social services and child-care support are more likely to continue their education and get higher paying jobs as they progress with their education. Being a young mother often affects education. Teen mothers are more likely to drop out of high school. Recent studies, though, have found that many of these mothers had already dropped out of school prior to becoming pregnant.  Effects Another study reported that teen mothers face significant levels of stress that can then lead to increased mental health concerns. In addition to higher rates of postpartum depression, teenage mothers have higher rates of depression. They also have higher rates of suicidal ideation than their peers who aren't mothers. Poor academic performance in the children of teenage mothers has also been noted, with many of the children being held back a grade level, scoring lower on standardized tests, and/or failing to graduate from secondary school. Daughters born to adolescent parents are more likely to become teen mothers themselves. Sons born to teenage mothers are three times more likely to serve time in prison. Risk Factors Factors include culture, lack of knowledge about sex and how to use contraceptives; barriers to access contraceptives including negative attitudes of health staff; peer pressure; sexual coercion; low self-esteem; low educational expectations; poverty; family breakdown; and heightened sex-based messages in the media. Teen pregnancy and motherhood can influence younger siblings. One study found that the younger sisters of teen mothers were less likely to emphasize the importance of education and employment and more likely to accept human sexual behavior, parenting, and marriage at younger ages. Younger brothers, too, were found to be more tolerant of non-marital and early births, in addition to being more susceptible to high-risk behaviors. If the younger sisters of teenage parents babysit the children, they have an increased probability of getting pregnant themselves. Role of drug and alcohol use Inhibition-reducing drugs and alcohol may possibly encourage unintended sexual activity. If so, it is unknown if the drugs themselves directly influence teenagers to engage in riskier behavior, or whether teenagers who engage in drug use are more likely to engage in sex. Correlation does not imply causation. The drugs with the strongest evidence linking them to teenage pregnancy are alcohol, cannabis, "ecstasy" and other substituted amphetamines. The drugs with the least evidence to support a link to early pregnancy are opioids, such as heroin, morphine, and oxycodone, of which a well-known effect is the significant reduction of libido – it appears that teenage opioid users have significantly reduced rates of conception compared to their non-using, and alcohol, "ecstasy", cannabis, and amphetamine using peers. Early puberty Girls who mature early (precocious puberty) are more likely to engage in sexual intercourse at a younger age, which in turn puts them at greater risk of teenage pregnancy. Lack of contraception-Adolescents may lack knowledge of, or access to, conventional methods of preventing pregnancy, as they may be too embarrassed or frightened to seek such information. Contraception for teenagers presents a huge challenge for the clinician. Young women often think of contraception either as 'the pill' or condoms and have little knowledge about other methods. They are heavily influenced by negative, second-hand stories about methods of contraception from their friends and the media. Prejudices are extremely difficult to overcome. Over concern about side-effects, for example weight gain and acne, often affect choice. Missing up to three pills a month is common, and in this age group the figure is likely to be higher. Restarting after the pill-free week, having to hide pills, drug interactions and difficulty getting repeat prescriptions can all lead to method failure. Sexual abuse Studies have found that 11–20% of pregnancies in teenagers are a direct result of rape, while about 60% of teenage mothers had unwanted sexual experiences preceding their pregnancy. Before age 15, a majority of first-intercourse experiences among females are reported to be non-voluntary, the study found that 60% of girls who had sex before age 15 were coerced by males who on average were six years their senior. One in five teenage fathers admitted to forcing girls to have sex with them. Multiple studies have indicated a strong link between early childhood sexual abuse and subsequent teenage pregnancy in industrialized countries. Up to 70% of women who gave birth in their teens were molested as young girls and by contrast, 25% of women who did not give birth as teens were molested. In some countries, sexual intercourse between a minor and an adult is not considered consensual under the law because a minor is believed to lack the maturity and competence to make an informed decision to engage in fully consensual sex with an adult.  In some countries, sex with a minor is therefore considered statutory rape. Dating violence Studies have indicated that adolescent girls are often in abusive relationships at the time of their conceiving. They have also reported that knowledge of their pregnancy has often intensified violent and controlling behaviors on part of their boyfriends. Girls under age 18 are twice as likely to be beaten by their child’s father as women over age 18. A UK study found that 70% of women who gave birth in their teens had experienced adolescent domestic violence. Similar results have been found in studies in the U.S. A Washington State study found 70% of teenage mothers had been beaten by their boyfriends, 51% had experienced attempts of birth control sabotage within the last year, and 21% experienced school or work sabotage. Socioeconomic factors Teenage pregnancy has been defined predominantly within the research field and among social agencies as a social problem. Poverty is associated with increased rates of teenage pregnancy. Economically poor countries such as Niger and Bangladesh have far more teenage mothers compared with economically rich countries. Childhood environment Women exposed to abuse, domestic violence, and family strife in childhood are more likely to become pregnant as teenagers, and the risk of becoming pregnant as a teenager increases with the number of adverse childhood experiences.  According to a 2004 study, one-third of teenage pregnancies could be prevented by eliminating exposure to abuse, violence, and family strife. The researchers note that "family dysfunction has enduring and unfavorable health consequences for women during the adolescent years, the childbearing years, and beyond. When the family environment does not include adverse childhood experiences, becoming pregnant as an adolescent does not appear to raise the likelihood of long-term, negative psychosocial consequences. Studies have also found that boys rose in homes with a battered mother, or who experienced physical violence directly, were significantly more likely to impregnate a girl. Studies have also found that girls whose fathers left the family early in their lives had the highest rates of early sexual activity and adolescent pregnancy. Girls whose fathers left them at a later age had a lower rate of early sexual activity, and the lowest rates are found in girls whose fathers were present throughout their childhood. Media influence A study conducted in 2006 found that adolescents who were more exposed to sexuality in the media were also more likely to engage in sexual activity themselves. According to Time, "teens exposed to the most sexual content on TV are twice as likely as teens watching less of this material to become pregnant before they reach age 20". Prevention Comprehensive sex education and access to birth control appear to reduce unplanned teenage pregnancy. It is unclear which type of intervention is most effective. In the U.S. free access to a long acting form of reversible birth control along with education decreased the rates of teen pregnancies by around 80% and the rate of abortions by more than 75%. Currently there are four federal programs aimed at preventing teenage pregnancy: Teen Pregnancy Prevention (TPP), Personal Responsibility Education Program (PREP), Title V Sexual Risk Avoidance Education, and Sexual Risk Avoidance Education. Education The Dutch approach to preventing teenage pregnancy has often been seen as a model by other countries. The curriculum focuses on values, attitudes, communication and negotiation skills, as well as biological aspects of reproduction. The media has encouraged open dialogue and the health-care system guarantees confidentiality and a non-judgmental approach. Abstinence only education Some schools provide abstinence-only sex education. Evidence does not support the effectiveness of abstinence-only sex education. It has been found to be ineffective in decreasing HIV risk in the developed world, and does not decrease rates of unplanned pregnancy when compared to comprehensive sex education. It does not decrease the sexual activity rates of students, when compared to students who undertake comprehensive sexual education classes. Question and Answers What are the signs of pregnancy? Missed or very light period Breast tenderness Nausea (often in the morning) Vomiting Feeling lightheaded Fainting Weight gain Feeling tired Swollen abdomen What are the chances of getting pregnant at 15? Many are surprised to learn that each month, on average, a woman only has a 15 to 20 percent chance of conception. For women in their 20s, their chances of getting pregnant within 1 year are 78 to 86 percent. For women 30 to 34, their chances of getting pregnant within 1 year are approximately 63 percent. Can a girl get pregnant at the age of 16? A woman can get pregnant and have a baby as soon as she begins ovulating, or producing eggs. This typically occurs about a year after they first begin menstruating, which for North American women, usually happens between the ages of 11 and 12. Some women start ovulating late, though, and others, extremely early. Can a 15 year old get someone pregnant? Boys are able to get a girl pregnant when they begin to produce sperm in their semen. This generally begins when they start puberty, which can be from ages 11 to 14. However, a girl can ovulate any time especially during the teenage years when there are menstrual irregularities and therefore ovulation is not regular. Does having a miscarriage make you high risk? Most women who miscarry go on to have healthy pregnancies after miscarriage. A small number of women — 1 percent — will have two or more miscarriages. After two miscarriages the risk of another miscarriage increases to about 26 percent, and after three miscarriages the risk of another miscarriage is about 28 percent. Is it possible for a female who has not experienced menstruation yet to become pregnant? Even though you may not have experienced menstrual flow, it is possible to have ovulated or released an egg. For example, ovulation occurs approximately 2 weeks before typical menstrual bleeding. If this is a first period, a girl is still fertile or able to conceive/get pregnant around the time the egg is released. How does teenage pregnancy affect the teen father? Fathering a child as a teenager can be frightening and a life-changing event. Teen fathers don`t have to worry about health implications of pregnancy and childbirth, they could face similar difficulties staying in school and earning a living. What are the options for teenagers who are pregnant? Teens who become pregnant may be afraid to see a doctor, but it`s extremely important for the safety of the mother and the unborn child. Your doctor should discuss all options with you regarding your pregnancy, including Abortion- ending the pregnancy medically Adoption- giving birth and legally permitting someone else to raise your child Giving birth and raising your child yourself. How can we prevent teenage pregnancy? The only way to be sure you won`t get pregnant is to not have sexual intercourse. However, there are many methods to reduce your chances of getting pregnant if you are sexually active. How can we prevent teenage pregnancy at school? Here, they share strategies and tips for helping their high school-aged daughters prevent pregnancy. Have the Sex Talk. Explain Safe Sex. Teach Her to Respect Herself. Encourage Abstinence. Lay Out the Consequences. Encourage Them to Gain Experience Caring for a Baby. Discuss the Options. Don't Make Sex a Taboo Subject. How can I prevent early pregnancy naturally? Papaya (Papita) if you have unsafe intercourse, try having papaya twice a day for 3-4 days afterwards to reduce chances of unwanted pregnancy. Ginger (Adrakh) Apricot (Khubani) Dried Fig (Anjeer) Cinnamon (Dalcheeni) Vitamin C. Asafoetida (Hing) Parsley (Ajamoda) Essay The terms “teen pregnancy” and “teenage parenting” are rife with moral accusations and factual ambiguities. Arising from a conference at Ryerson Polytechnic University, this essay delimit and clarify the multifarious facts that affect how society both responds to, and creates, the phenomenon of the teen parent. The contributors bring expertise from diverse disciplines-sociology, history, and philosophy-to address the pressing question: what should social policy be on the issues of teen pregnancy and parenting? An analysis of data discusses the material consequences of adolescent parenting-more poverty, less income, and less home ownership-but also challenges certain assumptions about the extent of such consequences. A discussion of focus-group results reveals that consideration of the socioeconomic barriers facing young single mothers, when given the necessary attention, suggests an often ignored set of issues relevant to judgments about responsibility: the experience of personal growth, the struggle to solve their own problems, and the search for independence. Delving in the ethics of responsibility and untangling the meaning of the term 'social construction' sets the context for policy debates on sophisticated, non-reductive terrain. The study's new findings, the interdisciplinary approach, and the focus makes this unique gathering of facts and ideas of central importance to students of sociology, health and women's studies, philosophy, urban youth culture, and public policy. This essay is dealing with the relationship of involvement notification and responsibility to the issue of teenage pregnancy. We consider federal legislation in this area evaluating public policies in terms of their supportiveness and sensitivity toward family involvement. Discussed are details on sex education and family planning service as well as governmental support programs for teenage parents. On the controversial issue of parental notification arguments both for and against are presented and guidelines are suggested for a constructive and supportive information policy when such a policy is to be implemented. A discussion of service programs available to pregnant teens and to teenage parents concerns itself with the exploration of ways to reorient present services in order to involve family members more intimately in the delivery of services of pregnant adolescents and adolescent parents. Also considered within this general topic is the involvement of adolescent fathers and ways in which such participation can and should be fostered. The need for constant and careful evaluation to assess success and to direct restructuring of programs as necessary is noted. Keywords Abortion- The deliberate termination of a human pregnancy, most often performed during the first 28 weeks of pregnancy Amphetamine- A synthetic, addictive, mood-altering drug, used illegally as a stimulant and legally as a prescription drug to treat children with ADD and adults with narcolepsy Anemia- A condition marked by a deficiency of red blood cells or of hemoglobin in the blood, resulting in pallor and weariness Caesarean section- A surgical operation for delivering a child by cutting through the wall of the mother`s abdomen Cannabis- AKA marijuana; a dried preparation of the flowering tops or other parts of the cannabis plant or a resinous extract of it (smoked or consumed, generally illegally, as a psychoactive (mind-altering) drug Contraceptive- A method or device serving to prevent pregnancy Fertility- A quality of being fertile; productiveness; ability to conceive children or young Impoverish- Made poor; deprived of strength or vitality Libido- Sex drive; sexual appetite; sexual passion Menarche- The first occurrence of menstruation Morphine- An analgesic and narcotic drug obtained from opium and used medically to relieve pain Nausea- A feeling of sickness with an inclination to vomit Opioid- A compound resembling opium in addictive properties or physiological effects Ovulation- Discharge of ova or ovules from the body Poverty- The state of being extremely poor Prenatal- Before birth, during or relating to pregnancy Prejudice- Preconceived opinion that is not based on reason or actual experience Pre-eclampsia- A condition in pregnancy characterized by high blood pressure, sometimes with fluid retention and proteinuria Sexual intercourse- sexual contact between individuals involving penetration, especially the insertion of a man`s erect penis into a woman`s vagina, typically culminating in orgasm and the ejaculation of semen Socioeconomic- Relating to or concerned with the interaction of social and economic factors STD or STI- Sexually transmitted disease or sexually transmitted infection Statutory Rape- A law term in some jurisdictions; a sexual intercourse with a minor