Preventing Teenage Pregnancy
Adeniyi Afolasade R.N.
NUR 4110 Section HD 38
Comprehensive Client Care for Urban Health Issues
Date: December 13, 2014
Introduction and targeted group
Approximately 750,000 to 850, 000 teenagers in the United States becomes pregnant every year. While teenage child bearing has been a normal reproductive pattern in some part of the world, it has been a major social problem in the industrialized nations. In particular the United States has the highest rates of adolescent pregnancy compared to other countries (Zinn, 2011). These figures maybe large but pregnancy rate is said to have recently reduced. Some researchers associate these to 75% better use of contraceptive and 25% to increased abstinence (Darfinger, 2008). Teen birthrate varies from state to state. New Hampshire reported the lowest rate of 13.8 births per 1000 in 2012 while New Mexico reported the highest rate of 47.5 births per 1000 (Ronquillo, 2014). The high rate of pregnancy among teenagers is associated with early sexual activity among teen girls. Inequality and poverty, low-cost contraceptive services and failure to give frank information about sex are also listed to cause high rate of pregnancy in the United States.
Teen birth rates are found to be high in communities with high unemployment, high divorce rate, and low level of trust, poverty and high crime rates. Kristin Luker, a sociologist said ‘the discouraged among the disadvantaged’ tends to become teen mothers. This translates that teens chooses to become mothers in the absence of getting social attention such as stable relationship (Wilkinson, 2010). The conclusion of two large studies from USA and New Zealand also point that the absence of father is important in teenage pregnancy. The researchers followed girls from early childhood to adulthood. The longer a father was absent from the family, there is more chance that his teenage girl will become a teen mom (Wilkinson, 2010).
Adolescents who give birth early pay for the consequence. There are many risks associated with pregnancy and abortion. The body of adolescent is not yet fully developed and pregnancy may cause internal trauma, permanent physical injury or may threaten the mother’s life and that of the fetus. While some of these complications may be prevented or reduced with early intervention of pre and post-natal care, same form of care is not available for low-income adolescent mother and in poor developing countries. Even in some instances where care is available, teenagers are reluctant to seek care because of shame and stigma.
There is a growing chaos in the lives of the adolescent. The soaring unruliness in the lives of adolescents is stem from the changes in the social institutions that have greatest influence on the development of competence and character. Some identified growing chaos are a wide gap between the rich and the poor, the lack of positive adult role models, an increasing number of anti-social gangs, more children are growing up in disadvantaged one-parent home (Westman, 2009).
Generally, getting teenagers to assume responsibility for their health has been very challenging to health care professionals. Adolescent pregnancy remains a global concern as 16 million girls (ages 15-19) gives birth annually. About 2 million out of this population are reported to be younger than 15 years. (CDC). Preventing teenage pregnancy cannot be stressed enough as this is neither good for the health of the teenager nor the infant. Preventing adolescent pregnancy is a high public-health priority (Schneider, 2006). Teenage pregnancy has more harmful effect as compared to its benefits- economic hardship, interrupting mothers’ education, career prospects to mention a few.
Challenges and barriers of preventing teenage pregnancy
There are many existing challenges in preventing teen pregnancy. A recent survey of adolescent health revealed a decrease in average age of puberty due to good nutrition standard. The earlier onset of puberty places adolescent at a greater risk of getting pregnant, as they are sexually active at early ages. According to a survey in Honduras and Gambia most adolescent reported their first sexual intercourse before the age of 15. These hold true in the United States where most students as young as 9th graders admitted to have had sexual intercourse in a 2011 survey (Ronquillo, 2014).
Inequality and poverty, associated with changing social attitude in developing countries can be blamed. Exposures to modern influence such as Television does not give a helping hand. The low incidence of effective contraceptive use among teens is another challenge. Sexual intercourse may not necessarily result in pregnancy but the use of contraception in adolescent is extremely low especially in developing countries. There is also a poor level of knowledge about contraceptive among this age group. Very few adolescents can name more than a few contraceptive methods and how they are used. Generally, sex education remains a sensitive and controversial issue in many countries. Most often, most important information is left unsaid or not acceptable. This makes children lack knowledge and they are left in the dark. Some adults on the other hand beliefs that the more young people know about sexuality and contraception, the more promiscuous they will become. The existence of traditions that encourages early marriage and childbearing has not been useful either. Some societies are in support of early marriage and childbearing. The pressure placed on young brides to bear child right after marriage are great as this also means proving their worth as a wife, daughter-and sister-in-law. Many in this type of situation will not consider the effect of that pregnancy on their health but to satisfy the expectation of their family and the community. Restricted access to contraception also plays a role in challenging teenage pregnancy as it is strictly prohibited in most cultures and religion. Especially in Africa, contraceptive are provided for married couples only over the age of 20.
Research
One controversial issue about teenage pregnancy is the myth that it causes poverty. Sociologists have argued among themselves that although teenage pregnancy may correlates with poverty, it does not cause poverty. Instead, teen mothers are noted to be poor before getting pregnant. Many teen mothers beat their way out of poverty by their mid-30s and improve on their economic status. Furstenberg’s longitudinal study of low-income (mostly black), teen mothers concludes that most teen mothers were in work force and had incomes above poverty line years after giving birth (Zinn, 2011).
In a California study, emergency contraception was made available for females younger than 18 through a pharmacy access. This was without prescription. A quantitative data were collected from simulated adolescent clients who called pharmacies to request for emergency contraception. In depth interview was conducted with the pharmacists and health care providers regarding the provision of the contraception to adolescents. Researchers posed as English and Spanish speaking females who had unprotected intercourse the night before and some who had unprotected sex 4 days prior. Calls were considered successful if the caller was told to come in and obtain the contraception. In their findings, 36% of all calls were successful, English speakers were more successful than Spanish speakers. Those that called the urban pharmacies were more successful as than those who call rural pharmacies. The research concluded that adolescents may have some obstacles in getting emergency contraception but enlarging Spanish –language services at the pharmacies and collaboration between providers and pharmacist could improve access. (Sampson)
Potential interventions
A closer look at statistics shows that half of the teens get pregnant due to contraceptive failure. Of note, they may not remember to take the pills. CDC is working to educate on the use of Long-acting reversible contraception (LARC). An example is the intrauterine device, which do not require action on regular basis. Since the Long acting reversible contraceptive methods are safe and effective for teens, they should be encouraged to use them.
Joseph Allen, a professor at University of Virginia suggests a nutritional model for preventing teenage pregnancy. Most of the teenagers are “poorly nourished” meaning they are left to behave like they desire. The nutrition model is designed to target raising the adolescent to be productive citizens. Its focus is to manage risky behaviors that raises from inadequate nurturance. The model is also supposed to focus on building their human capital through self-respect and self-confidence. And at the same time focus on their families, the environment they live as well as their social capital. Allen defined social capital as the connections between individuals,- networking, good will and trustworthiness. He further described physical capital as material things and human capital as characteristics of individual. Fostering adolescents’ human capital means nourishing their social capital by improving the quality of their family lives, communities and neighborhoods instead of fixing individual problems (Westman, 2009).
There is a cooperative action when family and community are bound together. Communities that have higher social capital have lower crime rate, higher educational achievement, better economic growth and better health. Adolescents need positive role models and opportunities that will encourage them to prowl after training and education. Lastly, staff needs to be trained to work with young people (Russel, 2010).
Policy recommendation
Policy is a set of action adopted or proposed by a government, party or individual. In attempt to break early marriage and pregnancy, children protection and human right advocates should request that legal age for marriage be increased in many countries.
The National Campaign to Prevent Teen and Unplanned Pregnancy challenges the nation to reduce pregnancy in adolescent by one-third by 2015. The campaign advocates ten steps for building adolescents social capital. Policy makers should recognize the problem is not solved, parents must do more by giving guidance to sexual behavior, stop fighting about abstinence versus contraception, intensify efforts of the community with high rate of adolescent pregnancy, especially Latinos, make the connection between adolescent pregnancy and poverty, help fathers fulfill their roles in adolescent development, start early, involve the powerful- like the entertainment media, elected officials, corporate executives, press leaders, foundation heads , faith leaders and educators. States and communities should set goals for reducing adolescent pregnancy, stay on the cutting edge of changing technologies. To pursue reducing teenage pregnancy, policy makers should dedicate a campaign to religion and public values (Brown, 1996). Health care professionals should be mandated to provide information to their teenage clients regarding consequences of early sexual activity and to teach abstinence as the healthiest option. Health care professionals should assess adolescents understanding or view of early sexual activity and pregnancy. Teenager who expresses commitment to abstain from sex before marriage should be given positive reinforcement. Establish multi-disciplinary project that will focus on improving adolescent health, collect and disintegrate information about teen health to other health professionals and general public. Encourage the use of evidence-based approaches to improve the health of adolescents. Give assess and encourage the use of contraceptive. Give comprehensive approach to sex education, encourage child-parent relationship. (CDC).
Stakeholders
Medicare and Medicaid: preventing teen pregnancy is a priority among this group of stakeholders because of its high cost. Firstly, teen’s health naturally is in jeopardy since they are not fully developed before pregnancy. Besides, children born to teenagers are more like to suffer chronic medical conditions than children of older mothers, which means more expenses to this organization (Ronquillo, 2014). There is increase in health care cost and child welfare. Teen childbearing is also costly for tax payers (federal, state, and local). About $9.4 billion was spent in 2010 by tax payers to carter for teen childbearing according to an analysis by The National Campaign to Prevent Teen and Unplanned Pregnancy. $3.1 billion for child welfare benefits, $2.1 billion for public sector health care expenses, $2.0 billion for incarceration and $2.2 billion in lost tax revenue because of low earnings of teen mothers (CDC). There is increase lost tax revenue for the federal government. State government will also benefit financially from reducing teen birth. Since most of the teen children are likely to serve jail terms or retained in juvenile facility, if there are less born, there will be less spending in such services. The community as a whole will no doubt also benefit from the prevention of teen birth. There will be lees crime on the street and community people will fear less of violence and other atrocities. Teenage parents are more likely to quite school at early stage and are likely to live in poverty than their peers as the will be underemployed or unemployed.
In conclusion, even though the rate of teen pregnancy has reduced globally, the current number remains alarming. Further reduction will be beneficial for the government, community, family and individual teenager. This is why it remains a priority for public health officials. None the lees, health care providers plays a critical role in reducing pregnancy among this population through the care we provide to our adolescent patients.
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References
Brown, S. (1996). Targeting teen pregnancy. Policy Review, (79), 60.
Darfinger, M.a. (2008). Honesty is the Best Policy: Sex Education and Accuracy. Journal
Of Legal Medicine, 29(1), 81-97.
Kahn, J.G., Brindis, C.D., & Glei, D.A. (1999). Pregnancies Averted Among U.S.
Teenagers By the Use of Contraceptive. Family Planning Perspectives, 31(1), 29-
34.
Ronquillo, R., & Fears, C. (2014). Teenage pregnancy prevention: Statistics and
programs. Washington, D.C.: Congressional Research Service, the Library of
Congress.
Russel, L. (2010). The teenage pregnancy strategy: beyond 2010. British Journal Of
Midwifery, 18(6), 374-375.
Bottom of FormWestman, Jack C. Breaking the Adolescent Parent Cycle: Valuing Fatherhood and
Motherhood. Lanham: U of America, 2009.
Wilkinson, R., & Pickett, K. (2010). The spirit level: Why greater equality makes
societies stronger. New York: Bloomsbury Press.
Sampson, O., Navarro, S., Khan, A., Hearst, N., Raine, T., Gold, M., … Bocanegra, H.
(n.d.). Barriers to Adolescents’ Getting Emergency Contraception Through
Pharmacy Access in California: Differences by Language and Region.
Perspectives on Sexual and Reproductive Health, 110-118.
Schneider, Mary. Introduction to Public Health. 2nd ed. Sudbury, Mass.: Jones and
Bartlett, 2006.
Top of FormBottom of FormZinn, Maxine Baca, and D. Stanley Eitzen. Diversity in Families. 9th ed. New York:
Harper& Row, 2011.
