Adolescent Pregnancy Worldwide about 14 million adolescent girls

Adolescent Pregnancy

Worldwide about 14 million adolescent girls give birth, while about 4. 4 million have abortions. Source: People’s Daily (2007)

Implications of Adolescent Pregnancy § Social exclusion § Greater reproductive health risks § Increased risk of poverty § Increased risk of maternal and infant mortality Source: Guttmacher Institute (2006)

Adolescent Pregnancy Contributes to the Cycle of Poverty According to Yampolskaya, Brown, and Vargo (2004), “. . . approximately 60% of adolescent mothers live in poverty at the time of the birth of their babies, and approximately 73% go on welfare within 5 years of giving birth. ”

Associated Factors § § § § § Poverty Unemployment Failing Nuclear Families Abuse Early Menarche Gang Activity Domestic violence Coercion Early Marriage § § § § Rape Alcoholism Substance Abuse Social Pressures Low Self Esteem School Drop outs Poor educational opportunities § Poor access to health care § Influence of the media Source: Data gathered from various cited resources (WHO, CDC, Guttmacher Institute)

Higher Risk with Adolescent Pregnancy, Birth and Postpartum Complications § § Hypertension Eclampsia Anemia Difficult labor and childbirth as a result of cephalopelvic disproportion § Increased maternal mortality § Low Birth Weight Source: IRIN-Africa (2007)

It is a Global Issue

Most men have sex before age 20. Copyright: The Alan Guttmacher Institute In Their Own Right- Worldwide

Approximate Pregnancy Rate Per 1, 000 girls < 20 -years-old Information in table was generated from data gathered from cited resources (Guttmacher Institute, WHO, CDC)

Worldwide, women bear a greater burden of sexual and reproductive illhealth than men. More than half a million women die in pregnancy and childbirth in resource constrained settings. Source: WHO (2006)

Adolescent Pregnancy Leads to Unsafe Abortions § A study in Nigeria in the early 1990’s, that included about 144 women (half of which were under 20 years of age), reported many complications- including a 9% death rate. Only 25% had no complications. § In some urban areas unmarried adolescents represent the majority of all abortion seekers. § In developing countries, the risk of death following unsafe abortions is several hundred times higher than one performed professionally in safe conditions. § Almost 14% of all unsafe abortions occur in adolescents under the age of 20. § The rate is higher in Africa than any other region. Source: WHO (2004)

Chile § More than 30, 000 adolescents between the ages of 15 and 19 give birth every year. § From 1990 to 2003, the proportion of live births to teenage mothers rose from 13. 8 percent of all births to 14. 9 percent. § In 2003, 17 of the 994 babies (1. 7 percent) born to mothers under age 15 died. § 335 of the 33, 838 babies (1. 0 percent) born to mothers between the ages of 15 and 19 died. Source: Health-Chile (2007)

Botswana § In 1996, six out of 10 teenage girls had been pregnant at least once, but only two out of 10 in 2003. § Among girls between the ages of 15 and 19 who have had sex, 40% have been pregnant. Source: Plus News Global (2007)

South Africa § The number of pregnant school girls jumped from 1, 169 in 2005 to 2, 336 in 2006 in Gauteng. § One in three girls had a baby by the age of 20. § 16 percent of pregnant women under the age of 20 tested HIV positive. § 30 percent of girls in South Africa said "their first sexual experience was forced or under threat of force". Source: IRIN Africa (2007)

Afghanistan § 57% of marriages are by girls under the age of 16 years old which has led to an increased maternal mortality rate. Source: Guttmacher Institute (2006)

Ghana § More than half marry in their teens. § 12% aged 15 -19 have had a child. § 25% report sexual coercion that leads to an unintended pregnancy. § 39% aged 12 -24 state that the last abortion they were involved in took place at home. The Alan Guttmacher Institute (2004)

United States § One million teenagers become pregnant annually. § The United States has the highest rate of teen pregnancy, childbirth and abortion among developed countries § 63% give birth, and 22% have abortions. Source: Adolescent Pregnancy and Childbirth in the U. S. (1999)

According to the Centers for Disease Control (CDC), teenage pregnancy rates nationally dropped 27 percent overall during the years 1990 -2000. Despite the decline, the teenage pregnancy rate in the United States is still the highest among industrialized nations. Even with the drop, 35 percent of U. S. teenage girls become pregnant at least once before age 20. Source: Centers for Disease Control (CDC) (2004)

The 2005 Youth Pregnancy Risk Behavior Survey § 47% of high school students had sexual intercourse at least once. § 37% of sexually adolescent students had not used a condom. Source: Branson (2006).

Adolescent Maternity Threatens Achievement of the Millennium Development Goals (MDGs) by 2015 § Since adolescent pregnancy leads to an increased infant and maternal mortality rate, achievement of the following goals will not be met if current trends continue: § Reduce by three-quarters the maternal mortality rate § Reduce by two-thirds the under-five mortality rate § Since in many parts of the world, pregnant girls are not allowed to remain in school, achievement of this goal will also not be met: § Eliminate gender disparity in all levels of education Source: Millennium Project (2005)

Healthy People 2010 § In an attempt to decrease adolescent pregnancy, Healthy People 2010 recommended the goal of …. increasing the “proportion of sexually active, unmarried adolescents aged 15 to 17 years who use contraception that both effectively prevents pregnancy and provides barrier protection against disease” Source: Healthy People 2010

Recommendations § Focus on women and girl’s reproductive health and education outcomes. § Provide Emergent obstetric care. § The provision of reproductive health care services to teens requires sensitivity to the special needs of this age-group including knowing about laws about confidentiality and services for birth control, pregnancy, abortion, and adoption. Source: Stanhope and Lancaster (2006)

§ Thorough assessments are vital, because factors such as a history of sexual victimization, family dysfunction, substance use, and failure to use birth control can influence whether a young girl becomes pregnant. § The pregnant teen will need support during and after pregnancy from her family and friends and from the father of the baby. Source: Stanhope and Lancaster (2006)

Reforms § In Chile, under the new regulations, public health services are authorized to prescribe, and to provide free of charge, traditional and emergency contraceptives to adolescents over 14, without the need for parental consent. § In Botswana, increased child support rules and daycare and encouragement for teens to stay in school have led to decreased teen pregnancy rates. § In Ghana, Media Campaigns to encourage condom use among sexually active youth are proving to be effective in reducing the number of adolescent pregnancies. Source: Health-Chile and Plus News Global

§ The “Young and Wise” campaign sponsored by Planned Parenthood in Ghana is another good campaign to decrease the number of adolescent pregnancies. § The African Youth Alliance is moving towards progress in reducing adolescent pregnancy. § The “Stop Aids Love Life” program in Ghana is also an effective tool in promoting self esteem leading to lower incidences of adolescent pregnancy. Source: Plus News Global (2007)

Successful Pregnancy Prevention Programs § Include collaborative approaches by the teens, their families, teachers, health professionals, businesses, the faith community, lawmakers, and other community organizations. Source: Brandis, Sattley, and Mamo (2005)

The Parent-Adolescent Relationship Education (PARE) Program § The program provides a curriculum for prevention of STDs and pregnancy in middle school youth and focuses on strengthening family communication about sexual issues and behaviors to help prevent teen pregnancy. § The National Campaign to Prevent Teen Pregnancy advocates PARE and includes information about reproduction, sex risks, and safe-sex behaviors including contraception and abstinence. § PARE emphasizes the importance of parental involvement on the reduction of early pregnancies. Source: Lederman, R. P. , & Mian, T. S (2003).

Education is Key § Education should be started before the age of 14, when young people become sexually active. § Information should be provided for teenagers about avoiding unintended pregnancies, including detailed information about contraception and its side effects. § There should be better management and training for nurses, so they can deal sympathetically with teenagers requiring contraception and provide the necessary information and education campaigns that take away the stigma of teenage sexuality, so that adolescents are not afraid to ask for contraception. § All teenagers should not just be allowed to remain in school and to return to school after birth, but they should be strongly encouraged to do so. Source: People's Daily (2007)

Every minute, somewhere in the world a young mother dies from complications in pregnancy and childbirth. Four million babies die each year within their first 28 days of life, and another 3. 3 million are stillborn. Millions of lives could be saved using the knowledge we have today, but the challenge is to transform this knowledge into action. Source: World Health Organization (WHO) (2006)

References Adolescent Pregnancy and Childbirth in the U. S. (1999) Retrieved March 10, 2007, from http: //www. prcdc. org/adolescent_pregnancy_and_childbearing_us. pdf. Alan Guttmacher Institute (2004). Adolescents in Ghana: Sexual and reproductive health. Retrieved March 10, 2007, from www. guttmacher. org Alan Guttmacher Institute ( 2006). In their own right-Addressing the sexual and reproductive health needs of men worldwide. Retrieved March 11, 2007, from www. guttmacher. org Brandis, C. D. , Sattley, D. , & Mamo, L. (2005). Theory to action: Frameworks for implementing community-wide adolescent pregnancy prevention strategies. Retrieved October 27, 2006 from http: //crhrp. ucsf. edu Branson, B. (2006). Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings Retrieved March 5, 2007, from www. cdc. gov/mmw. R/preview/mmwrhtml/rr 5514 a 1. htm Centers for Disease Control and Prevention (CDC) (2004). National Center for Health Statistics (NCHS) data on teenage pregnancy. Retrieved September 26, 2006 from www. cdc. gov. Guttmacher Institute (2006). Retrieved March 10, 2007, from http: //www. guttmacher. org Health-Chile (2007). Teen pregnancy bucks global downward trend. Retrieved March 14, 2007, from http: //ipsnews. net/news. asp? idnews=36729 Healthy People 2010. Retrieved September 27, 2006 from www. healthypeople. gov

• IRIN-Africa (2007). South Africa: Teenage pregnancy figures cause alarm. Retrieved March 14, 2007, from http: //www. irinnews. org/Report. aspx? Reportid=70538 § Lederman, R. P. , & Mian, T. S. (2003). The parent-adolescent relationship education (PARE) program: A curriculum for prevention of STDs and pregnancy in middle § Millennium Project (2005). Investing in development: A practical plan to achieve the millennium development goals. § People’s Daily (2007). Health services grow to meet increase in teen pregnancy. Retrieved March 9, 2007, from http: //english. people. com § Plus News Global (2007). Botswana: Baby steps in bringing down teen pregnancy. Retrieved March 14, 2007, from http: //www. irinnews. org/Repoert. aspx? Reportid=39151 § Stanhope, M. and Lancaster, J. (2006). Foundations of nursing in the community. Mosby. St Louis. § WHO (2004). Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality. Retrieved March 8, 2007, from www. who. int/reproductive health/publications/unsafe_abortion_estimates_04 § WHO (2006). Sexual and reproductive health of women living with HIV/AIDS. Retrieved March 5, 2007, from http: //www. who. int/hiv/en § Yampolaskaya, S. , Brown, E. C. , & Vargo, A. C. (2004). Assessment of teen pregnancy prevention interventions among middle school youth. Child and Adolescent Social Work Journal, 21, 69 -83.