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Teenage pregnancy is still a major issue in the US. As it may carry many risks for adolescents, it is necessary to support effective teenage pregnancy prevention methods available in our society. The purpose of this paper is to study the adolescent pregnancy rates in the US, identify the risk factors, list health and mental risks of teenage pregnancy, and find existing and other possible solutions to raising awareness of teenage pregnancy prevention methods. Although there is a downward trend in adolescent pregnancy rates, the US has the highest rates among developed countries.
Sexual abuse, problems with the healthcare system, and lack of comprehensive sex education are still major risk factors. In order to eliminate these factors, it is necessary to support awareness of the most effective contraception methods, fight poor governmental decisions, and find new modern ways to raise sexual health awareness, such as online podcasts, applications, or websites.
Adolescence is considered to be the most emotionally vulnerable age of a person’s life. Whereas it is a period of transition between childhood and adulthood, teenagers do not develop their cognitive and social skills fully yet. However, they come to an age of sexual maturity, which can result in romantic relationships or casual sexual encounters. Depending on different factors, both outcomes might lead to unintended teenage pregnancy.
According to Smith, Strohschein, and Crosnoe (2018), the United States still has the highest rate of adolescent pregnancies in developed countries. Despite the downward trend, it is not easy to maintain it (Martin, Hamilton, Osterman, Driscoll, and Mathews, 2018). Teenage pregnancy can be an overwhelming situation to deal with at such a young age; having adequate pregnancy preventative resources available in our communities is essential in order to aid in reducing pregnancy rates effectively.
Teen Pregnancy Rates and Dynamics
In order to analyze how unintended pregnancy rates can be reduced, it is necessary to start with the statistics. Researchers note that the average birth rate per 1,000 teenagers was 84.1 in 1991 (Cox et al., 2014). According to Martin et al. (2018), nowadays, the situation has drastically changed, with 18.8 births per 1,000 in 2017 among females aged 15-19. Thus, the average birthrate decreased 4.4 times over almost 30 years.
Such a decline tends to happen in 32 states, including Alabama, Ohio, New York, Mississippi, etc. In contrast, the teenage birthrate remained the same in the other 18 states, such as Connecticut, Hawaii, Kansas, Nebraska, etc. (Martin et al., 2018). However, the statistics clearly show that average teenage pregnancy rates are decreasing every year. Still, there is much work to be done to let the teenage pregnancy rates decrease in the future as the U.S. has larger problems than other developed countries.
Teenage Pregnancy Risk Factors
Meanwhile, the overall statistics show a decrease in adolescent pregnancies; it does not happen for all with equal success. According to Martin et al. (2018), there is a difference in birth rates by states with an average rate of 8.8 per 1,000 teenagers in Connecticut and 31.0 in Mississippi. However, this is not the only difference, and there are several most vulnerable groups in the US. According to Burrus (2018), these groups include Hispanic, African American, and American Indian teenagers. The risks of teenage pregnancy are also higher for other groups, such as foster care, runaway, or homeless adolescents (Burrus, 2018). However, any sexually mature female adolescent has unintended pregnancy risks despite their race, ethnicity, or social and cultural upbringing.
Sexual abuse is another teenage pregnancy risk factor. Non-voluntary sexual intercourse among teenagers still affects female adolescents resulting in an unwanted pregnancy. There is also a correlation between sexual abuse in childhood and early pregnancies. According to Harner (2016), more than half of pregnant teenagers have encountered early physical or sexual abuse. Thus, this is a major problem that has to be taken into account.
Unfortunately, many more important factors might be the cause of teenage pregnancies, and one of them is a lack of sex education. Researchers note that in 2012 one in four 15-17 female teens has ever had sex, and only two in ten have had formal sex education before their first sexual intercourse (Cox et al., 2014). Sex education provides knowledge of the main conventional methods of pregnancy prevention, such as correct condom use or birth control.
Teenage Pregnancy Health Risks
Among many other factors that might seriously affect a pregnant teenager’s life in case a young mother keeps the baby (including social or financial difficulties), the health risks should be considered in the first place. In case a pregnant adolescent is not supported by her family, or she is afraid of telling about her pregnancy, a future mother is at risk of not having prenatal care. Prenatal screens can show any complications with the pregnancy and can predict any defects of the fetus, which might be prevented if treated in time.
According to Corcoran (2016), among all, ethnic minorities tend to be the least insured groups and do not often receive proper prenatal treatment. Thus, during pregnancy, there is also a higher risk of miscarriage if the problems are not detected. Researchers also note that teenage mothers are also considered to be at risk of having a premature birth or low-birth-weight baby (Smith et al., 2018). Such complications can be the cause of a child’s death or disabilities as well as the labor might end in the death of a mother.
Mental health problems are also one of the major issues for a pregnant teenager to cope with. If a teenager is not emotionally supported, there might be a higher risk of depression during pregnancy or postpartum depression. According to Corcoran (2016), “Compared to nonpregnant teens, pregnant teens may have an even greater risk for depression” (p. 2). A child of such a mother might be at risk of intellectual or language delays because it does not receive proper care, especially if there is no father.
If a pregnant teenager does not want to keep the child, she faces abortion. However, it is considered to be one of the contraception methods; it can also be dangerous. If it is not performed correctly or is illegal, there is also a risk of having health problems in the future, such as infertility.
Teenage Pregnancy Socioeconomic Consequences
As far as socioeconomic consequences of teen pregnancy are concerned, adolescent pregnancy is usually associated with lower incomes and a decline in living standards. However, these considerations are not exactly correct. According to the recent research of Gorry (2019), the results of adolescent pregnancy may differ, depending on the group of teenagers. For example, the overall effect is not uniform for black, white, Latino, and Hispanic groups of teenagers. The researchers note that “the overall effects of teen childbearing are smaller and insignificant for the black and Hispanic and Latino populations” (Gorry, 2019, p. 2162). Moreover, young mothers from minority groups are encouraged to obtain a better education.
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For black teenagers, the labor and household income are increased due to teenage pregnancy. It is possible to note that Hispanic and Latino teenagers who had a child in their teens are in better financial situations in the longer run, compared to those who do not have a child as a teenager (Gorry, 2019, p. 2162). The same results of teen childbearing can be seen among adolescents from lower-income counties (not divided by race).
However, the results of teen pregnancy differ for white teenagers. According to Gorry (2019), the effect is most detrimental in terms of education as white teenagers are not likely to receive high school diplomas, or their schooling years might be reduced. Thus, white teenagers who have a child are in worse financial situations in the long run compared to those who do not. It is also important to note that the same results may be applied to adolescents from higher-income counties.
Teenage Pregnancy Prevention: Programs and Methods
As mentioned earlier, the teenage pregnancy rates in the US are the highest compared to other developed countries. According to Smith et al. (2018), although there is a stable downward trend, US teenagers are more likely to become pregnant as their use of contraception methods is lower in comparison with their peers from other countries. The researchers also note that US teenagers use less effective pregnancy prevention methods (Smith et al., 2018). As there are many health and socioeconomic risks associated with teen pregnancy mentioned before, the fact of teenager childbearing is considered a problem that has to have an effective solution.
Better education about effective contraception is an important element of a strategy to continue lowering teen pregnancy rates. According to the researchers, about nine in 10 sexually active younger teens used some form of contraception the last time they had sex (Cox et al., 2014). However, it does not mean all the methods applied are effective. The researchers note that only 1% used the most effective methods, such as intrauterine devices or implants (Cox et al., 2014). Such a small number only means that either teenager are not aware of these forms of contraception or they are not available for them.
Nowadays, there are several ways how teenagers might receive necessary information: in the family, school sex education lessons, and local sex education programs, or independently using the information on the Internet. However, the researchers note that almost a quarter of female adolescents aged 15–17 years have not spoken with their parents about how to say no to sex or about methods of birth control (Cox et al., 2014).
It means that this way is not enough as either part of the teenagers do not want to talk to their parents about sex or their parents cannot address this issue correctly. Moreover, as it was said here earlier, there is a higher risk of teenage pregnancy among such groups as homeless teenagers or foster care adolescents. There should be special programs for such adolescents, and they have to receive information about contraception methods at schools.
In order to raise awareness about contraception methods, it is necessary to use a comprehensive educational approach. Nowadays, there are two main forms of how sex education is taught: comprehensive and abstinence-only. The abstinence-only approach implies no sexual activity before marriage. On the contrary, the comprehensive approach means that teenagers are taught contraception methods, human sexuality, and sexually transmitted infections. Thus, it is considered to be more effective in addressing contraception methods (Santelli et al., 2017). It is necessary to provide obligatory comprehensive sex education classes at schools.
However, comprehensive sex education is not taught in all states. According to Santelli et al. (2017), the federal government began supporting abstinence promotion programs in 1981 via the Adolescent Family Life Act in order to promote chastity. Consensual sexual intercourse outside marriage is considered psychologically and physically harmful for teenagers by abstinence-only supporters.
However, according to recent studies, there are no harmful psychological and psychical effects on adolescents from consensual sex (Santelli et al., 2017). The efficacy of the abstinent-only sex education program has been proven extremely low. According to the researchers, “Abstinence is often not effective in preventing pregnancy or STIs as many young people who intend to practice abstinence fail to do so” (Santelli et al., 2017, p. 276).
If these “failed” teenagers are not taught effective contraception methods, the risk of pregnancy or STI is very high. Moreover, the abstinence-only approach raises human rights issues as access to sexual and reproductive health information is considered to be a basic human right (Santelli et al., 2017). The abstinence-only approach does not provide full sexual health information and therefore raises a major ethical problem. In order to continue lowering teenage pregnancy rates, it is necessary to push for comprehensive sex education in all states.
As said earlier, the US has experienced a drastic decline in teenage pregnancies for the past two decades. According to the researchers, this downward trend has been linked to the use of contraception methods (Santelli et al., 2017). The development of a comprehensive sex education system and Teen Pregnancy Prevention Program has contributed to this trend.
The Teen Pregnancy Prevention program was established in 2010 by Congress, and its goal was to provide medically accurate, evidence-based, and age-appropriate programs for the prevention of teen pregnancy. According to Charo (2017), “The Safer Sex program showed similarly significant reductions in early sexual initiation, and for those already sexually active, significant reductions in unprotected sex and sexually transmitted infections” (p. 1557).
The researchers also note that The Horizon program aimed at African American teens has managed to reduce the rates of unprotected sex, as well as a significant number of other Teen Pregnancy Prevention programs have proved successful (Charo, 2017). Overall, there were more than 80 programs funded by the Teen Pregnancy Prevention Program that helped reduce adolescent pregnancy rates.
Although the TPPP was considered successful, according to the researchers, as mentioned earlier and many others, it faced significant difficulties. At first, grants were ended for about 80 grantees, and then the entire TPPP was to discontinue by June 2018. The funding was stopped by the Department of Health and Human Services under the Trump Administration. Fortunately, this decision met much-deserved criticism, and many organizations decided to fight against it. According to Durkee (2018), “The lawsuit was brought against the HHS by consumer rights group The Public Citizen on behalf of organizations Policy and Research LLC, Project Vida Health Center, Sexual Health Initiatives for Teens and the South Carolina Campaign to Prevent Teen Pregnancy” (para. 3).
Four of the 81 grantees whose grants were to end were named in the lawsuit. Fortunately, The Public Citizen won the lawsuit, and the grantees will be able to continue their research, whereas other lawsuits concerning other groups are pending (Durkee, 2018). It is essential that the human rights organizations continue to fight against any unreasoned decisions of the Trump administration in the future.
School interventions with a simultaneous approach to different risk factors are also considered to be an effective solution to the teenage pregnancy problem. Researchers note that school interventions that target sexual health and alcohol abuse at the same time were found to have positive effects on alcohol use and sexual risk behavior (Denford, Abraham, Campbell, Busse, 2017). The most promising sex education programs are targeted at the school, family, and community risk and protective factors (Denford et al., 2017).
Also, it is necessary to adjust such programs for different genders. According to the researchers, behavior changes and attitudes towards sexual behavior as a result of school sexual health interventions were inconsistent and often different for young males and females (Denford et al., 2017). Thus, it means that more research should be done addressing the gender issue and how to use school interventions with much efficacy according to the perception of educational programs by different genders.
A potentially beneficial method to support comprehensive sex education at schools might be educating parents who support the idea of abstinence-only sex education programs. In general, almost all American parents support the idea of some kind of sex education at schools. According to researchers, 97% of parents feel that sex education at schools is important (Kantor, Levitz, Holstrom, 2019). However, it is also important to educate those parents who are not likely to support a comprehensive sex education approach.
In fact, only more politically liberal parents at a younger age, with higher education levels and lower household income, tend to support comprehensive sex education programs (Kantor, Levitz, Holstrom, 2019). Activists should support any programs for comprehensive sex education for adults and why it is crucial for adolescents so that parents will not promote abstinence-only sex education.
Another potentially successful method to help raise teenage pregnancy awareness is promoted online podcasts, webpages, or mobile applications. In the modern world, teenagers spend a lot of time online, and for some of them, it is the most important source of information. For example, there is a mobile application, “Girl Talk,” aimed at teaching sexual health to adolescent females. According to Brayboy et al. (2017), the app showed excellent results in providing necessary sexual health information in a private and accurate manner.
The participants also showed much enthusiasm at recommending this application to their friends. It is also possible to note that the application has the potential to narrow the gap between teenagers, healthcare providers, and parents (Brayboy et al., 2017). Of course, it is crucial to have such applications not only for adolescent females but males too.
Helping teenagers obtain information and receive help from local healthcare providers can also be useful in order to lower teenage pregnancy rates. The US healthcare system is more market-oriented, and the government does not approach social welfare much. The researchers note that The United States also has a weaker safety net than Canada, for example (Smith et al., 2018). Combined with high-income inequality, it leads to the problem of healthcare access for lower-income families. It is possible to note that, although the link between poverty and teenage pregnancy in the US is less strong than in Canada, for example, it still exists (Smith et al., 2018).
Not all teenagers can obtain information about effective contraception methods from healthcare providers. Researchers note that laws allowing teenagers to receive health services and protecting their confidentiality are different in each state (Cox et al., 2014). Access to local healthcare providers should be available for all adolescents. Improving healthcare provider confidentiality might help with the problem of teen pregnancy, as well as developing social welfare in general.
As teenage pregnancy might have a severe impact on an adolescent’s life, it is essential to be aware of the risks, raising awareness of the effective adolescent pregnancy prevention methods. Although there is a drastic decline in teenage pregnancy rates nowadays, the US still has the highest rates among developed countries. As an adolescent pregnancy might lead to mental and physical health problems, reduce schooling years, and harm teenager’s financial situations in the longer run, it is necessary to fight the pregnancy risk factors. It is important to raise awareness about sexual health with the help of comprehensive sex education programs, which proved to be the most successful ones.
It is also important to fight for the cancellation of abstinence-only programs in the U.S. and educate those parents who do not support comprehensive sex education. More research should be done on how to develop programs addressing simultaneous risk factors for teenage pregnancy. In addition, it is necessary to fight against poor governmental decisions and demand more focus on social welfare. As well as the use of modern world solutions such as web podcasts or smartphone applications in order to continue the downward teenage pregnancy trend.
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