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Abstract

Americans
take great pride in their leadership among nations. However, such a distinction
raises questions when the title is claimed for the highest teenage pregnancy
rate of any developed nation with nearly one million pregnancies each year.
There has been extensive research on the occurrence of teenage pregnancy, which
has produced important information about pregnancy rates and risk factors.
Researchers agree that pregnancy is a time of dramatic transition. A first time
pregnancy pushes the mother from the status of woman to mother. While these
changes are notable for the adult woman confronting pregnancy, their effect is
frequently magnified when the expecting mother is an adolescent.
Teenage pregnancy is an important public health issue that is common, largely
preventable, and associated with negative connotations for the teenagers who
become pregnant and their children.

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Introduction

Teenage pregnancy and
childbearing are key factors in leading or continuing teenage mothers in
disadvantage lives (Furstenburg, 2010). The
difficulties that come with an unplanned pregnancy in teens can have a profound
effect on their life. Their physical, social, mental, and emotional health will
all be affected by a sudden change in the course of their life. In addition, a
lack of social interaction can cause isolation from society and lead to
depression.

The public sector cost is
$950 million dollars for teenage births (National Abortion Federation, 2010).
Billions of taxpayer dollars are spent every year to care and support teenage
births. Although teen pregnancy has declined in the past, the United States is
still number one out of all industrialized countries of teen pregnancies. Teen
Birth rates are lowest in the Northeast and upper Midwest and highest across
the Southern states (Culp-Ressler, 2012). Therefore, implementing an in depth,
comprehensive sex education class covering parenting in schools will allow
teens to fully understand the consequences of having protected or unprotected
sex. Consequences of having sex at a young age generally results in unsafe sex
practices. The concerns can be due to the lack of knowledge about sex
education, and access to birth control/contraception (Culp-Ressler, 2012). Consequences
of unsafe sexual behavior include sexually transmitted infections and
pregnancy. The Guttmacher Institute (2013) say that:

·        
The
risks of poor neonatal outcomes such as a low birth weight infant, preterm
delivery or neonatal death are more than double the risk for an adult woman.

·        
Children
of teen mothers are more likely to be subject to abuse and neglect.

·        
As
many as 60% of those who become pregnant in early or mid-adolescence have a
history of childhood sexual or physical abuse and that cycle also may repeat
itself.

·        
At
least one-third of parenting adolescents of both sexes are themselves products
of adolescent pregnancy.

·        
Fewer
than 2% of teens who give birth before age 18 will graduate from college by age
30.

·        
Teen
mothers are also more likely to come from poverty and have higher rates of
school dropout.

·        
Teen
mothers are also at risk for repeat pregnancy and over 15% of teen births are
repeat pregnancies.

·        
Teen
childbirth cost the US $9.1 billion in 2004 according to the National Campaign
to Prevent Teen Pregnancy.

The United States has a
higher rate of teen pregnancy than other countries because one is not open to
talk about sex with a child once puberty occurs. Children are being introduced
to puberty at a much younger age today. Many different things can contribute to
girls having an earlier onset of puberty. Study shows girls who are obese have
a higher chance of puberty coming earlier than girls that are not obese (Mangel,
2010). Puberty is a time in a girl’s and boy’s life that changes them physically
and mentally. When teens reach puberty they start to explore their sexual
behaviors. Since young girls are starting their menstrual cycles earlier, it is
the perfect time to have the safe sex talk with them. The time for educating
teens about safe sex or no sex is suggested to start earlier than before.
Teenagers are most likely to seek sexual information from their friends
(Mangel, 2010). Therefore, it is important to keep trust and open communication
to avoid assumptions about what teenagers know about sexual education. Adequate
sex education is needed in today’s school curriculum in order to aid in the
fight against teen pregnancy.

Research has found an
association between exposure of sexual content on TV and teen pregnancy that
consists of 56% of sexual content (Rochman, 2012). Teen pregnancy is being
publicized as multi-media corporations, with shows such as “16 & Pregnant”,
“Teen Mom”, “Maury”, “Secret Life of the American Teenager”, “Juno” and more. According
to Rochman (2012), 15% of teenagers said that these shows display an altered
reality that teen pregnancy is easy, and it glamorized teen parenthood.
However, 82% said it helped them understand the challenges of teen pregnancy.
Teens expressed that they thought pregnancy would be harder after the show. These
shows and movies also provides informational resources for teenagers on how to
prevent mothers and children from homelessness, foster care, and the juvenile
system.

Despite of sex education
programs, condoms have been found to help prevent pregnancy. In 1995, condom
use among 15-19 years old prevented an estimated 1.65 million pregnancies in
the United States (Mangel, 2010). While the majority of teens have used
contraception in the past, most are using condoms or pills. Approximately half
of teens who are having sex are not using contraception. Of the teens who are
having sex and using contraception, more than half experience contraceptive
failure due to incorrect or inconsistent use or using less effective methods,
such as condoms alone or pills (Culp-Ressler, 2012). The most common reason
that teenagers did not use contraception was because they thought that they
could not get pregnant. Almost 25% stated that their partner did not want to
use contraception, which likely was a condom.

Laws

There are mandates and
laws for each state that gives a direction on sex education in schools.
According to the National Abortion Federation (2010), sex and HIV education is
mandated in 20 states and the District of Columbia. Seventeen states require
that information on contraception be provided when sex education is taught.
Thirty-seven states require that information on abstinence is provided.
However, there are 11 states with no sex education or HIV education mandate,
which those states have the highest teen pregnancy rate.

Before 2011, New York
mandated HIV education only programs that included information on condoms and
abstinence. Now it includes one semester of health sex education. The issues in
New York schools are that these programs are inconsistent and out of date
compared with other major American cities. In New York, 88% of middle schools
and high schools in the city do not have a licensed health education teacher
(Guttmacher Institute, 2013). I would recommend implementing a policy to
require the New York education system to have licensed and trained educators to
provide medically accurate information.

The federal law bans sex
discrimination in public schools. Discrimination against pregnant students is
strictly prohibited by Title IX. There are major contributing factors to high
school dropout rates. National Abortion Federation (2010) stated, the lack of
support and subtle forms of discrimination include:

·        
Schools refusing to give excused absences
for pregnancy related doctor’s appointments

·        
Teachers refusing to allow make-up work

·        
Counselors coercing students into
substandard alternative schools

·        
Exclusion from school activities based on
“morality” codes (White Cloud teens)

·        
Discouraging and disapproving comments
from adults and students

Prevention

One of Center of Disease Control’s
top priorities is prevention of unplanned teen pregnancies. They believe that
it is a “winnable battle” in public health. The evidence based prevention
programs that they want tackle addresses knowledge, skills, and beliefs/attitudes
toward teen pregnancy. Research thus far suggested that teen pregnancy
prevention goals are to:

·        
Decrease pregnancies among female teens

·        
Delay initiation of teen sexual activity

·        
Increase use of contraception,
particularly long-acting, reversible methods, among sexually active teens

Highly effective sex
education and HIV prevention have been shown to delay the initiation of sex,
frequency of sex, the number of new partners, the incidence of unprotected sex
and/or increasing the use of condoms and contraception (Guttmacher Institute,
2013). This is called Comprehensive sex education, which teaches about
abstinence as the best method for avoiding STDs and unintended pregnancy. It provides
information on condoms and contraception to reduce the risk of unintended
pregnancy and of infection with STDs, including HIV. The sex education program
further explains interpersonal and communication skills that encourages
teenagers to explore their own values, goals, and options.

Another alternative
program is called, Abstinence-Only-Until-Marriage or Risk Avoidance, that teach
abstinence as the only “morally correct option” of sexual expression for
teenagers (Culp-Ressler, 2012). They usually censor information about
contraception and condoms for the prevention of sexually transmitted diseases
(STDs) and unintended pregnancy. Teens who receive a comprehensive education
about sex are 50 percent less likely to have an unintended pregnancy than those
who receive sex educations that are abstinence-only or contraception-only
programs (Furstenburg, 2010).

Conclusion

Recommendations for the focus on teen
pregnancy prevention review should be in the areas of education and training,
employment and careers, and financial circumstances. Therefore, physician groups can lobby for policy
initiatives aimed at changing sexual risk behaviors among teenagers, including
enhanced sexual education at schools. The most important role for physicians is
to provide appropriate sexual health information and services in their
practices if they are providing clinical services to youths. They must
recognize the reality of teenage sexual activity. Studies have shown that, by
the end of high school, the majority of teenagers have had sexual intercourse
and that about 10% have had intercourse before age 15 (Furstenburg, 2010). As
part of the general inquiry into their well-being, physicians should ask all
teenagers about their sexual activity, use of condoms and contraception,
history of sexually transmitted infections and pregnancy, and the need for
information about other sexual health concerns. Scripts for these discussions
may be helpful since teenagers may be afraid to open up about their personal
life. According to law, teenagers have the right to confidential health care,
including receiving sexual health services, provided their emotional and
cognitive maturity allow for this (National Abortion Federation, 2010). Their
parents do not have an automatic right to know. The right to confidentiality is
not always understood by teenagers and should be appropriately communicated
during patient encounters.

The organization, The
National Campaign to Prevent Teen and Unplanned Pregnancy, is a great resource
for more information on teen pregnancy. Their website has short video clips and
statistics that helps those that wants to seek and improve the well-being of
children, the young mother and the families. The National Campaign feels that it
is important because teen pregnancy, especially unplanned pregnancy, is part of
the root of the problems to important public issues, and ultimately social
challenges. Their part and role in this problem is to work in the areas that
need the most help. This movement is to strengthen the cultures assumptions of
personal responsibilities regarding sex, getting pregnant and most importantly
bring a child into this world. Ultimately, the National Campaign provides more
and better education to the teens that this affects such as the parents, the
young adults, and anyone who could be affected by this social problem.

 

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