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Teenage pregnancy, also known as adolescent pregnancy, is
pregnancy Pregnancy is the time during which one or more offspring develops (gestation, gestates) inside a woman, woman's uterus (womb). A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occur ...
in a
female Female ( symbol: ♀) is the sex of an organism that produces the large non-motile ova (egg cells), the type of gamete (sex cell) that fuses with the male gamete during sexual reproduction. A female has larger gametes than a male. Females ...
adolescent or
young adult A young adult is generally a person in the years following adolescence. Definitions and opinions on what qualifies as a young adult vary, with works such as Erik Erikson's stages of human development significantly influencing the definition of ...
under the age of 20. This includes those who are legally considered adults in their country. The WHO defines adolescence as the period between the ages of 10 and 19 years. Pregnancy can occur with sexual intercourse after the start of
ovulation Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilize ...
, which can be before the first menstrual period (menarche) but usually occurs after the onset of periods. In well-nourished girls, the first period usually takes place around the age of 12 or 13. 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 Socioeconomics (also known as social economics) is the social science that studies how economic activity affects and is shaped by social processes. In general it analyzes how modern societies progress, stagnate, or regress because of their l ...
factors than with the biological effects of age. Risks of
low birth weight Low birth weight (LBW) is defined by the World Health Organization as a birth weight of an infant of or less, regardless of gestational age. Infants born with LBW have added health risks which require close management, often in a neonatal inten ...
,
premature labor Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between ...
,
anemia Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, t ...
, and pre-eclampsia are not connected to
biological age Biomarkers of aging are biomarkers that could predict functional capacity at some later age better than chronological age. Stated another way, biomarkers of ageing, aging would give the true "biological age", which may be different from the chrono ...
by the time a girl is 16, as they are not observed in births to older teens after controlling for other risk factors, such as access to high-quality
prenatal care Prenatal care, also known as antenatal care, is a type of preventive healthcare. It is provided in the form of medical checkups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as materna ...
. Teenage pregnancies are related to social issues, including lower
educational Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty. Vari ...
levels and poverty. Teenage pregnancy in developed countries is usually outside of
marriage Marriage, also called matrimony or wedlock, is a culturally and often legally recognized union between people called spouses. It establishes rights and obligations between them, as well as between them and their children, and between ...
and is often associated with a
social stigma Social stigma is the disapproval of, or discrimination against, an individual or group based on perceived characteristics that serve to distinguish them from other members of a society. Social stigmas are commonly related to culture, gender, ra ...
. Teenage pregnancy in developing countries often occurs within marriage and half are planned. However, in these societies, early pregnancy may combine with
malnutrition Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues ...
and poor health care to cause medical problems. When used in combination, educational interventions and access to birth control can reduce unintended teenage pregnancies. In 2015, about 47 females per 1,000 had children well under the age of 20. Rates are higher in Africa and lower in Asia. In the developing world about 2.5 million females under the age of 16 and 16 million females 15 to 19 years old have children each year. Another 3.9 million have abortions. It is more common in rural than urban areas. Worldwide, complications related to pregnancy are the most common cause of death among females 15 to 19 years old.


Definition

The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
defines adolescence as the period between the ages of 10 and 19 years. The mother's age is determined by the easily verified date when the pregnancy ''ends'', not by the estimated date of conception. Consequently, the statistics do not include pregnancies that began at age 19, but that ended on or after the woman's 20th birthday. Similarly, statistics on the mother's marital status are determined by whether she is married at the end of the pregnancy, not at the time of conception.


History

Teenage pregnancy (with conceptions normally involving girls between ages 16 and 19) was far more normal in previous centuries, and common in developed countries in the 20th century. Among Norwegian women born in the early 1950s, nearly a quarter became teenage mothers by the early 1970s. However, the rates have steadily declined throughout the developed world since that 20th-century peak. Among those born in Norway in the late 1970s, less than 10% became teenage mothers, and rates have fallen since then. In the United States, the
Personal Responsibility and Work Opportunity Act The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) is a United States federal law passed by the 104th United States Congress and signed into law by President Bill Clinton. The bill implemented major changes to ...
of 1996 included the objective of reducing the number of young Black and Latina single mothers on welfare, which became the foundation for teenage pregnancy prevention in the United States and the founding of the National Campaign to Prevent Teen Pregnancy, now known as Power to Decide.


Effects

According to the
United Nations Population Fund The United Nations Population Fund (UNFPA), formerly the United Nations Fund for Population Activities, is a UN agency aimed at improving reproductive and maternal health worldwide. Its work includes developing national healthcare strategies a ...
(UNFPA), "Pregnancies among girls less than 18 years of age have irreparable consequences. It violates the rights of girls, with life-threatening consequences in terms of sexual and reproductive health, and poses high development costs for communities, particularly in perpetuating the cycle of poverty." Health consequences include not yet being physically ready for pregnancy and childbirth leading to complications and malnutrition as the majority of adolescents tend to come from lower-income households. The risk of maternal death for girls under age 15 in low and middle income countries is higher than for women in their twenties. Teenage pregnancy also affects girls' education and income potential as many are forced to drop out of school which ultimately threatens future opportunities and economic prospects. Several studies have examined the
socioeconomic Socioeconomics (also known as social economics) is the social science that studies how economic activity affects and is shaped by social processes. In general it analyzes how modern societies progress, stagnate, or regress because of their l ...
,
medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
, and psychological impact of pregnancy and parenthood in teens. Life outcomes for teenage mothers and their children vary; other factors, such as poverty or social support, may be more important than the age of the mother at the birth. Many solutions to counteract the more negative findings have been proposed. 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. A holistic approach is required in order to address teenage pregnancy. This means not focusing on changing the behaviour of girls but addressing the underlying reasons of adolescent pregnancy such as poverty, gender inequality, social pressures and coercion. This approach should include "providing age-appropriate comprehensive sexuality education for all young people, investing in girls' education, preventing child marriage, sexual violence and coercion, building gender-equitable societies by empowering girls and engaging men and boys and ensuring adolescents' access to sexual and reproductive health information as well as services that welcome them and facilitate their choices". In the United States one third of high school students reported being sexually active. In 2011–2013, 79% of females reported using birth control. Teenage pregnancy puts young women at risk for health issues, economic, social and financial issues.


Teenager

Being a young mother in a first world country can affect one's
education Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty ...
. Teen mothers are more likely to drop out of
high school A secondary school describes an institution that provides secondary education and also usually includes the building where this takes place. Some secondary schools provide both '' lower secondary education'' (ages 11 to 14) and ''upper seconda ...
.The National Campaign to Prevent Teen Pregnancy. (2002).  . Retrieved May 27, 2006. One study in 2001 found that women that gave birth during their teens completed secondary-level schooling 10–12% as often and pursued
post-secondary education Tertiary education, also referred to as third-level, third-stage or post-secondary education, is the educational level following the completion of secondary education. The World Bank, for example, defines tertiary education as including univers ...
14–29% as often as women who waited until age 30. ''Young motherhood'' in an
industrialized country A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
can affect employment and social class. Teenage women who are pregnant or mothers are seven times more likely to commit suicide than other teenagers. According to the National Campaign to Prevent Teen Pregnancy, nearly 1 in 4 teen mothers will experience another pregnancy within two years of having their first."Statistics on Teen Pregnancy". National Campaign to Prevent Teen Pregnancy Pregnancy and giving birth significantly increases the chance that these mothers will become high school dropouts and as many as half have to go on welfare. Many teen parents do not have the intellectual or emotional maturity that is needed to provide for another life. Often, these pregnancies are hidden for months resulting in a lack of adequate prenatal care and dangerous outcomes for the babies. Factors that determine which mothers are more likely to have a closely spaced repeat birth include marriage and education: the likelihood decreases with the level of education of the young woman – or her parents – and increases if she gets married.


Child

Early motherhood can affect the
psychosocial development Erikson's stages of psychosocial development, as articulated in the second half of the 20th century by Erik Erikson in collaboration with Joan Erikson, is a comprehensive psychoanalytic theory that identifies a series of eight stages that a heal ...
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 Developmental disability is a diverse group of chronic conditions, comprising mental or physical impairments that arise before adulthood. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, espe ...
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 In physiology, the somatosensory system is the network of neural structures in the brain and body that produce the perception of touch ( haptic perception), as well as temperature ( thermoception), body position (proprioception), and pain. It ...
,
smiling A smile is a facial expression formed primarily by flexing the muscles at the sides of the mouth. Some smiles include a contraction of the muscles at the corner of the eyes, an action known as a Duchenne smile. Among humans, a smile expresses ...
, and
verbal communication Linguistics is the scientific study of human language. It is called a scientific study because it entails a comprehensive, systematic, objective, and precise analysis of all aspects of language, particularly its nature and structure. Linguis ...
, or to be sensitive and accepting toward their needs. Another found that those who had more social support were less likely to show
anger Anger, also known as wrath or rage, is an intense emotional state involving a strong uncomfortable and non-cooperative response to a perceived provocation, hurt or threat. A person experiencing anger will often experience physical effects, su ...
toward their children or to rely upon punishment. Poor
academic performance Academic achievement or academic performance is the extent to which a student, teacher or institution has attained their short or long-term educational goals. Completion of educational benchmarks such as secondary school diplomas and bachelor's deg ...
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
parent A parent is a caregiver of the offspring in their own species. In humans, a parent is the caretaker of a child (where "child" refers to offspring, not necessarily age). A ''biological parent'' is a person whose gamete resulted in a child, a male t ...
s are more likely to become teen mothers themselves. Sons born to teenage mothers are three times more likely to serve time in
prison A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, corre ...
.


Medical

Maternal and
prenatal Prenatal development () includes the development of the embryo and of the fetus during a viviparous animal's gestation. Prenatal development starts with fertilization, in the germinal stage of embryonic development, and continues in fetal devel ...
health is of particular concern among teens who are pregnant or parenting. The worldwide incidence of
premature birth Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 2 ...
and
low birth weight Low birth weight (LBW) is defined by the World Health Organization as a birth weight of an infant of or less, regardless of gestational age. Infants born with LBW have added health risks which require close management, often in a neonatal inten ...
is higher among adolescent mothers. In a rural hospital in West Bengal, teenage mothers between 15 and 19 years old were more likely to have anemia, preterm delivery, and a baby with a lower birth weight than mothers between 20 and 24 years old. Research indicates that pregnant teens are less likely to receive
prenatal care Prenatal care, also known as antenatal care, is a type of preventive healthcare. It is provided in the form of medical checkups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as materna ...
, often seeking it in the
third trimester Pregnancy is the time during which one or more offspring develops ( gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can ...
, if at all. The
Guttmacher Institute The Guttmacher Institute is a research and policy NGO that aims to improve sexual and reproductive health and rights worldwide. This research organization was started in 1968 and works to study, educate, and advance sexual and reproductive health ...
reports that one-third of pregnant teens receive insufficient prenatal care and that their children are more likely to have health issues in childhood or be
hospitalized A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency ...
than those born to older women. In the United States, teenage
Latinas Hispanic and Latino Americans ( es, Estadounidenses hispanos y latinos; pt, Estadunidenses hispânicos e latinos) are Americans of Spanish and/or Latin American ancestry. More broadly, these demographics include all Americans who identify as ...
who become pregnant face barriers to receiving healthcare because they are the least insured group in the country. Young mothers who are given high-quality maternity care have significantly healthier babies than those who do not. Many of the health-issues associated with teenage mothers appear to result from lack of access to adequate medical care. Many pregnant teens are at risk of
nutritional deficiencies Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues ...
from poor eating habits common in adolescence, including attempts to lose weight through dieting, skipping meals,
food faddism A fad diet is a diet that becomes popular for a short time, similar to fads in fashion, without being a standard dietary recommendation, and often making unreasonable claims for fast weight loss or health improvements. There is no single defin ...
, snacking, and consumption of fast food. Inadequate nutrition during pregnancy is an even more marked problem among teenagers in
developing countries A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreem ...
.
Complications of pregnancy Complications of pregnancy are health problems that are related to pregnancy. Complications that occur primarily during childbirth are termed obstetric labor complications, and problems that occur primarily after childbirth are termed puerperal d ...
result in the deaths of an estimated 70,000 teen girls in developing countries each year. Young mothers and their babies are also at greater risk of contracting
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
. The
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
estimates that the risk of death following pregnancy is twice as high for girls aged 15–19 than for women aged 20–24. The maternal mortality rate can be up to five times higher for girls aged 10–14 than for women aged 20–24. Illegal abortion also holds many risks for teenage girls in areas such as sub-Saharan Africa. Risks for medical complications are greater for girls aged under 15, as an underdeveloped pelvis can lead to difficulties in
childbirth Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births glob ...
. Obstructed labour is normally dealt with by caesarean section in
industrialized nations A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
; however, in developing regions where medical services might be unavailable, it can lead to
eclampsia Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. Pre-eclampsia is one of the hypertensive disorders of pregnancy that presents with three main features: new onset of high blood pressure, large amounts of protein in ...
,
obstetric fistula Obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum, ureter, or bladder. It can result in incontinence of urine or feces. Complications may i ...
, infant mortality, or maternal death. For mothers who are older than fifteen, age in itself is not a risk factor, and poor outcomes are associated more with socioeconomic factors rather than with biology.


Economics

The lifetime opportunity cost caused by teenage pregnancy in different countries varies from 1% to 30% of the annual GDP (30% being the figure in
Uganda }), is a landlocked country in East Africa. The country is bordered to the east by Kenya, to the north by South Sudan, to the west by the Democratic Republic of the Congo, to the south-west by Rwanda, and to the south by Tanzania. The sou ...
). In the United States, teenage pregnancy costs taxpayers between $9.4 and $28 billion each year, due to factors such as foster care and lost tax revenue. The estimated increase in economic productivity from ending teenage pregnancy in Brazil and India would be over $3.5 billion and $7.7 billion respectively. 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 Poverty is the state of having few material possessions or little at the time of giving birth. Additional research found that nearly 50% of all adolescent mothers sought
social assistance Welfare, or commonly social welfare, is a type of government support intended to ensure that members of a society can meet basic human needs such as food and shelter. Social security may either be synonymous with welfare, or refer specifical ...
within the first five years of their child's life. A study of 100 teenaged mothers in the UK found that only 11% received a
salary A salary is a form of periodic payment from an employer to an employee, which may be specified in an employment contract. It is contrasted with piece wages, where each job, hour or other unit is paid separately, rather than on a periodic basis. F ...
, while the remaining 89% were
unemployed Unemployment, according to the OECD (Organisation for Economic Co-operation and Development), is people above a specified age (usually 15) not being in paid employment or self-employment but currently available for work during the refere ...
. Most British teenage mothers live in poverty, with nearly half in the bottom fifth of the income distribution.Teenage pregnancy
everychildmatters.gov.uk


Risk factors


Culture

Rates of teenage pregnancies are higher in societies where it is traditional for girls to marry young and where they are encouraged to bear children as soon as they are able. For example, in some sub-Saharan African countries, early pregnancy is often seen as a blessing because it is proof of the young woman's
fertility Fertility is the capability to produce offspring through reproduction following the onset of sexual maturity. The fertility rate is the average number of children born by a female during her lifetime and is quantified demographically. Fertili ...
. Countries where teenage marriages are common experience higher levels of teenage pregnancies. In the
Indian subcontinent The Indian subcontinent is a list of the physiographic regions of the world, physiographical region in United Nations geoscheme for Asia#Southern Asia, Southern Asia. It is situated on the Indian Plate, projecting southwards into the Indian O ...
, early marriage and pregnancy is more common in traditional rural communities than in cities. Many teenagers are not taught about methods of birth control and how to deal with peers who pressure them into having sex before they are ready. Many pregnant teenagers do not have any cognition of the central facts of sexuality.
Economic incentive In general, incentives are anything that persuade a person to alter their behaviour. It is emphasised that incentives matter by the basic law of economists and the laws of behaviour, which state that higher incentives amount to greater levels of ...
s also influence the decision to have children. In societies where children are set to work at an early age, it is economically attractive to have many children. In societies where adolescent marriage is less common, such as many developed countries, young age at first intercourse and lack of use of contraceptive methods (or their inconsistent and/or incorrect use; the use of a method with a high failure rate is also a problem) may be factors in teen pregnancy.Beginning Too Soon: Adolescent Sexual Behavior, Pregnancy And Parenthood
US Department of Health and Human Services. Retrieved January 25, 2007.
Most teenage pregnancies in the developed world appear to be unplanned.Teenage Mothers : Decisions and Outcomes – Provides a unique review of how teenage mothers think
Policy Studies Institute, University of Westminster, 30 Oct 1998
Many Western countries have instituted
sex education Sex education, also known as sexual education, sexuality education or sex ed, is the instruction of issues relating to human sexuality, including emotional relations and responsibilities, human sexual anatomy, sexual activity, sexual reproduc ...
programs, the main objective of which is to reduce unplanned pregnancies and STIs. Countries with low levels of teenagers giving birth accept sexual relationships among teenagers and provide comprehensive and balanced information about sexuality.Guttmacher Institute. (2005)
Sex and Relationships
Retrieved August 8, 2006.
Teenage pregnancies are common among
Romani people The Romani (also spelled Romany or Rromani , ), colloquially known as the Roma, are an Indo-Aryan ethnic group, traditionally nomadic itinerants. They live in Europe and Anatolia, and have diaspora populations located worldwide, with sig ...
because they marry earlier.


Other family members

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 Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty ...
and employment and more likely to accept
human sexual behavior Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) t ...
,
parenting Parenting or child rearing promotes and supports the physical, emotional, social, spiritual and intellectual development of a child from infancy to adulthood. Parenting refers to the intricacies of raising a child and not exclusively for ...
, and
marriage Marriage, also called matrimony or wedlock, is a culturally and often legally recognized union between people called spouses. It establishes rights and obligations between them, as well as between them and their children, and between ...
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. Once an older daughter has a child, parents often become more accepting as time goes by. A study from Norway in 2011 found that the probability of a younger sister having a teenage pregnancy went from 1:5 to 2:5 if the elder sister had a baby as a teenager.


Sexuality

In most countries, most males experience sexual intercourse for the first time before their 20th birthday.Guttmacher Institute (2003
''In Their Own Right: Addressing the Sexual and Reproductive Health Needs of Men Worldwide.''
pp. 19–21.
Males in Western developed countries have sex for the first time sooner than in undeveloped and culturally conservative countries such as sub-Saharan Africa and much of Asia. In a 2005
Kaiser Family Foundation KFF (Kaiser Family Foundation), also known as The Henry J. Kaiser Family Foundation, is an American non-profit organization, headquartered in San Francisco, California. It prefers KFF since its legal name can cause confusion as it is no longer a ...
study of US teenagers, 29% of teens reported feeling pressure to have sex, 33% of sexually active teens reported "being in a relationship where they felt things were moving too fast sexually", and 24% had "done something sexual they didn’t really want to do".  Kaiser Family Foundation, January 2005. Retrieved 23 Jan 2007 Several polls have indicated
peer pressure Peer pressure is the direct or indirect influence on peers, i.e., members of social groups with similar interests, experiences, or social statuses. Members of a peer group are more likely to influence a person's beliefs, values, and behavior. A g ...
as a factor in encouraging both girls and boys to have sex.The National Campaign to Prevent Teen Pregnancy. (1997)
What the Polling Data Tell Us: A Summary of Past Surveys on Teen Pregnancy
teenpregnancy.org (April 1997).
Allen, Colin. (May 22, 2003).

" ''Psychology Today.'' Retrieved July 14, 2006.
The increased sexual activity among adolescents is manifested in increased teenage pregnancies and an increase in
sexually transmitted diseases Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral ...
.


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 ''Cannabis'' () is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: '' Cannabis sativa'', '' C. indica'', and '' C. ruderalis''. Alternative ...
, "ecstasy" and other substituted amphetamines. The drugs with the least evidence to support a link to early pregnancy are opioids, such as heroin,
morphine Morphine is a strong opiate that is found naturally in opium, a dark brown resin in poppies (''Papaver somniferum''). It is mainly used as a pain medication, and is also commonly used recreationally, or to make other illicit opioids. T ...
, and
oxycodone Oxycodone, sold under various brand names such as Roxicodone and OxyContin (which is the extended release form), is a strong, semi-synthetic opioid used medically for treatment of moderate to severe pain. It is highly addictive and a commonly ...
, of which a well-known effect is the significant reduction of
libido Libido (; colloquial: sex drive) is a person's overall sexual drive or desire for sexual activity. Libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act u ...
– it appears that teenage
opioid Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. Other medical uses include suppression of diarrhea, replacement therapy for opioid use ...
users Ancient Egyptian roles * User (ancient Egyptian official), an ancient Egyptian nomarch (governor) of the Eighth Dynasty * Useramen, an ancient Egyptian vizier also called "User" Other uses * User (computing) A user is a person who ...
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.Slater, Jon. (2000).
Britain: Sex Education Under Fire
" ''The UNESCO Courier'' Retrieved July 7, 2006.
Contraception for teenagers presents a huge challenge for the clinician. In 1998, the government of the UK set a target to halve the under-18 pregnancy rate by 2010. The Teenage Pregnancy Strategy (TPS) was established to achieve this. The pregnancy rate in this group, although falling, rose slightly in 2007, to 41.7 per 1,000 women. 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.
Prejudice Prejudice can be an affective feeling towards a person based on their perceived group membership. The word is often used to refer to a preconceived (usually unfavourable) evaluation or classification of another person based on that person's per ...
s are extremely difficult to overcome. Over concern about side-effects, for example
weight gain Weight gain is an increase in body weight. This can involve an increase in muscle mass, fat deposits, excess fluids such as water or other factors. Weight gain can be a symptom of a serious medical condition. Description Weight gain occurs w ...
and
acne Acne, also known as ''acne vulgaris'', is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and ...
, 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. In the US, according to the 2002
National Survey of Family Growth The National Survey of Family Growth (NSFG) is a survey conducted by the National Center for Health Statistics division of the Centers for Disease Control and Prevention to understand trends related to fertility, family structure, and demographics ...
, sexually active adolescent women wishing to avoid pregnancy were less likely than older women to use contraceptives (18% of 15–19-year-olds used no contraceptives, versus 10.7% for women aged 15–44).National Surveys of Family Growth More than 80% of teen pregnancies are unintended. Over half of unintended pregnancies were to women not using contraceptives, most of the rest are due to inconsistent or incorrect use. 23% of sexually active young women in a 1996 '' Seventeen'' magazine poll admitted to having had
unprotected sex Safe sex is sexual activity using methods or contraceptive devices (such as condoms) to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer ...
with a partner who did not use a condom, while 70% of girls in a 1997 '' PARADE'' poll claimed it was embarrassing to buy birth control or request information from a doctor. The
National Longitudinal Study of Adolescent Health The National Longitudinal Study of Adolescent to Adult Health, also known as Add Health, is a multiwave longitudinal study of adolescents in the United States. It was begun in 1994 in response to a Congressional mandate to study adolescent health, ...
surveyed 1027 students in the US in grades 7–12 in 1995 to compare the use of contraceptives among Whites, Blacks, and
Hispanic The term ''Hispanic'' ( es, hispano) refers to people, cultures, or countries related to Spain, the Spanish language, or Hispanidad. The term commonly applies to countries with a cultural and historical link to Spain and to viceroyalties forme ...
s. The results were that 36.2% of Hispanics said they never used contraception during intercourse which is a high rate compared to 23.3% of Black teens and 17.0% of White teens who also did not use contraceptives during intercourse. In a 2012 study, over 1,000 females were surveyed to find out factors contributing to not using contraception. Of those surveyed, almost half had been involved in unprotected sex within the previous three months. These women gave three main reasons for not using contraceptives: trouble obtaining birth control (the most frequent reason), lack of intention to have sex, and the misconception that they "could not get pregnant". In a study for the
Guttmacher Institute The Guttmacher Institute is a research and policy NGO that aims to improve sexual and reproductive health and rights worldwide. This research organization was started in 1968 and works to study, educate, and advance sexual and reproductive health ...
, researchers found that from a comparative perspective, however, teenage pregnancy rates in the US are less nuanced than one might initially assume. "Since timing and levels of sexual activity are quite similar across weden, France, Canada, Great Britain, and the US the high U.S. rates arise primarily because of less, and possibly less-effective, contraceptive use by sexually active teenagers." Thus, the cause for the discrepancy between rich nations can be traced largely to contraceptive-based issues. Among teens in the UK seeking an abortion, a study found that the rate of contraceptive use was roughly the same for teens as for older women. In other cases, contraception is used, but proves to be inadequate. Inexperienced adolescents may use condoms incorrectly, forget to take
oral contraceptives Oral contraceptives, abbreviated OCPs, also known as birth control pills, are medications taken by mouth for the purpose of birth control. Female Two types of female oral contraceptive pill, taken once per day, are widely available: * The combin ...
, or fail to use the contraceptives they had previously chosen. Contraceptive failure rates are higher for teenagers, particularly poor ones, than for older users. Long-acting contraceptives such as intrauterine devices, subcutaneous
contraceptive implant A contraceptive implant is an implantable medical device used for the purpose of birth control. The implant may depend on the timed release of hormones to hinder ovulation or sperm development, the ability of copper to act as a natural spermici ...
s, and contraceptive injections (such as
Depo-Provera Medroxyprogesterone acetate (MPA), also known as depot medroxyprogesterone acetate (DMPA) in injectable form and sold under the brand name Depo-Provera among others, is a hormonal medication of the progestin type. It is used as a method of bi ...
and
combined injectable contraceptive Combined injectable contraceptives (CICs) are a form of hormonal birth control for women. They consist of monthly injections of combined formulations containing an estrogen and a progestin to prevent pregnancy. CICs are different from progestoge ...
), which prevent pregnancy for months or years at a time, are more effective in women who have trouble remembering to take pills or using barrier methods consistently. According to ''Encyclopedia of Women's Health'', published in 2004, there has been an increased effort to provide contraception to adolescents via family planning services and school-based health, such as HIV prevention education.


Sexual abuse

Studies from South Africa 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 Guttmacher Institute 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; 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 those countries, sex with a minor is therefore considered
statutory rape In common law jurisdictions, statutory rape is nonforcible sexual activity in which one of the individuals is below the age of consent (the age required to legally consent to the behavior). Although it usually refers to adults engaging in sexual ...
. In most European countries, by contrast, once an adolescent has reached the age of consent, he or she can legally have sexual relations with adults because it is held that in general (although certain limitations may still apply), reaching the age of consent enables a juvenile to consent to sex with any partner who has also reached that age. Therefore, the definition of statutory rape is limited to sex with a person under the minimum age of consent. What constitutes statutory rape ultimately differs by jurisdiction (see age of consent).


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 than 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 US. A Washington State study found 70% of teenage mothers had been beaten by their boyfriends, 51% had experienced attempts of
birth control sabotage Reproductive coercion (also called coerced reproduction, reproductive control or reproductive abuse) is a collection of behaviors that interfere with decision-making related to reproductive health. These behaviors are meant to maintain power and ...
within the last year, and 21% experienced school or work sabotage. In a study of 379 pregnant or parenting teens and 95 teenage girls without children, 62% of girls aged 11–15 and 56% of girls aged 16–19 reported experiencing domestic violence at the hands of their partners. Moreover, 51% of the girls reported experiencing at least one instance where their boyfriend attempted to sabotage their efforts to use birth control.


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 ) , official_languages = , languages_type = National languagesBangladesh Bangladesh (}, ), officially the People's Republic of Bangladesh, is a country in South Asia. It is the eighth-most populous country in the world, with a population exceeding 165 million people in an area of . Bangladesh is among the mos ...
have far more teenage mothers compared with economically rich countries such as Switzerland and Japan.Indicator: Births per 1000 women (aged 15–19) – 2002
UNFPA, State of World Population 2003. Retrieved Jan 22, 2007.
In the UK, around half of all pregnancies to under 18 are concentrated among the 30% most deprived population, with only 14% occurring among the 30% least deprived. For example, in
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...
, the teenage birth rate in the well-off central regions is only 3.3 per 1,000, while in the poorer
Mezzogiorno Southern Italy ( it, Sud Italia or ) also known as ''Meridione'' or ''Mezzogiorno'' (), is a macroregion of the Italian Republic consisting of its southern half. The term ''Mezzogiorno'' today refers to regions that are associated with the pe ...
it is 10.0 per 1,000. Similarly, in the US, sociologist
Mike A. Males Mike A. Males (born 1950) is an American sociologist who is senior researcher for the Center on Juvenile and Criminal Justice, San Francisco San Francisco (; Spanish for " Saint Francis"), officially the City and County of San Franci ...
noted that teenage birth rates closely mapped poverty rates in
California California is a state in the Western United States, located along the Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the most populous U.S. state and the 3rd largest by area. It is also the m ...
: * per 1,000 women aged 15–19 Teen pregnancy cost the US over $9.1 billion in 2004, including $1.9 billion for health care, $2.3 billion for child welfare, $2.1 billion for incarceration, and $2.9 billion in lower tax revenue. There is little evidence to support the common belief that teenage mothers become pregnant to get benefits, welfare, and council housing. Most knew little about housing or financial aid before they got pregnant and what they thought they knew often turned out to be wrong.


Childhood environment

Girls 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 raised 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. Even when the researchers took into account other factors that could have contributed to early sexual activity and pregnancy, such as behavioral problems and life adversity, early father-absent girls were still about five times more likely in the US and three times more likely in New Zealand to become pregnant as adolescents than were father-present girls. Low
education Education is a purposeful activity directed at achieving certain aims, such as transmitting knowledge or fostering skills and character traits. These aims may include the development of understanding, rationality, kindness, and honesty ...
al expectations have been pinpointed as a risk factor. A girl is also more likely to become a teenage parent if her mother or older sister gave birth in her teens. A majority of respondents in a 1988 Joint Center for Political and Economic Studies survey attributed the occurrence of adolescent pregnancy to a breakdown of
communication Communication (from la, communicare, meaning "to share" or "to be in relation with") is usually defined as the transmission of information. The term may also refer to the message communicated through such transmissions or the field of inqui ...
between parents and child and also to inadequate parental supervision.
Foster care Foster care is a system in which a minor has been placed into a ward, group home ( residential child care community, treatment center, etc.), or private home of a state-certified caregiver, referred to as a "foster parent" or with a family ...
youth are more likely than their peers to become pregnant as teenagers. The National Casey Alumni Study, which surveyed foster care alumni from 23 communities across the US, found the birth rate for girls in foster care was more than double the rate of their peers outside the foster care system. A University of Chicago study of youth transitioning out of foster care in Illinois, Iowa, and Wisconsin found that nearly half of the females had been pregnant by age 19. The Utah Department of Human Services found that girls who had left the foster care system between 1999 and 2004 had a birth rate nearly three times the rate for girls in the general population.


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 Time is the continued sequence of existence and events that occurs in an apparently irreversible succession from the past, through the present, into the future. It is a component quantity of various measurements used to sequence events, ...
'', "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 Sex education, also known as sexual education, sexuality education or sex ed, is the instruction of issues relating to human sexuality, including emotional relations and responsibilities, human sexual anatomy, sexual activity, sexual reproduc ...
and access to birth control appear to reduce unplanned teenage pregnancy. It is unclear which type of intervention is most effective. In the US 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. In the United States, only 39 states and the District of Columbia out of the 50 states require some form of sex education of HIV education. Out of these 39 states and the District of Columbia, only 17 states require that the sexual education provided be medically accurate, and only 3 states prohibit a program from promoting sexual education in a religious way. These three states include California, Colorado, and Louisiana. Additionally, 19 of those 39 states stress the importance of only having sex when in a committed marriage. From this data, 11 states currently have no requirement for sexual education for any years of schooling, meaning these 11 states may have no sexual education at all. This could also mean these states are allowed to teach sexual education in any way they would like, including in medically inaccurate ways. This point is also valid for those 22 states that do not require sexual education to be medically accurate. Comprehensive sexual education has been proven to work to reduce the risk of teen pregnancies. Without a nationwide mandate for medically accurate programs, teenagers in the United States are at risk for missing out on valuable information that can protect them. It is unfair to expect teenagers to make educated decisions about sex that can lead to teen pregnancy when they have never been properly educated about the issue. A program developed by experts in public health and sexual education titled ''National Sexuality Education Standards,'' is a valuable resource that describes what the minimum requirements of sexual education should be across the nation. Giving teenagers the tools that are outlined in that roadmap would have positive effects, as it gives teenagers the resources to make educated decisions. Currently, there is not a national implementation of this program in the United States. Teen pregnancy can be reduced by sex education as a study in 55 US
counties A county is a geographic region of a country used for administrative or other purposesChambers Dictionary, L. Brookes (ed.), 2005, Chambers Harrap Publishers Ltd, Edinburgh in certain modern nations. The term is derived from the Old French ...
(out of 2,927 counties) showed. The study used federal funded sex education programs as a proxy for sex education, but provided no details about funding levels, the number of students reached, or the amount of time spent on sex education. Nevertheless, the reduction of teenage births (not pregnancy) was significant, at 3% reduction, indicating that an increase in funding, education, or reach could increase teenage pregnancy even further. Although 3% sounds like a small number, given a teenage girl population of 10 million females aged 15–19 (in 2020), and ~190,000 teenage births per year, a 3% reduction would translate to about 6000 prevented teenage births per year when extrapolated to the whole nation.


Abstinence only education

Some schools provide
abstinence-only sex education Abstinence-only sex education is a form of sex education that teaches not having sex outside of marriage. It often excludes other types of sexual and reproductive health education, such as birth control and safe sex. Comprehensive sex education ...
. Evidence does not support the effectiveness of abstinence-only sex education. It has been found to be ineffective in decreasing
HIV The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
risk in the developed world, and does not decrease rates of
unplanned pregnancy Unintended pregnancies are pregnancies that are mistimed, unplanned or unwanted at the time of conception. Sexual activity without the use of effective contraception through choice or coercion is the predominant cause of unintended pregnancy. W ...
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.


Assistance

Nurse-Family Partnership Nurse-Family Partnership (NFP) is a non-profit organization operating in the United States that connects mothers pregnant with their first child with registered nurses, who provide home visits until the child's second birthday. NFP interventio ...
(NFP) is a non-profit organization operating in the United States and the UK designed to serve the needs of young mothers who may have special needs in their first pregnancy. Each mother served is partnered with a registered nurse early in her pregnancy and receives ongoing nurse home visits that continue through her child's second birthday. NFP intervention has been associated with improvements in maternal health, child health, and economic security.


Public policy


Canada

In 2018, Québec's Institut national de santé publique (INSPQ) began implementing adjustments to the Protocole de contraception du Québec (Québec Contraception Protocol). The new protocol allows registered nurses to prescribe hormonal birth control, an IUD or emergency birth control to women, as long as they comply with prescribed standards in the Prescription infirmière : Guide explicatif conjoint, and are properly trained in providing contraceptives. In 2020, Québec will offer online training to registered nurses, provided by the Ordre des infirmières et infirmiers du Québec (OIIQ). Nurses that do not have training in the areas of sexually transmitted and blood borne infections may have to take additional online courses provided by the INSPQ.


United States

In the US, one policy initiative that has been used to increase rates of contraceptive use is
Title X The Title X Family Planning Program is the only federal grant program dedicated to providing individuals with comprehensive family planning and related preventive health services. It was enacted under President Richard Nixon in 1970 as part of th ...
. Title X of the
Family Planning Services and Population Research Act of 1970 The Title X Family Planning Program is the only federal grant program dedicated to providing individuals with comprehensive family planning and related preventive health services. It was enacted under President Richard Nixon in 1970 as part of th ...
() provides family planning services for those who do not qualify for
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and per ...
by distributing "funding to a network of public, private, and nonprofit entities o provideservices on a sliding scale based on income." Studies indicate that, internationally, success in reducing teen pregnancy rates is directly correlated with the kind of access that Title X provides: “What appears crucial to success is that adolescents know where they can go to obtain information and services, can get there easily and are assured of receiving confidential, nonjudgmental care, and that these services and contraceptive supplies are free or cost very little.” In addressing high rates of unplanned teen pregnancies, scholars agree that the problem must be confronted from both the biological and cultural contexts. On September 30, 2010, the
US Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
approved $155 million in new funding for comprehensive sex education programs designed to prevent teenage pregnancy. The money is being awarded "to states, non-profit organizations, school districts, universities and others. These grants will support the replication of teen pregnancy prevention programs that have been shown to be effective through rigorous research as well as the testing of new, innovative approaches to combating teen pregnancy." Of the total of $150 million, $55 million is funded by
Affordable Care Act The Affordable Care Act (ACA), formally known as the Patient Protection and Affordable Care Act and colloquially known as Obamacare, is a landmark U.S. federal statute enacted by the 111th United States Congress and signed into law by Pres ...
through the Personal Responsibility Education Program, which requires states receiving funding to incorporate lessons about both abstinence and contraception.


Developing countries

In the developing world, programs of reproductive health aimed at teenagers are often small scale and not centrally coordinated, although some countries such as Sri Lanka have a systematic policy framework for teaching about sex within schools. Non-governmental agencies such as the
International Planned Parenthood Federation The International Planned Parenthood Federation (IPPF) is a global non-governmental organisation with the broad aims of promoting sexual and reproductive health, and advocating the right of individuals to make their own choices in family ...
and
Marie Stopes International MSI Reproductive Choices, named Marie Stopes International until November 2020, is an international non-governmental organisation providing contraception and safe abortion services in 37 countries around the world. MSI Reproductive Choices as an ...
provide contraceptive advice for young women worldwide. Laws against
child marriage Child marriage is a marriage or similar union, formal or informal, between a child under a certain age – typically 18 years – and an adult or another child. * * * * The vast majority of child marriages are between a female child and a mal ...
have reduced but not eliminated the practice. Improved female
literacy Literacy in its broadest sense describes "particular ways of thinking about and doing reading and writing" with the purpose of understanding or expressing thoughts or ideas in written form in some specific context of use. In other words, hum ...
and educational prospects have led to an increase in the age at first birth in areas such as
Iran Iran, officially the Islamic Republic of Iran, and also called Persia, is a country located in Western Asia. It is bordered by Iraq and Turkey to the west, by Azerbaijan and Armenia to the northwest, by the Caspian Sea and Turkmeni ...
,
Indonesia Indonesia, officially the Republic of Indonesia, is a country in Southeast Asia and Oceania between the Indian and Pacific oceans. It consists of over 17,000 islands, including Sumatra, Java, Sulawesi, and parts of Borneo and New Guine ...
, and the Indian state of
Kerala Kerala ( ; ) is a state on the Malabar Coast of India. It was formed on 1 November 1956, following the passage of the States Reorganisation Act, by combining Malayalam-speaking regions of the erstwhile regions of Cochin, Malabar, South ...
.


Other

A team of researchers and educators in California have published a list of "best practices" in the prevention of teen pregnancy, which includes, in addition to the previously mentioned concepts, working to "instill a belief in a successful future", male involvement in the prevention process, and designing interventions that are culturally relevant.


Prevalence

In reporting teenage pregnancy rates, the number of pregnancies per 1,000 females aged 15 to 19 when the pregnancy ends is generally used. Worldwide, teenage pregnancy rates range from 143 per 1,000 in some sub-Saharan African countries to 2.9 per 1,000 in South Korea.UNICEF. (2001). . Retrieved July 7, 2006. In the US, 82% of pregnancies in those between 15 and 19 are unplanned. Among
OECD The Organisation for Economic Co-operation and Development (OECD; french: Organisation de coopération et de développement économiques, ''OCDE'') is an intergovernmental organisation with 38 member countries, founded in 1961 to stimulate e ...
developed countries A developed country (or industrialized country, high-income country, more economically developed country (MEDC), advanced country) is a sovereign state that has a high quality of life, developed economy and advanced technological infrastruct ...
, the US, the UK and
New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island count ...
have the highest level of teenage pregnancy, while Japan and
South Korea South Korea, officially the Republic of Korea (ROK), is a country in East Asia, constituting the southern part of the Korean Peninsula and sharing a land border with North Korea. Its western border is formed by the Yellow Sea, while its eas ...
have the lowest in 2001. According to the
UNFPA The United Nations Population Fund (UNFPA), formerly the United Nations Fund for Population Activities, is a UN agency aimed at improving reproductive and maternal health worldwide. Its work includes developing national healthcare strategies ...
, “In every region of the world – including high-income countries – girls who are poor, poorly educated or living in rural areas are at greater risk of becoming pregnant than those who are wealthier, well-educated or urban. This is true on a global level, as well: 95 per cent of the world’s births to adolescents (aged 15–19) take place in developing countries. Every year, some 3 million girls in this age bracket resort to
unsafe abortion An unsafe abortion is the termination of a pregnancy by people lacking the necessary skills, or in an environment lacking minimal medical standards, or both. An unsafe abortion is a life-threatening procedure. It includes self-induced abortions, ...
s, risking their lives and health.” According to a 2001
UNICEF UNICEF (), originally called the United Nations International Children's Emergency Fund in full, now officially United Nations Children's Fund, is an agency of the United Nations responsible for providing humanitarian and developmental aid to ...
survey, in 10 out of 12 developed nations with available data, more than two thirds of young people have had sexual intercourse while still in their teens. In Denmark, Finland, Germany, Iceland, Norway, the UK and the US, the proportion is over 80%. In Australia, the UK and the US, approximately 25% of 15-year-olds and 50% of 17-year-olds have had sex. According to the ''Encyclopedia of Women's Health'', published in 2004, approximately 15 million girls under the age of 20 in the world have a child each year. Estimates were that 20–60% of these pregnancies in developing countries are mistimed or unwanted."Teen Pregnancy"
(2004) in ''Encyclopedia of Women's Health''.
Save the Children The Save the Children Fund, commonly known as Save the Children, is an international non-governmental organization established in the United Kingdom in 1919 to improve the lives of children through better education, health care, and economic ...
found that, annually, 13 million children are born to women aged under 20 worldwide, more than 90% in developing countries.
Complications of pregnancy Complications of pregnancy are health problems that are related to pregnancy. Complications that occur primarily during childbirth are termed obstetric labor complications, and problems that occur primarily after childbirth are termed puerperal d ...
and
childbirth Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births glob ...
are the leading cause of mortality among women aged 15–19 in such areas.


Sub-Saharan Africa

The highest rate of teenage pregnancy in the world is in sub-Saharan Africa, where women tend to marry at an early age. In
Niger ) , official_languages = , languages_type = National languagesIndian subcontinent The Indian subcontinent is a list of the physiographic regions of the world, physiographical region in United Nations geoscheme for Asia#Southern Asia, Southern Asia. It is situated on the Indian Plate, projecting southwards into the Indian O ...
, early
marriage Marriage, also called matrimony or wedlock, is a culturally and often legally recognized union between people called spouses. It establishes rights and obligations between them, as well as between them and their children, and between ...
sometimes results in adolescent pregnancy, particularly in
rural In general, a rural area or a countryside is a geographic area that is located outside towns and cities. Typical rural areas have a low population density and small settlements. Agricultural areas and areas with forestry typically are descri ...
regions where the rate is much higher than it is in
urbanized ''Urbanized'' is a documentary film directed by Gary Hustwit and released on 26 October 2011. It is considered the third of a three-part series on design known as the Design Trilogy; the first being ''Helvetica'', about the typeface, and the seco ...
areas. Latest data suggests that teen pregnancy in
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
is high with 62 pregnant teens out of every 1,000 women. India is fast approaching to be the most populous country in the world by 2050 and increasing teenage pregnancy, an important factor for the population rise, is likely to aggravate the problems.


Asia

The rates of early marriage and pregnancy in some Asian countries are high. In recent years, the rates have decreased sharply in
Indonesia Indonesia, officially the Republic of Indonesia, is a country in Southeast Asia and Oceania between the Indian and Pacific oceans. It consists of over 17,000 islands, including Sumatra, Java, Sulawesi, and parts of Borneo and New Guine ...
and
Malaysia Malaysia ( ; ) is a country in Southeast Asia. The federation, federal constitutional monarchy consists of States and federal territories of Malaysia, thirteen states and three federal territories, separated by the South China Sea into two r ...
, although it remains relatively high in the former. However, in the industrialized Asian nations such as
South Korea South Korea, officially the Republic of Korea (ROK), is a country in East Asia, constituting the southern part of the Korean Peninsula and sharing a land border with North Korea. Its western border is formed by the Yellow Sea, while its eas ...
and
Singapore Singapore (), officially the Republic of Singapore, is a sovereign island country and city-state in maritime Southeast Asia. It lies about one degree of latitude () north of the equator, off the southern tip of the Malay Peninsula, bor ...
, teenage birth rates remain among the lowest in the world.


Australia

In 2015, the
birth rate The birth rate for a given period is the total number of live human births per 1,000 population divided by the length of the period in years. The number of live births is normally taken from a universal registration system for births; populati ...
among teenage women in Australia was 11.9 births per 1,000 women. The rate has fallen from 55.5 births per 1,000 women in 1971, probably due to ease of access to effective birth control, rather than any decrease in
sexual activity Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) ...
.


Europe

The overall trend in
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a subcontinent of Eurasia and it is located entirel ...
since 1970 has been a decreasing
total fertility rate The total fertility rate (TFR) of a population is the average number of children that would be born to a woman over her lifetime if: # she were to experience the exact current age-specific fertility rates (ASFRs) through her lifetime # she were t ...
, an increase in the age at which women experience their first birth, and a decrease in the number of births among teenagers. Most continental
Western European Western Europe is the western region of Europe. The region's countries and territories vary depending on context. The concept of "the West" appeared in Europe in juxtaposition to "the East" and originally applied to the ancient Mediterranean ...
countries have very low teenage birth rates. This is varyingly attributed to good
sex education Sex education, also known as sexual education, sexuality education or sex ed, is the instruction of issues relating to human sexuality, including emotional relations and responsibilities, human sexual anatomy, sexual activity, sexual reproduc ...
and high levels of contraceptive use (in the case of the
Netherlands ) , anthem = ( en, "William of Nassau") , image_map = , map_caption = , subdivision_type = Sovereign state , subdivision_name = Kingdom of the Netherlands , established_title = Before independence , established_date = Spanish Netherl ...
and
Scandinavia Scandinavia; Sámi languages: /. ( ) is a subregion in Northern Europe, with strong historical, cultural, and linguistic ties between its constituent peoples. In English usage, ''Scandinavia'' most commonly refers to Denmark, Norway, and Swe ...
),
traditional values Traditionalist conservatism, often known as classical conservatism, is a political and social philosophy that emphasizes the importance of transcendent moral principles, manifested through certain natural laws to which society should adhere ...
and
social stigma Social stigma is the disapproval of, or discrimination against, an individual or group based on perceived characteristics that serve to distinguish them from other members of a society. Social stigmas are commonly related to culture, gender, ra ...
tization (in the case of
Spain , image_flag = Bandera de España.svg , image_coat = Escudo de España (mazonado).svg , national_motto = ''Plus ultra'' (Latin)(English: "Further Beyond") , national_anthem = (English: "Royal March") , i ...
and
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...
) or both (in the case of Switzerland). On the other hand, the teen birth rate is very high in
Bulgaria Bulgaria (; bg, България, Bǎlgariya), officially the Republic of Bulgaria,, ) is a country in Southeast Europe. It is situated on the eastern flank of the Balkans, and is bordered by Romania to the north, Serbia and North Macedo ...
and
Romania Romania ( ; ro, România ) is a country located at the crossroads of Central, Eastern, and Southeastern Europe. It borders Bulgaria to the south, Ukraine to the north, Hungary to the west, Serbia to the southwest, Moldova to the east, and ...
. As of 2015, Bulgaria had a birth rate of 37/1.000 women aged 15–19, and Romania of 34. The teen birth rate of these two countries is even higher than that of underdeveloped countries like Burundi and Rwanda. Many of the teen births occur in Roma populations, who have an occurrence of teenage pregnancies well above the local average.


United Kingdom

The teen pregnancy rate in England and Wales was 23.3 per 1,000 women aged 15 to 17. There were 5,740 pregnancies in girls aged under 18 in the three months to June 2014, data from the
Office for National Statistics The Office for National Statistics (ONS; cy, Swyddfa Ystadegau Gwladol) is the executive office of the UK Statistics Authority, a non-ministerial department which reports directly to the UK Parliament. Overview The ONS is responsible for t ...
shows. This compares with 6,279 in the same period in 2013 and 7,083 for the June quarter the year before that. Historically, the UK has had one of the highest teenage pregnancy and abortion rates in Western Europe. There are no comparable rates for conceptions across Europe, but the under-18 birth rate suggests England is closing the gap. The under-18 birth rate in 2012 in
England and Wales England and Wales () is one of the three legal jurisdictions of the United Kingdom. It covers the constituent countries England and Wales and was formed by the Laws in Wales Acts 1535 and 1542. The substantive law of the jurisdiction is Eng ...
was 9.2, compared with an EU average of 6.9. However, the UK birth rate has fallen by almost a third (32.3%) since 2004 compared with a fall of 15.6% in the EU. In 2004, the UK rate was 13.6 births per 1,000 women aged 15–17 compared with an EU average rate of 7.7.


United States

In 2001, the teenage birth rate in the US was the highest in the developed world, and the teenage abortion rate is also high. In 2005 in the US, the majority (57%) of teen pregnancies resulted in a live birth, 27% ended in an induced abortion, and 16% in a fetal loss. The US teenage pregnancy rate was at a high in the 1950s and has decreased since then, although there has been an increase in births out of wedlock. The teenage pregnancy rate decreased significantly in the 1990s; this decline manifested across all
racial group A race is a categorization of humans based on shared physical or social qualities into groups generally viewed as distinct within a given society. The term came into common usage during the 1500s, when it was used to refer to groups of variou ...
s, although teenagers of
African-American African Americans (also referred to as Black Americans and Afro-Americans) are an ethnic group consisting of Americans with partial or total ancestry from sub-Saharan Africa. The term "African American" generally denotes descendants of ensl ...
and
Hispanic The term ''Hispanic'' ( es, hispano) refers to people, cultures, or countries related to Spain, the Spanish language, or Hispanidad. The term commonly applies to countries with a cultural and historical link to Spain and to viceroyalties forme ...
descent Descent may refer to: As a noun Genealogy and inheritance * Common descent, concept in evolutionary biology * Kinship, one of the major concepts of cultural anthropology **Pedigree chart or family tree ** Ancestry ** Lineal descendant **Heritag ...
retain a higher rate, in comparison to that of
European-American European Americans (also referred to as Euro-Americans) are Americans of European ancestry. This term includes people who are descended from the first European settlers in the United States as well as people who are descended from more recent E ...
s and Asian-Americans. The
Guttmacher Institute The Guttmacher Institute is a research and policy NGO that aims to improve sexual and reproductive health and rights worldwide. This research organization was started in 1968 and works to study, educate, and advance sexual and reproductive health ...
attributed about 25% of the decline to abstinence and 75% to the effective use of contraceptives. While in 2006 the US teen birth rate rose for the first time in fourteen years, it reached a historic low in 2010: 34.3 births per 1,000 women aged 15–19. As of 2017, the birth rate for teen pregnancy from girls ages 15–19 was at 18.8 per 1,000 women between this age group. Given a teenage girl population of 10 million females (aged 15–19, in 2020), this would translate to ~190,000 births per year. The Latina teenage pregnancy rate is 75% higher pregnancy rate than the national average. The latest data from the US shows that the states with the highest teenage birthrate are
Mississippi Mississippi () is a state in the Southeastern region of the United States, bordered to the north by Tennessee; to the east by Alabama; to the south by the Gulf of Mexico; to the southwest by Louisiana; and to the northwest by Arkansas. Miss ...
,
New Mexico ) , population_demonym = New Mexican ( es, Neomexicano, Neomejicano, Nuevo Mexicano) , seat = Santa Fe , LargestCity = Albuquerque , LargestMetro = Tiguex , OfficialLang = None , Languages = English, Spanish ( New Mexican), Navajo, Ke ...
and
Arkansas Arkansas ( ) is a landlocked state in the South Central United States. It is bordered by Missouri to the north, Tennessee and Mississippi to the east, Louisiana to the south, and Texas and Oklahoma to the west. Its name is from the O ...
while the states with the lowest teenage birthrate are
New Hampshire New Hampshire is a state in the New England region of the northeastern United States. It is bordered by Massachusetts to the south, Vermont to the west, Maine and the Gulf of Maine to the east, and the Canadian province of Quebec to the nor ...
,
Massachusetts Massachusetts (Massachusett: ''Muhsachuweesut Massachusett_writing_systems.html" ;"title="nowiki/> məhswatʃəwiːsət.html" ;"title="Massachusett writing systems">məhswatʃəwiːsət">Massachusett writing systems">məhswatʃəwiːsət'' En ...
and
Vermont Vermont () is a state in the northeast New England region of the United States. Vermont is bordered by the states of Massachusetts to the south, New Hampshire to the east, and New York to the west, and the Canadian province of Quebec to ...
.


Canada

The
Canadian Canadians (french: Canadiens) are people identified with the country of Canada. This connection may be residential, legal, historical or cultural. For most Canadians, many (or all) of these connections exist and are collectively the source of ...
teenage birth trended towards a steady decline for both younger (15–17) and older (18–19) teens in the period between 1992 and 2002;Dryburgh, H. (2002). Teenage pregnancy. Health Reports, 12 (1), 9–18; Statistics Canada . (2005). Health Indicators, 2005, 2. Retrieved fro
Facts and Statistics: Sexual Health and Canadian Youth – Teen Pregnancy Rates
/ref> it further dropped by a factor of more than 2-fold between 2000 and 2020 (from 20.1 per 1000 women in 2000 to 8.4 in 2020). Still, in Canada, the stability of familial structure significantly influences the risk of teenage pregnancy. Experiencing one or more episodes of poverty before the age of 13 made young Canadian girls 75% to 90% more vulnerable to teenage pregnancy.


Teenage fatherhood

In some cases, the father of the child is the husband of the teenage girl. The conception may occur within wedlock, or the pregnancy itself may precipitate the marriage (the so-called shotgun wedding). In countries such as
India India, officially the Republic of India (Hindi: ), is a country in South Asia. It is the seventh-largest country by area, the second-most populous country, and the most populous democracy in the world. Bounded by the Indian Ocean on the so ...
, the majority of teenage births occur within marriage. In other countries, such as the US and
Ireland Ireland ( ; ga, Éire ; Ulster Scots dialect, Ulster-Scots: ) is an island in the Atlantic Ocean, North Atlantic Ocean, in Northwestern Europe, north-western Europe. It is separated from Great Britain to its east by the North Channel (Grea ...
, the majority of teenage mothers are not married to the father of their children. In the UK, half of all teenagers with children are lone parents, 40% are cohabitating as a couple and 10% are married. Teenage parents are frequently in a romantic relationship at the time of birth, but many adolescent fathers do not stay with the mother and this often disrupts their relationship with the child. US surveys tend to under-report the prevalence of teen fatherhood. In many cases, "teenage father" may be a misnomer. Studies by the Population Reference Bureau and the National Center for Health Statistics found that about two-thirds of births to teenage girls in the US are fathered by adult men aged over 20. The Guttmacher Institute reports that over 40% of mothers aged 15–17 had sexual partners three to five years older and almost one in five had partners six or more years older. A 1990 study of births to California teens reported that the younger the mother, the greater the age gap with her male partner. In the UK, 72% of jointly registered births to women aged under 20, the father is over 20, with almost 1 in 4 being over 25.


Society and culture


Politics

Some politicians condemn pregnancy in unmarried teenagers as a drain on taxpayers, if the mothers and children receive welfare payments and social housing from the government.


See also

* List of youngest birth mothers *
Precocious puberty In medicine, precocious puberty is puberty occurring at an unusually early age. In most cases, the process is normal in every aspect except the unusually early age and simply represents a variation of normal development. In a minority of childr ...
*
Pregnancy over age 50 Pregnancy over the age of 50 has, over recent years, become possible for more women, and more easily achieved for many, due to recent advances in assisted reproductive technology, in particular egg donation. Typically, a woman's fecundity ends w ...
* Pregnancy school * Reproductive coercion *
Sexual abstinence Sexual abstinence or sexual restraint is the practice of refraining from some or all aspects of sexual activity for medical, psychological, legal, social, financial, philosophical, moral, or religious reasons. Sexual abstinence is distinct from ...
*
Single parent A single parent is a person who has a child or children but does not have a spouse or live-in partner to assist in the upbringing or support of the child. Reasons for becoming a single parent include divorce, break-up, abandonment, becoming wid ...


References


Further reading

* * * * * * * * * * *


External links

* *
Teenage pregnancies and obstetric outcome

Teen Pregnancy
a special issue from the Journal of Applied Research on Children (2011) {{DEFAULTSORT:Teenage Pregnancy Adolescent sexuality Youth Motherhood Pediatric gynecology Puberty