Teen birth and abortion rates, 1996

Country	birth rate	abortion rate	Combined rate
Netherlands	7.7	3.9	11.6
Spain	7.5	4.9	12.4
Italy	6.6	6.7	13.3
Greece	12.2	1.3	13.5
Belgium	9.9	5.2	15.1
Germany	13.0	5.3	18.3
Finland	9.8	9.6	19.4
France	9.4	13.2	22.6
Denmark	8.2	15.4	23.6
Sweden	7.7	17.7	25.4
Norway	13.6	18.3	31.9
Czech Republic	20.1	12.4	32.5
Iceland	21.5	20.6	42.1
Slovak Republic	30.5	13.1	43.6
Australia	20.1	23.9	44
Canada	22.3	22.1	44.4
United Kingdom	29.6	21.3	50.9
New Zealand	33.4	22.5	55.9
Hungary	29.9	30.2	60.1
United States	55.6	30.2	85.8

Socioeconomic and psychological outcomes

Several studies have examined the socioeconomic, medical, 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 use family and community support, social services and child-care support to continue their education and get higher paying jobs as they progress with their education.

Medical outcomes

Maternal and prenatal health is of particular concern among teens who are pregnant or parenting. The worldwide incidence of premature birth and low birth weight is higher among adolescent mothers. Research indicates that pregnant teens are less likely to receive prenatal care, often seeking it in the third trimester, if at all. The Guttmacher Institute reports that one-third of pregnant teens receive insufficient prenatal care and that their children are more likely to suffer from health issues in childhood or be hospitalized than those born to older women. However, studies have indicated that young mothers who are given high-quality maternity care have significantly healthier babies than those that do not. Many of the health-issues associated with teenage mothers, many of whom do not have health insurance, appear to result from lack of access to high-quality medical care. Many pregnant teens are subject to nutritional deficiencies from poor eating habits common in adolescence, including attempts to lose weight through dieting, skipping meals, food faddism, snacking, and consumption of fast food.

Inadequate nutrition during pregnancy is an even more marked problem among teenagers in developing countries. Complications of pregnancy 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 World Health Organization estimates that the risk of death following pregnancy is twice as great for women between 15 and 19 years than for those between the ages of 20 and 24. The maternal mortality rate can be up to five times higher for girls aged between 10 and 14 than for women of about twenty years of age. Illegal abortion also holds many risks for teenage girls in areas such as sub-Saharan Africa

Risks for medical complications are greater for girls 14 years of age and younger, as an underdeveloped pelvis can lead to difficulties in childbirth. Obstructed labour is normally dealt with by Caesarean section in industrialized nations; however, in developing regions where medical services might be unavailable, it can lead to eclampsia, obstetric fistula, infant mortality, or maternal death. For mothers in their late teens, age in itself is not a risk factor, and poor outcomes are associated more with socioeconomic factors rather than with biology.

Limiting teenage pregnancies

Many health educators have argued that comprehensive sex education would effectively reduce the number of teenage pregnancies, although opponents argue that such education encourages more and earlier sexual activity.

In the UK, the teenage pregnancy strategy, which was run first by the Department of Health and is now based out of the Children, Young People and Families directorate in the Department for Education and Skills, works on several levels to reduce teenage pregnancy and increase the social inclusion of teenage mothers and their families by:

• joined up action, making sure branches of government and health and education services work together effectively;
• prevention of teenage pregnancy through better sex education and improving contraceptive and advice services for young people, involving young people in service design, supporting the parents of teenagers to talk to them about sex and relationships, and targeting high-risk groups;
• better support for teenage mothers, including help returning to education, advice and support, work with young fathers, better childcare and increasing the availability of supported housing.

The teenage pregnancy strategy has had mixed success. Although teenage pregnancies have fallen overall, they have not fallen consistently in every region, and in some areas they have increased. There are questions about whether the 2010 target of a 50% reduction on 1998 levels can be met.

In the United States the topic of sex education is the subject of much contentious debate. Some schools provide "abstinence-only" education and virginity pledges are increasingly popular. A 2004 study by Yale and Columbia Universities found that fully 88 percent of those who pledge abstinence have premarital sex anyway. Most public schools offer "abstinence-plus" programs that support abstinence but also offer advice about contraception. 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.

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 developing world, programs of reproductive health aimed at teenagers are often small scale and not centrally coordinated, although some countries such as Indonesia and Sri Lanka have a systematic policy framework for teaching about sex within schools. Non-governmental agencies such as the International Planned Parenthood Federation provide contraceptive advice for young women worldwide. Laws against child marriage have reduced but not eliminated the practice. Improved female literacy and educational prospects have led to an increase in the age at first birth in areas such as Iran, Indonesia, and the Indian state of Kerala.

Childhood environment

Women 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 United States and three times more likely in New Zealand to become pregnant as adolescents than were father-present girls.

Low educational 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 between parents and child and also to inadequate parental supervision.

Foster care 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 United States, 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 3 times the rate for girls in the general population.