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.

Socioeconomic factors

Poverty is associated with increased rates of teenage pregnancy. Economically poor countries such as Niger and Bangladesh have far more teenage mothers compared with economically rich countries such as Switzerland and Japan.

In the UK, around half of all pregnancies to under 18s are concentrated among the 30% most deprived population, with only 14% occurring among the 30% least deprived. In Italy, the teenage birth rate in the well-off central regions is only 3.3 per 1,000, while in the poorer Mezzogiorno it is 10.0 per 1000.Sociologist Mike A. Males noted that teenage birth rates closely mapped poverty rates in California:

Teen pregnancy costs the United States over $7 billion annually.

County	Poverty rate	Birth rate*
Marin County	5%	5
Tulare County (Caucasians)	18%	50
Tulare County (Hispanics)	40%	100

* per 1000 women aged 15-19

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.

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 behaviours on part of their boyfriends. Women 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 United States. A Washington study found 70% of teenage mothers had been beaten by their boyfriends, 51% had experienced attempts of birth control sabotage 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 the girls aged 11-15 years and 56% of girls aged 16-19 years 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.

Sexual abuse

Studies have found that between 11 and 20 percent of pregnancies in teenagers are a direct result of rape, while about 60 percent 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 percent 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 percent of women who gave birth in their teens were molested as young girls; by contrast, 25 percent for women who did not give birth as teens were molested

In many 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. Sex with a minor in developed countries is considered statutory rape, although what constitutes statutory rape differs by jurisdiction (see age of consent).

Age discrepancy in relationships

According to the Family Research Council, studies in the US indicate that age discrepancy between the teenage girls and the men who impregnate them is an important contributing factor. Teenage girls in relationships with older boys, and in particular with adult men, are more likely to become pregnant than teenage girls in relationships with boys their own age. They are also more likely to carry the baby to term rather than have an abortion. A review of California's 1990 vital statistics found that men older than high school age fathered 77 percent of all births to high school-aged girls (ages 16-18), and 51 percent of births to junior high school-aged girls (15 and younger). Men over age 25 fathered twice as many children of teenage mothers than boys under age 18, and men over age 20 fathered five times as many children of junior high school-aged girls as did junior high school-aged boys. A 1992 Washington state study of 535 adolescent mothers found that 62 percent of the mothers had a history of being raped or sexual molested by men whose ages averaged 27 years. This study found that, compared with nonabused mothers, abused adolescent mothers initiated sex earlier, had sex with much older partners, and engaged in riskier, more frequent, and promiscuous sex. Studies by the Population Reference Bureau and the National Center for Health Statistics found that about two-thirds of children born to teenage girls in the United States are fathered by adult men age 20 or older.

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.

In the United States, according to the 2002 National Surveys of Family Growth, in 2002, sexually active adolescent women wishing to avoid pregnancy were less likely than those of other ages to use contraceptives (18% of 15- to 19-year-olds used no contraceptives, versus 10.7% average for women ages 15 to 44). 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 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.^[22]

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 or forget to take oral contraceptives. Contraceptive failure rates are higher for teenagers, particularly poor ones, than for older users. Reversible longer term methods such as intrauterine devices, subcutaneous implants, or injections (Depo provera, Combined injectable contraceptive), require less frequent user action, lasting from a month to years, and may prevent pregnancy more effectively in women who have trouble following routines, including many young women. The simultaneous use of more than one contraceptive measure further decreases the risk of unplanned pregnancy, and if one is a condom barrier method, the transmission of sexually transmitted disease is also reduced

Adolescent sexual behavior

According to information available from the Guttmacher Institute, sex by age 20 is the norm across the world, and countries with low levels of adolescent pregnancy accept sexual relationships among teenagers and provide comprehensive and balanced information about sexuality.

However, in a Kaiser Family Foundation 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". Several polls have indicated peer pressure as a factor in encouraging both girls and boys to have sex. Inhibition-reducing drugs and alcohol may encourage unintended sexual activity.

Causes of teenage pregnancy

In some societies, early marriage and traditional gender roles are important factors in the rate of teenage pregnancy. 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.In the Indian subcontinent, early marriage and pregnancy is more common in traditional rural communities compared to the rate in cities.

In societies where adolescent marriage is uncommon, young age at first intercourse and lack of contraceptive use may be factors in teen pregnancy. Most teenage pregnancies in the developed world appear to be unplanned.

Keep an upbeat attitude

if you plan to keep your baby, you will want to do it with support from those who love you. Don't alienate your family - give them time to warm up to the idea. Your parents won't be able to deny a beautiful child once it is here. Appeal to their better nature, and approach them with a plan for your future. Show them that with their help, you can and will take charge of your new life.

Both my parents were very supportive

but this is not always the case for young moms. In fact, many teens report that they are terrified of what their parent's reaction may be - and with good reason if they are from a broken or unsupportive family. It can be easy to stereotype and assume that teen moms are usually from this kind of home, but that would be counter-productive. I was not from a "broken home", but life happens and not always the way we plan it. We as a society need to be more supportive of all moms, of all walks of life.

Telling your parents is the tricky part

Since my mom delivers babies for a living, there wasn't much chance of hiding it from her for long. Before I could decide how to do it, she had already guessed. I had mentioned to her that I wasn't going to class one evening, and when she asked why I told her that I felt nauseous. She immediately knew. Since I wasn't living with her, she suggested I tell my dad soon. As fate would have it, they ran into each other at the grocery store and she warned him that I had something I needed to confide to him. He more or less guessed it on his own as well.

Typically, the first person you should tell will be the father of the child

The way you go about this will vary depending on your relationship. If you are in a serious relationship, you may have suspected pregnancy and taken the test together, in which case you both found out at the same time. If you are not in a serious relationship, chances are that you took the test alone, or perhaps with a close girlfriend. Either way, you will need to tell the father as he needs to be given the amount of responsibility that he is due. However, always keep in mind that while it takes two to tango, creating a baby does not a father make. You will initially have a 50/50 chance of the father being there for this child, so don't push him away by being demanding of him or you may lessen your chances. At any rate, the two of you need to decide what you are going to do, although it is ultimately your body and your decision.