Teen Pregnancy - PowerPoint by iRuAOGV

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									Teen Pregnancy
   Misty Thompson DO
     August 19, 2011
           Financial Disclosures
   I do not have any financial or beneficial
    relationship to disclose that may pose a conflict
    of interest
                 Objectives
 Review statistics regarding teen pregnancy
  trends
 Discuss available options for pregnant teens
 Discuss maternal and neonatal morbidities as
  they relate to teenage pregnancy
 Review how the media can affect teen
  pregnancy
 Discuss the physician’s role in pregnancy
  prevention, discussion of options, and prenatal
  care.
       Teen Pregnancy Statistics
   The US has the highest rates of teen pregnancy
    and births in the western industrialized world
   Teen pregnancy costs the world approx. $10
    billion annually
   34% of young women become pregnant before
    the age of 20 (approx. 820,000/yr)
          State Levels & Trends
   Between 2000-2005, teen pregnancy rates
    declined in every state except North Dakota
   States with the highest teenage birth rates are
    MS, TX, NM, AR, AZ
   The states with the lowest teenage birth rates are
    NH, VT, MA, CT, NJ.
       Facts on Teen Pregnancy
   Very few teens who become mothers plan on
    doing so; 82% are unintended, and teens
    account for 20% of unintended pregnancies
    annually
   Two-thirds of teen pregnancies occur among 18-
    19 year olds
   Accounts for 11% of all US births
        Facts on Teen Pregnancy
   Out of all teen pregnancies, 57% end in birth
   14% result in miscarriage
   29% are terminated by abortion
   US teen pregnancy rates are higher than those of
    other developed countries
     Teen Pregnancy Risk Factors
   Teens becoming sexually active earlier-
    pregnancy rates in among those under 15 years
    of age are on the rise. A large portion of these
    girls had an unwanted or non-voluntary
    experience their first time, but were more likely
    to go on to have more intercourse
     Teen Pregnancy Risk Factors
   Among ethnic groups, African Americans and
    Hispanic teens are more likely to become
    sexually active earlier
   Socioeconomic factors-Risky sexual behaviors in
    teens are more likely to occur in poor families,
    and among those with single parents. A study
    found that teens girls whose fathers were not
    present in the home were more likely to become
    pregnant than those who had regular contact
    and good relationships with their fathers .
     Teen Pregnancy Risk Factors
   Parents’ education levels-Those teenagers whose
    parents have lower levels of education are more
    likely to engage in risky sexual behavior, and
    more likely to become pregnant.
     Teen Pregnancy Risk Factors
   Teen religious involvement-Teenagers who have
    a low occurrence involvement in religious
    activities are more likely to experience teen
    pregnancy. Involvement in religious activities is
    one of the strongest factors related to delayed
    sexual activity.
     Teen Pregnancy Risk Factors
   Educational involvement-Teens that focus on
    school activity are less likely to engage in
    intercourse, and are more likely to use birth
    control when they do.
   Drug & alcohol use-Inhibition reducing drugs &
    alcohol may encourage unintended sexual
    activity (cannabis & amphetamines)
     Teen Pregnancy Risk Factors
   Age discrepancy in relationships-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.
     Teen Pregnancy Risk Factors
   Sexual abuse-between 11 and 20 percent of
    pregnancies in teenagers are a result of rape,
    while 60% of teenage mothers had unwanted
    sexual experiences preceding their pregnancy.
    Studies have found a strong link between
    childhood sexual abuse and teen pregnancy. Up
    to 70% of women who gave birth as a teen
    report being molested as young girls.
     Teen Pregnancy Risk Factors
   Dating violence-Studies show teens are often in
    abusive relationships at the time of conception,
    and the knowledge of their pregnancy intensifies
    controlling or violent behaviors of their
    boyfriends. 51% of teenage mothers have
    experienced birth control sabotage, 21%
    experienced school or work sabotage
      Teen Pregnancy Prevention
   In the US, the topic of sex education is the
    subject of much debate. “Abstinence-only”
    education & virginity pledges are becoming
    more popular in some schools. However, 88%
    of those who pledge abstinence have premarital
    sex anyway. Most public schools offer
    abstinence education along with advice about
    contraception.
      Teen Pregnancy Prevention
   Relationships with inequalities tend to be
    associated with lower contraceptive use &
    consistency
   Condom use is more frequent with casual sexual
    partners
   Consistent birth control use occurs in
    relationships where partners have discussed
    birth control prior to first having sex
      Teen Pregnancy Prevention
   Discussions between sexual partners about
    condoms and sexual histories are consistently
    linked with improved condom use
   The younger teenagers are at the time of sexual
    encounters with their partners, the less likely
    they are to use birth control.
      Teen Pregnancy Prevention
   Family and individual characteristics such as
    higher family socioeconomic status, living with
    both biological parents, and receiving sex
    education are associated with improved
    contraceptive use and consistency.
         Teens and Birth Control
   There are many reasons teens may not use birth
    control, even if they do not want to have a baby.
    They may:
   Think they will not get pregnant
   Be afraid to go to a health care provider or clinic
    to ask for birth control
   Not know how to get birth control or think they
    cannot afford it
         Teens and Birth Control
   Worry about their parents finding out
   Be afraid of what their partner thinks about
    birth control
   Think that birth control might hurt their ability
    to get pregnant in the future
   Have sex that was not planned
   Think they will not get pregnant the first time
    they have sex
         Teens and Birth Control
   In most states, minors (people younger than 18
    years) have the right to make choices about birth
    control without their parents’ permission.
   Inform patients that if they use their parents’
    health insurance to pay for birth control or a
    provider’s visit, it may appear on a bill that the
    parents receive
        Teens and Birth Control
   Education about how pregnancy occurs will
    help teens understand how the different
    methods of birth control work
   Discuss emergency birth control
      Options for Pregnant Teens
   When a teen pregnancy occurs, the young
    woman is faced with a decision as how to
    proceed with the pregnancy and/or birth.

   There are three choices available: adoption,
    abortion, and teen parenting.
                     Adoption
   Adoption is the least prevalent option among
    pregnant teens.

   Only 1-2% of women place their children up for
    adoption, and the number of teens who place their
    babies for adoption has declined sharply over recent
    decades.

   There are 3 adoption types: closed, semi-open, open
               Closed Adoption
   A confidential adoption in which the adoptive
    family and birth mother remain confidential, with
    no contact prior to or after the placement of the
    child. For many generations, it was common
    practice to keep all adoptions closed. Some people
    believe closed adoptions to be safer, mainly out of a
    fear that if the birth parents know where the
    adoptive family lives, that they will take back the
    adopted child.
           Semi-Open Adoption
   The adoptive family and birth parents usually
    will know basic information about each other,
    such as their first names and state of residence.
    Complete contact information, such as phone
    numbers and addresses, are not shared. While
    adoptive families and birth parents may speak
    to one another prior to the birth of the child,
    some confidentiality is maintained.
           Semi-Open Adoption
   Once the child has been placed with the
    adoptive family, the birth parents may still
    stay in contact with the family via letters and
    pictures, however this correspondence is
    handled by a third party, such as the adoption
    agency.
               Open Adoption
   Open adoption typically means that the birth
    parents and the adoptive family speak prior to
    and even after the child is born. This may
    include phone calls and face-to-face visits.
                Open Adoption
   Some adoptions of this nature are very open,
    with the adoptive family and birth parents
    exchanging contact information and agreeing to
    periodic visits by the birth parents as the child
    grows. It is also common in open adoptions for
    the adoptive family to mail pictures and letters
    to the birth parents.
                 Abortion
 Of teenagers who become pregnant, 29%
  choose to have an abortion rather than bear a
  child.
 Many states have enacted laws that restrict
  teenagers' access to abortion by requiring
  parental involvement in the abortion decision.
                     Abortion
   Parental notification laws-require medical
    personnel to notify a minor's parent(s) of her
    intention to obtain an abortion
   Parental consent laws-require medical personnel to
    obtain written permission from the parents before
    providing an abortion
   Almost all of the parental notification and consent
    laws have judicial bypass options that allow a teen
    who feels she cannot involve her parents to get a
    judge's permission to proceed with her abortion.
                    Abortion
   Abortion providers encourage teenagers to tell a
    parent or another important family member
    about their plans. Even without state laws, one
    or both parents of 61% of minors know about
    their daughters' abortions. The younger the teen,
    the higher the likelihood that she has told her
    mother about the situation.
                      Abortion
   Those young women who do not or cannot tell their
    parents often have important reasons such as a family
    history of alcoholism, abuse, or incest. To involve
    such parents could invite further abuse of the
    teenager.
   Rather than tell their parents, some teenagers resort
    to unsafe, illegal abortions or try to perform the
    abortion themselves. In doing so, they risk serious
    injury, death, or criminal charges.
     States Ranked by Rates of Teen
                Abortion
   New Jersey (47)
   New York (46)
   Maryland (38)
   Nevada (36)
   California (36)
   Hawaii (34)
   Florida (33)
   Delaware (31)
   Connecticut (30)
   Illinois (27)
              Teen Parenting
   Over half of teen pregnancies end with the
    woman choosing to deliver and rear the
    child.

   Teen mothers are less likely to complete
    high school or college than women who
    delayed having children, and fewer than
    1/3 of teen mothers complete high school.
                 Teen Parenting
   80% of teen mothers receive welfare at some point.

   25% of teen mothers have another child within two
    years of their first birth.

   Teen pregnancy often creates a cycle of poverty, crime,
    and further teen pregnancy.
              Teen Parenting
   Sons of teen mothers are 2.7 times more
    likely to go to prison than sons of women
    that had children after the age of 20

   Children of teenage mothers are twice as
    likely to be abused and neglected than
    children born to women over the age of 20.
        Pregnancy Complications
   There are special risks to a baby when the
    mother is not fully mature. Because most
    teenagers are not physically, emotionally, or
    financially ready to carry and care for a child,
    their babies tend to have LBW & are
    predisposed to a variety of illnesses. A teen
    mother will need the full support of her
    family to live a healthy lifestyle for her and
    her baby.
       Pregnancy Complications
   Compared with older age groups, teen mothers
    are at greater risk of having medical
    complications.
   Because the teenage mother is more likely to
    receive little or no prenatal care, she often
    becomes anemic
   Teens are more likely to develop preeclampsia &
    have preterm labor
        Pregnancy Complications
   Vitamin deficiencies are more common
   A teenage mother’s weight gain is likely to be
    inadequate-since the mother is still growing
    herself, she needs to eat properly not only for
    her own growth but for normal growth of the
    fetus.
        Pregnancy Complications
   Pelvic bones do not reach their maximum size
    until about the age of 18; therefore, the pelvis of
    the teenage mother may not have grown enough
    to allow vaginal delivery of a normal-size baby.
    For this reason, the incidence of cesarean
    section is higher in teenage mothers
       Pregnancy Complications
   Babies born to teenage mothers are more likely
    to die in the first year of life compared with
    babies born to mothers older than 20 years of
    age.
   Since the teenage mother is less likely to eat
    correctly during pregnancy, her baby often has a
    low birth weight, making it more likely the baby
    will become ill.
   Teens are more likely to smoke, drink, or take
    drugs during pregnancy
        Pregnancy Complications
   The teenage mother should be encouraged to
    seek prenatal care early in pregnancy, eat a
    nutritious diet, take prenatal vitamins, and
    engage in healthy physical activity. A supportive
    family can help the teenage mother cope with
    her new responsibilities, and social service
    agencies may be needed to help find ways to
    finish school and seek employment.
    Children Born to Teen Mothers
 Children born to teenage mothers are less
  likely to receive proper nutrition, health care,
  and cognitive and social stimulation. As a
  result, they are at risk for lower academic
  achievement.
 Children born to teenage mothers are at
  increased risk for abuse and neglect.
    Children Born to Teen Mothers
   Babies born to women who do not have regular
    prenatal care are 4 times more likely to die
    before the age of 1 year.
   Girls born to teenage mothers are 22% more
    likely to become teenage mothers themselves.
  Is the Media
Glamorizing Teen
   Pregnancy?
    Teen Pregnancy and the Media
   Teen pregnancy has gained significant attention
    in the media in recent years (from MTV’s
    popular shows 16 & Pregnant and Teen Mom to
    recent cover stories in major magazines).
   Some have criticized these efforts for
    glamorizing teen pregnancy. New research
    suggests that teens do not share that view.
    Teen Pregnancy and the Media
   According to a poll by The National Campaign
    to Prevent Teen and Unplanned Pregnancy,
    most teens (79% of girls & 67% of boys) agree
    that when a TV show or character they like deals
    with teen pregnancy, it makes them think more
    about their own risk of getting pregnant or
    causing a pregnancy and how to avoid it.
    Teen Pregnancy and the Media
 Among those young people who have watched
  MTV’s 16 and Pregnant, 82% think the show
  helps teens better understand the challenges of
  teen pregnancy and parenthood and how to
  avoid it.
 76% of young people say that what they see in
  the media about sex, love, and relationships
  can be a good way to start conversations with
  adults.
    Teen Pregnancy and the Media
   93% of those who had watched 16 & Pregnant
    agreed with the statement: “I learned that teen
    parenthood is harder than I imagined from these
    episodes.”
   About half (48%) say they have discussed these
    topics with their parents because of something
    they have seen in the media.
                  Conclusion
   The most important role of physicians is to be
    proactive & ask all teenaged patients about
    sexual activity and sexual health issues
   Inquire about contraception use
   Abortion counselling and referral should be
    provided when needed
                   Conclusion
   Many adolescents have the emotional and
    cognitive maturity to receive confidential health
    services, but many are not aware that they are
    entitled to patient confidentiality
   If pregnant teens choose to carry to term,
    exemplary care should be provided before,
    during, and after delivery to help minimize the
    risk of negative outcomes.
                 References
   womensissues.about.com/od/datingandsex/a/
    TeenAbortRates.htm
   www.solutionsforamerica.org/healthyfam/teen
    age-pregnancy.html
   www.advocatesforyouth.org/teen-pregnancy-
    prevention
   www.ncsl.org/IssuesResearch/Health/Abortion
    Laws/tabid/14401/Default.aspx
                 References
   www. Pregnantteenhelp.org
   www.thenationalcampaign.org
   Pregnancy.adoption.com
   www.livestrong.com/article/96985-
    complications-teenage-pregnancy
   www.cdc.gov/nchs/fastats/teenbrth.htm

								
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