Teenage Pregnancy

In the United States, 900,000 adolescents (fifteen-to nineteen-year-olds) became pregnant in 1996. While this was 15 percent lower than in 1994, it is still higher than any other developed country. There are twice as many teenage pregnancies in the United States each year as there are in England, Wales, or Canada, and eight times as many as in Japan. These figures include live births (accounting for approximately half of the total of 900,000), induced abortions, and fetal losses due to miscarriages and still births.

In 1996, the pregnancy rate was twice as high among non-Hispanic black and Hispanic teens as among non-Hispanic white teens. By 2003, the under-18 Hispanic and non-Hispanic black population will be greater than 50 percent of the adolescent population. These figures are important in planning pregnancy-prevention programs.

Teen pregnancy is one serious consequence of early initiation of sexual activity. Other serious consequences include an increased likelihood of late or no prenatal care, unattended births, reduced educational attainment, and decreased employment opportunities. Infants of teenage mothers are at greater risk of low birth weight and increased infant mortality. Thirteen percent of infants born to 15 year olds have a low birth weight, compared to 7 percent of infants born to mothers in their twenties. Infants of mothers 13 to 14 years old have an infant mortality rate of 17 per 1000 live births, compared to the rate of 10 per 1000 live births for those 15 to 19 years old, and a rate of only 4.5 per 1000 live births for all mothers in the United States. Children of teenage mothers are more likely to perform poorly in school, more likely to drop out of school, and less likely to attend college. Overall problems related to teen pregnancies cost taxpayers an estimated $7 billion per year.

After three decades of steady increases, the proportion of teenagers 15 to 19 years old who were sexually active decreased by 50 percent during the mid 1990s. In addition, condom use at first intercourse increased from 18 percent in 1975 to 54 percent in 1995.

Socioeconomic factors and limited life options, rather than ethnic or cultural background, place many youth at higher risk for unintended pregnancy. Early attempts at preventing teen pregnancies often ignored the complex relationship between development, environment, and behavior. Neither those programs that focus on increasing knowledge, nor abstinence-only programs have been effective in reducing the rate of unintended pregnancies. Adolescent behaviors are shaped by the desire to broaden horizons, interact with peers, or try out adult roles and behaviors. If early sexual behavior is the only perceived option to achieve these objectives, teens may well choose it.

As our society moves forward, a more comprehensive approach to reducing adolescent pregnancy is needed. Many risk behaviors, including early and unprotected intercourse, are linked and share common motivations. Programs designed to prevent pregnancy need to address these other behaviors as well. A variety of life choices need to be available for teens, and programs need to address real economic barriers if the unintended teen pregnancy rate in the United States is to be reduced.

JAMES J. FITZGIBBON

(SEE ALSO: Abortion; Condoms; Ethnicity and Health; Family Planning Behavior; Infant Health; Infant Mortality Rate; Maternal and Child Health; Perinatology; Pregnancy; Prenatal Care)