Presentation on theme: "Misty Thompson DO August 19, 2011"— Presentation transcript:
1Misty Thompson DO August 19, 2011 Teen PregnancyMisty Thompson DOAugust 19, 2011
2Financial Disclosures I do not have any financial or beneficial relationship to disclose that may pose a conflict of interest
3Objectives Review statistics regarding teen pregnancy trends Discuss available options for pregnant teensDiscuss maternal and neonatal morbidities as they relate to teenage pregnancyReview how the media can affect teen pregnancyDiscuss the physician’s role in pregnancy prevention, discussion of options, and prenatal care.
4Teen Pregnancy Statistics The US has the highest rates of teen pregnancy and births in the western industrialized worldTeen pregnancy costs the world approx. $10 billion annually34% of young women become pregnant before the age of 20 (approx. 820,000/yr)
5State Levels & TrendsBetween , teen pregnancy rates declined in every state except North DakotaStates with the highest teenage birth rates are MS, TX, NM, AR, AZThe states with the lowest teenage birth rates are NH, VT, MA, CT, NJ.
7Facts on Teen Pregnancy Very few teens who become mothers plan on doing so; 82% are unintended, and teens account for 20% of unintended pregnancies annuallyTwo-thirds of teen pregnancies occur among year oldsAccounts for 11% of all US births
8Facts on Teen Pregnancy Out of all teen pregnancies, 57% end in birth14% result in miscarriage29% are terminated by abortionUS teen pregnancy rates are higher than those of other developed countries
9Teen 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
10Teen Pregnancy Risk Factors Among ethnic groups, African Americans and Hispanic teens are more likely to become sexually active earlierSocioeconomic 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 .
11Teen 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.
12Teen 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.
13Teen 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)
14Teen 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.
15Teen 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.
16Teen 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
17Teen 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.
18Teen Pregnancy Prevention Relationships with inequalities tend to be associated with lower contraceptive use & consistencyCondom use is more frequent with casual sexual partnersConsistent birth control use occurs in relationships where partners have discussed birth control prior to first having sex
19Teen Pregnancy Prevention Discussions between sexual partners about condoms and sexual histories are consistently linked with improved condom useThe younger teenagers are at the time of sexual encounters with their partners, the less likely they are to use birth control.
20Teen 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.
21Teens 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 pregnantBe afraid to go to a health care provider or clinic to ask for birth controlNot know how to get birth control or think they cannot afford it
22Teens and Birth Control Worry about their parents finding outBe afraid of what their partner thinks about birth controlThink that birth control might hurt their ability to get pregnant in the futureHave sex that was not plannedThink they will not get pregnant the first time they have sex
23Teens 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
24Teens and Birth Control Education about how pregnancy occurs will help teens understand how the different methods of birth control workDiscuss emergency birth control
25Options 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.
26Adoption 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
27Closed AdoptionA 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.
28Semi-Open AdoptionThe 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.
29Semi-Open AdoptionOnce 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.
30Open AdoptionOpen 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.
31Open AdoptionSome 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.
32AbortionOf 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.
33AbortionParental notification laws-require medical personnel to notify a minor's parent(s) of her intention to obtain an abortionParental consent laws-require medical personnel to obtain written permission from the parents before providing an abortionAlmost 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.
34AbortionAbortion 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.
35AbortionThose 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.
36States 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)
37Teen ParentingOver 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.
38Teen 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.
39Teen ParentingSons of teen mothers are 2.7 times more likely to go to prison than sons of women that had children after the age of 20Children of teenage mothers are twice as likely to be abused and neglected than children born to women over the age of 20.
40Pregnancy 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.
41Pregnancy 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 anemicTeens are more likely to develop preeclampsia & have preterm labor
42Pregnancy Complications Vitamin deficiencies are more commonA 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.
43Pregnancy 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
44Pregnancy 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
45Pregnancy 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.
46Children 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.
47Children 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.
49Teen 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.
50Teen 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.
51Teen 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.
52Teen 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.
53ConclusionThe most important role of physicians is to be proactive & ask all teenaged patients about sexual activity and sexual health issuesInquire about contraception useAbortion counselling and referral should be provided when needed
54ConclusionMany adolescents have the emotional and cognitive maturity to receive confidential health services, but many are not aware that they are entitled to patient confidentialityIf 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.