Kids Having Kids-- What’s Up With Teen Pregnancy? None of us needs to be told that this is a very serious problem in our communities. Teen pregnancy has far reaching consequences—not only to the teenager and her baby, but to society as a whole. By Marva Johnston RNCNP

Teen Pregnancy--The Problem Picture this: A 14 year old girl stands in her bathroom reading the instructions on a home pregnancy test. She is shaking. For the last month she has believed she was pregnant, and this morning she threw up. She stands in the bathroom, looking in the mirror waiting nervously for the results. She wonders how she got to this point. She had been a straight A student and had never really done anything wrong. Now she finds out in her bathroom that she is pregnant. She looks at the positive pregnancy test in front of her in disbelief and begins crying. Unfortunately, this is not an uncommon occurrence

Teen Pregnancy--The Problem Over 1 million adolescents under 19 years old get pregnant each year 40% of these pregnancies are to girls under age 17 85-90% are unintended 4 in 10 teenage girls get pregnant at least once before age 20 Each hour 100 teens get pregnant and 55 give birth

Teen Pregnancy--The Problem U.S. teenagers have the highest rates of pregnancy, childbearing and abortion among developed countries U.S. rates are nearly double Great Britain’s, 4 times those of France and Germany and more than 10 times that of Japan

Teen Pregnancy Teenagers in the United States are more likely to have sexual intercourse before age 15 and have shorter and more sporadic sexual relationships than teenagers in Canada, France, Great Britain and Sweden. As a result they are more likely to have more than one partner in a given year. U.S. teenagers also have higher STD rates among comparable developed countries--because they have more sexual partners and probably lower levels of condoms use. Although US teen may start sexual activity earlier than in some other countries, by age 20, there isn’t much difference in the rates in the US and these countries—However, when it comes to pregnancy rates, that’s another story.

Teen Pregnancy The primary reasons why U.S. teenagers have the highest rates of pregnancy, childbearing, and abortion among developed countries is less overall contraceptive use and less use of the pill or other long-acting reversible hormonal methods, which have the highest use-effectiveness rates.

Teen Pregnancy In New Mexico New Mexico ranks 5th in the US in teen pregnancy rates In 1996 teens in New Mexico gave birth to 4851 babies One third of all New Mexico families begin while the mother is a teen Quay county ranks 6th in New Mexico in teen birth rates (2000) New Mexico, as you probably have figured out, has a problem with teen pregnancies. One reason is that although teen pregnancy rates have declined nationwide among whites and blacks, the rate of teen pregnancies for Hispanics continues high, and we have a large number of Hispanic teenagers in New Mexico

Pregnancy Rates in Women Under Age 20 Teen Pregnancy rates in NM are 110 per 1000, compared to the US rate of 97.

Births to Women Under Age 20 This chart compares the NM teen birth rate to the US birth rate--51 in US to 68.4 in NM

Teen Pregnancy Outcomes in New Mexico In NM teen pregnancies result in 62% live births, 23% abortions and 15% miscarriages

Special Problems in Teen Pregnancy I don’t think I need to tell you that there are special problems associated with teen pregnancies—for both the mother and the baby.

Health Consequences to Mother A teenage mother has special problems, emotionally and physically. Basically we are dealing with children having children here. These young mothers have immature bodies that have difficulty adjusting to a pregnancy and the younger the teen, the greater the problems associated with pregnancy. Adolescents who are pregnant are much more likely to have complications such as hypertension, diabetes, dehydration, urinary tract infections, premature labor, and problems with the placenta.

Sexually Transmitted Infections May have had multiple partners before pregnancy May change partners during pregnancy Low use of barrier methods Sexually transmitted infections are a very real concern in pregnant teens, and is an ongoing problem throughout the pregnancy. Often these young women have already changed partners before they realized they were pregnant and its not uncommon for them to ask us for an exact calculation of when they became pregnant so they will know who the daddy is. Of course this is impossible, especially if they had one partner on one day and another on another day. “Who’s the Daddy” is a very interesting game sometimes.

Nutrition This is a problem with teens in general, let alone those who are pregnant. According to my son, the 4 basic food groups are hamburgers, hot dogs, pizza and tacos. The major beverage choice is Coke. This is not necessarily a healthy diet for anyone let alone a pregnant woman.

Weight Problems Pregnant teens seem to fall into two categories--those who gain too much, or those who gain too little. Very few fall into a normal range. Many young women have a body image problem anyway and pregnancy may exacerbate an underlying problem with anorexia or bulimia. On the opposite end of the scale are those young women who gain an enormous amount of weight during the pregnancy, increasing their risk of diabetes during the pregnancy and health complications later in life.

Emotional Problems Teen years are hard anyway, and pregnancy only complicates things more. Add raging pregnant hormones into the normal adolescent mix and you can see that there will be problems. Depression, fear, anxiety, stress, all are common with teen pregnancies. Suicide is one of the leading causes of death in teens in New Mexico, and is always a concern with a teen pregnancy. New studies are also showing that a depressed pregnant woman may transmit depression to her fetus, and untreated depressed newborns grow into depressed infants, who are slower to walk, weigh less and are less responsive to others.

Teen Pregnancy--Consequences Pregnancy problems are not the only thing we have to look at when we are discussing teen pregnancy. There are many consequences for both the mom and the baby that endure for many years after the actual birth of the child

Health Consequences to Baby Because a teen mother is more likely to have health problems, the baby will also be at higher risk.

Health Consequences to Baby High rate of low birth weight results in: infant death blindness deafness chronic respiratory problems mental retardation cerebral palsy The proportion of babies with low birth weights born to teens is 28 percent higher than the proportion for mothers ages 20-24.

Health Consequences to Baby Low birth weight doubles the chances that the child will later be diagnosed with: Dyslexia ADHD Other disability Think how this can complicate things for a young mother who is already limited in her parenting skills

Social Consequences of Teen Pregnancy No doubt about it, high rates of teen pregnancies affect our whole society. The teen and her immediate family are not the only ones to pay for the consequences of the pregnancy

Social Consequences of Teen Pregnancy Teen mothers are: Less likely to complete school Less than 1/3 of teens who begin families before age 18 ever earn a high school degree 2/3 of families began by young unmarried women are poor 1/2 of all teen mothers and 3/4 of all unmarried teen mothers begin receiving welfare within 5 years of the birth of the child When children have children, their opportunities are diminished right from the start and the future is often poverty.

Social Consequences of Teen Pregnancy 80% of fathers do NOT marry the mother They pay low rates of child support--under $800 per year There is a real need for us to involve young fathers in the pregnancy. A lot of our young girls state on the first visit that the father is not involved, but we need to encourage involvement for several reasons--Number one, it is their baby too, and they need to be responsible enough to be involved in its life, financially and emotionally.Number two, next slide

Social Consequences of Teen Pregnancy Children who live apart from their fathers are: 5 times more likely to be poor twice as likely to drop out of school Twice as likely to abuse alcohol and drugs Twice as likely to end up in jail 4 times more likely to need help for emotional or behavioral problems You can see from these stats that it is very important to have male involvement

Childhood Consequences of Teen Pregnancy The teenager, herself is not the only one to suffer consequences from an unplanned pregnancy. There are many consequences to the the child itself

Childhood Consequences Children of teen parents usually get inadequate health care Average 3.8 visits per year to medical provider as opposed to 4.3 visits for children of parents 20-24 yrs old These children will remain in much poorer health than their contemporaries, and have statistically more serious health and dental problems later in life

Childhood Consequences Children of teen parents usually live in poverty Let’s face it, if Mom doesn’t complete high school, what kind of employment can she really get to support the family?

Childhood Consequences Percent below poverty This chart show a comparison of families in poverty, and those with a mother only are at much higher risk of living in poverty. Teens who become mothers before age 18 spend nearly 5 times more of their young adult lives as single parents than do women who postponed childbirth to age 20-21. Almost 80% of births to teens in New Mexico occur outside of marriage

Childhood Consequences Inadequate parenting Unable to provide optimal learning environment High rates of abuse/neglect Poor school performance Lower test scores Less likely to graduate As you might suspect, teenagers may not be the best parents. They really haven’t grown up themselves and it is not surprising that they have problems parenting. These little mother’s often do not think past the “cute, sweet, baby” stage. And as we all know, that lasts about 24 hours until you get home to a baby keeping you awake all day and all night. Babies are hard work, and parenting is a 24/7 job that lasts for 18 years—if you’re lucky to get rid of them by then! This is usually a rude awakening for young moms and they are ill prepared for the reality. Poor parenting can lead to all kinds of problems for their children

Inadequate Parenting Consequences Sons of teenage mothers are 13% more likely to end up in prison

Inadequate Parenting Consequences Daughters of teen mothers are 22% more likely to end up as teen mothers themselves This really is a vicious cycle.

Cost of Teen Pregnancy $40 Billion in welfare to teen mothers $7 Billion in direct healthcare costs We are all paying for the costs of teen pregnancy

Prevention This has got to be one of the most frustrating and controversial issues facing us today. As a public health nurse, I feel it would be very appropriate to put birth control in the high school coke machines, or line up every female teenager and mass immunize them with DEPO every 3 months. However, the school board contends that our children are not really having sex, so we run into a bit of a problem convincing them to do anything. All I know is that there must be a lot of immaculate conceptions out there! As a parent, I am happy that they are teaching abstinence and as a nurse I realize that total abstinence is the only way to prevent disease. However, as a WHCNP taking care of teens, I know that a teenager’s definition of abstinence and mine may be a whole lot different and may not prevent pregnancy or disease. Somehow, we need to join with the community to give our kids the best of both kinds of education

There is no Single Solution to Teen Pregnancy Teen pregnancy is not only a teen problem and there is no single solution that we can put into effect to solve it. The programs that work usually involve the teen, the family, and the community

Things That Work—The Teens’ Part Involvement in school and community Developing positive self esteem Dedication to better school performance Involvement in extracurricular activities—sports,music,etc. Parents need to involve their children in lots of activities that help to build self esteem, and they need to be involved right along with them. This seems to be an easy suggestion to make, but realistically, a lot of our teen pregnancies are to young women who are looking for a way out of their family situation. The mother of the teen may herself have been a teen mother and there may be no male role model anywhere in sight. As public health and school nurses, we have to do whatever we can to help fill in the gaps, and unfortunately, we are spread pretty thin

Things That Work—The Family’s Part Positive adult role models Participation in youth’s education Appropriate and consistent discipline Goal setting Increased and improved communication about sexuality More family activities With so many single parent families out there, it is hard for many children to have those positive role models—mentoring programs can help add some of those role models into the community, but volunteers are scarce. By our involvement in the community, maybe we can help parents and children communicate more effectively.

Things That Work—The Community’s Part Increased opportunities for youth Parent and teen support groups School based health centers Sexuality education at younger ages Easy access to contraceptive services Address need of families in poverty Counseling services It is an uphill battle, but our voices need to be heard in our own communities

Things That Work—The Community’s Part Life skills education Support of the entire community in the efforts to prevent teen pregnancy All children have equal access and opportunities in education, extracurricular activities, employment

Things That Work—Our Part Be involved Be accessible Be supportive Educate, educate, educate We are all a part of teen pregnancy prevention in our communities. We need to be involved and take every opportunity to educate ourselves, the community, the parents, and the teenagers about the risks involved in teen pregnancy and how to prevent it.