Researchers concur that pregnancy is a time of dramatic transition. A first-time pregnancy heralds a change from the status of woman to that of mother. The significance of this change is reflected in the terminology used to describe pregnancy; words such as "metamorphosis" and "transformation" are commonly applied. Some developmentalists have even referred to the pregnancy period as a time of crisis during which the woman undergoes not only psychological upheaval, but a revision of her sense of self and identity. While these changes are noteworthy for the adult woman confronting pregnancy, their effect is frequently magnified when the expectant mother is an adolescent.
Adolescent pregnancy is an issue that warrants the attention of developmentalists. The problem not only burdens individual teenagers and their newborn babies, but its widespread prevalence affects all strata of society and has begun to take a toll on welfare resources. Statistics help place the problem in perspective. Teenage pregnancy rates in the U.S. are at the highest level among Western nations. An estimated 96 per 1,000 women between the ages of 15 and 19 become pregnant each year (Repke, 1990). However, the reasons are not fully understood. Some proposed explanations include lack of knowledge about birth control, cultural differences that place esteem on adolescent motherhood, the teenager's sense of insecurity or impulsivity, dependency needs, and attempts to assert independence.
Sexual activity among teenage girls has become, in many communities, the norm rather than the exception. One study found that during the 1980s, 45% of young girls aged 15 to 19 were sexually active before marriage, and that an estimated 36% became pregnant within two years of their initial sexual experience (Davis, 1989). The effect of teenage pregnancy may be devastating for the young girl. van Winter & Simmons (1990) have reported that of the one million pregnancies among adolescents in the U.S. each year, approximately half result in live births, 400,000 end in elective abortions, and the remaining 100,000 end in spontaneous abortion. Fully 85% of these pregnancies are unplanned, according to these researchers, with 97% of teenage mothers keeping their infants. The annual cost to society of subsidizing the care of these infants is an estimated $20 billion (Hardy, 1988; Johnson, Lay, & Wilbrandt, 1988). Moreover, as Fielding & Williams (1991) report, despite the high incidence of pregnancy among adolescents and the lifelong burden associated with a completed pregnancy, teenagers are the least likely age group to practice contraception. Equally troubling is that the annual pregnancy rate among teenagers 14 years of age or younger continues to rise.
Moreover, the adolescent mothers' problems intensify during the prenatal and antenatal periods. Specifically, prenatal medical care is frequently delayed or inadequately delivered. Johnson, Lay, & Wilbrandt (1988) determined that 50% of pregnant teenagers received no medical care during the first trimester, 10% received no care during the first and second trimesters, and 2.4% received no medical care at any time during the pregnancy. According to Pomeranz, Matson, and Nelson (1991), among the complicating factors of teenage pregnancy is the high incidence of sexually transmitted diseases which have been associated with an increased risk of preterm labor and low infant birth weight. A delay between verification of the pregnancy and first obstetric visit may also place the fetus at risk. Lee & Corpuz (1988) found that 14.5% of infants born to mothers under 15 years of age and 9.4% of infants born to adolescents of 15 to 19 years have a low birth weight. In contrast, only 6.4% of infants born to mothers 20 years of age or older are of low birth weight. Low birth weight has been associated with increased levels of neonatal morbidity and mortality (van Winter & Simmons, 1990). …