Assessing the Patterns That Prevent Teenage Pregnancy
Trad, Paul V., Adolescence
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). Moreover, the low birth weight of infants born to adolescent mothers has been associated with unfavorable maternal health care factors, such as substance abuse, low income, single-parent status, and low educational level (Lee & Corpuz, 1988). According to Ringdahl (1992), family physicians can help curtail the trend of rising teenage pregnancies by identifying adolescents likely to engage in sexual behavior and providing contraceptive counseling. Follow-up is also recommended since adolescents harbor the unrealistic perception that they are invulnerable to pregnancy and may therefore not use contraceptives on a regular basis.
In addition, the consequences of adolescent pregnancy may extend far beyond the birth. Pregnancy during the teenage years almost inevitably results in an interruption of the adolescent's education. Often, the teenager drops out of school. One survey determined that more than two-thirds of adolescents who have their first child before age 15, and more than half of those who give birth between the ages of 15 and 17, do not complete high school (Repke, 1990). Teenage mothers earn approximately half as much as their counterparts who are not adolescent mothers (Repke, 1990). Two-thirds of the children of teenage mothers live below the poverty level by the age of six years. Among women younger than 30 years of age who receive welfare, 80% had their first child as a teenager (Repke, 1990).
Beyond these statistics, however, a host of other issues relate to the ability of the adolescent mother to endure the pregnancy successfully and to properly minister to the child after the birth. It is known, for example, that pregnancy is a time of emotional upheaval for the expectant mother, even under the most optimal conditions. Women undergo a full spectrum of physical and psychological changes at this time. Many women regress, recalling events. from their childhood that had long since been forgotten. Another common phenomenon is for the expectant mother to reevaluate the nature of the relationship she shares with her own mother. When the expectant mother is physically and psychologically mature, these experiences can be highly beneficial in preparing the woman for the responsibilities she will encounter with the infant. When the expectant mother is an adolescent, however, the dramatic shift in perspective that accompanies a normal pregnancy may become overwhelming. It should be remembered that the adolescent has not yet attained either physical or psychological maturity. With the onset of pregnancy, the teenager can no longer continue the normative strivings for identity that characterize the behavior of most of her peers. Instead, a kind of developmental arrest occurs and she is forced to focus on the pregnancy and its consequences. As a result, the pregnant teenager may engage in maladaptive behaviors and inappropriate emotions that affect not only her own development, but may influence her eventual relationship with the infant.
To deal with this psychological distortion, it is necessary to understand how the typical perturbations of pregnancy become exaggerated when the expectant mother is an adolescent. In this regard, pregnancy may be viewed as an emotional, as well as interpersonal experience. Moreover, intervention techniques for pregnant adolescents should focus on helping these teenagers cope with the emotional turmoil they are experiencing. Although many studies have addressed the sociological devastation of teenage pregnancy, few investigations have explored the developmental consequences of pregnancy on the teenager and recommended how these vicissitudes could be brought into alignment with the experiences of adult pregnant women.
Developmental Consequences of Adolescent Pregnancy
As a developmental phase, adolescence is positioned between childhood and adulthood. Most texts identify the onset of puberty as the end of childhood and the beginning of adolescence. As a result, the physical and sexual maturation associated with adolescence has always been a significant component of this developmental period. Equally important, however, are the psychological dimensions of adolescence. Conventional theory holds that adolescence is a time during which teenagers assert their sense of identity, rebelling from the control and authority of their parents. Thus, it is not unusual to encounter a high degree of emotional turmoil in the …
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Publication information: Article title: Assessing the Patterns That Prevent Teenage Pregnancy. Contributors: Trad, Paul V. - Author. Journal title: Adolescence. Volume: 34. Issue: 133 Publication date: Spring 1999. Page number: 221+. © 1999 Libra Publishers, Inc. COPYRIGHT 1999 Gale Group.
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