There is a greater risk of pre-eclampsia, pre-mature labour and low birth weight among teenage mothers.

There have been rapid advances in the obstetric and family planning services since the mid 20th Century, that has put the present day teenagers in a privileged position. The liberalization of abortion laws have also gone a long way in reducing the complications of teenage pregnancy.

Teenage Pregnancy in Developed Countries:

It has been estimated that 1 in 10 Americans girls, 15 to 19 years of age became pregnant, and 95% of these are unintended (Center for Disease Control ,Atlanka,1995a).

The incidence of teenage pregnancies rose by 23% 1972 and 1990. However pregnancies among girls between the ages of 15 and 19 declined by 17% between 1990 and 1996.There was also a drop in the teen birth rate by 20 % between 1991 and 1999, to approximately 50 births per 1000 young women.

The decrease in the birth rate since 1991 is attributed to the availability of contraception and abortion rather than a decrease in sexual activity.

Unintended pregnancies currently lead to approximately, 1.5 million abortions annually in the United States, a ratio of about 1 abortion to three live births.

Teenage Pregnancy in Developing Countries:

In developing countries there is also a high incidence of teenage pregnancies. This is due to early marriage rather than due to increased sexual freedom.

In South Asia 54% of teenagers are married compared to 24% in South East Asia and 2% in East Asia.

Probable Causes for the increase in teenage pregnancy:

i) Leisure time is less-structured

ii)The sexes mingle much earlier

iii)Age of menarche has reduced from 16 to 17 years in the late 19^th century to 12 to 13 years currently.

iv)Controls exerted by families and schools have relaxed.

v)Influence of news and entertainment media.

vi)Values governing intimacy have been liberalized.

Incidence of teenage pregnancy:

The incidence of teenage pregnancy shows marked variation from one country to another and between developed nations and developing nations. See above for the incidence of teenage pregnancy in USA.

In India 7% of teenage girls give birth annually. In India up to 60% of girls between 15-19 years of age are married.

Adolescent girls are more susceptible to sexually-transmitted diseases/infections, compared to older women. HIV in female adolescents can have a very high viral load (WHO, Joint UN Program HIV/AIDS, HIV in pregnancy, a review, Geneva, 1999).

The outcome and management of teenage pregnancy will be discussed in a subsequent post.

Teen Psychology: Sexual attitude /Behavior

There has been a change in the sexual attitudes and values over the last few decades. It is well established that menarche has been occurring 3 months earlier with each passing decade since 1900, when the mean age of menarche was 16 years.This has led to a marked increase in the number of extremely young pregnant women.

The adolescent period is a delicate period of transition into adulthood that requires adaptation. This is also a time to experiment with their bodies and emotions.

Klein (1978) wrote of teenage childbearing as “initiating a syndrome of failure, failure to complete one’s education, failure in limiting family size and failure to establish a vocation and become independent.”

References:

Pages 303 to 306 Chapter 35. The Extremes of Reproductive Age:Pregnancy in Adolescence and in Advanced Maternal Age by Arun A Rao. 2006. Medical Disorders in Pregnancy- An Update. Edited by Hiralal Konar and Pralhad Kushtagi. A publication of the Federation of Obstetric and Gynaecological Societies of India. Jaypee Publication.