Introduction
Adolescent pregnancy refers to the pregnancy of an underage adolescent girl (usually 11-17 years old). The problem with adolescent pregnancy stems from a mismatch between the age of sexual and social maturity. The age and criteria of social maturity vary from country to country and culture to culture. The occurrence of pregnancy in an adolescent girl has medical, social, economic, psychological, and other aspects (Govender et al., 2020). The incidence of adolescent births per 1,000 women aged 15-19 as of 2019 is: the global average is 42 per 1,000 women and varies by country (“Adolescent fertility rate”, 2020). Such data indicate that adolescent girls continue to face difficulties accessing sex education that could help avoid pregnancy. The project’s goal is to assess the extent of teen pregnancy and identify critical factors that threaten teenage girls.
Demographics
The teen birth rate has dropped to a new low every year since 2009. Nevertheless, the teen birth rate in the United States remains higher than in many other developed countries, including Canada and the United Kingdom. In 2020, the teen birth rate was 15.4 (births for every 1,000 women ages 15-19), eight percent less than in 2019. There were 158,043 births to women in this age group, less than five percent of all births in 2020 (WHO, 2020). As of 2019, Georgia has seen a decline in teen pregnancies. It is noted that there are 19.7 pregnancies per 1,000 teenage girls ages 15-19 (“Teen births in Georgia”, 2020). Also, the number is highest among Hispanics at 30.1; the lowest among Asian/Pacific Islanders at 3.4. In 2020, the number of births among adolescents was 6,572, and the average rate was 18.2 per 1,000 (“Georgia data”). The observed decrease is due to the actions of various regional and state programs, but more effort is needed.
Socioeconomic conditions
Adolescent pregnancy in the region disproportionately affects specific subpopulations: married adolescents, young people from linguistic, religious, and ethnic minorities, adolescents from low-income families, and other vulnerable groups. In addition, it has been found that the poorer teenage girls are, the more likely they are to become pregnant (compared to teenagers from wealthy families). On the one hand, this is due to the lack of finances for contraception (Goin et al., 2021). On the other hand, children from low-income families do not even have a school education where they are taught about sexual behavior and contraception.
Adolescent girls who grow up in an unsafe and unpredictable environment may have harmful plans for the future, causing them to make risky decisions. On the other hand, teenage girls who saw their friend or acquaintance get pregnant at an early age might learn about it indirectly (Araï Z-Ledezma et al., 2020). They might change their preferences for early childbearing and reduce their sex drive by focusing on other aspects of their lives, such as education and careers. Adolescent girls who were sexually molested at an early age may become sexually active at that age.
Environmental Hazards
Maintaining a favorable environmental environment goes a long way toward a healthy pregnancy. Various toxins in the air and water can adversely affect the mother and fetus. For pregnant adolescent girls, these risks are significantly increased by the immaturity of the body for childbirth. It is noted that smoking, alcohol, and psychoactive substances lead to the formation of stressful conditions that cause pregnant girls to bleed. As a result, the fetus most often dies early, and the girl may subsequently have chronic gynecological diseases.
It is also worth noting that adolescents are exposed to eco-social factors negatively affecting health. Goin et al. (2021) used experimental modeling and found that the vulnerability factor arising from environmental exposures leads to abortions and premature births. In addition, as exposure to factors increased, the number of spontaneous abortions increased, affecting the ability to conceive later in life. Thus, environmental factors are often coupled with social conditions of development and pose a risk to the young mother’s health.
Access to Health Care
Pregnancies for adolescent girls are always problematic, both socially and medically: abortions, juvenile motherhood, early marriages, and child abandonment in Children’s Homes, child abandonment. Pregnancies for teenage girls are always problematic, both socially and medically: abortions, juvenile motherhood, early marriages, and child abandonment in Children’s Homes, child abandonment. Often teen pregnancy programs seem cruel and stressful for girls (Araï Z-Ledezma et al., 2020). Seeking counseling continues to be awkward and uncomfortable, and teens cannot get over themselves. In addition, not all clinics are willing to host pregnant teens, which impose restrictions on seeking help.
In cases of already advanced pregnancies, teenagers are often unable to get parental support and, accordingly, to see a doctor in time. Cases of unsafe abortion lead to bleeding and infections, treatment for which is not always available to children from low-income families. In addition, contraceptives with high protection rates are often not sold to children, and some states prohibit their use altogether. Access to health care is severely limited by the stigma of sexuality among adolescents and the high cost of providing services.
Risk Factors for Mortality and Morbidity
Physiological Immaturity
The physiological maturity of the body comes much later than menstruation, hence the problems of adolescent pregnancy, endangering the life of the mother and fetus. The formation of the placenta – the main organ that connects the mother and child and ensures the growth and nutrition of the fetus – does not occur correctly due to the immaturity of the uterus. Placental insufficiency is formed, which leads to the birth of a low-weight, weak fetus (Moreno Arias et al., 2021). Childbirth in adolescents also involves several difficulties. Most of them are purely physiological – the pelvis may be narrow since growth processes are not over yet, labor is incorrect or weak, which is explained by hormonal insufficiency – because the body is not mature enough for such a severe process.
Mental Illnesses
Neuroticism is a state of anxiety, emotional instability, and emotional excitability. Emotional stability is characterized by maturity, excellent adaptability, lack of great tension, anxiety, and a tendency toward leadership and sociability. Individuals with high scores on the neuroticism scale develop neurosis in adverse stressful situations. Adolescent mothers face significant levels of stress, leading to increased mental health problems. Adolescent mothers are also at risk of developing symptoms of PTSD, mainly because of their high risk of exposure to social and interpersonal violence.
Concomitant Diseases
Pregnant adolescent girls are characterized by a high rate of extragenital diseases, hurting reproductive function. In half of the cases, young pregnant women already have gynecological pathologies; one in eight has one or two induced abortions. The mortality rate of girls aged 15-19 years from complications of pregnancy and childbirth is the second highest in the world (Moreno Arias et al., 2021). In the United States, the rate of pregnancies and abortions among adolescent girls has declined but still has one of the highest adolescent pregnancy rates.
Abortion
The term abortion refers to the expulsion of the products of conception from the uterus before the fetus becomes viable and can be spontaneous or induced. Artificial abortion can be safe or unsafe, depending on how it is performed (Moreno Arias et al., 2021). Abortion is considered unsafe if the procedure to terminate an unwanted pregnancy is performed either by persons lacking the necessary skills, in conditions lacking minimum medical standards, or both (“Trends in teen pregnancy and childbearing”). The vast majority of deaths in such situations result from complications of unsafe abortion.
Health Promotion Activities
In close cooperation with international organizations, WHO has identified measures to reduce the number of marriages occurring before the age of 18. These measures should focus on girls’ schooling, the impact on cultural norms, and the prohibition of early marriage. In order to reduce the number of pregnancies in girls under the age of 19, knowledge about fertility must be improved, taking into account the socio-cultural context of women.
First and foremost, health promotion activities should increase access to health services. Clinics should expand their scope of work and contribute to preventing teenage pregnancy. Open, anonymous women’s counseling sessions for adolescents should be conducted. Social acceptance and support are needed between the ages of 14 and 19; in a group setting, the clinic can track which girls are at risk and provide them with assistance (Govender et al., 2020). In addition, it is recommended to reduce the cost of initial consultations and provide the right to make an independent decision about abortion or preservation of pregnancy. Creating support programs just for adolescents will teach contraception and keep them healthy.
Second, children’s different socioeconomic backgrounds do not require them to attend different schools. Often, different income levels are found in mainstream schools, and family conditions may be similar. Educators and psychologists should be involved in expanding children’s understanding of pregnancy. Group and individual counseling on sexuality education will allow children to get informational support in time. The coverage of contraception and its variations and demonstration lessons with its use will develop responsibility in adolescents. It will lead to a positive response and less anxiety and allow schools and colleges to monitor their students.
Third, not insignificant is the management of pregnancy or abortion. Adolescent girls who decide to get rid of pregnancy or keep it are subject to the psychological consequences of that decision in either case. The lack of psychological counseling leads to increased teenage suicides and life-threatening adolescence due to increased stress (Govender et al., 2020). Psychological counseling programs for teen pregnancy management will help avoid post-traumatic stress disorder and prevent postpartum depression. In the case of abortion, psychologists will help manage the stress and gradually return the child to a healthy view of motherhood and children.
Conclusion
Thus, teenage pregnancy is a global problem, mostly stemming from the socioeconomic conditions of child development. There has been a decrease in the overall number of teenage pregnancies in the United States, but it remains high because of difficulties accessing health care. Risk factors for mortality and morbidity are physiological immaturity, mental disorders, comorbidities, and abortions. It is recommended to carry out health promotion activities to solve the problem of teenage pregnancy. They should include increasing and facilitating access to health services, providing sexual education in schools and colleges, and supporting teenagers with psychologists and doctors in the case of abortion or the preservation of pregnancy.
References
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Goin, D., Casey, J., Kioumourtzoglou, M.-A., Cushing, J., & Morello-Frosch, R. (2021). Environmental hazards, social inequality, and fetal loss: Implications of live-birth bias for estimation of disparities in birth outcomes. Environmental Epidemiology, 5(2).
Govender, D., Taylor, M., & Naidoo, S. (2020). Adolescent pregnancy and parenting: Perceptions of healthcare providers. Journal of Multidisciplinary Healthcare, 13, 1607-1628.
Moreno Arias, E. S., Peña Cordero, S. J., & Mesa Cano, I. C. (2022). Mortality rate and risk factors in adolescent pregnancy systemic review. Pro Sciences: Revista De Produc-ción, Ciencias E Investigación, 6(42), 291-300.
Teen births in Georgia. (2020). America’s Health Rankings. Web.
Trends in teen pregnancy and childbearing. (2020). Office of Population Affairs.
World health organization. (2020). Adolescent pregnancy. WHO.