teenage pregnancy

06007117 Teenage Pregnancy

Running Head: Teenage Pregnancy

THE ROLE OF CONTRACEPTION IN THE DECLINE OF TEENAGE PREGNANCY

06007117

University Of Worcester

Teenage pregnancy occurs in all societies but the level of teenage pregnancy and child bearing varies from country to country. The UK has the highest number of teenage pregnancies in Western Europe and the highest number of unmarried teenage mothers in the world; however teen pregnancy rates are much higher in the United States than in any other developing country in the world. (UNICEF) 2001.

The increased use of contraception accounts for 75% of the decline in teenage pregnancy rates, but many teenagers do not use contraception consistently and correctly. More than 30% of adolescents do not use any contraception the first time they have sexual intercourse.

It is hypothesised that with more available education to teenagers on sex education awareness and provision of contraceptives and advise, the higher the potential to reduce the number of teenage pregnancies. The following four literature review attempts to demonstrate and support this hypothesis.

In a study by Hydman Rodman (1985), he recognised several factors that stemmed from his awareness of the statistics on adolescent behaviours and the clashing ideologies about fertility control. He states that there is a growing awareness in teenagers in the sense that they had the ABILITY and could show that if given more responsibility followed by the training required to be responsible.

In a study by Frost and Forrest (1995), they reviewed five pregnancy prevention programmes. A similar pattern was shown in all reviews whereby there was a huge emphasis on abstinence or delay of sexual initiation, training in decision making and negotiating skills and education on sexuality and contraception. Out of the five programmes, four directly or indirectly provided access to contraceptive services. When compared, all four that measured the changes in rates of sexual initiation among their teenagers had a significant effect on that outcome, reducing the proportion of adolescents who initiated sexual activity by as much as 15%. Three out of the four programmes also significantly increased the rates of the use of contraceptive by 22% and targeted teens who were younger and those who weren’t yet sexually active. Two programmes where found to significantly reduce the percentage of teenagers who became pregnant. These programmes were the two that gave more access to contraceptive services.

The result in this study supported the hypothesis that contraception awareness does play a big role in the decline of teenage pregnancy.

However, although several programmes have demonstrated an ability to influence teenage behaviour regarding sexual activity and contraceptive use, there has been no definite figure to show that such behaviour changes actually contribute to lower rates of pregnancy or child birth. Calculating near accurate outcome rates face numerous problems. For example getting accurate data on pregnancies is difficult unless there is some way to verify self-reported behavior using medical records. Even if evaluators have access to reliable data, the ...

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The result in this study supported the hypothesis that contraception awareness does play a big role in the decline of teenage pregnancy.

According to the Social Exclusion Unit (SEU) 1999, The reduction in child poverty is directly linked to the reduction of teenage pregnancies; therefore cutting the number of teenage pregnancies is vital if the government is to meet its targets of reducing child poverty and social exclusion.
The government has pledged to halve teenage pregnancy rates by 2010. In June 1999, the Social Exclusion Unit (SEU) produced a blueprint for tackling Britain’s high number of teenage pregnancies. It concluded that,” Too many teenagers are being pressured into having sex rather than really choosing to, are not using contraception, and are, as a result, ending up pregnant or with a sexually transmitted infection.”
By contrast, sex education in the Netherlands is much less controversial, particularly at political level, Lewis et al 2001. The Netherlands has one of the lowest teenage pregnancy rates in the world, and the Dutch approach is often seen as a model for other countries. (Lewis J, 2001)

According to Ketting 1994 and Braeken, 1994, Dutch society is more open when it comes to issues about sex. Subsidised by the government, the “Lang leve de liefde” (“Long Live Love”) package, developed in the late 1980s, aims to give teenagers the skills to take their own decisions regarding health and sexuality. Nearly all secondary schools provide sex education as part of biology classes and over half of primary schools discuss sexuality and contraception. The curriculum focuses on biological aspects of reproduction as well as on values, attitudes, and communication and negotiation skills. The media has encouraged open dialogue and the health-care system guarantees confidentiality and a non-judgmental approach.

From the literature, there is strong consensus in the United Kingdom that teenage pregnancy and birth levels are too high. Despite dramatic decreases in teenage pregnancy rates and birth rates in the United Kingdom, this country still has substantially higher levels of adolescent pregnancy, childbearing and abortion than in many other Western industrialized countries.

While much can be learned from the experience and insights of people in the United Kingdom who are engaged in efforts to reduce teenage pregnancy rates, birth rates and sti’s, important lessons can also be learned from other countries. Cross-national comparisons can help to identify factors that may be so pervasive, they are not readily recognized within the United Kingdom; such comparisons can also suggest new approaches that might be helpful, this is the reason for a comparative look with another country with low rates of teenage pregnancy and sti’s.

Why the Rates Are Down

If recent declines in teen childbearing are the result of fewer teens getting pregnant in the first place, the obvious next question is: why? Are fewer teens avoiding pregnancy by abstaining from sex, or are those who are having sex using contraception more successfully?

Not surprisingly, the answer is: both. But deconstructing that answer is critical, because it goes to the heart of a number of relevant and timely public policy questions, among them the debate over public funding for abstinence-only education and for more-comprehensive approaches ().

In 1999, researchers at The Alan Guttmacher Institute (AGI) analyzed the reasons behind the recent declines in the U.S. teen pregnancy rate, using data from two comparable, large-scale government surveys, the 1988 and 1995 cycles of the National Surveys of Family Growth, and recent information on rates of teenage pregnancies, births and abortions. AGI's methodology follows the consensus of a group that was convened by the National Institute of Child Health and Human Development to examine measurement issues regarding teen sexual activity and contraceptive use, which included researchers from AGI, the National Center for Health Statistics, The Urban Institute, Child Trends and the National Campaign to Prevent Teenage Pregnancy.

The AGI analysis concluded that approximately one-quarter of the decline in teenage pregnancy in the United States between 1988 and 1995 was due to increased abstinence. (The proportion of all teenagers who had ever had sex decreased slightly, but nonsignificantly, during this period, from 53% to 51%.) Approximately three-quarters of the drop resulted from changes in the behavior of sexually experienced teens. (The pregnancy rate among this group had fallen 7%, from 211 per 1,000 to 197.)

The researchers considered a number of behavioral changes that could explain why a smaller proportion of sexually experienced teenage women became pregnant in 1995 than in 1988, including the possibility that they were having less sex. However, they found that, overall, there was little change between the two years in how often sexually experienced teenagers had intercourse.

Instead, the researchers found that overall contraceptive use increased—but only slightly, from 78% in 1988 to 80% in 1995. More importantly, teenagers in 1995 were choosing more-effective methods. A significant proportion had switched to long-acting hormonal methods that were introduced to the U.S. market in the early 1990s, namely, the injectable contraceptive (Depo-Provera) and the contraceptive implant (Norplant). By 1995, more than one in eight teen contraceptive users (13%) was using a long-acting method, and primarily because of this shift, sexually active teens became increasingly successful at avoiding pregnancy.

When teens give birth, their future prospects and those of their children decline. Teen mothers are less likely to complete high school and more likely to live in poverty than other teens. Pregnant teens aged 15–19 years are less likely to receive prenatal care and gain appropriate weight and more likely to smoke than pregnant women aged 20 years or older. These factors are also associated with poor birth outcomes. The United States has set a national goal of decreasing the rate of teenage pregnancies to 43 pregnancies per 1,000 females aged 15–17 years in 2010.

There have been significant declines in pregnancy, birth, and abortion rates for teenagers over the past decade.1 From 1990 to 2002, the pregnancy rate among 15- to 17- year-olds decreased 42%, from 77.1 per 1,000 females to 44.4.2 The birth rate declined 45%, from its peak at 38.6 per 1,000 in 1991 to 21.4 per 1,000 in 2005.3 In 2002, more than 750,000 pregnancies among U.S. teenagers, aged 15–19 years resulted in 425,000 live births, 215,000 abortions, and 117,000 fetal losses.4

Teens simply not ready?

•

Although an adolescent girl's body may be ready for reproductive activity in a

functional sense, there can be a marked delay in the incorporation of physical

changes into her psychological and emotional awareness. An increasing number

of young people are confronted by sexual feelings and opportunities for sexual

experimentation for which they are not cognitively or psychosocially prepared;

this lack of preparation increases the vulnerability of American teenagers to the

harmful consequences of early sexual experimentation, pregnancy, and sexually

transmitted disease.

The adolescent birthrate has declined in the majority of industrialized countries over the past 25 years, and in some cases has been more than halved. Similarly, pregnancy rates in 12 of the 18 countries with accurate abortion reporting showed declines. Decreases in the adolescent abortion rate, however, were less prevalent. Conclusions: The trend toward lower adolescent birthrates and pregnancy rates over the past 25 years is widespread and is occurring across the industrialized world, suggesting that the reasons for this general trend are broader than factors limited to any one country: increased importance of education, increased motivation of young people to achieve higher levels of education and training, and greater centrality of goals other than motherhood and family formation for young women.

Bibliography

Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries
Susheela Singh, Jacqueline E. Darroch
Family Planning Perspectives, Vol. 32, No. 1 (Jan. - Feb., 2000), pp. 14-23

By: Frost, Jennifer J.; Forrest, Jacqueline Darroch. Family Planning Perspectives, Sep/Oct95, Vol. 27 Issue 5, p188-195, 8p; (AN 10023759)

Braeken, D. (1994). ‘Sex Education in The Netherlands: a fairy

tale?’. In Forum for Family Planning, Can We Learn from the

Dutch? London: FPA

Ketting, E. (1994). ‘Teenage Pregnancy: a problem that can be

reduced’. In Forum for Family Planning, Can We Learn from

the Dutch? London: FPA