The birth rate for teenagers for the 12-month period ending June 1996, was 55.6 births per 1,000 women aged 15-19 years, 5% lower than the comparable period ending June 1995 (58.3). Birth rates for teenagers 15-19 years have declined since 1991; the rate for teenagers 15- 17 years for the current 12-month period ending June 1996 (34.9 per 1,000) was 6% lower than for the same period ending June 1995 (37.2). The rate for older teenagers 18-19 years declined 3% from 90.9 to 87.8 per 1,000. Birth rates for teenagers 15-19 years fell 3% for white (49.3), American Indian (76.6) and Hispanic (104.3) women. The rate for black teenagers declined the most at 8% (92.9) (Peters, Martin, and Maurer, 1997).
Despite the decline in birth rates for teens, the problem of teenage pregnancy remains serious in the United States. The number of sexually active teens has increased, causing the overall pregnancy rates to increase (Campaign for Our Children, 1997). Every 26 seconds another adolescent becomes pregnant, and every 56 seconds another adolescent gives birth (Campaign For Our Children, 1997). Today, adolescent pregnancy continues to be a multidimensional problem that has staggering social and economic tolls on individuals, families, and communities within the American society. The profound impact is evident in the physical, psychosocial, and cognitive development of the mother and infant and reaches beyond the price of diapers and formula to the price of shattered families and unrealized dreams (Drake, 1996). Usually, pregnancies of young, unmarried women have the following outcomes:
Compared with adolescents in other industrialized countries, adolescents in the United States do not have higher levels of sexual activity but do have higher rates of pregnancy, abortion, and childbirth (Montessoro and Blixen, 1996).
Abortion rates are decreasing nationally for women in their teen years. Annually, adolescents account for less than one third of abortions and women over 20 account for 69%. White adolescents, or those from more advantaged backgrounds, are more likely to terminate birth. Poverty has been thought to be a consequence of adolescent pregnancy (Roye and Balk, 1996). Also, Smith (1996) found significantly higher pregnancy rates among women with a maltreatment history in the longitudinal data of a sample of 249 teenage women. Since most teen pregnancies end in abortion or live births, adoption is rare and the result is the adolescent raising the child. The best national estimates to the cost of teenage pregnancy are 35 to 50 billion dollars annually. Approximately 53% of funds from the AFDC assistance program (Aid to Families with Dependent Children) are directly spent as a result of adolescent childbearing. In addition to the high costs born by adolescent mothers, the American taxpayer also pays a price for the high rate of early childbearing (Montessoro and Blixen, 1996). An even greater cost is the self perpetuating cycle of the consequences of teenage pregnancy:
The physical, social, and emotional needs of the pregnant adolescent and her developing infant present unique challenges for nurses. Since adolescents move through the developmental tasks of adolescence and pregnancy at different rates, it is important that their developmental stages are determined (Drake, 1996). Three key concepts have been identified by Fedak, Peart, and Connolly (1996) in adolescent learning and can be utilized in designing appropriate interventions:
Campaign For Our children Teen Pregnancy Fact Sheet: Facts, Figures, & Statistics, April 1997.
www.cfoc.org./statsregional.html. (Additional information is available from the National Campaign to Prevent Teenage pregnancy, 2100 M Street, NW Suite 300, Washington, DC 20037.)
Drake P: Assessing developmental needs of pregnant adolescents, J Obstet Gynecol Neonat Nurse 25(6):518-524, 1996.
Fedak JM, Peart DE, Connolly LM: A teen-driven prenatal program, Canadian Nurse 92(1):51- 52, 1996.
Montessoro AC, Blixen CE: Public policy and adolescent pregnancy: a reexamination of the issues, Nurs Outlook 44(1):31-36, 1996.
Peters KD, Martin JA, Maurer JD: Births and deaths: United States, July 1995-June 1996. Monthly vital statistics report 45 (10 supp 2), Hyattsville, MD, National Center for Health Statistics, 1997.
Roye CF, Balk SJ: Evaluation of an intergenerational program for pregnant and parenting adolescents, Maternal-Child Nurs J 24(1):32-40, 1996.
Smith C: The link between childhood maltreatment and teenage pregnancy, Social Work Res 20(3):131-141, 1996.
See Chapter 17 in Essentials of Pediatric Nursing, 5th edition.
See Chapter 20 in Nursing Care of Infants and Children, 5th and 6th editions.
March 15, 2002