TEENAGE PREGNANCY

Teenage pregnancy is a social problem that affects the entire community. It is important to examine the causes of this problem, the effects the problem has on our society and the individual, and some of the possible ways of combating this problem. In every city in the United States teenage girls and boys face premature parenthood. If they chose to accept the responsibility of their actions and not opt for either abortion or adoption, they have to grow up quickly in order to face many harsh realities--these can include early marriage, health risks, interrupted education, lack of employment skills, and, usually, inevitable poverty. Teenage parents are very likely to become dependent on either their families for financial help or the welfare system, and to remain dependent for many years. The emotional devastation on these young people can lead to life-long scars.

Teen pregnancy is a problem that not only affects individuals, but society as a whole. It is important to understand the psychological effects of becoming pregnant at such a young age. The teenage years are acknowledged to already produce emotional turmoil in adolescents; it is therefore difficult to imagine the added stress of an unplanned and often unwanted pregnancy. Just as there are many physical changes during pregnancy, there are also many psychological changes as well. Depression and denial are the first emotional state that most pregnant girls experience. Many initially refuse to accept the reality of the situation, or are overwhelmed by the enormous decision of whether to terminate the pregnancy, keep the child, or give it up for adoption after it is born. Panic and desperation can become all-consuming at this point and some teens may try to terminate their own pregnancy or even to inflict harm on themselves. There are thousands of pregnant teens who commit, or attempt to commit, suicide every year. Although this statistic is appalling, it is an example of the rollercoaster of emotions related to pregnancy.

Birth rates for United States teenagers age 15-19 declined steadily throughout the 1990s, falling from 62.1 births per 1000 teens in 1990 "to 43 in 2002, a reduction of 28%" ("U.S. Birth Rate Reaches Record Low" 2003). The decline in the birth rate for younger teens has dropped 38% from 1990 to 2002. "The reduction in teen pregnancy has clearly been one of the most important health success stories of the past decade," said Health and Human Services Secretary Tommy G. Thompson. "The fact that this decline in teen births is continuing represents a significant accomplishment" (www.cdc.gov, 2003). Although the rate of teenage pregnancy in the United States has declined greatly within the last decade, it is still an enormous problem that should be addressed. The rate is still twice as high as in other industrialized countries, and school administrators still rank it as one of their ten top problems.

Teenage pregnancy is not something that has recently developed. It has always been present, but it is only in the last three decades that we have noticed its growth and severe impact on many aspects of society. Prior to this it was shrouded in secrecy and shame. My mother was an unwed teenage mother in 1945 and she vividly recalled having to hide her condition for as long as was possible and checking herself into a home for unwed mothers when it was no longer possible. In those days it was socially unacceptable for a girl to be pregnant outside of marriage. Young girls refrained from sex out of fear of pregnancy and being socially ostracized. Among those who did break the rules, hurried marriages--often called "shotgun weddings"-- were frequently the norm. A young man had to compete for a girl's affections by at least promising marriage. The sexual revolution of the late 1960s and early 70s changed all that. Sex is no longer seen as a sacred act reserved only for married couples. It is treated casually and lightly and for many is seen as a natural part of the dating process. Contraception and abortion have become much more available, while values in general have hit an all time low. Virginity, once so highly regarded, is fast becoming a rare commodity.

Rates of sexual initiation among adolescents began to rise dramatically in the 1970s with higher percentages of teenagers experiencing sex at younger and younger ages. "55% of U.S. teenagers have participated in sexual activity by the time they are 17, along with 25% of 15 year olds" (Singh 1999 ). Adolescents growing up in this changed environment face a greater challenge than those growing up in the more conservative past

The social change that led to this attitude reversal is not only based on a change in sexual behaviors, but on a change in the very nature of adolescence. The sequence of events that lead from adolescence to adulthood have become longer and more complex. There is an enormous gap between the time a girl begins menstruation and the time she marries. Statistics on marriage show that the average age for a woman to enter into her first marriage is now 25.3 ("Median Age at First Marriage" 2002), while the average age for the onset of menstruation is 12.2. This is an enormous gap of thirteen years. It stands to reason that if girls are capable of having children at a younger age, they are also experiencing sexual feelings at a younger age than did their mothers and grandmothers.

Why then do so many teenagers who are sexually active ignore the issue of birth control? The truth is that many do not. If teens had not increased their use of contraception in recent years, teen pregnancy rates would not have declined. Yet it is still not as prevalent as it should be. Although teens are using contraception much more frequently than they did 15 or 20 years ago and their preferred method--condoms--is widely available in stores, they do not use it consistently. For many there is still the stigma of embarrassment attached to the process of purchasing condoms or going to a doctor to obtain oral contraceptives. There are those who may be unable to afford to have a prescription filled. Others may believe that if you plan ahead, you have already made the decision to have sex and are diminishing the romance or spontaneity of the experience. Pregnant teens often delude themselves into thinking that if they are swept away by passion, then they aren't really to blame; it's simply an accident. A costly accident. "In the United States, the annual cost of teen pregnancies from lost tax revenues, public assistance, child health care, foster care, and involvement with the criminal justice system is estimated to be about $7 billion" ("Teen Pregnancy 2003)

The fact remains that unplanned pregnancies can create health risks for both mother and baby. "Teens too often have poor eating habits, neglect to take a daily multivitamin, and may smoke, drink alcohol and take drugs, increasing the risk that their babies will be born with health problems. Studies show that teens are less likely than older women to gain an adequate amount of weight during pregnancy (25 to 35 pounds is recommended). Low weight gain increases the risk of having a low-birthweight baby" (Berenson, A., 1997). Low birth weight babies can be mentally retarded, have organs that are not fully developed, which can result in complications such as bleeding in the brain, respiratory distress syndrome, and intestinal problems. There is also a risk of dying in early infancy that is much higher than normal weight babies. A teenage mother is more at risk of pregnancy complications such as premature or prolonged labor, anemia and high blood pressure. These risks are even greater for teens that are less than 15 years old. Pregnant teens are least likely of all maternal age groups to get early and regular prenatal care. If a girl is embarrassed to be seen at a clinic or worried about a lack of confidentiality, she may not seek care, putting herself and her baby at risk

Sexually transmitted diseases are another pregnancy risk factor. Three million teens are affected by STDs each year, out of 12 million cases reported. These include chlamydia (which can cause sterility), syphilis (which can lead to blindness, death, and death to the infant) and AIDS, which is fatal to the mother and can infect the unborn infant.

How to prevent teen pregnancy from occurring has been a question for more than thirty years. Preventing teenagers from having unplanned pregnancies is an important goal that has been pursued since the 1970s when births to teenagers were first diagnosed as a major social problem. More and more, local, state and national efforts are focusing on the prevention of underage pregnancy, with the emphasis on sex education and family planning services. The truth of the matter is that sex education, though available in these enlightened times, is often too little and too late to have much of an impact. Many girls have absolutely no contact with family planning services until they are already pregnant. In an age when sex seems to be the most openly discussed topic in the media as well as in ordinary people's daily lives, parents still struggle with what and how much to tell their children. Many avoid the issue altogether by leaving it in the hands of the educational system. When it comes to deciding how to approach the topic in schools, however, the subject is a potential battleground of different approaches and viewpoints.

Getting a great deal of media attention in recent years has been the "abstinence-only" programs, endorsed by President Bush. "Congress spent $100 million in 2001 for abstinence sex education programs...Bush has said that funding should match what the federal government spends on dispensing contraceptives to teenagers at public health clinics, about $135 million a year" ((Brogan 2002). Abstinence-only programs teach that premarital sex is wrong no matter what the circumstances, and, in order not to present a mixed message, offer no information concerning contraception. Supporters of this method see the declining birth rates as proof that the abstinence programs are working, and refute the "widely accepted claims that the decrease in pregnancy is primarily due to the increased use of contraception" (Pardue 2002).

On the flip-side is what is known as comprehensive sex education. This method approaches sex education as something every teen needs to know, teaching "practical information about sex. Generally this focuses on how contraceptives work, where to get them, and why they are important" (Coeyman, 2003).

Abstinence-only supporters believe that comprehensive sex education encourages promiscuity, though there is no actual data to support such a theory. Those that favor comprehensive sex education believe that in not supplying teens with basic information about contraception, the risk of teenage pregnancy will inevitably increase. The two sides can find only one thing to agree on--that teenage pregnancy must be prevented. A middle ground needs to be reached.

Our educational system is faced with an enormous challenge in helping young people who are the future of our society. They must be guided safely through adolescence, probably the toughest, most emotionally traumatic age of all. Parents want their children to know how to make healthy, responsible choices about sexual issues but don't feel comfortable answering their children's questions. Most parents want their children to learn about sex where they learn about everything else--in school, where their questions can be answered correctly. Schools nationwide should include a course in sex education as part of their regular curriculum, including schools in rural areas which may not have available social services. Parents should do their part by providing more psychological support. Sex education programs should try to learn what facts young people already know about sex, and then add to the existing knowledge by correcting the many misconceptions they will undoubtedly have. There should be more interaction in the classroom, with students genuinely encouraged to ask questions. More discussion into the topics of love, values, and future ambitions that could be derailed by a wrong decision made now--not just the basic biological mechanics of sexual intercourse or "No, it's wrong" morals--but to understand what truly is involved in having a physical relationship with someone. Adolescents need to know what kind of relationships there are, about love and commitment, marriage and partnership, laws relating to sexual behavior and relationships, as well as the whole range of religious and cultural views on sexuality. The issue of self-esteem should also be delved into. Many adolescents become involved in sex--and sometimes promiscuity--simply because of low self- esteem, and the feeling of empowerment or liberation from parental authority that sex gives them. This is sensitive territory, one that should ideally be handled at home by parents, but in the majority of homes this is not going to happen. Therefore, it must be tackled within the educational system, and by teachers who are comfortable with the subject and not easily embarrassed. In addition, young people should be provided with information about the various methods of contraception, abortion and adoption, as well as sources of advice and support available in their community. It is often just as difficult for teens to communicate with their parents on the subject of sex as it is for parents to talk freely on the subject. Therefore, this writer would also include a regular parental involvement group, held in the evening, where parents and teens could have real, meaningful discussions about sex, contraception, pregnancy, etc. This might make it easier to establish an open dialogue at home. It would take only a slight modification of the sex education programs already in place to implement such a proposal. Abstinence prior to marriage should, of course, be stressed as the best option, but not at the expense of ignoring human nature or practical information about contraception.

As remedies to this age old problem are examined and discussed, it becomes more and more evident that we, supposedly one of the most advanced countries on the planet, have to be more zealous in reducing the number of teenage girls who become pregnant each year. Although methods have improved greatly over the past three decades, girls are still not receiving all the support that they could in avoiding unwanted pregnancies. Early in 2003, the U.S. Senate rejected a bill that would have required insurance companies to cover birth control (Holland 2003). Currently, only a third of all insurance companies offer this type of coverage, yet most cover Viagra, the popular male potency drug. This perpetuates the double standard that the sexual needs of men are more important than female reproductive freedoms. We need to concentrate our energies on preventing the preventable. Three quarters of all teen pregnancies are unwanted. If we made girls (and boys) consistently aware of how to prevent pregnancy, we would continue to lower the teenage pregnancy rate. Better education would also make those teens who do become parents better able to cope with the situation. Teen pregnancy should be treated as a disease that must be treated with education and improved knowledge. The consequences of teen pregnancy on our society are far too important to ignore.