Teenage pregnancy

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Teenage pregnancy

A US government poster on teen pregnancy. Over 1100 teenagers,

mostly aged 18 or 19,[1]give birth every day in the United States.

Classification and external resources

Specialty Obstetrics

ICD-10 Z33

ICD-9-CM 650

[edit on Wikidata]

Teenage pregnancy is pregnancy in human females under the age of 20. A girl can become
pregnant from sexual intercourse after she has begun to ovulate which can be before her first
menstrual period (menarche), but usually occurs after the onset of her periods.[2] In well-nourished
girls, menarche usually takes place around the age of 12 or 13.[3]
Pregnant teenagers face many of the same obstetrics issues as other women. There are, however,
additional medical concerns for pregnant girls aged under 15, who are less likely to have become
physically developed enough to sustain a healthy pregnancy or to give birth. [4] For girls aged 1519
risks are associated more with socioeconomic factors than with the biological effects of age.[5]Risks
 of low birth weight, premature labor, anemia, and pre-eclampsia are connected to the biological
age itself, as it was observed in teen births even after controlling for other risk factors (such
as utilization of antenatal care etc.).[6][7] Every day in developing countries, 20,000 girls under age 18
give birth.[8] This amounts to 7.3 million births a year.[8] If all pregnancies are included, the number of
adolescent pregnancies is much higher.
In developed countries, teenage pregnancies are often associated with social issues, including
lower educational levels, higher rates of poverty, and other poorer life outcomes in children of
teenage mothers. Teenage pregnancy in developed countries is usually outside of marriage, and
carries a social stigma in many communities and cultures.[9] By contrast, teenage parents in
developing countries are often married, and their pregnancies welcomed by family and society.
However, in these societies, early pregnancy may combine with malnutrition and poor health care to
cause medical problems.
Teenage pregnancies appear to be preventable by comprehensive sex education and access to birth
control.[10][needs update]Abstinence-only sex education does not appear to be effective.[11]

Contents
[hide]

1Definition

2Effects

o 2.1Mother

o 2.2Child

o 2.3Medical

3Causes

o 3.1Culture

o 3.2Other family members

o 3.3Sexuality

o 3.4Role of drug and alcohol use

o 3.5Early puberty

o 3.6Lack of contraception

o 3.7Age gap in relationships

o 3.8Sexual abuse

o 3.9Dating violence

o 3.10Socioeconomic factors
 o 3.11Childhood environment

o 3.12Media influence

4Prevention

o 4.1Education

o 4.2Abstinence only education

o 4.3Public policy

o 4.4Other

5Prevalence

o 5.1Worldwide

o 5.2Sub-Saharan Africa

o 5.3India

o 5.4Asia

o 5.5Europe

o 5.6United Kingdom

o 5.7United States

o 5.8Canada

6Teenage fatherhood

7History

o 7.1Pre-20th century

o 7.220th century

o 7.321st century

8Society and culture

o 8.1Politics

9See also
 10References

11Further reading

12External links

Definition[edit]

An anti-teenage pregnancy poster

The age of the mother is determined by the easily verified date when the pregnancy ends, not by the
estimated date of conception.[12]Consequently, the statistics do not include pregnancies that began in
women aged 19 if they did not end until on or after the woman's 20th birthday.[12] Similarly, statistics
on the mother's marital status are determined by whether she is married at the end of the pregnancy,
not at the time of conception.

Effects[edit]
According to the United Nations Population Fund (UNPFA), Pregnancies among girls less than 18
years of age have irreparable consequences. It violates the rights of girls, with life-threatening
consequences in terms of sexual and reproductive health, and poses high development costs for
communities, particularly in perpetuating the cycle of poverty. [13] Health consequences include not
yet being physically ready for pregnancy and childbirth leading to complications and malnutrition as
the majority of adolescents tend to come from lower-income households. The risk of maternal death
for girls under age 15 in low- and middle-income countries is higher than for women in their twenties.
[13]
Teenage pregnancy also affects girls education and income potential as many are forced to drop
out of school which ultimately threatens future opportunities and economic prospects. [8]
Several studies have examined the socioeconomic, medical, and psychological impact of pregnancy
and parenthood in teens. Life outcomes for teenage mothers and their children vary; other factors,
such as poverty or social support, may be more important than the age of the mother at the birth.
Many solutions to counteract the more negative findings have been proposed. Teenage parents who
can rely on family and community support, social services and child-care support are more likely to
continue their education and get higher paying jobs as they progress with their education. [14]
A holistic approach is required in order to address teenage pregnancy. This means not focusing on
changing the behaviour of girls but addressing the underlying reasons of adolescent pregnancy such
as poverty, gender inequality, social pressures and coercion. This approach should include
providing age-appropriate comprehensive sexuality education for all young people, investing in girls
education, preventing child marriage, sexual violence and coercion, building gender-equitable
societies by empowering girls and engaging men and boys and ensuring adolescents access to
sexual and reproductive health information as well as services that welcome them and facilitate their
choices.[8]
Mother[edit]

Teen birth rates internationally, per 1000 girls aged 1519, (2008). United States and United Kingdom have
some of the highest teenage pregnancy rates in the developed world.

Being a young mother in a first world country can affect one's education. Teen mothers are more
likely to drop out of high school.[15]However, recent studies have found that many of these mothers
had already dropped out of school before becoming pregnant, but those in school at the time of their
pregnancy were as likely to graduate as their peers.[16] One study in 2001 found that women who
gave birth during their teens completed secondary-level schooling 1012% as often and
pursued post-secondary education 1429% as often as women who waited until age 30. [17] Young
motherhood in an industrialized country can affect employment and social class. Less than one third
of teenage mothers receive any form of child support, vastly increasing the likelihood of turning to
the government for assistance.[18]The correlation between earlier childbearing and failure to complete
high school reduces career opportunities for many young women.[15]One study found that, in 1988,
60% of teenage mothers were impoverished at the time of giving birth.[19] Additional research found
that nearly 50% of all adolescent mothers sought social assistance within the first five years of their
child's life.[15] A study of 100 teenaged mothers in the United Kingdom found that only 11% received
a salary, while the remaining 89% were unemployed.[20] Most British teenage mothers live in poverty,
with nearly half in the bottom fifth of the income distribution. [21] Teenage women who are pregnant or
mothers are seven times more likely to commit suicide than other teenagers. [22] Professor John
Ermisch at the institute of social and economic research at Essex University and Dr Roger Ingham,
director of the centre of sexual health at Southampton University found that comparing teenage
mothers with other girls with similarly deprived social-economic profiles, bad school experiences and
low educational aspirations, the difference in their respective life chances was negligible. [23]

Silouette of a pregnant teen

Teenage motherhood may actually make economic sense for young women with less money, some
research suggests. For instance, long-term studies by Duke University economist V. Joseph Hotz
and colleagues, published in 2005, found that by age 35, former teen moms had earned more in
income, paid more in taxes, were substantially less likely to live in poverty and collected less in
public assistance than similarly poor women who waited until their 20s to have babies. Women who
became mothers in their teens freed from child-raising duties by their late 20s and early 30s to
pursue employment while poorer women who waited to become moms were still stuck at home
watching their young children wound up paying more in taxes than they had collected in welfare.
[24]
Eight years earlier, the federally commissioned report "Kids Having Kids" also contained a similar
finding, though it was buried: "Adolescent childbearers fare slightly better than later-childbearing
counterparts in terms of their overall economic welfare." [24]
According to the National Campaign to Prevent Teen Pregnancy, nearly 1 in 4 teen mothers will
experience another pregnancy within two years of having their first. [25] Pregnancy and giving birth
significantly increases the chance that these mothers will become high school dropouts and as many
as half have to go on welfare. Many teen parents do not have the intellectual or emotional maturity
that is needed to provide for another life.[citation needed] Often, these pregnancies are hidden for months
resulting in a lack of adequate prenatal care and dangerous outcomes for the babies. [26] Factors that
determine which mothers are more likely to have a closely spaced repeat birth include marriage and
education: the likelihood decreases with the level of education of the young woman or her parents
and increases if she gets married.[27]
Child[edit]
Early motherhood can affect the psychosocial development of the infant. The children of teen
mothers are more likely to be born prematurely with a low birth weight, predisposing them to many
other lifelong conditions.[28] Children of teen mothers are at higher risk of intellectual, language, and
socio-emotional delays.[26] Developmental disabilities andbehavioral issues are increased in children
born to teen mothers.[29][30] One study suggested that adolescent mothers are less likely
to stimulate their infant through affectionate behaviors such as touch, smiling, and verbal
communication, or to be sensitive and accepting toward his or her needs.[29] Another found that those
who had more social supportwere less likely to show anger toward their children or to rely
upon punishment.[31]
Poor academic performance in the children of teenage mothers has also been noted, with many of
the children being held back a grade level, scoring lower on standardized tests, and/or failing to
graduate from secondary school.[15] Daughters born to adolescent parents are more likely to become
teen mothers themselves.[15][32] Sons born to teenage mothers are three times more likely to serve
time in prison.[33]
Medical[edit]
Maternal and prenatal health is of particular concern among teens who are pregnant or parenting.
The worldwide incidence of premature birth and low birth weight is higher among adolescent
mothers.[5][15][34] In a rural hospital in West Bengal, teenage mothers between 15 and 19 years old were
more likely to have anemia, preterm delivery, and a baby with a lower birth weight than mothers
between 20 and 24 years old.[35]
Research indicates that pregnant teens are less likely to receive prenatal care, often seeking it in
the third trimester, if at all.[5] The Guttmacher Institute reports that one-third of pregnant teens receive
insufficient prenatal care and that their children are more likely to have health issues in childhood or
be hospitalized than those born to older women.[36]
Young mothers who are given high-quality maternity care have significantly healthier babies than
those who do not. Many of the health-issues associated with teenage mothers appear to result from
lack of access to adequate medical care.[37]
Many pregnant teens are at risk of nutritional deficiencies from poor eating habits common in
adolescence, including attempts to lose weight through dieting, skipping meals, food
faddism, snacking, and consumption of fast food.[38]
Inadequate nutrition during pregnancy is an even more marked problem among teenagers
in developing countries.[39][40] Complications of pregnancy result in the deaths of an estimated 70,000
teen girls in developing countries each year. Young mothers and their babies are also at greater risk
of contracting HIV.[4] The World Health Organizationestimates that the risk of death following
pregnancy is twice as high for women aged 1519 than for those aged 2024. The maternal
mortality rate can be up to five times higher for girls aged 1014 than for women aged 2024. Illegal
abortion also holds many risks for teenage girls in areas such as sub-Saharan Africa. [41]
Risks for medical complications are greater for girls aged under 15, as an
underdeveloped pelvis can lead to difficulties in childbirth. Obstructed labour is normally dealt with
byCaesarean section in industrialized nations; however, in developing regions where medical
services might be unavailable, it can lead to eclampsia, obstetric fistula, infant mortality, or maternal
death.[4][8] For mothers who are older than fifteen, age in itself is not a risk factor, and poor outcomes
are associated more with socioeconomic factors rather than with biology.[5]

Causes[edit]
Culture[edit]
Rates of teenage pregnancies are higher in societies where it is traditional for girls to marry young
and where they are encouraged to bear children as soon as they are able. For example, in some
sub-Saharan African countries, early pregnancy is often seen as a blessing because it is proof of the
young woman's fertility.[41] Countries where teenage marriages are common experience higher levels
of teenage pregnancies. In the Indian subcontinent, early marriage and pregnancy is more common
in traditional rural communities than in cities.[42] The lack of education on safe sex, whether it is from
parents, schools, or otherwise, is a cause of teenage pregnancy. Many teenagers are not taught
about methods of birth control and how to deal with peers who pressure them into having sex before
they are ready. Many pregnant teenagers do not have any cognition of the central facts of sexuality.
[43]

Economic incentives also influence the decision to have children. In societies where children are set
to work at an early age it is economically attractive to have many children. [44]
In societies where adolescent marriage is less common, such as many developed countries, young
age at first intercourse and lack of use of contraceptive methods (or their inconsistent and/or
incorrect use; the use of a method with a high failure rate is also a problem) may be factors in teen
pregnancy.[45][46] Most teenage pregnancies in the developed world appear to be unplanned. [46][47] Many
Western countries have instituted sex education programs, the main objective of which is to reduce
unplanned pregnancies and STDs. Countries with low levels of teenagers giving birth accept sexual
relationships among teenagers and provide comprehensive and balanced information about
sexuality.[48]
Other family members[edit]
Teen pregnancy and motherhood can influence younger siblings. One study found that the younger
sisters of teen mothers were less likely to emphasize the importance
ofeducation and employment and more likely to accept human sexual behavior, parenting,
and marriage at younger ages; younger brothers, too, were found to be more tolerant ofnon-
marital and early births, in addition to being more susceptible to high-risk behaviors.[49] If the younger
sisters of teenage parents babysit the children, they have an increased risk of getting pregnant
themselves.[50] Once an older daughter has a child, parents often become more accepting as time
goes by.[51] The probability of the younger sister having a teenage pregnancy went from one in five to
two in five if the elder sister had a baby as a teenager.[52]
Sexuality[edit]
See also: Adolescent sexuality
In most countries, most men experience sexual intercourse for the first time before their 20th
birthdays.[53] Men in Western developed countries have sex for the first time sooner than in
undeveloped and culturally conservative countries such as Sub-Saharan Africa and much of Asia. [53]
In a 2005 Kaiser Family Foundation study of US teenagers, 29% of teens reported feeling pressure
to have sex, 33% of sexually active teens reported "being in a relationship where they felt things
were moving too fast sexually", and 24% had "done something sexual they didnt really want to do".
[54]
Several polls have indicated peer pressure as a factor in encouraging both girls and boys to have
sex.[55][56] The increased sexual activity among adolescents is manifested in increased teenage
pregnancies and an increase insexually transmitted diseases.
Role of drug and alcohol use[edit]
Inhibition-reducing drugs and alcohol may possibly encourage unintended sexual activity. If so, it is
unknown if the drugs themselves directly influence teenagers to engage in riskier behavior, or
whether teenagers who engage in drug use are more likely to engage in sex. Correlation does not
imply causation. The drugs with the strongest evidence linking them to teenage pregnancy
are alcohol, cannabis, "ecstasy" and other substituted amphetamines. The drugs with the least
evidence to support a link to early pregnancy are opioids, such as heroin, morphine, and oxycodone,
of which a well-known effect is the significant reduction of libido it appears that
teenage opioid users have significantly reduced rates of conception compared to their non-using,
and alcohol, "ecstasy", cannabis, and amphetamine using peers.[45][54][57][58]
Early puberty[edit]
Main article: Precocious puberty
Girls who mature early are more likely to engage in sexual intercourse at a younger age, which in
turn puts them at greater risk of teenage pregnancy.[59]
Lack of contraception[edit]
Main article: Birth control
Adolescents may lack knowledge of, or access to, conventional methods of preventing pregnancy,
as they may be too embarrassed or frightened to seek such information. [55][60]Contraception for
teenagers presents a huge challenge for the clinician. In 1998, the government of the United
Kingdom set a target to halve the under-18 pregnancy rate by 2010. The Teenage Pregnancy
Strategy (TPS) was established to achieve this. The pregnancy rate in this group, although falling,
rose slightly in 2007, to 41.7 per 1000 women. Young women often think of contraception either as
'the pill' or condoms and have little knowledge about other methods. They are heavily influenced by
negative, second-hand stories about methods of contraception from their friends and the media.
Prejudices are extremely difficult to overcome. Over concern about side-effects, for example weight
gainand acne, often affect choice. Missing up to three pills a month is common, and in this age
group the figure is likely to be higher. Restarting after the pill-free week, having to hide pills, drug
interactions and difficulty getting repeat prescriptions can all lead to method failure. [61]
In the United States, according to the 2002 National Surveys of Family Growth, sexually active
adolescent women wishing to avoid pregnancy were less likely than older women to use
contraceptives (18% of 1519-year-olds used no contraceptives, versus 10.7% for women aged 15
44).[62] More than 80% of teen pregnancies are unintended. [63] Over half of unintended
pregnancies were to women not using contraceptives,[62] most of the rest are due to inconsistent or
incorrect use.[63] 23% of sexually active young women in a 1996 Seventeen magazine poll admitted
to having had unprotected sex with a partner who did not use a condom, while 70% of girls in a
1997 PARADE poll claimed it was embarrassing to buy birth control or request information from a
doctor.[55]
In a 2012 study, over 1,000 females were surveyed to find out factors contributing to not using
contraception. Of those surveyed, almost half had been involved in unprotected sex within the
previous three months. These women gave three main reasons for not using contraceptives: trouble
obtaining birth control (the most frequent reason), lack of intention to have sex, and the
misconception that they "could not get pregnant." [64]
In a study for The Guttmacher Institute, researchers found that from a comparative perspective,
however, teenage pregnancy rates in the United States are less nuanced than one might initially
assume. Since timing and levels of sexual activity are quite similar across [Sweden, France,
Canada, Great Britain, and the U.S.], the high U.S. rates arise primarily because of less, and
possibly less-effective, contraceptive use by sexually active teenagers. [65] Thus, the cause for the
discrepancy between rich nations can be traced largely to contraceptive-based issues.
Among teens in the UK seeking an abortion, a study found that the rate of contraceptive use was
roughly the same for teens as for older women.[66]
In other cases, contraception is used, but proves to be inadequate. Inexperienced adolescents may
use condoms incorrectly, forget to take oral contraceptives, or fail to use the contraceptives they had
previously chosen. Contraceptive failure rates are higher for teenagers, particularly poor ones, than
for older users.[57] Long-acting contraceptives such as intrauterine devices,
subcutaneous contraceptive implants, and contraceptive injections (such as Depo-
Provera and Combined injectable contraceptive), which prevent pregnancy for months or years at a
time, are more effective in women who have trouble remembering to take pills or using barrier
methods consistently.
According to The Encyclopedia of Women's Health, published in 2004, there has been an increased
effort to provide contraception to adolescents via family planning services and school-based health,
such as HIV prevention education.[67]
Age gap in relationships[edit]
See also: Age disparity in sexual relationships
According to the Family Research Council, a conservative lobbying organization, studies in the US
indicate that the age gap between teenage girls and the men who impregnate them is an important
contributing factor. Teenage girls in relationships with older males, are more likely to become
pregnant than those in relationships with boys their own age. They are also more likely to carry the
baby to term rather than have an abortion. A review of California's 1990 vital statistics found that
men aged over 19 fathered 77% of all births to girls aged 1618, and 51% of births to girls aged
under 16. Men aged over 25 fathered twice as many children of teenage mothers as boys aged
under 18, and men aged over 20 fathered five times as many children of girls aged under 16 as boys
aged under 16. A 1992 Washington state study of 535 adolescent mothers found that 62% of the
mothers had a history of being raped or sexually molested by men whose ages averaged 27 years.
This study found that, compared with nonabused mothers, abused adolescent mothers initiated sex
earlier, had sex with much older partners, and engaged in riskier, more frequent, and promiscuous
sex. Studies by the Population Reference Bureau and the National Center for Health Statistics found
that about two-thirds of children born to teenage girls in the United States are fathered by adult men
age 20 or older.[68]
Sexual abuse[edit]
See also: Sexual abuse
Studies from South Africa have found that 1120% of pregnancies in teenagers are a direct result of
rape, while about 60% of teenage mothers had unwanted sexual experiences preceding their
pregnancy. Before age 15, a majority of first-intercourse experiences among females are reported to
be non-voluntary; the Guttmacher Institute found that 60% of girls who had sex before age 15 were
coerced by males who on average were six years their senior.[69] One in five teenage fathers admitted
to forcing girls to have sex with them.[70]
Multiple studies have indicated a strong link between early childhood sexual abuse and subsequent
teenage pregnancy in industrialized countries. Up to 70% of women who gave birth in their teens
were molested as young girls; by contrast, 25% of women who did not give birth as teens were
molested.[71][72][73]
In some countries, sexual intercourse between a minor and an adult is not considered consensual
under the law because a minor is believed to lack the maturity and competence to make an informed
decision to engage in fully consensual sex with an adult. In those countries, sex with a minor is
therefore considered statutory rape. In most European countries, by contrast, once an adolescent
has reached the age of consent, he or she can legally have sexual relations with adults because it is
held that in general (although certain limitations may still apply), reaching the age of consent enables
a juvenile to consent to sex with any partner who has also reached that age. Therefore, the definition
of statutory rape is limited to sex with a person under the minimum age of consent. What constitutes
statutory rape ultimately differs by jurisdiction (see age of consent).
Dating violence[edit]
See also: Dating abuse and Teen dating violence
Studies have indicated that adolescent girls are often in abusive relationships at the time of their
conceiving.[74][74][75] They have also reported that knowledge of their pregnancy has often intensified
violent and controlling behaviors on part of their boyfriends. Girls under age 18 are twice as likely to
be beaten by their child's father than women over age 18. A UK study found that 70% of women who
gave birth in their teens had experienced adolescent domestic violence. Similar results have been
found in studies in the United States. A Washington State study found 70% of teenage mothers had
been beaten by their boyfriends, 51% had experienced attempts of birth control sabotage within the
last year, and 21% experienced school or work sabotage.
In a study of 379 pregnant or parenting teens and 95 teenage girls without children, 62% of girls
aged 1115 and 56% of girls aged 1619 reported experiencing domestic violence at the hands of
their partners. Moreover, 51% of the girls reported experiencing at least one instance where their
boyfriend attempted to sabotage their efforts to use birth control. [76]
Socioeconomic factors[edit]
A young poverty-stricken girl clutches her child. Frontispiece illustration from Street Arabs and Gutter
Snipes by George Carter Needham, Boston, 1884.

Teenage pregnancy has been defined predominantly within the research field and among social
agencies as a social problem. Poverty is associated with increased rates of teenage pregnancy.
[57]
Economically poor countries such as Niger and Bangladesh have far more teenage mothers
compared with economically rich countries such as Switzerland and Japan.[77]
In the UK, around half of all pregnancies to under 18s are concentrated among the 30% most
deprived population, with only 14% occurring among the 30% least deprived. [78] For example, in Italy,
the teenage birth rate in the well-off central regions is only 3.3 per 1,000, while in the
poorer Mezzogiorno it is 10.0 per 1,000.[45] Similarly, in the United States, sociologist Mike A.
Males noted that teenage birth rates closely mapped poverty rates in California:[79]

County Poverty rate Birth rate*

Marin County 5% 5

Tulare County (Caucasians) 18% 50

Tulare County (Hispanics) 40% 100

* per 1000 women aged 1519

Teen pregnancy cost the United States over $9.1 billion in 2004, including $1.9 billion for health care,
$2.3 billion for child welfare, $2.1 billion for incarceration, and $2.9 billion in lower tax revenue. [80]
There is little evidence to support the common belief that teenage mothers become pregnant to get
benefits, welfare, and council housing. Most knew little about housing or financial aid before they got
pregnant and what they thought they knew often turned out to be wrong. [47]
Childhood environment[edit]
Women exposed to abuse, domestic violence, and family strife in childhood are more likely to
become pregnant as teenagers, and the risk of becoming pregnant as a teenager increases with the
number of adverse childhood experiences.[81] According to a 2004 study, one-third of teenage
pregnancies could be prevented by eliminating exposure to abuse, violence, and family strife. The
researchers note that "family dysfunction has enduring and unfavorable health consequences for
women during the adolescent years, the childbearing years, and beyond." When the family
environment does not include adverse childhood experiences, becoming pregnant as an adolescent
does not appear to raise the likelihood of long-term, negative psychosocial consequences. [82] Studies
have also found that boys raised in homes with a battered mother, or who experienced physical
violence directly, were significantly more likely to impregnate a girl. [83]
Studies have also found that girls whose fathers left the family early in their lives had the highest
rates of early sexual activity and adolescent pregnancy. Girls whose fathers left them at a later age
had a lower rate of early sexual activity, and the lowest rates are found in girls whose fathers were
present throughout their childhood. Even when the researchers took into account other factors that
could have contributed to early sexual activity and pregnancy, such as behavioral problems and life
adversity, early father-absent girls were still about five times more likely in the United States and
three times more likely in New Zealand to become pregnant as adolescents than were father-present
girls.[84][85]
Low educational expectations have been pinpointed as a risk factor.[86] A girl is also more likely to
become a teenage parent if her mother or older sister gave birth in her teens. [32][50] A majority of
respondents in a 1988 Joint Center for Political and Economic Studies survey attributed the
occurrence of adolescent pregnancy to a breakdown ofcommunication between parents and child
and also to inadequate parental supervision.[55]
Foster care youth are more likely than their peers to become pregnant as teenagers. The National
Casey Alumni Study, which surveyed foster care alumni from 23 communities across the United
States, found the birth rate for girls in foster care was more than double the rate of their peers
outside the foster care system. A University of Chicago study of youth transitioning out of foster care
in Illinois, Iowa, and Wisconsin found that nearly half of the females had been pregnant by age 19.
The Utah Department of Human Services found that girls who had left the foster care system
between 1999 and 2004 had a birth rate nearly 3 times the rate for girls in the general population. [87]
Media influence[edit]
A study conducted in 2006 found that adolescents who were more exposed to sexuality in the media
were also more likely to engage in sexual activity themselves.[88]
According to Time, "teens exposed to the most sexual content on TV are twice as likely as teens
watching less of this material to become pregnant before they reach age 20". [89]

Prevention[edit]
Comprehensive sex education and access to birth control appear to reduce unplanned teenage
pregnancy.[10] It is unclear if a single intervention is most effective.[10]
In the United States free access to a long acting form of reversible birth control along with education
decreased the rates of teen pregnancies by around 80% and the rate of abortions by more than
75%.[90]
Education[edit]
The Dutch approach to preventing teenage pregnancy has often been seen as a model by other
countries. The curriculum focuses on values, attitudes, communication and negotiation skills, as well
as biological aspects of reproduction. The media has encouraged open dialogue and the health-care
system guarantees confidentiality and a non-judgmental approach. [91]
Abstinence only education[edit]

Add promoting abstinence inGhana: No Sex Ad (Anti-HIV/AIDS Signage)

Some schools provide abstinence-only sex education. Evidence does not support the effectiveness
of abstinence-only sex education.[11] It has been found to be ineffective in decreasing HIV risk in the
developed world,[92] and does not decrease rates of unplanned pregnancywhen compared to
comprehensive sex education.[11] It does not decrease the sexual activity rates of students, when
compared to students who undertake comprehensive sexual education classes. [93]
Public policy[edit]
In the U.S., one policy initiative that has been used to increase rates of contraceptive use is Title X:
Title X of the 1970 Public Health Service act provides family planning services for those who do not
qualify for Medicaid by distributing "funding to a network of public, private, and nonprofit entities [to
provide] services on a sliding scale based on income." [94] Studies indicate that, internationally,
success in reducing teen pregnancy rates is directly correlated with the kind of access that Title X
provides: What appears crucial to success is that adolescents know where they can go to obtain
information and services, can get there easily and are assured of receiving confidential,
nonjudgmental care, and that these services and contraceptive supplies are free or cost very
little.[65] In addressing high rates of unplanned teen pregnancies, scholars agree that the problem
must be confronted from both the biological and cultural contexts.
On September 30, 2010, The U.S. Department of Health and Human Services approved $155
million in new funding for comprehensive sex education programs designed to prevent teenage
pregnancy. The money is being awarded "to states, non-profit organizations, school districts,
universities and others. These grants will support the replication of teen pregnancy prevention
programs that have been shown to be effective through rigorous research as well as the testing of
new, innovative approaches to combating teen pregnancy."[95] Of the total of $150 million, $55 million
is funded by Affordable Care Act through the Personal Responsibility Education Program, which
requires states receiving funding to incorporate lessons about both abstinence and contraception.
In the developing world, programs of reproductive health aimed at teenagers are often small scale
and not centrally coordinated, although some countries such as Sri Lanka have a systematic policy
framework for teaching about sex within schools.[42] Non-governmental agencies such as
the International Planned Parenthood Federation and Marie Stopes International provide
contraceptive advice for young women worldwide. Laws against child marriage have reduced but not
eliminated the practice. Improved female literacy and educational prospects have led to an increase
in the age at first birth in areas such as Iran, Indonesia, and the Indian state of Kerala.
Other[edit]
A team of researchers and educators in California have published a list of "best practices" in the
prevention of teen pregnancy, which includes, in addition to the previously mentioned concepts,
working to "instill a belief in a successful future", male involvement in the prevention process, and
designing interventions that are culturally relevant. [96]

Prevalence[edit]
Main article: Prevalence of teenage pregnancy

Teenage birth rate per 1,000 females aged 1519, 20002009 [97]

Worldwide[edit]
In reporting teenage pregnancy rates, the number of pregnancies per 1,000 females aged 15 to 19
when the pregnancy ends is generally used.[98]
Worldwide, teenage pregnancy rates range from 143 per 1000 in some sub-Saharan African
countries to 2.9 per 1000 in South Korea.[45][99] In the United States, 82% of pregnancies in those
between 15 and 19 are unplanned.[100] Among OECD developed countries, the United States, United
Kingdom and New Zealand have the highest level of teenage pregnancy, while Japan andSouth
Korea have the lowest in 2001.[101] According to UNFPA, In every region of the world - including high-
income countries - girls who are poor, poorly educated or living in rural areas are at greater risk of
becoming pregnant than those who are wealthier, well-educated or urban. This is true on a global
level, as well: 95 per cent of the worlds births to adolescents (aged 15-19) take place in developing
countries. Every year, some 3 million girls in this age bracket resort to unsafe abortions, risking their
lives and health.[13]
According to a 2001 UNICEF survey, in 10 out of 12 developed nations with available data, more
than two thirds of young people have had sexual intercourse while still in their teens. In Denmark,
Finland, Germany, Iceland, Norway, the United Kingdom and the United States, the proportion is
over 80%. In Australia, the United Kingdom and the United States, approximately 25% of 15-year-
olds and 50% of 17-year-olds have had sex.[45] According to The Encyclopedia of Women's Health,
published in 2004, approximately 15 million girls under the age of 20 in the world have a child each
year. Estimates were that 2060% of these pregnancies in developing countries are mistimed or
unwanted.[67]
Save the Children found that, annually, 13 million children are born to women aged under 20
worldwide, more than 90% in developing countries. Complications of pregnancy andchildbirth are the
leading cause of mortality among women aged 1519 in such areas.[4]
Sub-Saharan Africa[edit]
The highest rate of teenage pregnancy in the world is in sub-Saharan Africa, where women tend to
marry at an early age.[99] In Niger, for example, 87% of women surveyed were married and 53% had
given birth to a child before the age of 18.[41]
India[edit]
In the Indian subcontinent, early marriage sometimes results in adolescent pregnancy, particularly
in rural regions where the rate is much higher than it is in urbanized areas. Latest data suggests that
teen pregnancy in India is high with 62 pregnant teens out of every 1,000 women. [102] India is fast
approaching to be the most populous country in the world, and increasing teenage pregnancy, an
important factor for the population rise, is likely to aggravate the problem. [103]
Asia[edit]
The rates of early marriage and pregnancy in some Asian countries are high. In recent years, the
rates have decreased sharply in Indonesia and Malaysia,[citation needed] although it remains relatively high
in the former. However, in the industrialized Asian nations such as South Korea and Singapore,
teenage birth rates remain among the lowest in the world.[42]
Europe[edit]
The overall trend in Europe since 1970 has been a decreasing total fertility rate, an increase in the
age at which women experience their first birth, and a decrease in the number of births among
teenagers.[104] Most continental Western European countries have very low teenage birth rates. This
is varyingly attributed to good sex education and high levels of contraceptive use (in the case of
the Netherlands and Scandinavia), traditional values and social stigmatization (in the case
of Spain and Italy) or both (in the case ofSwitzerland).[9]
United Kingdom[edit]
Main article: Teenage pregnancy and sexual health in the United Kingdom
The teen pregnancy rate in England and Wales was 23.3 per 1,000 women aged 15 to 17. There
were 5,740 pregnancies in girls aged under 18 in the three months to June 2014, data from
the Office for National Statistics shows. This compares with 6,279 in the same period in 2013 and
7,083 for the June quarter the year before that. Historically, the UK has had one of the highest
teenage pregnancy and abortion rates in Western Europe.
There are no comparable rates for conceptions across Europe, but the under-18 birth rate suggests
England is closing the gap. The under-18 birth rate in 2012 in England and Wales was 9.2,
compared with an EU average of 6.9. However, the UK birth rate has fallen by almost a third (32.3%)
since 2004 compared with a fall of 15.6% in the EU. In 2004, the UK rate was 13.6 births per 1,000
women aged 1517 compared with an EU average rate of 7.7.
A spokeswoman for the British Pregnancy Advisory Service said: "Contrary to popular perception,
this data shows that the teenage pregnancy rate is falling dramatically in England and Wales. While
the UK has historically had a high teenage conception rate, it is now at its lowest level on record and
not significantly out of step with other European countries.
"We have seen a huge decline in the number of babies born to teenage mothers over the last
decade, in part due to the improvements we've seen in contraception advice and services for
younger women, with straightforward access to abortion services when their chosen method lets
them down. But it also reflects broader societal shifts, with younger women quite rightly expecting
and able to pursue educational and professional ambitions." [105]
United States[edit]
Main article: Teenage pregnancy in the United States
The teenage birth rate in the United States is the highest in the developed world, and the teenage
abortion rate is also high.[45] In 2005 in the U.S., the majority (57%) of teen pregnancies resulted in a
live birth, 27% ended in an induced abortion, and 16% in a fetal loss. [106] The U.S. teenage pregnancy
rate was at a high in the 1950s and has decreased since then, although there has been an increase
in births out of wedlock.[107] The teenage pregnancy rate decreased significantly in the 1990s; this
decline manifested across all racial groups, although teenagers of African-
American and Hispanic descent retain a higher rate, in comparison to that of European-
Americans and Asian-Americans. The Guttmacher Institute attributed about 25% of the decline
to abstinence and 75% to the effective use of contraceptives.[108] While in 2006 the U.S. teen birth
rate rose for the first time in fourteen years,[109] it reached a historic low in 2010: 34.3 births per 1,000
women aged 1519.[1]
The latest data from the United States shows that the states with the highest teenage birthrate
are Mississippi, New Mexico and Arkansas while the states with the lowest teenage birthrate
are New Hampshire, Massachusetts and Vermont.[110]
Canada[edit]
The Canadian teenage birth has also trended towards a steady decline for both younger (1517)
and older (1819) teens in the period between 1992 and 2002.[111] However, teen pregnancy has
been on the rise since 2013.[112]

Teenage fatherhood[edit]
In some cases, the father of the child is the husband of the teenage girl. The conception may occur
within wedlock, or the pregnancy itself may precipitate the marriage (the so-called shotgun wedding).
In countries such as India the majority of teenage births occur within marriage.[42][45]
In other countries, such as the United States and the Republic of Ireland, the majority of teenage
mothers are not married to the fathers of their children. [45][113] In the UK, half of all teenagers with
children are lone parents, 40% are cohabitating as a couple and 10% are married. [114] Teenage
parents are frequently in a romantic relationship at the time of birth, but many adolescent fathers do
not stay with the mother and this often disrupts their relationship with the child. U.S. surveys tend to
under-report the prevalence of teen fatherhood. [115] In many cases, "teenage father" may be a
misnomer. Studies by the Population Reference Bureau and the National Center for Health Statistics
found that about two-thirds of births to teenage girls in the United States are fathered by adult men
aged over 20.[116][117] The Guttmacher Institute reports that over 40% of mothers aged 1517 had
sexual partners three to five years older and almost one in five had partners six or more years older.
[118]
A 1990 study of births to California teens reported that the younger the mother, the greater the
age gap with her male partner.[119] In the UK 72% of jointly registered births to women aged under 20,
the father is over 20, with almost 1 in 4 being over 25.[120]

History[edit]
Teenage pregnancy was normal in previous centuries, and common in developed countries in the
20th century. Among Norwegian women born in the early 1950s, nearly a quarter became teenage
mothers by the early 1970s. However, the rates have steadily declined throughout the developed
world since that 20th century peak. Among those born in Norway in the late 1970s, less than 10%
became teenage mothers, and rates have fallen since then.[121][122]
Pre-20th century[edit]

It is often said that Mary, the mother of Jesus, was aged 12 to 14 when she became
pregnant with Him.[123]

Hildegard of Vinzgouw, the second wife of Charlemagne, was about 14 years old when she
gave birth to her first son in 772 CE.[124]

In 1187 Isabella of Hainault was aged 17 when she gave birth to Louis VIII of France, but she
died in 1190 aged 19 the day after giving birth to twin boys; both boys died 3 days later.[125]

Isabel de Clare and all five of her daughters were teenage mothers. [126]

Violant of Aragon queen consort of Castile and Len gave birth to her first three children
before she was 20 in 1256.[127]

In 1230 Isabel Bigod, daughter of Hugh Bigod, 3rd Earl of Norfolk and Maud Marshal,
became a widow aged 18 with 3 children. She went on to have at least six more children with
her second husband John FitzGeoffrey.[128][129]

Margaret Beaufort, the mother of Henry VII of England, was 13 years old when she gave
birth to him in 1457. The birth was particularly difficult due to her physical immaturity and small
size and she would never give birth again.[130] She feared for her eldest granddaughter, Margaret
Tudor, and would not allow her to be sent to her husband James IV in Scotland until she was
grown enough. Even so, the younger Margaret gave birth to her first three children before she
was 20 in 1509; all three died in infancy.[131]
20th century[edit]

Singer Bobby Darin was born to a teenage mother in 1936, whom he believed to be his
sister for most of his life, until she revealed to him as being his actual mother in his adult life. He
was never told the identity of his true father.[132]
 Child actress turned diplomat Shirley Temple was 19 when she gave birth to her first child,
Linda Susan, in 1948.[133][134][135]

Ann Dunham was 18 when in 1961 she gave birth to her son, Barack Obama,
the 44th President of the United States.[136]

Naomi Judd gave birth to Wynonna Judd on May 30, 1964, the same day her high school
diploma was mailed to her. Wynnona was born Christina Claire Ciminella; Michael Ciminella was
not the biological father but married Naomi to give Christina his surname. [137]

Oprah Winfrey was 14 when she gave birth to a boy, who died shortly after birth. [138]

Dimple Kapadia was 17 when she gave birth to her first daughter and 19 when she gave
birth to her second one.[139]

Tamara Beckwith dropped out of Cheltenham Ladies' College in order to have her
daughter, Anouska Poppy Pearl in 1987. The father was an American Marine. Anouska is now
studying acting in Los Angeles.[140]

Dwayne Michael Carter Jr. (Lil Wayne) had his baby, Reginae, with his now ex-wife Antonia
"Toya" Johnson when he was 15 and she 14.[141][142]
21st century[edit]

Pop singer Fantasia Barrino, winner of American Idol 2004, was 16 when she gave birth to a
daughter named Zion Quari' in 2001; in 2005 she released a controversial song about single
motherhood titled "Baby Mama."[143]

Taylor Hanson, a member of the pop band Hanson, was 19 when his 18-year-old wife
Natalie gave birth to their first child, a son named Jordan Ezra, in 2002. [144]

Yulia Volkova, of the controversial Russian pop band t.A.T.u., was 19 when she gave birth to
her daughter Viktoria Pavlovna Volkova in September 2004; she had spoken publicly about
having an abortion the year before.[145]

Singer and actress Solange Knowles, the younger sister of singer Beyonc Knowles, was 18
when she gave birth to her first child, Daniel Julez Smith Junior, in October, 2004. [146][147]

Asia Nitollano, who joined the pop group The Pussycat Dolls after winning a reality TV show,
was 17 when she gave birth to her daughter in 2005. [148][149][150]

Oscar-nominated actress Keisha Castle-Hughes was 17 when she gave birth to her first
child, a girl named Felicity-Amore, in 2007.[151]

Actress and singer Jamie Lynn Spears, younger sister of pop singer Britney Spears, gave
birth to a daughter in 2008 when she was 17.[152]
 Bristol Palin, 18, the teenage daughter of John McCain's 2008 vice presidential
candidate former[153] Alaskan Governor Sarah Palin, gave birth on December 27, 2008 to a son
named Tripp.[154]

Lou Doillon, French actress and daughter of Jane Birkin, gave birth to son Marlowe Jack
Tiger Mitchell in 2002 at age 19.[155]

Society and culture[edit]

Politics[edit]
Some politicians condemn pregnancy in unmarried teenagers as a drain on taxpayers, if the mothers
and children receive welfare payments from the government.[156][157]