Definition Teenage pregnancy is a pregnancy that occurs from puberty, to age 19. Puberty is the stage of adolescence when a girl becomes able to sexually reproduce. The pregnancy may be wanted or unwanted.
A young woman can become pregnant even before her first menstrual cycle. Ovulation, release of an egg from the ovary, may occur before the first period. In the absence of adequate contraception the egg can become fertilised. An estimated 50% of teenagers use no birth control the first time that they have intercourse. Approximately 20% of teenage pregnancies occur within one month after the first sexual experience.
Penetration does not have to occur for a teenager to become pregnant. Sperm can travel long distances. Sperm in the area of the external vulva can cause pregnancy. It is very important for teenagers to have proper knowledge and understanding of a woman's body and how it functions before they become sexually active. However, providing this information is no guarantee that pregnancy will be prevented.
What are the signs and symptoms of the condition? All of the typical symptoms of pregnancy can appear. These symptoms include:
nausea
vomiting
breast tenderness
irregular vaginal spotting or bleeding
stomach cramping or bloating
increased drowsiness and moodiness
Many teenagers do not want to tell anyone about a pregnancy. Therefore, these symptoms often go unnoticed by friends and family. The teenager with irregular periods may not even realise she is pregnant until late in the pregnancy.
What are the causes and risks of the condition? The ultimate "cause" of teenage pregnancy is unprotected intercourse. This results in fertilisation of the egg by the sperm. Risk factors for teenage pregnancy include:
trouble in school or with the law
high-risk behaviours (alcohol and substance abuse)
low academic interest and achievement
single-parent homes
limited job opportunities
social isolation
stress and depression
delinquency
exposure to domestic or sexual violence
a previous unplanned teenage pregnancy
poverty
What can be done to prevent the condition? Programs that are effective in delaying attempts at sexual intercourse are the first line of defence. Parents can have open, honest, and educational talks with teenagers and preteens at home. Schools and healthcare professionals can help parents obtain educational materials. They can also provide advice to teenagers about how to prevent pregnancies.
Prevention should also include easy access to contraception. This can be accomplished through clinics, private medical offices, or emergency departments Emergency contraception should be discussed with all sexually active teenagers.
How is the condition diagnosed? Any teenage woman who presents to a doctor's office with irregular or absent periods should undergo a pregnancy test, (HCG). This should be done even if she says she has not had sexual intercourse. An early diagnosis of pregnancy helps the teenager to adjust emotionally and physically. Early antenatal care is essential.
What are the long-term effects of the condition? The long-term effects of teenage pregnancy are far reaching. Single motherhood is associated with:
continued poverty and welfare dependency
social isolation
a low level of education
limited job opportunities
depression
further unwanted pregnancies
exposure to domestic violence
child behavioural problems
substance abuse
medical problems, such as pelvic inflammatory disease, cervical cancer, and ectopic pregnancy
It can be overwhelming when an infant is born prematurely. The financial, emotional, and medical needs of the infant may be too difficult for a teenage mother and/or her extended family to deal with.
What are the risks to others? Teenage mothers have a much higher risk for:
anaemia
pregnancy-induced hypertension
lower genital tract infections (which may lead to premature labour and delivery)
Infants born to teenage mothers are at higher risk of:
complications of prematurity
accidental trauma and poisoning
minor acute infections
lack of immunisation or vaccinations
developmental delays
behaviour problems
exposure to domestic violence
poverty
What are the treatments for the condition? A pregnant teenager should be tested for STDs and treated if infected. Counselling regarding the signs of early labour should be given. An evaluation by a social worker during the pregnancy is advisable. This is done to determine the home environment in which the infant will live. Standard care within a hospital setting will include monitoring for signs of complications of pregnancy. These include preeclampsia, foetal distress, failure to progress in labour, or the need for caesarean section.
What are the side effects of the treatments? The side effects of treatment depend on how the pregnancy ends. The girl may have a dilatation and curettage, vaginal delivery, or caesarean section. Medications used during these procedures include antibiotics, anaesthetics, labour-inducing agents, labour-prevention agents, and analgesics. Any medication can cause side effects. Bleeding and infection are possible complications.
What happens after treatment for the condition? Contraceptive counselling is highly important in order to prevent repeat teenage pregnancies. Long-acting hormonal contraceptives, such as injectable medroxyprogesterone acetate or levonorgestrel implants, should be considered. The most popular form of contraception for teenagers is birth control pills. However, 68% of teens stop using birth control pills after only 1 year, and 38% of those teenagers become pregnant.
Barrier methods such as condoms, diaphragms, and foam have high failure rates among teenagers. This is due to sporadic and improper use. In the event of unprotected sexual intercourse, teens should be advised that emergency contraception is now available. Abstinence or not having sex should always be discussed.
Author: Eva Martin, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
