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Am J Prev Med. 1991 Jan-Feb;7(1):47-52.

Adolescent pregnancy in the United States: a review and recommendations for clinicians and research needs.

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UCLA School of Public Health 90024.


Adolescent pregnancy, often unplanned and unwanted, has a negative impact on the physical, emotional, educational, and economic condition of the pregnant teenager. Forty percent of the one million adolescents who became pregnant in 1986 chose abortion, and, of the remainder, 61% were unmarried. Teenage mothers in greater numbers and at younger ages are opting to keep and raise their children. In 1987 over $19 billion in federal monies were expended on families begun when the mother was a teenager. The preferred approach to this problem is prevention of teenage pregnancy rather than abortion, with emphasis on sex education and access to family planning information and contraceptive devices for both females and males. Sex education in schools is presented in widely varying formats; in fact, prevention of pregnancy may not even be presented. Family planning clinics are subject to the whims and biases of the funding agencies. Clinicians have an important role in providing guidance for teenage patients and their parents, but can also influence school and community leadership to ensure that all teenagers receive sound sex education in school programs and that family planning agencies are permitted to counsel teenagers and provide contraceptive devices.


Of the close to 1 million teenagers in the US who became pregnant in 1986, over 470,000 opted to continue the pregnancy. 38% of these births were to females 17 years of age or younger, and 61% of the teen mothers were unmarried. Such untimely childbearing has substantial negative effects on the teenage mother's physical, emotional, educational, and economic condition. In addition, children born to such mothers experience compromised physical and intellectual attainment due to parental immaturity and the related economic and social instability. There are costs to society as well; in 1987, over US$19 billion in federal funds was spent to support families begun when the mother was a teenager. The most effective approach to this problem is prevention of teenage pregnancy through sex education, access to family planning information, and provision of contraception to both males and females. 30% of sexually active unmarried 15-19 year olds reported never-use of contraception in the National Survey of Family Growth, and this rate is higher among black adolescents. Although 60% of 12-17 year olds interviewed in 1986 reported receiving some form of sex education through the public schools, only a third had been exposed to a comprehensive presentation of reproduction, sexual development, and birth control. Use of family planning clinics is consistently associated with a large increase in the number of teenagers using more reliable forms of contraception such as the pill as well as substantial reductions in non-use of birth control. Authoritative guidance on the part of family planning providers has been shown to produce higher rates of contraceptive use than an independent decision-making style. Other pregnancy prevention strategies with documented potential include offering contraceptive information and prescriptions in secondary schools or a combination of sex education and counseling in the schools with services in a nearby free-standing location.

[Indexed for MEDLINE]

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