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  • Title: Pregnancy in adolescents.
    Author: Davis S.
    Journal: Pediatr Clin North Am; 1989 Jun; 36(3):665-80. PubMed ID: 2660090.
    Abstract:
    The United States must improve its efforts to reduce teen pregnancy. We occupy an alarming position in the developed world from the standpoint of the magnitude of the pregnancy issue. While our society promotes sexuality to sell all sorts of consumer goods, it still refuses for the most part to make contraceptives familiar and available to sexually active teens. The youngest adolescents, 10 to 14 years, are having sex and babies at an increasing rate. Their children will have limited futures. Only by stepping up our efforts to prevent early pregnancy will we make possible a life of opportunity and choice for the young people of our country. Consequences will be costly and tragic if we do not. The distinctive aspects of adolescent pregnancy in the U.S. are reviewed under the rubric of the "new morbidity": illnesses caused by social and life-style conditions. Quantitative trends in adolescent pregnancy are reviewed with statistics such as the annual U.S. Pregnancy rate for girls under 15, 5/1000, 4 times as high as Canada, the only other Western nation with a rate over 1/1000. Other countries pinpoint teen pregnancy, not sexual activity, as the key problem. Some social factors that have increased teen pregnancy are earlier menarche, increasing poverty, more single parent households. Determinants of sexually activity can be classed as individual, family and developmental. Individual factors include economic disadvantage, lack of opportunity and hopelessness and other problem behaviors. Family factors include race and female head of family. Development factors include pre- operational thinking, which prevents future planning and may require experience with sex to learn about it, and egocentricism, which implies an imaginary audience and the personal fable that "it will never happen to me." Teen pregnancy entails the medical risks of higher maternal mortality, cephalopelvic disproportion, anemia, toxemia and hypertension, resulting in prematurity and low birth weight. Social detriments are associate with teen childbearing, such as lower educational achievement, lower lifetime work accomplishment and income, larger families, cognitive delays in child development, lower school success and emotional problems for the child and higher risk for neglect and abuse. The cost of just Aid for Families with Dependent Children, Food Stamps and Medicaid for adolescent headed families is over $16 billion per year. The current administration has approached the problem by cutting funds, teaching the immorality of abortion, reducing the contraceptive availability and recommending teenage abstinence. The most effective programs in the U.S. are comprehensive school-based clinics.
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