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  • Title: Teenage pregnancy.
    Author: Block RW, Saltzman S, Block SA.
    Journal: Adv Pediatr; 1981; 28():75-98. PubMed ID: 7041565.
    Abstract:
    The pediatrician's role in teenage pregnancy is multifaceted. The problem is a sociologic phenomenon with medical consequences. The pregnant teenager actually represents three patients: the mother, the baby, and the adolescent herself. Prepregnancy nutrition can be improved through pediatric education and advice. Sex education can be improved through the advocacy of pediatricians, who can discuss postponing parenthood until the end of adolescence with many of their patients. Services to prevent pregnancy can be offered by pediatricians. Unfortunately, in Oklahoma it is illegal to dispense contraceptives to minors without parental consent. Pediatricians should work to gain acceptance of laws modeled after the American Academy of Pediatrics' health care for minors policy. Lastly, support services to promote proper parenthood and establishment of families can be developed with pediatric input. The entire problem must be viewed in the context of current social patterns, an understanding of adolescent development, the significance of peer pressures, and the biological changes that make it possible for children to bear children. This discussion of teenage pregnancy focuses on the following: the scope of the problem; identification of the pregnant teenager; causes of teenage pregnancy (biologic factors, the role of peers, societal influences, and contraception); the teenage father; complications of pregnancy; nutrition in teenage pregnancy (protein requirements, vitamins, minerals, and trace minerals); the options for a pregnant teenager; and prevention. Of much concern is the 61% increase in the total number of births to females aged 15 and younger in the U.S. between 1960 and 1977. Teenage pregnancy is not a new problem, yet in the last 20 years several factors have influenced the awareness of the problem and its consequences. Furstenberg identifies several reasons for increased attention devoted to teen pregnancy: an increase in the teenage population; more awareness of population control; more liberal teenage sexual behavior, coupled with a disdain for early marriage, and resulting in increased illegitimate birth; and governmental concern regarding socioeconomic conditions vis-a-vis teenage parenthood and poor educational, vocational, and social stability. Experience shows that the pregnant teenager is unlikely to have completed growth tasks, particularly the acquisition of independent thinking and a mature understanding of self. There is a significant population of females aged 12.5-15 years who biologically and physically are close to being mature women and are capable of becoming pregnant. That population grows larger monthly throughout the schoolage years. Repeatedly, teenagers encountered in practice, clinics, and an outreach educational project have reported that peer pressure is their single greatest motivator in regard to sexual behavior. In the last 20 years, the concept in advertising has been sex and an attitude of acceptance toward sexuality. If society acquiesces to the constant exposure of its young people to sex, it needs to provide a support system that enables the adolescent to deal effectively with sex. Adolescents frequently deny that they can become pregnant, and consequently they fail to even consider contraception. The potential teenage father needs to be prepared by education and counseling for either appropriate delay of his role as a father or coping with its premature occurrence. It appears that with the exception of preeclampsia and a small bony pelvis in the adolescent, the majority of complications of teenage pregnancy are more a function of lack of prenatal care than they are of maternal age. Factors related to nutrition that place the adolescent at risk during pregnancy include low prepregnancy weight, insufficient weight gain, obesity, existing medical complications, dietary faddism, pica, and low income or ethnic variances.
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