9 May

More than one million pregnancies occur each year among American teenage females, which is equivalent to one adolescent pregnancy beginning every 35 seconds. Since the majority of these pregnancies are unplanned and unwanted, it is no surprise that they frequently create considerable psychological anguish, serious economic consequences, and even health risks that are too often ignored or misunderstood.A few background statistics can highlight the scope of this epidemic.30,000 pregnancies occur annually among girls under fifteen years of age.400,000 American teenagers have abortions each year, accounting for more than one-third of all abortions performed in this country.Six out of ten teenage females who have a child before age seventeen will be pregnant again before age nineteen.With one out of twenty adolescent females having a baby each year, America’s teenage birth rate is the highest in the western hemisphere, double the rate of Sweden, and is an astonishing seventeen times higher than Japan’s.Four out of ten girls now fourteen years old will get pregnant in their teens.These statistics show how widespread the problem of unintended teenage pregnancy is, but to understand why it is a problem, we need to examine some additional aspects of the consequences of teenage pregnancy. To begin with, there are increased health risks associated with teenage pregnancy, particularly among younger teens (those in the thirteen- to sixteen-year age group). For example, babies of teenage mothers have an increased chance of being underweight and are nearly twice as likely to die in infancy as those born to women in their twenties. In addition, teenagers tend to have more medically complicated pregnancies — including miscarriages, toxemia, and hemorrhage — as well as a higher risk of maternal death than women in their twenties.Possibly even more alarming than these medical risks are the socioeconomic consequences of unintended teenage pregnancy. Even though it is now illegal to expel students who are pregnant or who are mothers from public schools, most teenage mothers who keep their babies drop out of school and don’t return. Largely as a result of this abrupt withdrawal from formal education, women in this group are far less likely than their peers to enter the job market or to gain regular employment. It is no surprise, then, that these teenage mothers are overrepresented in poverty statistics and are apt to become largely dependent on government services and support.Unmarried teenage girls who find themselves pregnant are confronted by a series of psychologically complicated choices, as well. They often get little or no support — either emotionally or financially — from the child’s father. They must decide whether to have, an abortion (which sometimes produces intense feelings of guilt and anguish) or have the baby. If they have the baby, they then must decide to keep it or put it up for adoption; today, fewer than 5 percent of unwed teenage mothers choose adoption as a course of action. In other cases, their partners may pressure them to do something they don’t want to, thus creating additional pressures and uncertainties. Here’s how one seventeen-year-old described her dilemma:When I found out I was pregnant, my boyfriend insisted that we get married and have the baby. I had no interest in marrying him or in being saddled with an infant at age eighteen, so I refused. But his parents hired a lawyer to try to stop me from having an abortion, and the whole thing wound up being a nightmare for me and my parents. Fortunately, I got the abortion and dumped my so-called boyfriend, so I’ll be going to college next year instead of playing mommy.Some teenagers, unlike the one quoted above, find themselves rushed into unanticipated marriage as a result of a pregnancy. Unfortunately, these marriages are much likelier than most to end in divorce or desertion, and there is a suicide risk among these young women that is considerably higher than in the general population.There is relatively little research describing the consequences of unintended teenage fatherhood. This may be partly because it is difficult to identify these individuals for study and partly because they are not socially or economically linked to the pregnancy outcome in the same ways mothers are. However, the available evidence (summarized concisely in reports from the Alan Guttmacher Institute and the Ford Foundation) shows that males who become fathers while in their teens tend to have lower income and less educational attainment than peers who postpone fatherhood until their twenties. Nevertheless, the impact of teenage pregnancy is considerably less on males than on females.Clearly, many adolescent males continue to regard the ultimate responsibility for contraception as the female’s, generally feeling that an unintended pregnancy could have been prevented and thus is the “fault” of the female — in other words, that it is “not their worry.” Others feel a joint responsibility that extends only to offering to share (or perhaps pay entirely) for the cost of an abortion; to them, this gesture is an honest acknowledgment of their involvement and willingness to help, but it is involvement of the most limited sort. In fact, as the noted sex educator Sol Gordon points out, “almost 90 percent of all teenage boys who make a teenage girl pregnant abandon her.”While there are no easy solutions to the problem of unintended teenage pregnancy, it appears that misinformation or complete lack of information is a key factor. At present, only one-third of American junior and senior high schools offer sex education courses, and many of those offered are remarkably incomplete. Since many of the sex education courses are given only to older teenagers, their preventive function is lessened considerably. Those people who believe that sex education should be taught in the home — while voicing a fine idea — overlook the reality of the situation today. Research indicates that only about 10 percent of parents discuss sexuality with their teens beyond simply saying “don’t.” On the other hand, a 1982 study by Zelnik and Kim demonstrates that among unmarried sexually active teenage women, those who have had sex education courses have fewer pregnancies than those who haven’t.Almost all authorities agree that greater responsibility for contraceptive use by the adolescent male is a major element in the effort to reduce the rate of unintended teenage pregnancy. First, educating males about contraceptive options at an early age seems warranted since studies suggest that this information leads to better contraceptive use. Although teenage males are generally unwilling to admit to ignorance or misinformation about sex, it is not unusual to find fifteen- or sixteen-year-old boys who believe that a diaphragm should be removed right after intercourse, or who don’t know the fertile days in a female’s menstrual cycle. Such education need not be restricted to schools — it can be done at home, in church-affiliated programs, or as part of community projects. Education must be practical, too, explaining how and where to purchase contraceptives, why it’s important to discuss birth control with a partner, and why consistent contraceptive use is necessary.Another important step is to provide males (as well as females) with a better view of how birth control practices relate to their own lives. For instance, teens must recognize how rigid sex roles or the risk of parental disapproval can influence their contraceptive behavior. In addition, teens need to be aware that the risk of contracting a sexually transmitted disease is materially reduced by use of certain contraceptive methods. This is important not only because it encourages the teenage male to use contraception, but because the male’s expression of interest and concern about contraception encourages his partner to find and use an appropriate method as well. In addition, teenagers need incentives to engage in responsible birth control practices.Some authorities suggest public campaigns geared at urging teens to say “no” to having intercourse. This approach might be effective with some adolescents, but would probably not be realistically effective with the majority of teenagers, given today’s , patterns of sexual behavior in our culture: it is hard to put a genie back in a bottle. Also, such an approach runs the risk of being repressive — it is, after all, an attempt to frighten teens into abstinence — and this may produce a backlash. Indeed, anti-drug and anti-cigarette campaigns have often been discredited by teens on this basis. In any case, since it is unlikely that the majority of sexually experienced teenagers will become celibate en masse, it is necessary to provide teens with positive role models toward appropriate contraceptive use and a more effective view of the ways in which responsibility in sexual behavior is important to their welfare.*95\342\2*

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