II. Epidemiology
- United States Teen Pregnancy rates have been decreasing for decades, but still remain high, especially among non-white cohorts
- Incidence: 158,000 teenage pregnancies (4%) of a total of 3.6 Million U.S. live births in 2020
- Contrast with 365,000 teenage pregnancies (9%) of 4 Million U.S. live births in 2010
- Non-White or hispanic Teenage Pregnancy rate is twice non-hispanic white rate
- U.S. Teen Birth Rate: 15.4 per 1,000 females age 15 to 18 years (2020)
- Decreasing from peak of 96 per1000 in 1957 (was 60 in 1990, 17.4 per 1000 females in 2018)
- However, rates vary widely throughout the country (from 6.1 in Massachusetts to 27.9 in Mississippi)
- Teen sexual intercourse Incidence has decreased and Contraception use has increased since the 1980s
- Between 2011 and 2015, of 15-17-year-olds, 31% of boys and 28% of girls had sexual intercourse.
- Contrast with 1988 when 60% of boys and 51% of girls reported sexual activity
- Up to 98% of girls reported Condom use
III. Causes: Inadequate Contraception use
- Majority of teenage pregnancies are unplanned
- Inconsistent Condom usage
- Teens conceive on OCP twice as often as adults
- Teens have poorer Maternal and Baby Health Outcomes
- Later Prenatal Care
- Poor nutrition
- Other lifestyle
IV. Complications: Maternal
- Late onset of Prenatal Care
- Hypertensive Disorders of Pregnancy
- Anemia
- Poor maternal weight gain
- Sexually Transmitted Infection
- Substance Abuse in Pregnancy
- Depression in Pregnancy and Postpartum Depression
- Operative delivery
- Intimate Partner Violence
- Socioeconomic adverse effects (esp. in the 20% with recurrent Teen Pregnancy)
- Decreased maternal level of education reached (50% will not complete high school by age 22, compared with 90% if nonpregnant)
- Financial dependence (including government support)
V. Complications: Newborn
- Preterm delivery
- Low birthweight infant
- Childhood behavioral disorder
- Increased infant mortality
VI. Management
- Provide easy access to perinatal care
- Repeatedly screen for high risk conditions
- Substance Abuse in Pregnancy
- Intimate Partner Violence
- Sexually Transmitted Infection (and expedited partner therapy)
- Depression in Pregnancy and Postpartum Depression (as well as other Mood Disorders)
- Anemia and other nutritional deficiency
- Hypertensive Disorders of Pregnancy
- Food insecurity
- Homelessness
- Expand support network
- Involve social workers and case managers
- Involve nutritionists as needed
- Family Home Visiting referral (e.g. NFP, HFA, MECSH) via local public health
- Doula
- Provide counseling regarding pregnancy options (termination, adoption, parenting)
- Schedule appointments and prenatal classes that allow patient to continue education and work
- Allow for drop-in availability for nurse visits and Telemedicine
- Coordinate postpartum visits with Well Child Visits
- Encourage Breast Feeding (facilitate Breast Pumps and other support)
- Ensure reliable Contraception after delivery (e.g. IUD, Contraceptive Implant)
VII. Resources
- Teen Pregnancy (CDC)