Diseases & Conditions
Contraception and Adolescent Pregnancy
Although adolescents may engage in sexual activity, many sexually active adolescents are not fully informed about contraception, pregnancy, and sexually transmitted diseases, including human immunodeficiency virus (HIV) infection. Impulsivity, lack of planning, and concurrent drug and alcohol use decrease the likelihood that adolescents will use birth control and barrier protection.
Any of the adult contraceptive methods may be used by adolescents (see Family Planning: Contraception ). Problems with adolescents and contraception revolve around adherence. For example, many adolescent girls who are taking oral contraceptives forget to take them regularly or stop using them for various reasons—often not substituting another form of birth control. Some girls do not feel empowered to ask their male partners to use condoms during sex. Boys generally prefer not to use condoms.
Because adolescence is a transitional stage in life, pregnancy can add significant emotional stress. Pregnant adolescents and their partners tend to drop out of school or job training, thus worsening their economic status, lowering their self-esteem, and straining personal relationships.
Pregnant adolescents, particularly the very young and those who are not receiving prenatal care, are more likely than women in their 20s to have medical problems such as anemia and toxemia. Infants of young mothers (especially mothers younger than 15 years) are more likely to be born prematurely and to have a low birth weight. However, with proper prenatal care, older adolescents have no higher risk of pregnancy problems than adults from similar backgrounds.
Having an abortion (see Family Planning: Abortion ) does not remove the psychologic problems of an unwanted pregnancy—either for the adolescent girl or her partner. Emotional crises may occur when the pregnancy is diagnosed, when the decision to have an abortion is made, immediately after the abortion is performed, when the baby would have been born, and on the anniversaries of that date. Family counseling and education about contraceptive methods, for both the girl and her partner, can be very helpful.
Parents may have different reactions when their daughter says she is pregnant or their son says his girlfriend is pregnant. Emotions may range from apathy to disappointment and anger. It is important for parents to express their support and willingness to help the adolescent sort through his or her choices. Parents and adolescents need to communicate openly about abortion, adoption, and parenthood—all tough options for the adolescent to struggle with alone.
Last full review/revision February 2003
Source: The Merck Manual Home Edition