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THE PERILS OF TEEN PREGNANCY by BARRY LAUTON, M.D. Pregnancy rates among teenage girls have reached epidemic proportions. There were over two million teen pregnancies in 1980 and three million in 1995. Because some girls in early adolescence have limited ability for abstract thought, as well as incomplete personality development, they may lack understanding of contraceptive measures and the reality and the consequences of pregnancy. Adolescence means the “period of growing up,” from the Latin word adolescence, meaning to grow up. It begins with puberty and concludes with adulthood. Adolescence has traditionally been regarded as the teenage years, although in the past two decades it may actually start at ages 10 to 12 years depending on individual rates of maturation. Puberty, the start of adolescence, is a stage of sexual maturation in which the child is capable of reproduction. The rates of physical maturation and of emotional maturation do not coincide. Emotional development occurs more slowly than the physical changes. During adolescence, a metamorphosis takes place that is known as maturation. It involves physical, sexual (hormonal), psychological and social changes. Thus, adolescence should not be thought of as the “in-between years” from childhood to adulthood, but rather as a dynamic process by which children become adults. It has been subdivided into Early, Middle and Late phases, the goals of each phase being pertinent to the topic of teen pregnancy. Early Adolescence comprises the years from 11 to 13 in girls and from 12 to 14 in boys. The goal, whether conscious or not, is to deal with puberty. The child must cope with growing sexual development and awareness, along with the physical and emotional changes that result from increased sex hormones and glandular activity. During Middle Adolescence—from ages 14 through 16—girls are further along in their intellectual development. Although aware of contraceptive measures, they may refuse to use them either to defy parents or to test their womanhood. An unwanted pregnancy will play havoc with an adolescent’s already confused world. What will be her plans for the future? How will she deal with angry parents and possible rejection by boyfriend and family? The young pregnant teenager is likely to become socially isolated, especially during her Early or Middle years. In Late Adolescence, a girl’s intellectual powers have usually become honed. For these more mature teenagers, ages 16 to 19, the main goal is to establish an identity separate from their parents. Some teenagers do not succeed and develop an “identity crisis.” Some of these individuals develop a negative identity and some become the “revolutionaries” or those who turn to drugs. Pregnant teenagers in later adolescence are usually better equipped to accept the responsibility for an unplanned pregnancy and not blame others. Pregnant teens opt for marriage and keeping the baby, adoption or—in the majority of pregnancies in this age group—termination of pregnancy. A teenager’s decision often depends on whether or not the baby’s father can support the new family and on the feelings of both sets of parents or caregivers. The decision on whether or not to carry the pregnancy also depends on how much the teenager understands about what parenthood entails and how willing she is to relinquish her freedom. Advice from professionals, such as a social worker or the girl’s physician, is often helpful, especially when generational conflicts and the teenage girl’s natural rebelliousness make it difficult for parents to communicate with their pregnant daughter. To make matters worse, pregnancy that takes place before the end of adolescence is fraught with risks to the young mother and baby. The earlier the pregnancy, the greater the danger. There is a high incidence of toxemia and of septicemia, blood infection. Cesarean section may be necessary. There may be prolonged labor and premature birth. The infants of these young women often may be underdeveloped and may suffer more birth defects than newborns of adult women. (From a biological perspective, the optimal time for having children is between ages 20 and 29, especially ages 20 to 24.) Finally, in addition to the emotional problems outlined above, the irresponsible young pregnant teenager may give inadequate care to the baby or may be reluctant to visit a physician or clinic for sound postnatal and postpartum care. For the pregnant teenager, a sensitive physician or obstetrician with whom the teenager can speak freely and feel comfortable is essential! Frequently, the parents of the girl with an unplanned pregnancy may also benefit from professional help. Finally, some teenagers at age 18 or 19 may choose to become pregnant. They may feel mature enough to handle the demands of childrearing. Only recently has the teenage father been considered in the matter of a teenage pregnancy. Most of these boys are frightened and guilt-laden, but many of them also want to be consulted in the fate of their child. They should be included in the decision-making and, sometimes, may need counseling. Of course, the entire problem of unplanned teenage pregnancy may be prevented by careful education of teenagers throughout the formative adolescent years. For a referral to a Saint Barnabas Medical Center pediatrician or obstetrician, please call 1-888-SBMC-DOC. [ top ] |
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