Conclusion of teenage pregnancy

A service of the national library of medicine, national institutes of al research council (us) panel on adolescent pregnancy and childbearing; hofferth sl, hayes cd, editors. Risking the future: adolescent sexuality, pregnancy, and childbearing, volume ii: working papers and statistical appendices. Risking the future: adolescent sexuality, pregnancy, and childbearing, volume ii: working papers and statistical detailsnational research council (us) panel on adolescent pregnancy and childbearing; hofferth sl, hayes cd, gton (dc): national academies press (us); tshardcopy version at national academies presssearch term < prevnext >. 4teenage pregnancy and its resolutionsandra thone major source of confusion in the literature dealing with teen pregnancy and childbearing is precisely the distinction between pregnancy and its outcomes. People often say they're referring to teenage pregnancy when they only have information on births. Pregnancy can be resolved in a number of ways, only one of which is a live birth kept by the mother. However, in talking about the problems of teen pregnancy, the problems that have been well-documented to date are those associated with that one outcome—bearing and raising a child as a teenager. Teens are resolved are presented, followed by a discussion of research that sheds light on the factors associated with resolving a pregnancy one way rather than another. A summary and conclusions section closes the oundin 1984 there were 469,682 births to teenagers 15 to 19, 9,965 births to teens under 15. The change in the absolute numbers of births and pregnancies does not adequately indicate the incidence of teen pregnancy and childbearing because it does not take into account changes in the number of teen women. Pregnancy rates1 per 1000 women 15 to 19 rose 9 per- cent between 1974 and 1984; however, because the proportion who were sexually active also rose over the period, the pregnancy rates per 1000 sexually active women 15 to 19 actually fell 8. That is, what is the chance that a young woman would become pregnant as a teenager? Although this probability has been estimated using survey data, since abortions are underestimated in such data, the estimates of pregnancy will be low. The data that are most helpful in showing what the actual risk of pregnancy is among those who are sexually active, breaks the probability down by the length of time since first intercourse and uses a life table methodology to estimate the risk of conception within the first two years after first intercourse (zabin, 1979; koenig and zelnik, 1982). Data collected in 1976 (zabin, 1979) indicate that within the first three months 9 percent of white and 14 percent of black teenage women will have experienced a first premarital pregnancy (table 3. By the end of the first year that figure has risen to 17 percent for whites and 27 percent for blacks, and by the end of two years, 30 percent of whites and 37 percent of black teenagers will have experienced a first premarital pregnancy. Data from 1979 (koenig and zelnik, 1982) suggest a slight increase in the probability of pregnancy during the first two years after first intercourse between 1976 and 1979, with 33 percent of white teenagers and 43 percent of black teenagers experiencing a first premarital pregnancy within two years after first intercourse (table 3. The probability of a first pregnancy is strongly affected by two factors—the age at first intercourse and the use of contraception (tables 4. Pregnancy rates are much for those older at first intercourse and for those who always used a contraceptive method. There was little difference in pregnancy between those who used a prescription and non-prescription methods, as long as they always used it (koenig and zelnik, 1982). In 1982 the total births to teenagers 15 to 19 represented 47 percent of the total number of pregnancies (abortions plus births plus miscarriages [table 3. Resolutions to a premarital pregnancy considered here are abortion versus having a live birth, marriage versus non-marriage, and adoption versus keeping the birth versus abortionthe proportion of teenage pregnancies that ended in a live birth decreased over the past decade (table 3. The percent of teenage pregnancies terminated by abortions climbed rapidly, increasing from 27 percent to 40 percent between 1974 and 1980. Levels of sexual activity among teenagers are actually higher in denmark than in the u. In both countries the pregnancy rates increased initially after liberalization of abortion, but levels in denmark returned to those prior to liberalization, while those in the united states continued to rise. However, while they have leveled off in denmark, they have continued to rise in the united rapid increase in pregnancy and abortion rates in the u. Showed, pregnancy rates among those sexually active actually showed a decline between 1974 and valuable lessons from these data and from a recent study of five western european nations (jones et al. 1986) are that 1) high levels of sexual activity do not necessarily result in high pregnancy rates, given adequate use of contraception, and 2) low birth rates do not necessarily imply high abortion rates; they may simply imply low pregnancy rates. 1985) also found that in each of 5 developed nations they investigated, that 15–17 year olds were much more likely to abort a pregnancy than 18–19 year olds: the difference was smallest in the u. This suggests substantial differences between united states and other countries in choice of resolution for unplanned pregnancies, differences which will be pursued a little geone way of resolving an out-of-wedlock teenage pregnancy is by marrying. Assuming that abortions indicate that a pregnancy was unintended, it can be inferred that most pregnancies to married women are intended. The remainder, 80 to 85 percent, are premarital r, it was pointed out that about 24 percent of sexually active teenagers age 14 become pregnant each year. However, this does not tell us how many teenagers age 14 become pregnant before they reach 20 or marry. According to 1979 survey data (zelnik and kantner, 1980), 16 percent of all metro teenage women 15 to 19 had ever experienced a premarital pregnancy, double that of 1971. Of those sexually active, 33 percent had ever experienced a premarital pregnancy, a small increase since 1971. Thus, when control is introduced for the increase in sexual activity over the decade of the 1970's, the incidence of premarital pregnancy has not changed very much. The major reason for the large apparent increase in premarital pregnancy is the increase in sexual activity. There was an increase in premarital pregnancy among sexually active white teens, but not among black teens. Thus premarital pregnancy has increased, but not as much among those sexually active as it appears from the increase in the population of teenagers. Data from the 1982 national survey of family growth show a slight decline in premarital pregnancy among teenagers between 1979 and 1982, although the difference is probably not statistically significant. In 1982 14 percent of all teen women 15 to 19 had ever experienced a premarital pregnancy, compared with 16 percent in 1979. Of those premaritally sexually active, 30 percent experienced a premarital figures substantially underestimate the true proportion of teenagers who become pregnant before they reach age 20 or marry because abortions are substantially underreported in surveys—by as much as 50 percent. Unmarried black teenage females are the least likely to accurately report their abortions, with unmarried white teenage females only slightly more accurate. Since accurate pregnancy estimates depend on accurate abortion reports, the reports of pregnancy obtained from surveys will be lower than those estimated on the basis of nationally collected data from organizations such as the centers for disease control and the alan guttmacher institute. Suggest that based on 1981 data about 40 percent of white teenagers 15–19 and 63 percent of black teenagers would experience a first pregnancy before reaching age increase in premarital pregnancy over the decade of the 1970s was not due to an increased wantedness of pregnancy. Shows that the proportion of premaritally pregnant teens who were unmarried at resolution who wanted the pregnancy actually declined between 1971 and 1979 for whites and blacks alike, and the proportion using contraception increased (zelnik and kantner, 1980; table 4. However, since the proportion who marry to resolve a premarital pregnancy also declined, the proportion who wanted a pregnancy probably also declined for all premaritally pregnant teen ceptive use generally improved between 1971 and 1982. Shows that the percentage of premaritally sexually active teen women who ever experienced a premarital first pregnancy rose in all contraceptive use statuses 1976–79, except for those who used contraception at first intercourse but not always (zelnik and kantner, 1980). The authors attribute this increase in pregnancy, particularly among the youngest teens, to sharply increased frequency of intercourse and to decreased reliance on the most effective methods of contraception (koenig and zelnik, 1982).

Data are not yet available from the 1982 nsfg to see whether pregnancy rates continued to increase among contraceptive users as well as non-users. We suspect they have not, since pregnancy rates have been ondata from three surveys of young women (bachrach, 1985) show that the proportion of teenage women whose first pregnancy ended in a first premarital birth and who gave their baby up for adoption declined in the 1970s between 1971 and 1976 and leveled off at a low level between 1976 and 1982 (table 8. Legal abortion became an alternative to adoption for many young women who had an unintended pregnancy and who would have adopted if abortion were not available. It has been argued that the reduced social stigma attached to unwed pregnancy caused a shift away from adoption as an alternative to childbirth. Just documenting the changes that have occurred is a difficult chfactors associated with resolution of premarital teen pregnancies: delivering the babyonce a teenager is pregnant, what factors are associated with whether she has an abortion or carries the pregnancy to term and delivers the baby? One study found that the younger the teen at conception, the more likely she was to carry the pregnancy to term (zelnik et al. The true explanation may be the underreporting of abortions in sample surveys of teenagers, which is likely to be most serious for the younger teens. This is a serious problem for analytic study of abortion using sample birth year of the teenager is important. Women are more likely than in the past to resolve a premarital pregnancy by abortion (table 4. Although in the early 1970s black teenagers had a lower likelihood of using abortion to resolve pregnancy, according to these abortion ratios, after 1974 the abortion ratios are similar or slightly higher for blacks than whites. Among young teenagers the ratio of abortions to births is lower for blacks than whites (table 4. Most important family factor associated with delivering a baby versus aborting a pregnancy is parental education. The higher the education of parents, the lower the likelihood that a teenager, once pregnant, will have a live birth (zelnik et al. The most important factors affecting the outcome of the pregnancy was whether the pregnancy was wanted. Girls who said they wanted the pregnancy were much more likely to have a live birth than those who didn't (zelnik et al. Of course, this measure of wantedness was obtained after the resolution of the pregnancy; ex-post facto rationalization may be measured s about abortion and birth are important. The most important factors associated with choice of pregnancy resolution are expectations and academic achievement. Controlling for a number of individual characteristics, such as education of the father, wantedness of pregnancy, importance of religion and race, they found the probability of abortion to be significantly lower in states having relatively generous afdc benefit levels (moore and caldwell, 1977). 1980) examined a group of 299 pregnant teenagers who went to health providers in ventura county, california between 1972 and 1974 for assistance in terminating a pregnancy or for prenatal care. The teens were interviewed twice, once prior to abortion or delivery and a second time six months after the resolution of the pregnancy. However, more young women than those currently living in welfare families would be eligible for welfare if they did give birth; thus the study really measures the effect of actual receipt of welfare benefits, rather than their s associated with marriage before birth (legitimation)young women are less likely now than in the past to resolve a premarital pregnancy by marrying. The proportion of women pregnant before marriage who resolved a premarital pregnancy by marrying dropped by 50 percent between 1971 and 1979 for both whites and blacks (zelnik and kantner, 1980). We look only at pregnancies that end in a live birth, we see that of the total first births to white and black teenagers, the proportion conceived outside of marriage has risen, and the proportion premaritally conceived but legitimated before birth rose then declined to about the same initial level (o'connell and rogers, 1985). As a result, the proportion born out of wedlock rose studies have examined factors associated with whether a premaritally pregnant teenager who subsequently had a birth married prior to that birth: zelnik et al. They found that (among those who were premaritally pregnant and gave birth) white teenagers, those from a higher socioeconomic status background and those who wanted the baby were more likely to marry before bearing the child. Those girls whose families had been receiving financial aid from the state during pregnancy were less likely to marry than those who had not been receiving such assistance (eisen et al. The previous analyses have explored the decisions in temporal sequence: that is, they have looked at, first, the decision to abort or carry a premarital pregnancy to term, and, second, the decision to marry or not marry before birth among those who carry to term. The results suggest that teenagers who make adoption plans are similar to those who have abortions but different from those who take on parenting responsibilities. Data from the 1982 national survey of family growth (bachrach, 1985) show that teenagers under 18, whose parents have had some college, whose baby was born before 1973, and who were living with both parents at age 14 were more likely than other teenagers to place the child for adoption if they had a premarital recent studies (kallen, 1984; resnick, 1984) are funded by the office of adolescent pregnancy programs to look more closely at the factors affecting the decision of unmarried pregnant teens to make an adoption plan. Of those who had made a firm decision to abort soon after learning about pregnancy, 94 percent said that the decision was correct 6 months later. Eisen and zellman (1984) study of pregnant teens in ventura county, california found no significant difference in decision satisfaction 6 months after pregnancy resolution by type of decision made, age or ethnic group. Among teenagers who chose abortion, those with better educated mothers, who had advocated abortion for themselves, who were more approving of abortion in general and who used contraception more consistently following abortion were more satisfied (eisen and zellman, 1984). Young teenagers in the united states have a very high probability of bearing the child, once pregnant, compared to older teenagers or teenagers in other countries (jones et al. Results from the national survey of young women suggested that, net of other factors, girls younger at conception are more likely than older teens to carry a pregnancy to term. The chapter has emphasized differences between blacks and whites, but conclusions about race differences in pregnancy resolution based on analyses of survey data are of necessity weak because of differential reporting of abortion by race in those data sets. During the teen years, the ratio of induced terminations of pregnancy to live births is higher for whites than for blacks. Thus, in this case, using the abortion rate would lead to a completely different and erroneous conclusion about black-white differences. Since birth occurs nine months and abortion approximately 3 months after a conception, a proportion of the young women who conceived (and who eventually bore a child) at the same time as those who conceived and who eventually terminated the pregnancy through abortion would be one year older at outcome. Thus the event (pregnancy) occurred at the same age, but this would not be reflected in the statistics. The figure is smaller for teenagers, as could be expected, since they have not had as much time to have one, let alone two abortions. After adjusting for the fact that abortions performed on teenagers are performed later in pregnancy, which is somewhat more risky, rates of mortality and morbidity from abortion are somewhat lower for teenagers than for adult women. There is only one instance in which teenagers appeared to be at higher risk of injury than adults. Teenagers appeared to be at higher risk of cervical damage than older women (cates et al. Although in 1971 the percentage of teen women who had a premarital second pregnancy was higher 2 years after the outcome of the first premarital pregnancy for those who had an abortion than for those who had a birth, by 1979 the figures were reversed. In 1979 teen women who had terminated their premarital first pregnancy by abortion were less likely to have a second pregnancy within two years than those who had carried the first pregnancy to term (koenig and zelnik, 1982). Finally, results from a 1982 national survey show that fewer than one half of 1 percent of women exposed to the risk of unintended pregnancy, who did not use contraception, mentioned the availlability of abortion as a reason for nonuse (forrest and henshaw, 1983). And conclusionshow women choose to resolve their pregnancies has become one of the major factors determining the number and rate of births to teens. Major question that several researchers have addressed is why individual women choose one form of resolution to a pregnancy over another. Research suggests that a premaritally pregnant teen is more likely to give birth rather than obtain an abortion if she wanted the pregnancy, is of lower socioeconomic status, is unfavorably disposed to abortion, has lower aspirations and educational expectations, receives parental financial assistance, currently lives in a family that receives public assistance, and lives in a state with higher afdc benefit levels.

Viewcite this pagenational research council (us) panel on adolescent pregnancy and childbearing; hofferth sl, hayes cd, editors. Chapter 4, teenage pregnancy and its this pagebackgroundthe resolution of teen pregnanciesresearchsummary and conclusionsrecent activityclearturn offturn onteenage pregnancy and its resolution - risking the futureteenage pregnancy and its resolution - risking the futureyour browsing activity is ty recording is turned recording back onsee more... Best intentions: unintended pregnancy and the well-being of children and r: conclusions and /10766 to get more information about this book, to buy it in print, or to download it as a free pdf. Unintended pregnancy is not just a problem of teenagers or unmarried women or of poor women or minorities; it affects all segments of society. For example, currently married women and those well beyond adolescence report sobering percentages of unintended pregnancy: in 1987, about 50 percent of pregnancies among women aged 20–34 were unintended, 40 percent of pregnancies to married women were unintended, and more than three-fourths of pregnancies to women over age 40 were unintended. In 1988, for example, 82 percent of pregnancies among teenagers were unintended, as were 88 percent among never-married the 1970s and early 1980s, a decreasing proportion of births were unintended at the time of conception. In 1990, about 44 percent of all births were the result of unintended pregnancy; the proportion is close to 60 percent among women in poverty, 62 percent among black women, 73 percent among never-married women, and 86 percent among unmarried consequences of these high levels of unintended pregnancy are serious, imposing appreciable burdens on children, women, men, and families. A woman with an unintended pregnancy is less likely to seek early prenatal care and is ted citation:"conclusions and recommendations. Such consequences undoubtedly impede the formation and maintenance of strong addition, an unintended pregnancy is associated with a higher probability that the child will be born to a mother who is adolescent, unmarried, or over age 40—demographic attributes that themselves have important socioeconomic and medical consequences for both children and adults. Pregnancy begun without planning and intent also means that individual women and couples are not able to take full advantage of the growing field of preconception risk identification and management, nor of the rapidly expanding knowledge base regarding human er, unintended pregnancy leads to approximately 1. Reflecting the widespread occurrence of unintended pregnancy, abortions are obtained by women of all reproductive ages, by both married and unmarried women, and by women in all income categories; in 1992, for example, less than one-fourth of all abortions were obtained by teenagers (centers for disease control and prevention, 1994). Although abortion has few long-term negative consequences for women's health, resolving an unintended pregnancy by abortion can often be a sobering and emotionally difficult experience that no woman welcomes. Recently, these tensions have taken a violent turn, as exemplified by the murder of several individuals associated with clinics that perform committee has found that the extent and consequences of unintended pregnancy are poorly appreciated throughout the united states. Although considerable attention is now focused on teenage pregnancy and nonmarital childbearing, and controversy over abortion continues, the common link among all these issues—pregnancy that is unintended at the time of conception—is essentially invisible. Cause or address only one aspect of the problem and a few vulnerable groups (such as young unmarried women on welfare) are singled out for committee has concluded that reducing unintended pregnancy will require a new national understanding about the extent and consequences of this problem. And third, it speaks as much to planning for pregnancy as to avoiding unintended pregnancy. Bearing children and forming families are among the most meaningful and satisfying aspects of adult life, and it is in this context that encouraging intended pregnancy is so central. The data presented in this report clearly indicate that the lives of children and their families, including those now mired in persistent poverty and welfare dependence, would be strengthened considerably by an increase in the proportion of pregnancies that are purposefully undertaken and consciously begin the long process of building national consensus around this norm, the committee recommends a multifaceted, long-term campaign to (1) educate the public about the major social and public health burdens of unintended pregnancy; and (2) stimulate a comprehensive set of activities at the national, state, and local levels to reduce such campaign should emphasize the fact that reducing unintended pregnancy will ease many contemporary problems that are of great concern. Childbearing by both teenagers and unmarried women would decline, and abortion in particular would be reduced dramatically. At the same time, however, it is important to help the public understand that even if it were possible to eliminate all unintended pregnancies among both teenagers and unmarried women, there would continue to be large numbers of such pregnancies, because it is not only these groups who contribute to the pool. The problem of unintended pregnancy is as much one of public policies and institutional practices as it is one of individual behavior, and therefore the campaign should not try to reduce unintended pregnancies only by actions focused on individuals or couples. Clearly need increased attention and services, reducing unintended pregnancy will require that influential organizations and their leaders—corporate officers, legislators, media owners, and others of similar stature—address this problem as noted above, the committee calls for a campaign that is both multifaceted and long-term, emphases that derive from the data presented in chapters 4 through 7 showing that no single factor accounts for unintended pregnancy and that the underlying issues are very complex. Therefore, only a comprehensive effort will succeed in reducing unintended pregnancy, as has been the case for other national campaigns, such as those to reduce smoking, limit drunk driving, and increase the use of seat belts. Unintended pregnancy will not be reduced appreciably, the committee believes, unless more individuals and institutions make a major commitment to resolving this problem. Or, to put these questions in a slightly different way, which factors best predict unintended pregnancy and should therefore be the main targets of action? The committee proposes a portfolio of activities to prevent unintended pregnancy that, like many public health campaigns, emphasizes basic information and preventive services accompanied by comprehensive program evaluation and research. It also addresses the important domain of personal feelings and ted citation:"conclusions and recommendations. Committee recommends that the campaign to prevent unintended pregnancy stress five core goals broadly applicable to men as well as women and to older individuals as well as teenagers:Improve knowledge about contraception, unintended pregnancy, and reproductive health in general;. Address the major roles that feelings, attitudes, and motivation play in using contraception and avoiding unintended pregnancy;. And scrupulously evaluate a variety of local programs to reduce unintended pregnancy; ate research to (a) develop new contraceptive methods for both women and men, (b) answer important questions about how best to organize contraceptive services, and (c) understand more fully the determinants and antecedents of unintended describing these five goals in more detail, it is important to comment on one particular aspect of contemporary american life that may influence the course of the recommended campaign. Nonetheless, such trends represent major social and cultural changes in the united states and stand in stark contrast to values that were widely shared, at least in theory, throughout much of this century, such as female celibacy before marriage and the unacceptability of young teenagers being sexually active, let alone "living together. Most probably agree that human sexual expression is a normal and central part of both individual pleasure and species survival, yet the serious issues and repercussions arising from sexual relationship—unintended pregnancy and sexually transmitted diseased (stds), in particular—remain difficult to discuss, and in many instances they are considered controversial. Some urge that we turn back the clock and try to restrict sexual activity to marriage; others espouse a new ethic of sexual activity that emphasizes personal freedom and pleasure, finding little that is worrisome even about childbearing out of wedlock; still others stake out positions somewhere ted citation:"conclusions and recommendations. It would be particularly helpful if more people understood that the united states does not differ appreciably from many other countries in its patterns of sexual activity, but it does report higher levels of unintended , abstinence cannot be counted on as the major means to reduce unintended pregnancy. Most of the men and women at risk of unintended pregnancy are beyond adolescence and many are married (chapter 2), and for this large majority, the primary prevention strategy should be increasing contraceptive use. However, the committee unequivocally supports abstinence as one of many methods available to prevent pregnancy. Furthermore, it urges that young teenagers be counseled and encouraged to resist precocious sexual involvement. Sexual intercourse should occur in the context of a major interpersonal commitment based on mutual consent and caring and on the exercise of personal responsibility, which includes taking steps to avoid both unintended pregnancy and stds. This issue is at the heart, however, of the disagreement described , it is critically important that officials at all levels of government and public life not misinterpret or over-react to opposition regarding the strategies to reduce unintended pregnancy that are articulated in this report. In addition, there will still probably be some couples who take the risk of using no contraception at all for a period of time, despite having no clear ted citation:"conclusions and recommendations. For those women who become pregnant unintentionally, access to both high-quality prenatal care as well as to safe abortion is needed in order to present women and couples with a range of options for managing the pregnancy. Recent reports from romania further underscore the horrors that women face when they must live in an environment that fails to provide accessible, medically safe termination of pregnancy (the lancet, 1995). Goal 1: improve knowledge about contraception, unintended pregnancy, and reproductive first focus of the campaign to reduce unintended pregnancy should be to increase knowledge about contraception, unintended pregnancy, and reproductive health generally. Although knowledge alone is often insufficient to increase contraceptive vigilance, it can be viewed as a necessary precondition to other actions needed to reduce unintended committee recommends that the national campaign to reduce unintended pregnancy include a wide variety of strategies for educating and informing the american public about contraception, unintended pregnancy, and reproductive health in general. These activities should be directed to more than just adolescent girls, highlighting the common occurrence of unintended pregnancy among women age 20 and over, and especially among those over age 40 for whom an unintended pregnancy may carry particular medical risks. They must also include messages for boys and men, emphasizing their stake in avoiding unintended pregnancy, the contraceptive methods available to them, and how to support their partners' use of contraception, along with related material on ted citation:"conclusions and recommendations. The need to engage males in reproductive health issues is also underscored by the material reviewed in chapter 7 on violence and nonconsensual sex as contributors to unintended pregnancy. Material should also explain the value of using a condom and a female contraceptive method simultaneously to reduce the risk of both unintended pregnancy and contracting an committee was impressed by the material suggesting that one of the main information and education sources in the nation—the media—is not helping in the task of conveying accurate, balanced information regarding contraception and sexual behavior, and too often highlights the risks rather than the benefits of contraception. Only rarely do they present sexual activity in a manner that supports responsibility, respect, caring and consent, and protection against both unintended pregnancy and stds.

Many television executives decline to advertise contraceptive products because they fear controversy; at the same time, they air advertisements that routinely use sexual innuendo to help sell consumer products and programs that are peppered with sexual activity of all committee recommends that the electronic and print media help to educate all americans about contraception, unintended pregnancy, and related topics of reproductive health. The media should present accurate material on the risks and benefits (including the non-contraceptive benefits) of contraception and should broaden messages about preventing stds to include preventing unintended pregnancy as well. Media producers, advertisers, story writers, and others should also review carefully the overall amount and content of the sexual activity portrayed in the media and balance current entertainment programming so that sexual activity is preceded by a mutual understanding of both partners regarding its ted citation:"conclusions and recommendations. Similarly, advertising of contraceptive products and public service announcements regarding unintended pregnancy and contraception should be more is reason to be optimistic about enlisting the help of the media to reinforce messages about preventing unintended pregnancy. In enlisting the help of the media in preventing unintended pregnancy, it will be important to ensure that any media-based social marketing efforts are theory-based, long-term, and carefully gn goal 2: increase access to second focus of the campaign to prevent unintended pregnancy should stress increasing access to contraception, especially the more effective methods that require contact with a health care professional. The committee was persuaded that one of the reasons for such high rates of unintended pregnancy in the united states is that, through a combination of financial and structural factors, the health care system in the united states makes access to prescription-based methods of contraception a complicated, sometimes expensive proposition. Condoms, the most accessible form of contraception, provide valuable protection against stds but must be accompanied by other contraceptive methods (preferably those that require a prescription) to afford maximum protection against unintended pregnancy. Unfortunately, other accessible nonprescription methods such as foam and other spermicides neither prevent the transmission of stds nor offer the best protection against unintended two recommendations that follow take different approaches to increasing access to contraception: reducing financial barriers and broadening the pool of health professionals and institutions that promote pregnancy planning. These reflect the committee's conclusion that financial barriers may limit access to prescription-based methods of contraception, especially for low-income women, and that, overall, there are too few health professionals who actively ted citation:"conclusions and recommendations. As is the case for the first recommended campaign goal—increasing knowledge—the committee views access to contraception as a basic first step toward reducing unintended pregnancy—a necessary precondition, and a fundamental committee recommends that financial barriers to contraception be reduced by: (1) increasing the proportion of all health insurance policies that cover contraceptive services and supplies, including both male and female sterilization, with no copayments or other cost-sharing requirements, as for other selected preventive health services; (2) extending medicaid coverage for all postpartum women for 2 years following childbirth for contraceptive services, including sterilization; 1 and (3) continuing to provide public funding—federal, state and local—for comprehensive contraceptive services, especially for those low-income women and adolescents who face major financial barriers in securing such first part of this recommendation addresses the need for contraceptive services to be covered more adequately by health insurance, as is increasingly the case for such other preventive intervention as immunizations. The program also laid the foundation for payment to county public health clinics as providers of direct services to the gh evaluation research has not yet defined the precise effects of either medicaid or title x on unintended pregnancy, those studies that have been completed on the effects of publicly-funded family planning services (tly, women who are enrolled in medicaid through some avenue other than aid to families with dependent children (afdc) are typically covered for only 60 days ted citation:"conclusions and recommendations. Moreover, there is no question that these programs help to finance contraceptive services for many women (and some men), the principal means by which unintended pregnancy is prevented. It is essential that such public investment be maintained as part of the overall effort to help men and women avoid unintended pregnancy and achieve their reproductive strength of the title x program, in particular, is that because it is a federally administered program, states are prohibited from imposing restrictions on services at the local level that may limit access to contraception (such as not allowing minors to receive contraceptive care in clinics supported in whole or in part by title x). Without better data regarding their impact on unintended pregnancy or other related outcomes, they remain particularly vulnerable to attack, and it is difficult to know how best to strengthen increase access to contraception, the committee also recommends that the campaign to reduce unintended pregnancy broaden the range and scope of health professionals and institutions that promote and provide steps will help meet this goal. Pediatricians in particular should include pregnancy planning and interconceptional care in their routine scope of practice to increase the proportion of pregnancies that are intended (e. Counseling parents of infants and young children about the benefits of pregnancy planning and spacing for themselves and their young families). Second, administrators should increase the coordination, sometimes even co-location, between basic family planning services and many other health and social programs that typically serve individuals at high risk of unintended pregnancy, such as std clinics, homeless centers, drug treatment programs, wic offices (that is, offices that provide services financed by the ted citation:"conclusions and recommendations. Third, those who provide social work, employment training, educational counseling, and other social services should be taught (in their initial training as well as through in-service programs) about the importance of talking with their clients regarding the benefits of pregnancy planning and how to do so. The data presented in chapter 6 suggest that (1) personal and interpersonal factors exert a profound effect on whether and how well contraception is used, (2) using contraception carefully to avoid pregnancy requires strong, consistent motivation, and (3) such motivation is often based on the perception that pregnancy and childbearing, at a given point in time, are less attractive than other alternatives. In truth, avoiding unintended pregnancy is hard to do; it requires steady dedication over time, often from both partners, and specific skills. A significant portion of the unintended pregnancy experienced by low-income adolescents especially may be due to weak or inconsistent motivation to use contraception. Although pregnancy may not be fully intended in this population, there may be insufficient incentives to practice contraception scrupulously; pregnancy is the common result. Accordingly, the third element of the campaign to reduce unintended pregnancy should emphasize the importance of motivation in using contraception and avoiding unintended pregnancy and the potent role that social environment can play in shaping such motivation at all order to increase the careful and consistent use of contraception, the committee recommends that contraceptive services be sufficiently well funded (through adequate reimbursement rates, increased public-sector support, or both) to include extensive counseling—of both partners, whenever possible—about the ted citation:"conclusions and recommendations. Similarly, school curricula and programs that train health and social services professionals in reproductive health should include ample material about the skills that contraception requires and about the influence of personal factors on successful contraceptive use, along with more conventional information about reproductive physiology and contraceptive influence of motivation in pregnancy prevention also underscores the importance of longer-acting, coitus-independent methods of contraception (e. Although few women and couples rely on these methods (chapter 4), their long-term potential for reducing unintended pregnancy is great. Earlier recommendations offered specific suggestions for increasing knowledge about and access to contraception; all of these efforts, including augmented provider training, should give special attention to longer-acting, coitus-independent a broader level, policy leaders need to confront the likelihood that, particularly for those most impoverished, achieving major reductions in unintended pregnancies may well require that other more compelling alternatives to pregnancy and childbearing be available. Put another way, increasing knowledge about contraception and improving access to it as well may not be enough to achieve major reductions in unintended pregnancy when the surrounding environment offers few incentives to postpone childbearing. This comment is not meant to suggest that unless poverty is eliminated unintended pregnancy cannot be reduced. The point is rather that, in the poorest communities especially, only small reductions in unintended pregnancy will likely be achieved by the usual prescription of ''more education, information and services. Afdc) and other income transfer programs exert an important influence on non-marital gh the committee has no simple recommendation about how to reduce poverty or its corrosive effects on human behavior, it does offer a modest ted citation:"conclusions and recommendations. Committee recommends that, in all of its activities, the campaign to reduce unintended pregnancy should stress the importance of personal motivation and feelings in careful contraceptive use and should highlight the influence of social environment on such motivation. Similarly, the connection between unintended pregnancy and poor social environments should be emphasized more explicitly by academic investigators, journalists and the media, politicians, and other opinion leaders interested in problems of social the section on research below, the committee also notes the need to learn more about the complicated interplay of poverty, motivation, hopes for the future, and their combined effects on contraceptive use and unintended pregnancy. Campaign goal 4: develop and scrupulously evaluate a variety of local programs to reduce unintended aspect of the committee's work that it found most distressing was how little is known about effective programming at the local level to reduce unintended pregnancy. Given all of the public concern about teenage pregnancy, nonmarital childbearing, aids, and high-risk sexual behavior, it is quite remarkable that, even using fairly flexible inclusion criteria, the committee was able to identify fewer than 25 programs whose effects on unintended pregnancy, broadly defined, had been carefully evaluated. This lack of program information indicates that there is great need for research to determine various ways to reduce unintended pregnancy. Accordingly, as the fourth element of the campaign to reduce unintended pregnancy:The committee recommends that public- and private-sector funders support a series of new research and demonstration programs to reduce unintended pregnancy. These programs should be designed to answer a series of clearly articulated questions, evaluated very carefully, and replicated when promising results focus and design of these new programs should be based, at a minimum, on a careful assessment of the 23 programs identified by the committee that have been well enough evaluated to provide an understanding of their effects on specific fertility measures related to unintended pregnancy. Evaluation data from these programs support several broad conclusions: (1) even those few programs showing positive effects report only modest gains, which demonstrates how difficult it can be to reduce unintended pregnancy; (2) ted citation:"conclusions and recommendations. Evaluated programs target adolescents, especially adolescent girls, knowledge about how to reduce unintended pregnancy among adult women and their partners is exceedingly limited; (3) there is insufficient evidence to determine whether "abstinence-only" programs for young adolescents are effective, but encouraging results are being reported by programs with more complex messages stressing both abstinence and contraceptive use once sexual activity has begun; (4) few evaluated programs actually provide contraceptive supplies, which may help to explain the small effects of many programs; (5) only mixed success has been reported from programs trying to prevent rapid repeat pregnancies among adolescents and young women; and (6) virtually none of the evaluated programs attempt to influence the surrounding community environment shaping sexual activity and contraceptive design of these new research and demonstration programs should also reflect four additional themes. Second, available data suggest that multifaceted programs to reduce unintended pregnancy are particularly effective—i. Third theme that should shape these new programs is the need to develop and test out new ways to involve men more deeply in the issue of pregnancy prevention and contraception. In other areas such as the development of programs to reduce cardiovascular risk factors, and it would be wise to build on this experience for the problem of unintended pregnancy (puska et al. These broad themes, several additional issues seem particularly important for attention in a new research and demonstration program directed at reducing unintended pregnancy. These include such questions as: how can women over age 35 and their partners, and especially women over age 40, be reached with information and services to reduce unintended pregnancy? And evaluating these programs will be assisted by better and more plentiful state and local data on unintended pregnancy. State and local data also help to identify areas where unintended pregnancy is especially prevalent and can be valuable supplements to federal t new investments in measuring the effectiveness of intervention programs, the nation risks wasting large sums of money on failed strategies. With regard to the first area, the committee, like many other groups,Suggested citation:"conclusions and recommendations. Reliable methods that are highly effective in preventing both pregnancy and stds are lacking, as are methods that might prevent the spread of stds but permit pregnancy. Their combined leadership and funding will remain crucial for progress in this second area of research focuses on learning about how best to organize contraceptive services and highlights the role that health services research can play in reducing unintended pregnancy.

Two aspects of such research have already been mentioned: the need for better research on the effectiveness of publicly-supported programs that help to finance contraceptive services and the need for new research and demonstration programs at the community level to learn more about how to reduce unintended pregnancy. Many of the same funding entities noted earlier could also take a leadership role on these and related topics in health services third area of research addresses gaps in knowledge about the complex cultural, economic, social, biological, and psychological factors that lie behind widely varying patterns of contraceptive use and therefore unintended pregnancy. There are two basic reasons for the limited state of knowledge about the determinants and antecedents of unintended pregnancy—one methodological and the other theoretical. Even those large-scale surveys that have used representative samples and multiple indicators (such as the nsfg) are limited by their heavy emphasis on social and demographic factors to the virtual exclusion of psychosocial and cognitive theoretical issue, perhaps even more important than the methodological one, is that there is insufficient collaboration across disciplines in research on the determinants and antecedents of unintended pregnancy. Typically, demographers and sociologists have ignored the psychological underpinnings of contraceptive use and unintended pregnancy, psychologists have overlooked the social and demographic factors at work, and economists have limited themselves to economic influences on fertility. Greater interdisciplinary collaboration will be needed to blend these many perspectives into useful predictive er, even though contraception occurs in the context of a social interaction between two partners, few studies have examined men's knowledge, attitudes, and perceptions about contraception and pregnancy; and fewer studies have examined gender differences on these issues. Although there is an obvious overlap between pregnancy prevention and std prevention, there ted citation:"conclusions and recommendations. For example, the condom is very effective in preventing the transmissions of many stds, but it is not as effective as some other methods available for pregnancy prevention. By contrast, oral contraceptives are excellent at preventing pregnancy but offer no protection against stds. So, when only one method is used, rather than a combination that would maximize protection against both consequences, a judgment of some sort is being made between the relative risk and importance of stds versus the relative risk and importance of pregnancy. Research on the determinants of contraceptive behavior has yet to integrate this new dynamic into existing theories used to explain varying patterns of contraceptive use or method gh it is unreasonable to think that it is possible to achieve perfect understanding of all the predictors of unintended pregnancy or the relative importance of each, the scientific community could clearly be farther down the road than it is now. The committee suspects that the effectiveness of intervention programs to reduce unintended pregnancy will remain modest until the knowledge base in this area is material on personal feelings and beliefs summarized in chapter 6 (especially the ethnographic information on motivation) and the many issues covered in chapter 7 (particularly as regards the conflicting views and attitudes in american toward sexual behavior, which in turn may impede candid discussion about contraception, among other things) offer intriguing and very appealing explanations for the observed phenomena. Careful multidisciplinary work is needed to elaborate these inquiries and to integrate them with the more traditional explanations of unintended pregnancy, such as inaccessible contraception or insufficient knowledge about contraception and reproductive health. In all such multivariate research, it will be important to study the determinants of sexual behavior as well as contraceptive use, inasmuch as the two are often intimately connected and may jointly influence the risk of unintended ch in these areas will be enhanced by more refined and differentiated tools to measure the intention status of a given pregnancy. As this report has repeatedly noted, the concept of an "unintended pregnancy" may be too simplistic to capture what is often a complicated set of feelings, ted citation:"conclusions and recommendations. Moreover, the two partners involved may have quite different views regarding the intendedness of a particular conception—a consideration rarely reflected in existing research on unintended pregnancy. Additional work along these general lines merits players can help to lead and finance research on the determinants and antecedents of unintended pregnancy. As this report has documented, unintended pregnancy has far-reaching consequences for children, affecting their health and development ted citation:"conclusions and recommendations. Although groups representing women's issues—reproductive health in particular—have long been vocal in their support of contraception and pregnancy planning, the groups focused on children's issues have been far less visible, especially the maternal and child health community. The national campaign to reduce unintended pregnancy will need their voices as well, not only because of the substance of this issue but also because children's groups have great political appeal and credibility. Report concludes where it began: unintended pregnancy is frequent and widespread, has significant negative consequences, and is poorly understood as a major public health and social challenge. The community-based strategy to prevent coronary heart disease: conclusions from the ten years of the north karelia project. Best intentions: unintended pregnancy and the well-being of children and paperback | $ members save 10% or register to save! Additionally, child welfare advocates long have overlooked the connection between pregnancy planning and the improved well-being of families and communities that results when children are , current issues--health care and welfare reform, and the new international focus on population--are drawing attention to the consequences of unintended pregnancy. In this climate the best intentions offers a timely exploration of family planning issues from a distinguished panel of committee sheds much-needed light on the questions and controversies surrounding unintended pregnancy. The book offers specific recommendations to put the united states on par with other developed nations in terms of contraceptive attitudes and policies, and it considers the effectiveness of over 20 pregnancy prevention best intentions explores problematic definitions--"unintended" versus "unwanted" versus "mistimed"--and presents data on pregnancy rates and trends. The book also summarizes the health and social consequences of unintended pregnancies, for both men and women, and for the children they does unintended pregnancy occur? The committee explores the complicated web of peer pressure, life aspirations, and notions of romance that shape an individual's decisions about sex, contraception, and pregnancy. Sign up for email notifications and we'll let you know about new publications in your areas of interest when they're we invest and e pregnancy research paper. In order to prevent teenage pregnancy, teenagers need to have r, research found that the children of teenage mothers suffered with. Teenage pregnancy research paper - experienced scholars, top-notch services, timely delivery and other benefits can be found in our custom. Teec essay teenage pregnancy research paper thesis statements country essay four other puerto rico storeyed joy of giving week essay wlsessays netgear. Therefore, the purpose of the paper was to explore and get from 'the horses' mouths' whether or not poverty is the major cause of the teenage pregnancy. If you're struggling with writing an essay on the topic of teenage pregnancy, feel free to review the essay example below for writing inspiration. Doing a research paper on any topic can take you a lot of e pregnancy and childbearing have considerable, long-term consequences for teenage parents and their children. Read more about our research project: early parenthood and teenage pregnancy at the university of najim1٭. Teenage pregnancy research proposal paper - get basic recommendations as to how to receive the greatest essay ever papers and essays at. Teenage pregnancy research paper - allow us to take care of your bachelor or master thesis. Teen pregnancy essays teenage pregnancy is thesis statement on teenage pregnancy a thesis for wordpress major concern in today. Background: the objective of the study was to evaluate the maternal and fetal outcome of teenage pregnancy and find the effect of antenatal. The drugs with the strongest evidence linking them to teenage pregnancy are alcohol, cannabis, "ecstasy" and other substituted amphetamines. The good news is that the rates of teenage pregnancy and births in the us have. Given all these noted influential factors that contributes in the increasing trend of teenage pregnancy, many preventive strategies have been created around the. The last 20 years has seen a decline in teen pregnancy and today it is at its lowest. Teen pregnancy has been on the decline, the united states still has the highest rate of teen pregnancy among western industrialized countries. Many people automatically jumped to the conclusion that teen pregnancy rates are rising as well, but the increase in birth rates may simply indicate that more teen moms are opting for adoption instead of , you’ve probably heard it said that if we solve the teen pregnancy problem, we solve much of the abortion problem. Sadly, this demeaning approach to personal behavior just dumps fuel on the teen pregnancy fire and leads to unintended pregnancies, really sick stds, heartaches and sex leads to teen pregnancy. The effects of teen parenthood follow the young fathers and their children throughout their hear about teen pregnancy in movies, in the news, at school and from your parents. You know that teen pregnancy leads to all sorts of problems, to abortions, and to more.