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Pregnancy In College: Risks And Prevention

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Introduction

Teenage pregnancy and childbearing pose a real challenge to the health system, society and families. It can be defined as a pregnancy in girls aged less than 20 years old (WHO). In the analysis of who is more likely to become a teenage mother, it is possible to observe some characteristics in almost all mothers. Firstly, lower socioeconomic status and lower maternal education seem to be primary risks factors and additionally, girls whose mother gave birth as a teenager are more likely to become pregnant at a young age. Furthermore, it is necessary take into account the unavoidable stress of being an adolescent, which can often lead to low self-esteem, poor school performance, poverty and, lack of a strong parental presence, which are all risks factors for young teenagers. Most of the time, when teenagers decide to become sexually active they do not know how to protect themselves and they fail to use appropriate contraception. It is common that before becoming pregnant, the mothers have a history of using illegal substances such as drugs, tobacco, and alcohol, and even though most of them interrupt this behavior during the pregnancy, they start again right after birth, creating health risks for the newborn. Additionally, it can be observed that women who belong to the social class V -unskilled- incur approximately in 10 times the risks compared to women from class I -professionals. Also, it can be linked at the V social class the high unemployment rate among these young mothers, which is almost always correlated with the interruption of their studies during the pregnancy that more often than not, they never get started again.

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Relevance in Europe and Statistics

The World Health Organization (WHO) has estimated that every year almost 16 million females aged 15-19 and one million girls aged less than 15 give birth. In Europe, the United Kingdom remains to be one of the countries with the highest rates. Conception rates in women aged between 15 and 17 in 2012 were 27. 7 per 1000 compared with 47. 1 per 1000 in 1998, so even though the evidence of a clear decrease is present, the risk is still very high. It is possible to see a decrease also in the termination of pregnancy rates, that from 19. 8 per 1000 in 2007 scaled down to 11. 7 per 1000 in 2013.

It is interesting and yet also worrisome to notice how in all five categories the number of women aged 15-19 is higher than the women aged 20-29. In the first category ‘less than upper secondary education’ the highest number is 92 in Portugal and the lowest is 24 in Finland. For the second category ‘not working’ the highest is Spain with 70 and Portugal is the lowest with 37. For the third category ‘without partner,’ Ireland has the higher score with 42 and Greece is the lowest with 4. The fourth category ‘neither women or partner working’ the highest score is 46 in Ireland and the lowest are Greece and Austria with a score of 6. The fifth and last category ‘household income in lowest 20%’ it can observed the highest score in the Netherlands with 78 and the lowest in Denmark with 24. In order to focus on the United Kingdom here, taking a look at this graph that compares England, Scotland and Wales for women aged less than 16, 18 and 20 from 1994 to 2010, it is notable a decrease for all the considered groups.

Maternal Outcomes

One of the risks is Anemia, ‘that is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin’, which seems to be a greater risk for young women. Additionally, there is also a higher risk of gestational diabetes, which causes high blood sugar severely affecting the pregnancy and the baby’s overall health. Furthermore, several studies discussed the occurrence of various infections among pregnant teenagers such as urinary tract infections, chorioamnionitis, and pyelonephritis. Hypertensive disorders with preeclampsia and eclampsia are often increased in teenagers. Postpartum depression (PPD) is a common infirmity experienced by numerous mothers. Figueiredo et al. assessed 108 pregnant women (54 adolescents and 54 adults). They found that contrasted and grown-ups, youthful moms gave expanded rates of gloom both amid pregnancy (25. 9% versus 11. 1%) and2-3 months post-partum – 25. 9%vs. 9. 3%.

Neonatal Outcomes

Preterm delivery (less than 37 weeks of gestational) rises the chance of risks for both the mother and child. However, Briggs et al. who essentially noticed an expansion in preterm delivery in adolescent mothers, observed this is not an actual risk if the mother does not smoke cigarettes, other studies instead, found an extensive danger just in girls under 15-16 years of age. Moreover, it can be observed low birth weight as a risk factor and most of the studies demonstrate that the most endangered age group is the one less than 17 and 15. A study in Finland concluded that adolescent pregnancy increase the change of Pervasive Developmental Disorders (PDD) in the posterity. PDD alludes to a gathering of conditions that include the postponement being developed of numerous fundamental aptitudes, most quite like the capacity to communicate with others, to socialize, and to use imagination.

Role of Fathers

It is more unusual to think about the other part of the couple: the father. The father can have an important and determinant role in the couple’s life and in the child’s growth development and future. Normally the information about them is obtained by the teen mothers and not by the fathers themselves, so this can lead sometimes to misinformation, biased information or lack of knowledge. Usually, the fathers are older than the mothers, studies found them to be around 20 years old or older. Similarly to the mothers, the fathers are usually educationally unsuccessful, they have limited earnings, they have problems with the law and they use drugs and alcohol. Quite often, the relationship with the most is fairly absent, yet if present, studies hint that the number of interactions steadily decrease over the span of time of the pregnancy. Some couples decide to get married to provide a ‘real family’ concept to the newborn and this does seem to improve the economic status for the mother, since usually takes it upon herself to remain at home with the child and doesn’t have a job; yet, most of the marriages – 66%-75% – do end with a divorce. The father’s relationship with the child follows in line with the relationship with the mother and initially, they seem to accept the idea to become a father, but as time passes and the baby grows, given the fact that the interactions decrease more and more, it all results in an absent father figure, who does not provide for food, clothing, and/or housing. Sometimes the situation is helped by the fact that the fathers are not involved in the decision making during either the pregnancy or the child’s life: this can directly entail more relationship struggles between mother and father, and it can lead to a sense of isolation and impotence regarding the makings of the child’s life.

Prevention

Over the years, health care professionals and governments have developed programs and strategies aimed at preventing adolescent pregnancy. There are three types of prevention: primary, secondary, and tertiary. The primary prevention focuses on avoiding the first pregnancy and can be divided in five categories: abstinence-only programs, which present just abstinence as the core concept of the program without any mention to contraceptives; sexual education, during which the adolescents receive education regarding sexuality, contraception and sexually transmitted diseases; increasing access to contraceptives; role-playing activities in which teenagers, through a role-playing game, learn how to say “no” to unwanted sexual encounters; the last one, is multi-component programs in which more techniques mentioned above are used together. The secondary prevention is based on the prevention of a second pregnancy during the adolescence; the most successful programs are those that combine help for the mother and for the child in one place. The tertiary prevention instead deals with the prevention of morbidity and mortality of the young mothers and their child and with the reintegration of the mothers in the society, which despite being the least developed compared to the other two does offers physical and professional psychological support. National teenage pregnancy strategy: In 1999, the British government decided to launch 10-year national teenage pregnancy strategy that planned to halve the rate of conceptions by 2010 and to reduce the risk of a long-term social exclusionю

This strategy was comprised of four major components. The first was a national media campaign containing messages about resisting to the pressure of an early sexual activity, encouraging the use of contraception and the availability of confidential and professional advice. Moreover, the second component was an action to arrange a coordination across different agencies at a national and local level. Finally the third one was an improvement in education on sex and relationships and access to sexual health services. The last component was support for teenage parents to return to study or to find a job. The strategy also offered a telephone helpline, “Sexwise”, to provide information to young people nationwide.

Discussion and Conclusion

Firstly, this paper has shown how teenage pregnancy is related to various factors such as lower economic status, low maternal education, poor school performance, previous history of adolescent pregnancy and lack of strong parents presence. However, despite of these common factors, the role of the two partners differs after the birth. Indeed, it can be observed that the interactions between the father and the child decrease over the time, due to lack of decision making in the child’s life and this leads the father to not provide for the food, clothing and housing. Secondly, it has shown the maternal and neonatal outcomes both pre and postpartum, that can lead to various risks and serious diseases. Thirdly, it has shown the conceptions rates in Europe and how these decreased during time, due to prevention, for which there are three different types with programs. Finally, this paper displayed one of the most effective strategies to prevent the teenage pregnancy that is the National teenage pregnancy strategy, launched by the British Government in 1999, which halved the conception rates in ten years. Further work needs to be carried out to explain better the other aspects of this extensive topic about the options, that the parents must to take into account to decrease the possibility of their kids to become parents at an young age or the opportunities and choices of the adolescents, once discovered the pregnancy, to give a better future to their child. Finally, the government’s role has to be examined in order to find a way to give financial, physiological and practical support to new parents and how the already existing strategies can be implemented.

10 October 2020

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