Adolescent Pregnancy

Socrates is renowned for his inquiry based approach to learning. So when I decided I wanted to study issues in adolescent pregnancy, I started posing questions. What factors contributed to teen pregnancy? Are there causal risk factors for the girls who get pregnant? Are there certain characteristics that make a girl more at risk? What social factors contribute to adolescent pregnancy? I also wanted to address some issues like what supports are available for these girls and the availability or publicity of these supports. What are these girl’s options?

How acceptable socially these options are and possible trends as to the choice of options? What are the implications for social work practice? Social Issue? History has shown that there have always been children born outside of marriage. The stigma on the unwed mother has always been there, and has not changed. So why is this a social issue? The fact is that these unwed mothers are children themselves, and are believed to not be ready to have children of their own. Adolescent pregnancy is a social issue because of stigmas placed on these girls: socially, religiously, and economically (Cervera, 1989).

Other factors that contribute to the social issue are the concerns about children raising children, and the impact this has on the adolescent’s life and the child’s life, whether positive or negative (Hao, 2000). It also places a financial strain on the social support systems intact as these girls’ needs increase while they look at their own socio-economic status and provide for their child’s needs (CBC). “The questions raised by teen parenting are questions about the way we as a society construct our responsibilities towards children. (Wong 1999, pg. 3).

There is also growing concern whether if these choices are made with a full understanding leads to some of the myths about adolescent pregnancy (Combs-Orbe, 1990). One of the primary being the myths of how easy it is to raise children brings a kind of romanticism to it, and that often misleads girls into feeling they are capable of keeping and sustaining a pregnancy and child. Some girls have the belief that a child would cause her boyfriend to marry her, or a child would bring them closer in a relationship. How much does this affect us? “Four out of ten” girls in the United States will become pregnant before age 20.

United States has the highest incidence of adolescent pregnancy, with Canada following close behind. 1 In Canada the teenage birth rate is 6 times that of Japan or Switzerland, but we fall behind New Zealand (CICH). In Lethbridge 8. 2% of the live births are to pregnant teenagers, approximately 170 births per year. (Karla Wright) The majority of adolescent pregnancies are unintentional, with statistics ranging from 50 percent, (CBC) to 73% (Zabin, 1993). In 1990, 21% of all births were to unmarried teen mothers. (Wong 1999) What are the long term outcomes for these girls?

The economic costs of this issue also comes into play, because the mother is still young, the consequences if she keeps the child will affect the rest of her life. “A young woman having an unintended birth is associated with termination of schooling, increased likelihood of some time on welfare, and failure to achieve the level of work success achieved by adolescents who postpone having children. ” (CBC) These girls fail to recognize their pregnancy early off, and fail to access prenatal care, or eat properly during the pregnancy which will impact their children.

The poverty rate of single mothers is high, with single mothers costing the Alberta government 22 million a year for support. (CBC) In a report published by the Canadian Institute of Child Health (CICH) they list some consequences for these girls and their children. Some of them noted are the fact that a woman who first gave birth at 16 and younger are more likely to have a second child within the next two years than are young women who have had their first child between 17-20, and the fact that the pressures teen parents face predispose them to child abuse and neglect.

For the child, there are a certain set of consequences outlined in the CICH report, that babies of teenage mothers are at an increased risk of pre-term birth and low birth rat and death during infancy, that the infant mortality rate is 60% higher, and the child is more prone to accidents and illnesses. They are about three times more likely to show a conduct disorder then children born to older mothers. They also show lower marks in math and reading. Factors that contribute to the cause of adolescent pregnancy

The most obvious contribution to what causes adolescent pregnancy is sex, but what is of interest is what causes these girls to engage in unprotected sexual activity. Several of these factors have been outlined in the literature, there is the media image on sex, and there is also a lack of education in the schools. Western society with its predominantly Christian roots sends mixed social messages to teens about sexual activity, and the consequences of their actions. The religious influences and education influence both stresses the slogan of abstinence saying that sex should be reserved until after marriage.

Yet the same society has a radically different message it sends through media. “More than two-thirds of the shows on U. S. television now have sexual content” (CNN 2001). Teen television characters that engage in sexual activity have also risen over the years (CNN 2001). In soap operas the amount of sexual acts to the mention of safe sex practices is appalling; in one week with 300 acts performed, safe sex was only mentioned 5 times (Moore, 2002). The reckless sexual behavior of the soap opera stars is far from the reality of STD’s, assault, and unplanned pregnancies.

Teens are bombarded by this portrayal of risky sexual activity in a socially acceptable medium. They also begin to see the Hollywood romanticism of raising children, in a popular show like ‘Reba’ there is a pregnant teen that still went to school while pregnant, married her boyfriend, and is keeping the child. (Moore, 2002; Cereva, 1989; Hao 2000 ) Another recent movie that shows the Hollywood idea of raising children is “Sugar and Spice” that has a squad of cheerleaders robbing a bank in order to gain money for one girl and her boyfriend to support their child.

There are also issues in this dichotomy between what is seen on TV as glamorous and normal, and what is taught in school. The education system is based on the fact that children will hopefully be given “The Talk” by their own parents, and the school can get away with simply dealing with the biology lessons. The inability for some parents to talk about sex with their kids also leads to further misperceptions and lack of information. The lack of knowledge about contraception methods also plays into the incidences of adolescent pregnancy.

In Alberta, the parents have to be informed of when the children are dealing with sex education in health class, and what may be mandated in the curriculum may not be taught in a catholic school, or in a religiously influenced school. “Many teachers reported that they do not cover topics such as sexual orientation, oral or anal sex, masturbation and pleasure/fulfillment. Also, most teachers use traditional methods such as lectures, videos, and large group discussions, Active learning strategies such as role-playing, student journals, and small group discussions are used infrequently[a1]. (CMEC) There is a myth that more sex education in schools would promote sexual activity, but all the literature supports the complete opposite claim, that it would actually decrease the amount of pregnant adolescents.

Risk factors for girls? There is a ‘myth’ that if your mother was a single mother then you have an increased likelihood to be a single mother yourself. This is supported in some of the literature, “teen mothers themselves are most likely to come from homes with a single parent who had limited control” (Rodriques Jr. nd Moore, 1995, 687). A support to that statement is that the girls from a single parent family know that it is possible to raise a child on their own and does not need the other parent. There also is the evidence that a girl who has an older sibling who is a teen mom “were almost four times more likely to have already had sex… had significantly more permissive attitudes toward childbearing… [and] perceived younger ages for typical life-course transitions” (East 1998, 159).

Girls who come from lower economic status, will have less likelihood of buying good contraception and have an increased likelihood of being put into high risk scenarios. (http://www. agi-usa. org/pubs/fb_teen_sex. html) Another indicator of who will become a pregnant teen is whether they have a reason or not to postpone pregnancy, the girls who have no reason and see themselves as having nothing to loose have higher instances of pregnancy, than the girls who do have reasons to postpone their pregnancy.

Economic groups that have been marginalized tend to have higher instances of teen pregnancy. “Teen pregnancy is almost five times more common in the lowest compared to the highest income neighborhoods” (Health Canada, CICH). This may be caused by a simple fact that these girls can not economically access contraception methods, or may be in a school environment that is over crowded and may not get the attention or the education they deserve. Another risk factor for these girls is the social environment in the homes.

As mentioned earlier having a single parent mother increases the likelihood for the daughter to be a single mother. There are statistics that say that if both parents have a good relationship with each other and their child, the child is less likely to engage in sexual behavior at an early age, and there are also statistics that show that a child whose parents are in conflict, may choose to delay sexual activity until later, because they do not want to end up like their parents.

There is also a view supported by the front line workers that I spoke to that girls who are pregnant teens are looking for love, and the fact that a child will give them unconditional love is appealing to them. (Karla Wright, Judy, Valerie) The lack of a father figure, or an inadequate father figure is also something that came up in the interviews as reasons for why a girl might become pregnant. The lack of knowledge of what a normal relationship that is not based on sex is because they had no role model is another popular belief.

One big risk factor that has been correlated positively to teen pregnancy is substance abuse. To these girls unprotected sex is “just another risk” (Judy sexual health nurse) “The report said drug-using teens are five times as likely to have sex than nonusers, and three times as likely to have it with four or more partners, according to the two-year analysis of data. ” (http://www. cyi-stars. org/articles/TeenPromiscuity. htm) Sex is a commodity that girls can barter for drugs, or for their next high, and they may not see the consequences of these actions. The Options

Now that I had a base for what I began to start to focus on the options made themselves available for these girls that become pregnant. There were basically three options for these girls: they could keep the baby, abort it, or carry the baby to term and place it for adoption. “When adolescents become unintentionally pregnant they face several difficult choices. About equal proportions of pregnant adolescents have unintended births (37%) or induced abortions (35 %), with smaller percentages of adolescent pregnancies ending in miscarriages or intended births (about 14 %). Moore, 2002) Abortion is a harder choice to make because of the stigma that occurs with it. The public debate about whether the fetus is still alive and that the procedure is murder makes it very difficult for an individual to decide.

The girls have to suffer through a physical trauma, and run the risk of it impacting their future reproductive health. (Zabin, 1993) They also have to deal with the emotional issues of “what if”, and dealing with anniversaries. Project Rachael, 2002) Then on top of this there are the social consequences, when asking a Catholic classmate, Tom Miklos, about abortion, he mentioned Project Rachel, and the girls who choose to have abortions are unable to tell anyone about it. (Miklos, 2002) Clinics in Calgary are normally closely guarded and hidden, as the staff has to deal with protests or possible security threats to themselves and their patients. If a girl is seen leaving a clinic, it may be assumed that she is having an abortion, when in fact most clinics also offer counselling, and prenatal care.

Currently in Lethbridge there are no abortion clinics, and abortions have to be performed up in Calgary. A girl who is fifteen if she decides this option, must find the nearly impossible way up to Calgary on her own, be ready to pay the 500 dollars for it, and stay overnight in Calgary, all without causing a stir or letting anyone else know. If the adolescent decides for whatever reason to carry the baby to term she is now faced with the reality of bearing a child.

She has two options available to her: she can keep and raise the child herself and or with the help of her family, or she can give the child up for adoption. The services available to her now change. There are adoptions where it is completely closed and the girl will never meet the child again and the prospective parents never meet the birth mother. In contrast, there are open adoptions where the girl can help choose the family her child is going into. Programs here in Lethbridge I ran into a serious problem trying to find someone to ask about teenage pregnancy in Lethbridge.

The strong religious base made it hard for me to look up services, as there does not seem to be a published list. I asked several adolescent females, children of coworkers or neighbours, if they knew about services and they all answered, “Not Really”. With the knowledge that no planned abortions were carried out here, I went after other options and people who worked with these adolescents. There are no prevention programs other than what is found in the schools or in church. I spoke with some of the volunteers and the local director at Birthright, Barbara Spiess.

I visited with a medical doctor, Dr. Aoishi at the clinic here at the university, and went to the Sexual Health Clinic and spoke with a nurse there; Judy Brandley a RN. I also visited Crossroads Counseling and Adoption Center and spoke with Suvi Teigen a B. SW. who works as an adoption coordinator. I spoke with some of the educators for pregnant teens, Valerie Martell-Kostiuk B. A. and Karla Wright B. A B. Ed. t from 5th on 5th, and with a staff member2 at the Family Center about their “Parenting as a Balancing Act” program.

I was looking to see what they would say their take on the issue was.. Dr. Aoshi, once I had convinced her that I was not pregnant myself and that this was a legitimate project, told me that no abortions are performed in Lethbridge proper, not even in emergency situations. Those girls are shipped up to Calgary, where the abortions are performed. She said that trends that she had noted in her practice were that girls may not have had access to contraception methods, or the pregnancy was a result from inadequate use of contraception methods.

The Sexual Health Clinic has a publicized list of service for pregnant girls, it is not geared especially for teens, but gives resources and supports for the females. The nurse I spoke to said that it is very rare that a girl who gets a positive on a home pregnancy test does not come in for a professional test as a double check. Judy mentioned that the moment when the test comes back positive becomes a life changing moment, and she helps the girls through the “Oh my God” reaction, and the followin stage of ” {insert name} is going to kill me! The Sexual Health Clinic offers nutritional supports and prenatal care for the girls.

One thing that Judy said that hit me especially hard, was that nurses had to be invited into schools, and that she would like to see more collaboration between nurses and teachers in educating girls. They also are one of the few agencies here in Lethbridge who lay down all the options for these girls, including abortion. Crossroads Counselling and Adoption center, offers girls a chance to place their babies through an open adoption.

An open adoption is when the girls get to help choose the family that their baby goes into and both sides has the option of information. The trends that Suvi noted was that girls who were younger were more likely to place the babies and then try and get them back, or stop the proceedings and keep the child. Girls who were older, who had been around the block a few times knew what they were getting into and were more likely to place a child permanently. Birthright is the most publicized agency for pregnant teens in Lethbridge, a note of pride to Barbara Spiess.

Birthright is a referral service for pregnant women, it offers a free pregnancy test to girls who are not sure. The volunteers are not trained counselors, but can act as a friend to a woman going through the pregnancy. They will also be invited to schools, and are in favor of abstinence as the only option of teaching. They can also use their volunteer networks to find voluntary donations for the girl. Birthright is also connected with the Better Beginning Program, a program that offers food coupons, nutrition advice, and items for the parenting mother.

Last but not least I found some education programs, the ‘5th on 5th’ Youth Center offers programs for young parents. There is an educational program taught by Valerie Martell-Kostiuk called the young parents program, and there is also a course taught by Karla Wright (B. A, B. Ed) called You and Your Child. The program facilitated by Valerie, is a 5 week program, that covers topics like how to have a healthy pregnancy, labor and delivery, care of an infant, what to expect in the future, and some career planning. Karla Wright teaches a program for pregnant teens, that is a 5 credit program that goes towards their highschool diploma.

You and Your Child is an 8 week program that deals with topics like nutrition, parenting styles, stress and anger management, child safety, problem solving and decision making. The youth are trained in infant First Aid and CPR. Karla Wright mentioned that she would like to see more prevention programs in the schools. That if girls were taught that there were others way to validate themselves other than sex, and more frank open education about relationships, and contraception methods in schools; than the amount of girls she would see in her office would decrease. . 5th on 5th’ offers one more program to parenting teens, this program is SupportNet, where a computer and an internet hook up is placed in the home of the pregnant or parenting teen.

This allows them access to supports like chat rooms or internet libraries for gathering information on problems that arise from being a new parent. This also allows the individuals to gain computer skills, and work on their resumes. The Family Center also offers programs for parenting teens, the ‘Parenting as a Balancing Act’, helps teach parenting skills, and offers a support network for the parents. ill in later when can find resources……. Implications for Social Work Practice No matter how many education and prevention programs are put into place there will always be girls who get pregnant, whether intentional or not.

Social Workers can try to advocate for better support systems for these girls, and for increased social supports for the prevention projects. Social stigma is an issue I have not yet addressed. In a small town setting the girls are often labeled negatively and have to deal with the stigma of the option they choose: adoption, abortion, or raising the child.

The statistics on the outcome of these girls and their children are not promising. The stigma is often the deciding factor on whether the girl decides a certain option or not. If a girl keeps the child, she is socially isolated because of the fact that she is a parent and is having to be in the adult world of caring for her child. The child has to face the social stigma placed on the mother, that the mother did something bad or is a bad person for having a child too early. Teen moms are often considered ‘easy’ and may be the subject of unwanted advances. Those who give birth and keep the child are stereotyped as wanting to get pregnant.

The religious stigma of abortion, often denies the girl the option, and the stigma of having had an abortion will often influence the girl later. The role that is needed to help alleviate this stigma is counseling, this will free the knowledge that the girl who gets pregnant is not necessarily a ‘bad’ person, and will need to provide some emotional support for the girl no matter what option she chooses. One of the roles for Social Workers to play in this is a broker,by trying to find a way to help these girls or these teen families access the resources they need, and the support systems necessary to keep them from marginalisation.

By providing the basics: food, clothing, adequate shelter, safety, etc, social workers can minimize the strain on the system caused by teen pregnancy, and their children and influence the long term outcomes. Programs that offer pre-natal/post-natal care, life skills, parenting, and skill development are needed, and the access and publicity for these programs need to be increased. More education is also needed, the education of the reality of what it takes to bear a child, and to raise it successfully will counteract the myths seen on television.

The education has to be easily acceptable, and taught by people who feel comfortable enough with the issue to be open and able to answer questions. Their also has to be more education on relationships, that they are possible without having to have sex. More information on the methods of contraception, and more need to be taught than just the biology, and not just focusing on high risk adolescents, instead using a blanket method because what may be seen in school is not necessarily reflective of what goes on at home. Inquiry Process reflection

This was an interesting project I had to deal with some attitude issues both on the part of myself and the people I talked to. I had been exposed to the reality of teen pregnancy through a friend who is a teen mother, and had some knowledge of the contrast between the reality of teen mothers and the television perfect version. Some attitudes I found when dealing with several of the support programs I visited were that I had to verify the fact that I was not a potential client. Some people I talked to felt uncomfortable with discussing some of the options like abortion.

The programs I found are support programs, for after the fact, none accessed before the pregnancy. The burden of prevention is left at the home or at the front door of the school. There are two main causal factors that contribute to adolescent pregnancy, the lack of education and the media’s portrayal of sex. There are so many reasons why a girl can become a pregnant adolescent, from lack of education on contraception methods, to economic issues such as not being able to access contraception methods, to social issues like the home environment they grew up in.

The factors that affect these girls once they become pregnant fall under the same categories. Education as to what they’re options are, the social acceptability of these options, and knowledge of the outcomes for what they choose. The economic marginalisation of these girls is also a major concern, and it seems that the social service network is suffering from cutbacks and can not deal with the strain these girls place on it.

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