Health Centers > Clinical Obstetrics and Gynecology > Teenage Pregnancy
Teenage Pregnancy
Neither child nor adult, adolescents constitute an age class by themselves with specific health and behavioral problems, which has prompted some hospitals to create specialized adolescent departments. These units have as their goal the medical, psychological and social management of these individuals in all their complexity.
Teenage Pregnancy
- Teenage Pregnancy
- Teenage Sexuality and Sex Education
- Teenage Fertility/Pregnancy by the Numbers
- Pregnancy and Addictive Behavior
- Pregnancy and Congenital Malformations
- Early Pregnancies and Aggressions
- Problems Associated with Underage Pregnancy
- Teenage Parenting
- Course of the Pregnancy and Delivery
- Psychological Profiles of Pregnant Adolescents
- Outcome of the Pregnancy as a Function of the Adolescent's Age
- Modifications of the French Abortion Law
The encounter between the teenager and the medical community nonetheless remains ambivalent, colored by a relational avidity but also a fear of becoming dependent.
This age group, which covers the transitional period between childhood and adulthood, is increasingly recognized as having is own pathologies that merit an adapted approach. Does the term youth rhyme with health?
An inquiry conducted in 1999 by the Centre de Recherche d'Etude et de Documentation en Economie de la Santé (CREDES) on 2,309 youths, 11-20 years old, showed that 45% suffered from dental problems, 13% had dermatological diseases (especially acne), 7% of the girls had genitourinary infections and 6% had respiratory diseases.
Behavioral disorders, however, characterize particularly well the health problems of today's teenagers: addictive behavior, attempted suicides, road accidents, aggression and/or eating disorders.
Although early maternity has always been part of the history of women, pregnancy is often an 'accident' associated with high-risk behavior. Pregnancy can express the anxiety of everyday living, or it may be a poorly adapted response to an already precarious situation or a simple continuation of the family's history.
In 2009, 46 percent of high school students reported ever having had sexual intercourse.[1]
The teen birth rate in the United States is currently at an all-time low, but remains much higher than rates in other developed nations.[2]
The vast majority (8 in 10) of all pregnancies among adolescents are either unplanned or occurred before the adolescents were ready to be parents.[3]
One in six (18%) 15-year-old females will give birth by her 20th birthday. This percentage is higher for black (1 in 4) and Hispanic (1 in 3) adolescents than for white adolescents (1 in 10).[4]
Teens in the United States and Europe have similar levels of sexual activity. However, European teens are more likely than U.S. teens to use contraceptives generally and to use the most effective methods; they therefore have substantially lower pregnancy rates
Stress Urinary Incontinence
The International Continence Society (ICS) defines SUI as the complaint of involuntary leakage on effort or exertion, or on coughing or sneezing ...
Teenage Sexuality and Sex Education
In France, the mean age at the time of the first sexual relationship has remained 17 years for both sexes since 1985. In contrast, the age distribution for the first sexual experience indicates ever younger participants: 21% of the boys and 10% of the girls first had sexual intercourse at 15 years or younger.
Between 15 and 18 years, 47% of the boys and 41% of the girls have already had sexual intercourse with penetration. In the USA, 56% of the girls and 73% of the boys 15-19 years old have had sexual experiences, whereas about 20% of the girls and 33% of the boys have been sexually active before 15 years of age. The mean age for the first sexual experience is the same as in France, i.e., about 17 years for girls and 16 years for boys. All studies have shown that the earlier sexual intercourse is practiced, the more often it is an act of submission rather than of desire.
Pediatric and Adolescent Gynecology
1. Gynecologic Clinical Examination of the Child and Adolescent
2. Imaging in Pediatric and Adolescent Gynecology
3. The Prepubertal Girl
L Ambiguous Genitalia in the Newborn: Diagnosis, Etiology and Sex Assignment
L Vulvo-Vaginal Disorders
L Precocious Puberty (Complete, Partial)
L Ovarian Cysts in Prepubertal Girls
L Sexual Abuse in Prepubertal Children and Adolescents
4. The Adolescent Girl
L Delayed Puberty
L Menstrual Irregularities
L Adolescent Dysmenorrhea
L Hyperandrogenism in Adolescent Girls
L Ovarian Masses in Adolescent Girls
L Breast Diseases in Adolescents
L Sexually Transmitted Diseases
L Contraception for Adolescents
In 1994, the French national campaign against human immunodeficiency virus infection and its acquired immunodeficiency syndrome (AIDS) made condoms the primary method of contraception for first sexual experiences.
Sexual intercourse during adolescence tends to be sporadic (5-15 times/year) and unplanned (63% occurring during vacations). Furthermore, these relationships are of short duration, rarely exceeding 1 month, which partially explains the first-line use of condoms.
Younger teenagers are especially vulnerable to coercive and non-consensual sex. Involuntary sexual activity has been reported by 74% of sexually active girls younger than 14 years and 60% of those under 15 years.
The contraceptive pill is often started several months later because adolescents primarily associate condoms with prevention of AIDS and sexually transmitted diseases rather than with unwanted pregnancy. Nevertheless, use of the pill markedly increases with regular sexual activity to the detriment of condoms.
Thus, the dual message 'pill and condom' has been poorly integrated into the mores and often remains temporally disassociated.
SEXUAL ACTIVITY
Fewer than 2% of adolescents have had sex by the time they reach their 12th birthday. But adolescence is a time of rapid change. Only 16% of teens have had sex by age 15, compared with one-third of those aged 16, nearly half (48%) of those aged 17, 61% of 18-year-olds and 71% of 19-year-olds.[1] There is little difference by gender in the timing of first sex.
On average, young people have sex for the first time at about age 17, [2] but they do not marry until their mid-20s.[3] This means that young adults may be at increased risk for unintended pregnancy and STIs for nearly a decade or longer.
Teens are waiting longer to have sex than they did in the recent past. In 2006 - 2008, some 11% of never-married females aged 15 - 19 and 14% of never-married males in that age-group had had sex before age 15, compared with 19% and 21%, respectively, in 1995.[1]
In 2006 - 2010, the most common reason that sexually inexperienced teens gave for not having had sex was that it was "against religion or morals" (38% among females and 31% among males). The second and third most common reasons for females were "don't want to get pregnant" and "haven't found the right person yet."[4]
Among sexually experienced teens, 70% of females and 56% of males report that their first sexual experience was with a steady partner, while 16% of females and 28% of males report first having sex with someone they had just met or who was just a friend.[4]
The national investigation, 'Adolescents', conducted in 1993 by M. Choquet (Director of Research at the Institut National de la Santa et de la Recherche Medicale, INSERM) and S. Ledoux found that level of education appears to influence the regularity and number of sexual experiences. Still, 21% of sexually active girls do not use any means of contraception. This should be kept in mind during the preparation of messages to be transmitted to teenagers.
Teenage sexuality passes through two phases: first, infantile sexuality, corresponding to the discovery of one's body and pleasure of the organ, and then, genital sexuality, reflecting the capacity to reach orgasm and to reproduce.
The latter phase, in turn, is composed of two stages: first, the discovery of one's body and its power, and second, the discovery of the repercussions associated with the complementarity of the sexes (the need for the other).
For the young male, when it 'works', he is satisfied. For the young woman, the question of fertility is always lying just under the surface and is what exposes her most to the risk of pregnancy: the need for 'verification' of the good functioning of her body.
CONTRACEPTIVE USE
The majority of sexually experienced teens (78% of females and 85% of males) used contraceptives the first time they had sex.[4]
The use of contraceptives during first sex by females aged 15- 19 has increased, from 48% in 1982 to 78% in 2006- 2010.[4]
Adolescents who have sex at age 14 or younger are less likely than older teens to have used a method at first sex and take longer to begin using contraceptives.[1]
The condom is the most common contraceptive method used at first intercourse; 68% of females and 80% of males use it the first time they have sex. [4]
Contraceptive use at first sex has increased over time. Particularly large increases in condom use at first sex occurred partially in response to the AIDS epidemic. [4]
In 2006- 2010, some 96% of sexually experienced female teens had used a condom at least once, 57% had ever used withdrawal and 56% had used the pill. Smaller proportions had used other methods.[4]
Dual method use offers protection against both pregnancy and STIs. In 2006- 2010, one in five sexually active female teens (20%) and one-third of sexually active male teens (34%) reported having used both the condom and a hormonal method the last time they had sex.[4]
In 2006- 2010, 86% of female teens and 93% of male teens reported using contraceptives at last sex. These proportions represent a marked improvement since 1995, when only 71% of female teens and 82% of male teens had reported using a method at last sex. However, the proportions were generally unchanged between 2002 and 2006- 2010.[4]
In 2009, 4.5% of female teen contraceptive users relied on long-acting reversible contraceptives, including IUDs and implants. This is an increase from 1.5% in 2007 and just 0.3% in 2002. [8]
In 2006- 2008, eight percent of females aged 15- 17 and 18% of females aged 18- 24 had ever used emergency contraception. [9]
Nearly one in four female teens at risk for unintended pregnancy (18%) were not using any contraceptive method at last intercourse.[10]
[1] Centers for Disease Control and Prevention. (2010). Youth Risk Behavior Surveillance Survey - United States, 2009. Surveillance summaries: MMWR 2010; 59 (No. SS-5). Retrieved from http://www.cdc.gov/mmwr/pdf/ss/ss5905.pdf
[2] Hamilton, B. E., Martin, J. A., & Ventura, S. J. (2010). Births: Preliminary data for 2009. National Vital StatisticsReports, 59(3): Hyattsville, MD: National Center for Health Statistics. Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_03.pdf
[3] Finer, L. B., & Henshaw, S. K. (2006). Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspectives on Sexual and Reproductive Health, 38(2), 90-96.
[4] Abma, J. C., Martinez, G. M., & Copen, C. E. (2010). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, National Survey of Family Growth 2006-2008. National Center for Health Statistics. Vital andHealth Statistics, 23(30). Retrieved from http://www.cdc.gov/nchs/data/series/sr_23/sr23_030.pdf
[4-1]Martinez G et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006 - 2010 National Survey of Family Growth, Vital and Health Statistics, 2011, Series 23, No. 31.
[5] Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing 2002, Vital and Health Statistics, 2004, Series 23, No. 24.
[6] Santelli J, Sandfort T and Orr M, Transnational comparisons of adolescent contraceptive use: What can we learn from these comparisons? Archives of Pediatrics & Adolescent Medicine, 2008, 162(1):92 - 94.
[7] Chandra A et al., Sexual behavior, sexual attraction, and sexual identity in the United States: data from the 2006 - 2008 National Survey of Family Growth, National Health Statistics Reports, 2011, No. 36.
[8] Finer LB, Jerman J and Kavanaugh ML, Changes in use of long-acting contraceptive methods in the United States, 2007 - 2009, Fertility and Sterility, 2012, 98(4):893 - 897.
[9] Kavanaugh ML, Williams SL and Schwarz EB, Emergency contraception use and counseling after changes in United States prescription status, Fertility and Sterility, 2011, 98(8):2578 - 2581.
[10] Mosher WD and Jones J, Use of contraception in the United States: 1982 - 2008, Vital and Health Statistics, 2010, Series 23, No. 29.
[11] Guttmacher Institute, Minors' access to contraceptive services, State Policies in Brief (as of May 2013), 2013, Daily Ob-Gyn News
