12.4.1 Pregnancy

Although adolescent pregnancy rates have declined since 1991, teenage birth rates in the United States are higher than most industrialized countries. In 2020, females aged 15–19 years experienced a birth rate of 15.4 per 1,000 women (Martin et al., 2020). This is a drop of eight percent from 2019. It appears that adolescents seem to be less sexually active than in previous years, and those who are sexually active seem to be using birth control.

12.4.1.1 Risk Factors for Adolescent Pregnancy

Miller et al. (2001) found that parent/child closeness, parental supervision, and parents’ values against teen intercourse (or unprotected intercourse) decreased the risk of adolescent pregnancy. In contrast, residing in disorganized/dangerous neighborhoods, living in a lower SES family, living with a single parent, having older sexually active siblings or pregnant/parenting teenage sisters, early puberty, and being a victim of sexual abuse place adolescents at an increased risk of adolescent pregnancy.

12.4.1.2 Consequences of Adolescent Pregnancy

After a child is born life can be difficult for a teenage mother. Only 40 percent of teenagers who have children before age 18 graduate from high school. Without a high school degree, her job prospects are limited and economic independence is difficult. Teen mothers are more likely to live in poverty and more than 75 percent of all unmarried teen mothers receive public assistance within 5 years of the birth of their first child. Approximately, 64 percent of children born to an unmarried teenage high-school dropout live in poverty. Further, a child born to a teenage mother is 50 percent more likely to repeat a grade in school and is more likely to perform poorly on standardized tests and drop out before finishing high school (March of Dimes, 2012).

12.4.2 Sexually transmitted Infections

Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) or venereal diseases (VDs), are illnesses that have a significant probability of transmission by means of sexual behavior, including vaginal intercourse, anal sex, and oral sex. It’s important to mention that some STIs can also be contracted by sharing intravenous drug needles with an infected person, through childbirth, or breastfeeding. Common STIs include:

• chlamydia
• herpes (HSV-1 and HSV-2)
• human papillomavirus (HPV)
• gonorrhea
• syphilis
• trichomoniasis
• HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome)

According to the Centers for Disease Control and Prevention (CDC) (2023), there was an increase in the three most common types of STDs in 2021. Those most affected by STDs include racial and ethnic monitories, adolescents and young adults, and men who have sex with men. The most effective way to prevent transmission of STIs is to practice abstinence, (not participating in sexual intercourse), safe sex, and to avoid direct contact of skin or fluids which can lead to transfer with an infected partner. Proper use of safe-sex supplies (such as male condoms, female condoms, gloves, or dental dams) reduces contact and risk and can be effective in limiting exposure; however, some disease transmission may occur even with these barriers.

12.4.3 Contraceptive Methods and Protection from Sexually Transmitted Infection

There are many methods of contraception that sexually active adolescents can use to reduce the chances of pregnancy (table 12.2 and Figure 12.11).

Table 12.2. Contraception Methods.

In choosing a birth control method, dual protection from the simultaneous risk for HIV and other STIs also should be considered. Although hormonal contraceptives and IUDs are highly effective at preventing pregnancy, they do not protect against STIs, including HIV. Consistent and correct use of the male latex condom reduces the risk for HIV infection and other STIs, including chlamydial infection, gonococcal infection, and trichomoniasis.

Figure 12.11. Image by rexchimex is licensed under CC BY 4.0.