Running head: ADOLESCENT PREGNANCY

Adolescent Pregnancy
Amanda McKellar
Ferris State University

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Adolescent Pregnancy
In this paper, adolescent (teen) pregnancy is referred to as a pregnancy in a female younger than
19 years of age unless otherwise mentioned. Although teen pregnancy is a national epidemic,
rates reached record lows in 2011. The rate of pregnancies dropped 8% for girls aged 15-17 and
5% for girls aged 17-19 (CDC, 2014). These teens who conceive at such a tender young age are
part of an extremely vulnerable population. Many nurses have strong biases, attitudes, and
stereotypes toward these young women. It is important to understand why nurses feel this way in
order to provide optimal care and education to these girls. Teen pregnancy has been around since
the dawn of time and effects all cultures and ethnicities at different rates. Pregnancy happens in
every demographic are and can have dire consequences for the parents and the infant. Conditions
and diseases that affect normal age and older women that are pregnant can also effect young girls
and at higher risk. The conclusion discusses options on how nurses can change delivery of care
to these individuals.
Stereotype, Bias, & Attitude
Huge stereotypes exist toward these young girls who become pregnant. Finding stereotypes
about these young women is as simple as asking people how they feel about it. Peers of the
pregnant teens in high school have strong stereotypes just as well as the elderly population.
Many people view these young girls as promiscuous, dirty, or misbehaved. In actuality, these
girls could have been raped, or they could be kind-hearted girls who made a bad decision.
Health care personnel such as nurses must understand the thoughts and feelings of the teen and
possibly their loved ones and/or support person in order to provide quality care. According to
Joy Magness (2012), It is a common occurrence for nurses to lack the appropriate knowledge to

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care for adolescents which can mitigate the support they can provide during the birth process.
The attitudes of doctors, nurses, lab personnel, or even housekeeping may be negative toward
these girls. The negative attitudes can deter the adolescent from accepting essential prenatal care,
health screenings, or education. Not only do the personal biases held by nurses affect the young
girl, but they can potentially affect the health and well-being of the infant. If the nurse is aware
of these biases and stereotypes, she can be hyper vigilante as a patient advocate to make sure
quality care is provided to the adolescent and the infant.
Population, Culture, Ethnicity
Teen pregnancy affects all cultures and ethnicities but to different extents. For example, in 1991,
the rate of live births was highest in non-Hispanic blacks at 120 per 1000. In descending order,
the next ethnicities in line were: Hispanic, American Indian/Alaskan native, non-Hispanic white,
and Asian/Pacific Islander with the lowest rate (See appendix 1). From 2011-2012, all pregnancy
rates by race decreased except for Indian/Alaskan native and Asian/Pacific Islander (CDC,
2014). The CDC states that the high (57%) combined pregnancy rate of blacks and Hispanics can
be contributed to greater health disparities affecting this population. They are socioeconomically
disadvantaged and have lesser opportunities than do other races. Nurses can use this knowledge
to their advantage by referring teens to support groups in the community for pregnancy
prevention.
Demographics
As discussed, teen pregnancy affects blacks and Hispanics at the most alarming rates.
Unfortunately, most of these teens are living in underprivileged areas such as inner cities. Not to
say that pregnancy doesnt happen to families that live in higher socioeconomic classes; teen

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pregnancy happens in all socioeconomic classes. As mentioned before, adolescent pregnancy is

generally referred to as being a pregnancy between 15 and 19 years of age. However, some
organizations and people refer to an adolescent pregnancy as any pregnancy in a girl younger
than 19 years of age. In Wexford County in 2013, Michigan, the rate of teen pregnancy has been
steadily decreasing. However, at 56.2 pregnancies per 1000, the amount of teen pregnancies in
Wexford is still distinctly above the state benchmark in Michigan at 48 pregnancies per 1,000
girls (DHD #10, 2014). The average national rate in 2013 was 29.4 pregnancies per 1000 girls,
which is significantly lower than the Wexford County and Michigan average (CDC, 2014.)
Health Concerns
Many health concerns surround pregnancy in general. Two categories of women tend to have
higher risks; the very young, and the very old. Mitchell (2014) says, America has noted
psychological distress and suicidal behaviors reaching prevalence of between 13% and 67%
among pregnant adolescents. As if contemplated suicide isnt scary enough, the adolescent is at
risk for a preterm labor, low birth weight infants, preeclampsia, placenta previa, and a higher rate
of Cesarean-section (C-section). The teen has higher rate of C-section because of their
developmental age. Their pelvis size and shape is not prepared for delivering a normal sized
infant. In low and middle income countries, births to moms less than 20 years of age face a 50%
higher risk stillbirth or dying in the first few weeks or life versus infants born to mothers aged
20-29 (WHO, 2014). Pregnant teens could also be affected by a preexisting cardiovascular
defect, infection, or hemorrhage at any time antepartum or postpartum. There are several
physical concerns with young pregnancy but there are also many mental concerns. The teen may
face seclusion from the family, loss of friends, and inability to graduate and go on to college.
This in turn places them at a higher risk to be stuck in the cycle of poverty for the rest of their

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lives. Children of these pregnant teens also tend to follow in this cycle when they reach
adolescence.
Disease Process
One disease that seems to affect the teenage population quite heavily is preeclampsia. In 2010,
the rate of preeclampsia in women under the age of 20 was 45.9 pregnancies per 1000 births (see
appendix 1, table 2). The rate is only higher in women 40 years of age or older (CDC, 2010).
According to labor and delivery teachings at Ferris State University, preeclampsia is
characterized by a blood pressure of 140 systolic and 90 diastolic that develops after twenty
weeks of gestation. A high blood pressure before twenty weeks of gestation is considered
chronic hypertension and is also carefully monitored. Although risk factors have been identified,
there has yet to be a distinct cause. According to Yu, Zhang, Wang, Hong, Mallow, Walker,
Pearson, Heffner, Zuckerman, and Wang (2013), Lifetime stress, perceived stress during
pregnancy, and chronic hypertension were each associated with an increased risk of
preeclampsia To be diagnosed with preeclampsia rather than just gestational hypertension, a
woman must have protein in her urine at a level or about 300 grams per 24 hour period. This is
because the poorly functioning kidneys are inadequately filtering substances, allowing proteins
to be spilled into the urine. Symptoms may include headache or heartburn. Special precautions
and monitoring are taken to avoid progression to eclampsia where seizures are involved. The
only known cure for preeclampsia at any age is to deliver the fetus.
Conclusion
Nursing care can help the young population avoid preeclampsia by educating young children on
contraception measures to avoid pregnancy altogether. Nurses can teach abstinence, but at some
point, teens are going to get curious and begin to explore. It is of the utmost importance that

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these teens are educated on safe sexual practice and have access to appropriate resources. Since
preeclampsia has somewhat of an unknown cause, nurses should monitor the teens during
pregnancy for the condition and teach them about the symptoms. If the teen develops the
condition, the nurse must make sure that they understand how to properly care for themselves in
order to avoid further complications such as eclampsia.

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References
Adolescent pregnancy. (2014, September 1). Retrieved January 26, 2015, from
http://www.who.int/mediacentre/factsheets/fs364/en/
Health Profile Chartbook 2013 Wexford. (2014, February 18). Retrieved January 26, 2015, from
http://dhd10.org/images/Wexford_Chartbook_2013__Feb_18_2014.pdf
Magness, J. (2012). Adolescent pregnancy: The role of the healthcare provider. International
Journal for Childbirth Education, 27(4), 1-1. Retrieved January 20, 2015 from CINAHL
Teen Pregnancy. (2014, June 25). Retrieved January 20, 2015, from
http://www.cdc.gov/teenpregnancy/
Teen Pregnancy. (2010). Retrieved January 26, 2015, from
http://www.cdc.gov/nchs/
Wilson-Mitchell, K. (2014). Factors Associated with Adolescent Pregnancy, Psychological
Distress, and Suicidal Behavior in Jamaica: An Exploratory Study. Journal of Midwifery
and Womens Health, 59(5), 552-552. Retrieved January 22, 2015, from CINAHL.
Yu, Y., Zhang, S., Wang, G., Hong, X., Mallow, E. B., Walker, S. O., . . . Pearson, C. (2013).
The combined association of psychosocial stress and chronic hypertension with
preeclampsia. American Journal of Obstetrics and Gynecology, 209(5), 438.
doi:10.1016/j.ajog.2013.07.003

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Appendix