University of California
Type of paper: Thesis/Dissertation Chapter
This assignment will consist of 4000 words based around the health issue of teenage pregnancy. I will then discuss the view from a ‘Biopsychosocial’ perspective, which will include explanations as to why pregnancy occurs amongst teenagers. This assignment will include a portfolio of evidence which I collected from various sources about teenage pregnancies. About teenage pregnancy
According to, (UNICEF, 2008) Teenage pregnancy is defined as a teenage girl, typically within the ages of 13-19, becoming pregnant. Teenage pregnancy commonly refers to girls who have not yet reached legal adulthood. In the UK, sex is permissible for girls of sixteen years or over. Most teenagers do not plan on getting pregnant at an early age, however, some do. Nonetheless, getting pregnant at an early age can cause teenagers extra health risks because their bodies are not mature enough, some risks can be high blood pressure and premature babies, which leads to a low birth weight for the baby. More serious risks can lead to still births or death of the mother and baby (Medline Plus, 2013). Julia Bodeeb also expressed that teenage mothers face difficult changes in pregnancy; this is because teenagers do not in general seek medical help or care during the three trimesters of pregnancy which potentially could cause complications to the baby in later pregnancy (Bodeeb, 2011) Around 16 million girls give birth every year in the world. The majority of these pregnancies are from less developed countries. However, according to WHO (2012) around three million girls have unsafe abortions every year, this is because young girls are scared of telling people that they are pregnant in case they get judged for example friends not wanting to be around them, family telling them to leave home and partners leaving them.
Epidemiological data on Teenage Pregnancy
The media has a huge impact on publishing statistics about teenage pregnancy whilst doing either one or two things, negatively criticise it, or big it up. A report by Kmietowicz (2002), shows that the rates of teenage pregnancy are higher in the UK and USA .It has been suggested that their education poorly prepares teenage girls for life in a modern sexual society than any other country does. The United Kingdom is currently at the top of the European table with 30 births to every 1000 teenage girls, at the bottom of the table were Sweden who had less than 7 births per 1000 teenage girls. The figures in the article showed that 1.25 million teenagers in some of the world’s wealthiest countries will become pregnant and three quarters of a million teenage girls will become mothers. Also it states that research carried out by the University of Essex shows teenage girls who become pregnant are twice as likely to from poverty stricken families. One study suggests that the blame is due to which the change is socio-sexual transformation puts much more pressure on young girls to experiment with sex rather than the old fashioned traditional family values.
By comparison to other similar sized countries in the UK teenagers are more likely to pressurise their peers into experimenting with sex; by the use of conversation, the media and also buying products. This report also showed that it is education which is failing the teenagers and that they should have more knowledge about what happens if they do not take precautions with regards to safe sex (Kmietowicz, 2002) The most worrying report which has recently been subjected to the public by the media is that. It shows that these one million girls will either themselves suffer complications of pregnancy or that their unborn child may suffer from complications of pregnancy. These complications could be life threatening to both mother and bay and could have long lasting effects on both the health and well-being of the mother and baby. Many teenage girls become pregnant because they are denied access to contraception because they are either not available in that area or there are deep cultural problems surrounding contraception (Blair, 2012). It shows that girls under 15 are five times more likely to die during pregnancy than women in their 20’s.
Babies born to under 18’s are sixty per cent more likely to die as the girls bodies are too immature to deliver the baby. Despite these terrifying figures 20 percent of girls around the world are likely to have their babies before their 18th birthdays. Most aid organisations have avoided this issue due to sensitivity to the girls who have died or lost their babies and cultural issues however with the figures becoming so high they now have to promptly investigate in strategies’ to change this (Blair, 2012) Statistics revealed by the government and other sources such as the Department of Health, WHO, and national statistics show that even in 1998 the New Labour government produced strategies’ and plans, and put aside a staggering £340 million budget to reduce relative poverty and inequality which would then reduce the rate in teen pregnancy. Still, 15 years later, one of the highest growing concerns with the British government (Freedoms Consequences, 2009) is that of teenage pregnancy.
The government states that steady progress is being made but this only shows when statistics are used and interpreted in the right way. The table showing the rates of teenage pregnancy have reduced by 13.3 percent however looking closer they have only reduced by 5.3 percent. The highest rate of reduction in teenage pregnancy was between 1998 and 2009 which was before any real government funds became available. When the government increased funding the declination slowed which is shown in the ‘Freedom’s consequences report’. Also statistics show that in most European countries teenage pregnancy rates have steadily declined since the 1920’s however the UK’s has stayed very similar with not much fluctuation since 1969. Freedom’s Consequences (2009) show that between 1998 and 2006 the under 18’s contraception rate has fallen by 13.3 percent however this is 3 times higher than Germany. Annual statistics show that in the UK 41, 768 under 18 year olds became pregnant and 4,399 of those were under 16’s, a majority of these pregnancies resulted in illegal abortions however the statistics will always remain a suspicion rather than confirmed.
Around 20 percent of births to girls 18 and under were second births or sub sequential births to miscarriages and abortions. These figures are disturbing as further research into these figures have shown that a girl from a lower class background is ten times more likely to become pregnant than a girl in a higher class background and therefore social exclusion is one of the biggest concerns for the government to approach. Teenage parents are more likely to come from deprived backgrounds whilst teenagers from high class backgrounds are most likely to go onto university and get high paid jobs. Other figures have shown that teenagers are three times more likely to smoke throughout their pregnancy and 50 percent are less likely to breastfeed. The longer term outcomes are even more worrying, over 60 percent of these parents were or will become lone parents causing a staggering rise in the cost of state benefits. By the age of 30, 22 percent of these parents were also living in poverty, and are less likely to have qualifications and 70 percent of these will claim income support. Forty percent of mothers under the age of 20 are said to be living in parents, relatives and friends accommodation rather than their own, and 70 percent education deceased even if they were in the middle of gaining qualifications for example half way through a year.
A scary aspect of these figures is that teenagers are likely to move house, once even twice or three times during pregnancy which can cause health issues for the mother and baby due to stress and strain. All in all most teenage parents come from poorer backgrounds, are single, and end up living in secure accommodation in an area that’s frequent with pregnant girls. They then don’t receive good education and this decreases their chances of getting good jobs and providing better futures for themselves and their children. (Freedom’s Consequences, 2009) The graph showing the rates in teenage pregnancy show that the UK have the second highest rates within the UK with the United States which has a much higher population rate to start with being the first. It also shows in the UK have double the amounts of births to teenage girls than Germany, nearly 20 times more than Portugal and 25,000 more than the Netherlands (Why Church, 2013). Another graph illustrates that the north east have the highest amount of teenage pregnancies whilst 40% of these girls are having their babies, an enormous 60% of these girls are aborting their babies.
The East have the lowest amount of teenage pregnancies however only 2,500 out of 6000 girls are keeping their babies and the rest are terminating their pregnancies (The Poverty Site, 2011). The last graph is a bar chart which shows a study of 55 people and their sexual activity. Out of the group 27 under 16’s had not had sexual intercourse whilst 5 were having regular sexual intercourse. Only 4 over 16’s remained absent from intercourse whilst 19 over 16s were having regular intercourse (The Poverty Site, 2010). To compare the UK to another country of the similar size is going to provide a clear picture to what different countries do to solve their health issues. Therefore, United Kingdom vs. Germany! German schools also receive sex education classes which focus on birth control and abstinence (Prenatal Diagnostic and obstetrics, N.D) . 4% of teenagers in Germany actually plan their pregnancies whereas, 34% do not use contraception (Pro Familia, 2006).
Germany has also very strict values that if a teenage girl gets pregnant outside of marriage they have two options; keep it and possibly get disowned off family and friends or have an abortion. With a lot of girls opting for abortions the rates have increased to 60%, however, pregnant Catholic or Protestant teenagers normally go for an abortion. Whereas, Muslim teenagers generally carry the baby full term (Pro Familia, 2006). Bio-Psycho-Social influences
There are many different influences in a teenager’s life which makes them want to become pregnant at an early age. The Bio-psycho-social model was introduced by George Engel in the 1970’s as he believed that health was down to three main factors which are biological, social and psychological (Nursing Theories, 2012) There is one main biological factor that influences teenage pregnancy which is the menstrual cycle. The menstrual cycle usually happens around the ages of 8 to 13 (Clearblue, 2012). The menstrual cycle sends signals to your brain so it knows when to start producing hormones. At the start of a girl’s period her estrogen levels are its lowest but starts to increase throughout her period (Clearblue, 2012). Sociological factors seem to influence teenagers the most. This is because a lot of teenager have famous role models such as Jamie-Lynn Spears, also teenagers in today’s society can watch programmes on television which may influence pregnancy amongst teenagers such as MTV ’16 and pregnant’ and also the well-known film ‘Juno’ (Media Influences on Adolescent Pregnancy , 2011).
Programmes like this have been criticised as ‘glamorising pregnancy’ (Live Science, 2012). Some teenagers are constantly searching for attention and affection and look for love in the wrong areas such as male company, this then can allow teenagers to take it further and become pregnant (Divine Caroline, 2013). In today’s society it also seems that if a friend gets pregnant then you have to as well! There can be many reasons why a teenage girl might get pregnant but there is one main judgement about teenage pregnancies, which is that ‘all pregnant teenagers get pregnant for the benefits and housing’ (Maevarish, 2010) . Rosen (1996) thought that poverty was the reason why teenagers got pregnant at a young age, what this means is that teenage mothers get pregnant to abuse the welfare system because they do not want to be in poverty anymore and need a ‘way out’. In contrast to that Krauthammer (1993) stated that ‘welfare encourages illegitimacy and teenage pregnancy’.
In the UK, teenage pregnancy seems to be the highest in urban areas instead of the wealthiest areas likes Chelsea. Urban areas are classed as built up areas with a variety of services and a population of more than 1500 people (Urban Area, 2013). This is because children and teenagers cannot afford to fund for good education and also good health care, therefore, in wealthier towns they can afford to do all this so their child has a good start at life (Rogers & Evans, 2011). Psychological factors are also a huge influence on teenage pregnancy which includes abuse and teenagers being in care. These influences can have dramatic effects on a teenager when their growing up and still trying to find out what they want to become in life (Manlove & Welti, 2011) Abuse is the main psychological factor that happens to teenagers every day; abuse could be physical such as, rape or hitting (Patricelli, 2005). Teenagers could also be mentally abused by family, friends or strangers for example telling them their ‘stupid’ or not loved. This could then lead to the teenager retaliating and finding affection elsewhere (Cohen, 2011) . Nonetheless, Klein (1996) argues that a huge amount of teenage girls that became pregnant are and were victims of rape by an adult male. Klein stated; “… 62 percent of 535 teen mothers had been raped or molested before they became pregnant” Linda Villarosa, (1996) also agreed that adult men were the main reason why teenagers got pregnant.
Villarosa (1996) expressed those teenage pregnancies where down to sexual exploitation of teenage women, she also argued that as a society we do not try and find the real causes of teenage pregnancies. Another psychological influence is teenager’s being in care. This can influence teenager pregnancies because the teenagers may feel like they are not loved because they have been put into care (Teen Ink, N.D). When a child is put into care, they may feel like they are not wanted or loved, therefore, they may look for a male to get love from and to feel needed. This may later lead to teenage pregnancies. It is also known that if a teenager grew up in care or foster care the majority of children will go into care themselves, this means that it is a vicious cycle which may never end (Child Trends, 2011) Strategies
There are many strategies that are in place to help reduce teenage pregnancies, these include ‘Teenage pregnancy strategy: Beyond 2010’; ‘Getting maternity services right for pregnant teenagers and young fathers’ and so on (Department of Education, 2013) One strategy is the ‘Teenage pregnancy and sexual health marketing strategy’. This strategy was introduced in 2009 to help young people feel comfortable talking about sexual health such as asking for Chlamydia screening. This strategy found through evidence that having better communication, it will reduce sexual health problems like the Netherlands. In the Netherlands, they deal with the problem there and then instead of making it wait for a while.
Teenage pregnancy and sexual health marketing strategy also makes adverts so young people can watch in the comfort of their own homes, and if they need to find out more they can go to their nearest sexual health clinic or text the free messaging service (Department of Health, 2009) The sexual health charity, Brook, has launched a new scheme known as ‘Ask Brook’. This service is a free of charge and allows young people to text any queries that they have about sexual health or relationships. After texting this service, the young person will receive a response by an experienced sexual health worker within one working day. Brook (N.D) is a confidential service which will allow young people and teenagers to feel at ease with what they ask the service, however, they state that if they feel someone is in danger when they text the service they will have to break the confidentiality. This service is a good opportunity for teenagers and young people up to the age of 21 to ask for advice, even if they do not want to speak to a health profession face to face. It also allows people that come from deprived backgrounds and who cannot afford to have mobile phone credit to still text the service as it is free of charge. (Brook, N.D) Getting maternity services right for pregnant teenagers and young fathers was first introduced by the Department of Health in 2008. It was then revised in 2009 when the Department of Health received response from midwives and the Fatherhood Institute who wanted to see more engagement from young fathers in pregnancy.
This strategy states that one in fifteen births are to women under 20 years of age and that young people tend not to get good maternity services because they are not taken seriously by professionals. Inside the document it provides information and a guide for midwives, doctors and maternity support workers and it also allows these professions to read why the Government are focusing on young mothers and fathers (Department of Education, 2009). Teenage pregnancy strategy: beyond 2010 presents the development that has been made in reducing England’s teenage pregnancy rate between 1998 and 2008; it also shows a review of the evidence to evaluate what is being done is local areas and what is effective in reducing the numbers of teenage pregnancies in the UK. This document includes a lot of information such as, what has changed since 1998, and why teenage pregnancies matter and what services are better to deal with the issue (Department of Education, 2010) Supporting teenagers who are pregnant or parents – Sure Start plus National Evaluation was launched by the Government in 2001 as a pilot programme for the Teenage pregnancy strategy.
It was introduced to improve health and social effects for teenage parents and their children. The assessment expected to find out what could be learnt from Sure Start Plus programmes that could be distributed to other programmes and related partner services (Department of Education, 2005). Enabling young people to access contraceptive and sexual health information and advice is ‘the legal and policy framework for social workers, residential social a workers, foster carers and other social care practitioners’ (Department of Education, 2013). This initiative was revised in 2004 from the ‘Teenage Pregnancy Unit (TPU) and Quality Products’ it now gives sexual health workers the chance to provide advice and contraception to teenagers that needed it and understood the side effects of the contraception (Department of Education, 2004). Health inequalities
A health inequality is defined as ‘something that puts someone at a disadvantage’ (Marmot, 2005). All health inequalities can be reduced and all are avoidable (Whitehead, 1992). The Government launched and put commitment the NHS plan, which was introduced to tackle health inequalities and provide a better life for adults and young people. The NHS Plan has targets which were set by the Government such as ‘Supporting vulnerable individuals and families’ and also ‘Breaking the cycle of health inequalities‘, which is mainly about education and giving people a chance to prove themselves; it also try to reduce poverty in the United Kingdom which may reduce health inequalities (Nuffield Trust, N.D). Health inequalities consist in any health issue: According to NCB (2013) education is a likely influence in teenage pregnancy as sex education is at a low standard and does not show what happens once a girl has had the baby at a young age in detail, it just gives an overview on how you get pregnancy, precautions and what happens once you have given birth such as changing nappies and feeding them.
They do not find all the information about late nights, losing friends and the risks of death and illness during and after the pregnancy as this is something schools do not teach those (Independent, 2012). Young girls also find that they feel ‘at a loss’ which means that if they do not do well in school and leave with high grades they will not get a good job with a high income and therefore will remain in a low place in society. The only way to get out of this situation is to have a baby and get state benefits which they think is a large income with not many outgoings (Why It Matters, 2010). Therefore, education is an inequality because if a teenager does not receive a decent education and knowledge about key subjects such as sex education, also teenagers would not know what is happening with their body and the risks of having unprotected sex such as sexually transmitted infections (STI), and also pregnancy. However, if a teenage is found to be pregnant and have an STI, it could be very dangerous for the teenager and unborn baby (Baby Center, 2013). Ethnicity and religion are key health inequalities as some religions beliefs are not to use contraception therefore safe sex is not possible when being active with a partner.
This is depicted with Roman Catholicism, their belief and their teaching says that you should not use a barrier in preventing God’s gift of life (Chait, N.D). According to Nelson (1982) you should not have sex outside of marriage which will be a proven barrier and in marriage you should not use contraception as God has chosen you to carry ‘his’ child. In today’s society however teenagers do have sex outside of marriage and this has caused a problem in lack of contraception which results in many teenage pregnancies. Other religions that contribute with this teaching are; Islam as they encourage reproducing life strongly and even though it is not a religious law it is strongly believed you should, like Catholicism, not put a barrier in the way of what God has chosen for you (BBC, 2009). One more contribution to health inequalities linked into teenage pregnancy is location. If you are from a higher class area your medical care will be a lot better than in a lower class area, you will be able to see doctors and other health organisations who will be able to provide contraception more easier and quicker than a lower class area who do not have the doctors and organisations as readily available to provide contraception. Another factor in location is rural and urban societies.
According to Medline Plus (2013) a rural location has limited medical resources and may include travelling to outside of the area which some teenagers may not know are there, they may also worry that their confidentiality is limited as their parents or other people they know will use the same place, they may not have the money to travel to than urban societies that have many medical organisations such as The Brook which are private and confidential and promote this information to young people more easy to access such as in town centres which does not involve excusing yourself to adults and parents for going, and are easier to get to like walking or buses for you travel via as they will be closer and more frequent (Brook, N.D). Marmot (2008) stated that in reducing health inequalities you require to promote six different objectives which are;
‘1. Give every child the best start in life
2. Enable all children, young people and adults to maximise their capabilities and have control over their lives
3. Create fair employment and good work for all
4. Ensure healthy standard of living for all
5. Create and develop healthy and sustainable places and communities
6. Strengthen the role and impact of ill-health prevention.’ (Fair Society, Healthy Lives, 2008)
In conclusion, teenage pregnancy is common all over the world and is a world issue. However, from the information stated above, it can be avoided and reduced with better sex education classes and a lot more media advertisement this is because teenagers in today’s society seem to be interested in media and what is new in the news. The strategies I mentioned focus on all areas that can be targeted to reduce teenage pregnancy rates in the United Kingdom from free messaging services to giving advice to those who need it. The strategies also allow people from deprived backgrounds to get involved and question their sexual health and sexual activity. Therefore, the Government need to keep bringing out fresh new ideas which will capture the attention of teenagers in the 21st Century.
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