The prevalence of teenage pregnancy worldwide has become a cause of major concern in recent years. It is viewed as an urgent crisis as the number of teenage girls bearing children outside of marriage increases. It affects the community and society at large. Some of the risk factors that lead to teen pregnancy are participation in unsafe sexual activities, poor performance and insufficient attendance of school, substance abuse, low family income, under use of contraception, deprivation and single parent families. There are several at risk circumstances related to teen pregnancy. These include higher dropout rates and less schooling, health and medical complications, poverty encircled life and decreased career aspirations.
Child bearing is the leading cause of teen girls dropping out of high school. Less than 50% of teen mothers complete their high school education and less than 2% attend college. Some young mothers have a second child within two years which further hinders them from attaining further education; this causes them to become economically dependent; the mother and her child face a lifetime of economic, educational and health challenges. Children born to teen mothers do worse in school as compared to those born to older mothers. Many of them repeat a grade, are placed in special education classes, experience milder education problems and have a lower probability of graduating from high school. These educational problems and disabilities can be attributed to the single marital status, high poverty prevalence and low level of education of the teenage mothers.
The negative effects teen pregnancy has on perinatal results and long term morbidity has resulted in it becoming a public health issue. Teen mothers have poor prenatal care since they fail to attend their prenatal appointments. They are at a higher risk of experiencing pregnancy complications, early marital breakdown if they are married and post natal depression. In addition, they tend to give birth to premature babies, low weight babies and babies who die in their first year of life. Furthermore, their infants experience higher infant mortality and morbidity rates as compared to those born to older mothers.
Teen pregnancy has several adverse effects and thus measures should be taken to reduce its prevalence. In addition, teen mothers should be provided with and encouraged to pursue opportunities to further their education and careers. This will go a long way in curbing the risk factors associated with teen pregnancy and in allowing them, and their children lead wholesome, productive lives.
In Manitoba, 6 teenagers become pregnant every day. This gives us one of the highest teen pregnancy rates in Canada, 55 pregnancies per 1,000 girls aged 15-19 years (www.thinkagain.ca). What does this say about adolescent sexuality in our province, and even in our community. Why are so many teens sexually active? And are they physically and emotionally ready to have sex? Adolescent sexuality has increased whereas the age of adolescents decreases. There were 2,205 pregnancies among 10-19 year olds in 1999/2000(Teen Sex, 2002). Teens are influenced by media (television, music, and magazines), peers, parents, and sex education at school. Unfortunately some of these influences don’t talk about the risks of sex, and protection against pregnancy and STI’s. The final decision about whether or not to have sex or use birth control is up to the adolescent.
When is it right? Most people make a decision about when to have sex for the first time. Part of the decision is asking questions about many parts of sex. There are also questions about the responsibilities and the risks involved with sex. Sex is a pleasurable and exciting part of life. Some risks and problems of sexual activity that affect the body are unprotected sex, disease, or pregnancy. Being able to communicate about such risks and problems is an equally important part of sexual readiness. A teen who is ready for sexual activity needs to understand STDs and be prepared to prevent their spread. Using condoms during sexual activity can be a healthy choice. Females are biologically more likely than males to get an STD (Sexual Readiness, 2000). This is because of the way the female body is built. The germs that cause STDs have more places to linger and cause problems in the female body. They must also understand the risks of sex while under the influence of alcohol or other drugs. The combination of alcohol and other drugs with sexual activity is dangerous. Using alcohol and other drugs makes it difficult for a person to think clearly. For example, a couple may not use protection during sex, or a drunk or high partner may not respect the other partner’s sexual limits. A Sexual relationship involves many emotions. Choosing to be part of any relationship can be an emotional risk. When sex is involved, the emotional risk can increase because sex can change a relationship. Teens who learn to understand and express their emotions are preparing for sexual readiness. Another part of being ready for a sexual relationship is setting limits and standards for yourself. Limits are boundaries, or points beyond which someone will not go. Standards are expectations of how a relationship should be. It is important to decide how far you are willing to go before any sexual activity takes place. For couples who choose to engage in sexual intercourse, communication is especially important. Communicating about possible outcomes before they happen is important. For example, couples should discuss the method of protection they will use and how they will deal with a possible pregnancy before they have sexual intercourse. Willingness to take responsibility is a sign that a person is ready for a sexual relationship. Responsibility involves establishing, keeping, and respecting sexual limits and standards. Most teens are physically ready to have sexual intercourse at a young age. However, physical ability is only part of being ready to have sex. Being ready for a sexual relationship in all other ways should be a thoughtful, multiple-step process. It is normal for this process to happen over a period of time rather that all at once.
Below is a checklist of questions you should ask yourself to judge your own sexual readiness (www.thinkagain.ca ):
- Do I feel pressured?
- Do I have to “prove” that I love my partner?
- Have I thought about how sex might change the way I feel about myself?
- Will sex change my relationship?
- Do I feel comfortable with my body and how it works?
- Can I openly discuss feelings with my partner without feeling scared or embarrassed?
- Do I understand that unprotected sex may result in a possible pregnancy or STDs?
- Will I buy and use protection during sexual activity?
- Do I think this will be a fun and pleasurable experience for me?
- How does having sex fit with my beliefs?
According to one survey, teens today learn about sex from the following sources: friends – 45%, television – 29%, parents – 7%, and sex-education classes – 3% (Teen Sex, 2002). Children and teens learn about sexuality from their peers, or people their own age. Peer influences on sexuality begin in childhood. Children learn what boys do and what girls do through their play activities. Children put pressure on each other to act and dress in certain ways. They may tease or ridicule a child who doesn’t fit their idea of masculine or feminine. Peer influences become strongest during teen years. Teens look to their peer group for support as they begin the process of separating from their family. Friends and classmates influence teen sexuality in several ways. They usually have sharply defined gender roles and rules about sexuality, they may give information about sex, but it may not always be correct, and friends may try to pressure others into having sex. Influences from the media. The media includes television, movies, newspapers, magazines, books, advertising, and, most recently, the Internet. The Media often encourages unhealthy sexual attitudes and behaviours among teens. Teens today live in a world in which sex is everywhere. It appears on billboards, in the lyrics to popular songs, and in newspaper headlines. Nowhere is sex more common than on television. According to one estimate, TV exposes the average teen to 14,000 sexual messages each year (Changing Bodies, Changing Lives, 1998). On MTV, 75% of the videos that tell a story use sexual images. Over half involve violence, and 80% combine sex and violence (Sex, 2000). The sexual content of TV shows, movies, music videos, and other media may be direct or indirect. There may be scenes of couples kissing passionately, taking off each other’s clothes, and preparing for intercourse. This is direct, in-your-face sex. Indirect content includes comedians making jokes about sex or talk show hosts discussing the sex lives of their guests. Sexual scenes in the media usually feature young and attractive people. They may have just met. These people rarely discuss the possibility of an unplanned pregnancy or an STD. Teens may view sex as something couples automatically do in a relationship and may believe that having sex will make them seem mature. Teens may learn a great deal about the physical side of sexual intercourse from the media. However, TV shows and movies usually don’t show how sex affects people emotionally and the importance of respect and communication in a relationship. Parents and other caregivers play a major part in shaping a child’s sexuality. They help to establish the child’s gender identity and gender role and teach attitudes about sex and sexual behaviour. Parents begin the process of gender identity b giving their newborn a “girl’s” name or a “boy’s” name. Parents teach gender roles by the toys they give their children and through household tasks. Many of today’s parents avoid following traditional ideas of masculine and feminine. Parents have many opportunities to influence their children’s attitude toward sexuality. Their words and behaviour can contribute to either healthy or unhealthy sexual attitudes. Ideas learned as a child may stay with a person for the rest of his or her life. Parents can have a big influence on sexual behaviour of their teen children. Teens have many questions about dating, romantic relationships, sex, and birth control. They often want help setting limits on sexual activity and saying no to pressure to have sex. Most teens would like to be able to talk with their parents about these matters. Children and teens may learn about sexuality through formal, or planned, sex-education instruction. However, they are more likely to learn about sexuality indirectly from teachers, textbooks, and school activities. Several studies have shown that teachers, educational materials, and school activities influence students’ gender identity and role(Sex 2000). Knowing about influences on sexuality is important for everyone. It’s especially important for teens because they are at a critical stage in their sexual development.
Couples who decide to have sexual intercourse must protect themselves against unplanned pregnancy and STDs. Both partners must take responsibility. If a couple can’t talk about birth control and protection, they should think again about having sex. Many methods of birth control are available. Two main groups are over-the-counter methods and prescription methods. A few over-the-counter methods also protect against STDs. Over-the-counter birth control and protection can be purchased without a doctor’s prescription. It’s available in places such as drugstores and supermarkets, and are inexpensive and easy to use. They include: male and female condoms, spermicides, and dental dams. The male condom is a latex or soft plastic covering that fits over the erect penis during vaginal, oral, and anal intercourse. Male condoms are 98% effective in preventing pregnancy when used correctly with every act of intercourse. The latex condom protects against certain STDs, including HIV. For this reason, they are strongly recommended for use with other birth control methods. The female condom is a soft plastic pouch that fits inside the vagina. The open end remains outside the vagina for the penis to enter. Female condoms are from 79% – 95% effective in preventing pregnancy. Their effectiveness in preventing STDs is not known. Spermicides include foam, creams or gels, suppositories, and contraceptive film. They are inserted into the vagina. Spermicides are best used as backup protection with male condoms, diaphragms, and cervical caps. They may provide some protection against certain STDs, but this needs more research. The dental dam is a silky, thin latex material that protects against STDs during oral-vaginal or oral-anal sex. A person can lick or kiss through the dam. Prescription birth control must be obtained from a health care professional. Generally, a female first must have a pelvic exam(examination of the reproductive organs). Prescription birth control includes: birth control pills, Depo-Provera, Norplant, diaphragms, and cervical caps. None of these methods protect against STDs. Birth control pills when taken exactly as prescribed, prevent pregnancy almost 99% of the time. They are convenient to use but because they are drugs birth control pills can cause side effects. Depo-Provera is a birth control shot. Every 12 weeks, the female gets a shot in the arm or buttock. Depo-Provera is almost 100% effective in preventing pregnancy, but can also cause side effects. Norplant consists of 6 rubbery capsules. Each capsule is about 1 inch long. A doctor inserts the capsules on the underside of a females upper arm. Norplant is nearly 100% effective in preventing pregnancy. Protection lasts for five years. A diaphragm is a latex cup worn inside the vagina during sex. A doctor or nurse fits a female with a diaphragm. It should be used with a spermicidal cream or gel to be most effective in preventing pregnancy. Without spermicide, a diaphragm is only 82% effective. With spermicide, this figure raises to 94%. A cervical cap is like a diaphragm, only smaller. It fits more tightly over the cervix than a diaphragm does. The cervix is the opening between the vagina and the uterus. The uterus is the hollow organ when an unborn baby develops. When used with spermicide, cervical caps are 91% effective in preventing pregnancy. That concludes the two main groups of birth control, leaving adolescents and adults with many options.
The large, complicated, and interrelated accumulation of factors suggest that the course that leads to adolescent sexual activity and pregnancy is complex. Not merely one or two, but a multitude of antecedents are related to one or more sexual behaviours and pregnancy, including characteristics of the teens themselves, their peers and sexual partners, their families and their communities and states. The decision is yours.
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