Is Adolescent Pregnancy a Problem?

Pregnancy in adolescence has been widely studied in Latin America, although perhaps less in the Caribbean. There cannot be said to be a consensus on whether this pregnancy is a negative or positive event per se during this stage of life. However, most authors agree that it is not medically recommended because “pregnancies among adolescents, especially the youngest ones, tend to threaten the life and health of both mother and child. Adolescents suffer more pregnancy complications than older women due to a combination of factors: being first-time mothers, not having completed the final stage of growth (incomplete development of the skeleton and pelvis) and not receiving proper prenatal care” (IPAS, 2001). “Adolescent pregnancy isregarded from a medical and social point of view as a risky situation for the health and personal development of the mother, her child and her partner” (Díaz Sánchez, 2003).

Pregnancy during this life stage is often regarded as a social and public health problem, particularly since it is apparently on the increase. But the health problems derived from this state are primarily linked to women’s living conditions rather than to their youth. Those facing problems during their pregnancy are often those who live in disadvantaged conditions, have limited access to health services, and therefore have insufficient or inadequate prenatal care, in addition to suffering from malnutrition and lacking good health before pregnancy. They may sometimes engage in habits that are bad for their gestation, such as smoking (Pantelides, 2004; Gogna et al., undated). Many experiences show that “with appropriate psycho-social support and proper prenatal control, the obstetrical results of adolescent mothers are comparable to or almost as good as those in women over the age of 20”. (Gogna et al., sd).

There are those that consider that adolescent pregnancy is negative socially, emotionally and economically because “early motherhood usually leads young women to prematurely stop studying, making them unable to obtain better paid jobs. Societies and families may exclude young women that become pregnant out of wedlock”. (IPAS, 2001). However, other studies (Silber et al., 1995; Stern, 1997 and 2001; Pantelides, 2004) assert that adolescent pregnancy and the problems generally linked to it cannot be generalized, since they largely depend on the context in which they occur. Rather than assuming that adolescent pregnancies have a single negative implication and meaning, one should bear in mind the different contexts in which they take place, both for their assessment and for implementing the corresponding public policies.

As indicated earlier, these pregnancies occur more often among young women belonging to the most disadvantaged social classes than among those of a higher socioeconomic level. (Pantelides, 2004). On the basis of the National Reproductive Health Survey 2003 conducted in Mexico, Menkes and Suárez (2005) analyzed data from 1,799 adolescents who had been pregnant at any time between the ages of 12 and 19. The results indicate the presence of specific rates of adolescent pregnancy that are very different for women ages 15 to 19, according to their socioeconomic stratus: 158‰ among the very lowest stratum, 84‰ in the lower stratum and only 2‰ and 0.6‰ for the middle and upper class strata.

In their study on adolescent pregnancy, Stern and García (2001) conclude that “perhaps, in an attempt to establish a causal relationship between early pregnancy and poverty in our countries, one should consider that the context of poverty and lack of opportunity is a ‘cause’ of early pregnancy and its negative consequences and not vice versa” (p.337). Guzmán et al., (2001) corroborate this same relationship, stating: “Poverty is a determining factor, which underlines the influence of the socioeconomic context in which the family lives on early adolescent fertility”. This situation is also observed in indigenous groups in countries such as Colombia, Peru and Guatemala, which are in an extremely vulnerable situation.

Stern (1995) indicates that adolescent pregnancy in a rural context is not the same as that in other circumstances since this event is influenced by “the persistence of a traditional norm which assigns to women the roles of wife and mother as her only destination, and/or by the lack of other options”. According to the author, in a marginal urban context in which there is job insecurity, family violence, and early school drop-out rates, as well as an enormous lack of material goods and life options, the main implications of pregnancy “would revolve around the growing vulnerability and lack of protection of adolescents in their situation” which is often reflected in the fact that young women from this sector of the population resort to abortions in precarious conditions.

In this respect, other authors also point out that there is “evidence that in many cases, pregnancy is more the result than the cause of a complex set of problems that include academic failure and a poor relationship with one’s parents” (Guzmán et al., 2001). Although early pregnancy is often supposed to result in dropping out of school, many studies show that dropping out of school occurs more often before pregnancy (Pantelides, 2004). In Mexico, Romero et al. (1994) indicate that over 70% of adolescents that went to hospital to give birth or abort had dropped out of school before they became pregnant. They also found that the majority of women that continued their studies wished to abort. In a study conducted in 2000 in three cities in Brazil (El Salvador, Rio de Janeiro and Porto Alegre, Aquino et al. (2003) show that with the birth of their fist child, some adolescents dropped out of school, 25% permanently and 17% temporarily. But 42% of them had already dropped out of school before becoming pregnant. In Argentina, the results of a survey on pregnant girls aged 15 to 19 conducted in hospitals in 2003 and 2004 also indicate that a large number of these teenagers dropped out of school before pregnancy (Gogna et al., undated).

Adolescent pregnancies, as mentioned earlier, are not always regarded as a social problem since they may be encouraged or expected in certain societies. This is particularly true in the case of recently married young women: far from being stigmatized, a pregnancy may be a factor in upward social. On other occasions, young women’s pregnancies lead to a union that also confers social status.

In a study conducted in Colombia, Florez et al. (2004) conclude that adolescent pregnancy is positively perceived, enabling a woman to achieve greater social status, in addition to helping her form a real family and strengthen her female identity. For men, such a pregnancy is a way of confirming their masculinity.

Whatever the view of adolescent pregnancies may be, there are often neither planned nor wanted. They often also result from unprotected sex due, among many other factors, to a lack of timely access to information and contraceptives, or to sex with violence. These types of pregnancies have adverse implications. Some of them end in abortion and others in unwanted children. Lack of prevention in sexual relations can also be translated into sexually transmitted infections (STI,) such HIV/AIDS. This can be explained by the ignorance of many young people about the way their bodies function, in addition to the fact that they are unaware of the risks inherent in the exercise of sexuality, as its was stated in a research project conducted in Mexico (Ehrenfeld, 1999).

Moreover, adolescents are not always able to ensure that their partners will practice protected sex. This is mainly due to male domination, particularly when young girls have sex with older men, or in cases of sexual abuse. This situation explains why these young women are exposed to situations that carry high risk to their health, as noted by Radhakrishna and Greesiade (1997), risks identified by these authors are known as “3U” (a triple jeopardy: Unprotected sex, Unwanted pregnancy, and Unsafe abortion). In Argentina, Weller (2000) describes the problem of male domination among “girl-mothers” (aged 9 to 13): “80% of them have had children with men who are at least 10 years older than them, and the rest with males that are at least 20 years older than them”.

For Palma et al. (2006), adolescent abortion is largely due to the fact that the pregnancies occur out of wedlock. However, they point out, many pregnancies among adolescents under 20 are indeed wanted.

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