Many adolescents engage in sexual activity but may not be fully informed about contraception, pregnancy, and sexually transmitted infections, including hepatitis C and human immunodeficiency virus (HIV) infection. Impulsivity, lack of planning, and concurrent drug and alcohol use decrease the likelihood that adolescents will use birth control and barrier protection (such as condoms).
(See also Introduction to Problems in Adolescents.)
Contraception in adolescents
Any of the adult contraceptive methods may be used by adolescents, but the most common problem is adherence. For example, some adolescent girls forget to take birth control pills every day or stop taking them entirely and may not substitute another form of birth control. Although male condoms are the most frequently used form of contraception, there are still perceptions that may inhibit consistent use. For example, adolescents may think condoms decrease pleasure and interfere with “romantic love.” Some adolescents also are shy about asking partners to use condoms during sex. Longer-term forms of contraception, such as intrauterine devices (IUDs), hormonal injections that last 3 months or longer, or implants under the skin that may be effective for several years, are popular with adolescent girls.
Adolescent pregnancy
Pregnancy can be a source of significant emotional stress for adolescents.
Pregnant adolescents and their partners tend to drop out of school or job training, thus worsening their economic status, lowering their self-esteem, and straining personal relationships. Pregnant adolescents are less likely than adults to get prenatal care, resulting in poorer pregnancy outcomes, such as higher rates of premature birth. Pregnant adolescents, particularly the very young and those who are not receiving prenatal care, are more likely than women in their 20s to have medical problems such as anemia (when the body does not have enough healthy red blood cells) and preeclampsia (high blood pressure and protein in the urine that can stress the fetus).
Infants born to younger adolescents (especially those under 15 years of age) are more likely to be born prematurely and to have a low birth weight. However, with proper prenatal care, older adolescents have no higher risk of pregnancy problems than adults from similar social and economic backgrounds.
A pregnant adolescent may choose to continue or terminate the pregnancy. An adolescent may raise the child herself or together with the child's father, possibly with support of family members, or may give up a child voluntarily (adoption).
All of the options may cause emotional stress. Counseling for both the girl and her partner can be very helpful. Counseling should also include education about use of contraception after the pregnancy.
An adolescent's parents may have different reactions when their child is pregnant or has impregnated someone. Emotions may range from distress to excitement, apathy, disappointment, or anger. It is important for parents to express their support and willingness to help the adolescent sort through their choices. Parents and adolescents need to communicate openly about abortion, adoption, and parenthood, which are all tough options for adolescents to struggle with alone.
