Teen Pregnancy

Charles Barnard, Kristen Bender, and Bryan Kokx

Teen pregnancy is a problem that affects all members of our society. This wiki first presents facts and statistics on teen sexual behavior and teen pregnancy. Second, there is a discussion on preventing teen pregnancy. Third, we address the issue of supporting pregnant and parenting teens. Last, there is a discussion of the moral implications of teen pregnancy on a democratic school system.

TEEN PREGNANCY: WHERE ARE WE NOW?

Teenage pregnancy is a major educational, social, and economic issue in the United States. One-third of all girls will become pregnant sometime before they reach age 20 (“Adolescent Reproductive Health,” 2008). The 2002 National Survey of Family Growth (NSFG), conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics, revealed some sobering figures. One quarter of teens, females and males, have had sexual intercourse by age 15. Nearly half of teens have had sexual intercourse by age 17. Fifteen percent of younger teens, age 15-17 years, had had two or more sexual partners in the last 12 months (Mosher, Chandra, & Jones, 2005).

Percentage of Teens Who Have Had Oral Sex, but not Vaginal Sex, by Age (years)
15 Years 16 Years 17 Years 18 Years
Females 8% 10% 15% 8%
Males 13% 12% 14% 10%
Percentage of Teens Who Have Had Vaginal Sex, by Age (years)
15 Years 16 Years 17 Years 18 Years
Females 26% 40% 49% 70%
Males 25% 37% 46% 62%
Number of Sexual Partners in the Last 12 Months for Teens Age 15-17 Years
0 Partners 1 2 3+ Previously Sexually Active (not in last year)
Females 50.2% 24.7% 7.0% 7.5% 8.4%
Males 52.4% 25.5% 8.4% 7.0% 5.9%

The 2002 National Survey of Family Growth demonstrated that the percentage of teens having sexual intercourse has actually decreased since the mid 1990s, particularly among younger teens age 15-17 years (“QuickStats,” 2005). From 1995 to 2002, the percentage of females age 15-17 years who have had vaginal intercourse decreased 21% and the percentage of males age 15-17 years who have had vaginal intercourse decreased 28%.

Percentage of Teens Who Have Had Vaginal Intercourse, by Age (years)
1995 2002
Females 15-17 Years 38% 30% 21% decrease from 1995
Females 18-19 Years 68% 69%
Males 15-17 Years 43% 31% 28% decrease from 1995
Males 18-19 Years 75% 64%

In the 2002 NSFG (“Key Statistics from the NSFG,” 2008), females age 15-17 years described their partner relationships at the time of first vaginal intercourse as

Just met/just friends 14.0%
Going out once in a while 6.6%
Going steady 74.6%
Cohabitating/engaged/married 3.7%

From 1990 to 2002, the number of teen pregnancies for females age 15-19 years decreased 26%. The teen pregnancy rate for females age 15-19 years decreased 35% from 1990 to 2002 and 10% from 2000 to 2002 (“Key Statistics from the NSFG.” 2008).

Teen Pregnancies and Teen Pregnancy Rate for Females Age 15-19 Years
1990 1995 2000 2002
Pregnancies 1017000 903000 834000 757000
Live Births 522000 500000 469000 425000
Induced Abortions 351000 263000 235000 215000
Pregnancy Rate per 1000 Females 116.8 84.8 76.4

In 2001, over 80% of teenage pregnancies were unintended. Forty percent of these unintended pregnancies ended in induced abortions. Finer and Henshaw (2006) demonstrated a large difference in the unintended pregnancy rate by income level. The unintended pregnancy rate for women with an income below the poverty level was 112 per thousand females. The unintended pregnancy rate for women with an income twice the poverty level was only 29 per thousand females. As income increased, the rate of unintended pregnancies ending in induced abortions increased and the rate of unintended births decreased. From 1994 to 2001, women with income below the poverty level had a 29% increase in the rate of unintended pregnancies and a 44% increase in the rate of unintended births. Over the same 1994 to 2001 time span, women with an income twice the poverty level had a 20% decrease in the rate of unintended pregnancies as well as a decrease in unintended births.

Finer and Henshaw (2006) also demonstrated a large difference in the unintended pregnancy rate by education level. Women who did not graduate from high school had an unintended pregnancy rate three times the rate of women who graduated from college. Women who were not high school graduates were less likely to end their pregnancies by induced abortions. Thus, they had an unintended birth rate four times the rate of women who graduated from college. From 1994 to 2001, women who graduated from college had decreases in the rates of unintended pregnancies and induced abortions. Over the same time span, women who did not graduate from high school had an increase in the rate of unintended pregnancies, no change in abortion rates, and an increase in the rate of unintended births.

There are significant differences in the rates of pregnancies, live births, and induced abortions by race (Ventura, Abma, Mosher, & Henshaw, 2004).

Pregnancy Rates, Live Birth Rates, and Induced Abortion Rates for Females Age 15-19 Years (rates per thousand females)
1990 2000
All Races Pregnancy Rate 116.3 84.5
Birth Rate 59.9 47.7
Abortion Rate 40.3 24.0
White Pregnancy Rate 87.7 56.9
Birth Rate 42.6 32.6
Abortion Rate 32.5 14.8
Black Pregnancy Rate 221.3 151.0
Birth Rate 116.2 79.2
Abortion Rate 83.5 57.4
Hispanic Pregnancy Rate 155.8 132.0
Birth Rate 100.2 87.3
Abortion Rate 39.1 30.3

In 2000, the pregnancy rate for Black teens was 2.7 times greater than white teens. The pregnancy rate for Hispanic teens was 2.3 times greater than white teens. From 1990 to 2000, the pregnancy rate for white teens decreased 35%, for Black teens decreased 32%, and for Hispanic teens decreased 15%. Differences in pregnancy and birth rates by race have continued this decade. In 2006, the birth rate for all teens was 41.9 per thousand females, for white teens 26.6, for Black teens 63.7, and for Hispanic teens 83.0. (“Adolescent Reproductive Health,” 2008).

In a 1993 survey of 46 developed countries, female teens in the United States had the second highest teen pregnancy rate and the second highest birth rate (Dangal, 2005). The U.S. pregnancy rate was twice the rate in England, France, and Canada; three times the rate in Sweden; and seven times the rate in the Netherlands. Compared to teens in other developed countries, U.S. teens have similar age of initiation of first vaginal sex and similar frequency of sexual intercourse. The much higher pregnancy and birth rates of U.S. teens are due to less frequent use of contraceptives and use of less effective birth control methods (Dangal, 2005).

In the United States over the past 15 years, the teen pregnancy rate has decreased each year from 61.8 in 1991 to 40.5 in 2005. For younger female teens age 15-17, the decrease in the pregnancy rate has resulted from increased use of contraceptives (77% contribution to the decline) and a decreased percentage of sexually active teens (23% contribution to the decline). For older female teens age 18-19, the decrease in the pregnancy rate has resulted entirely from increased use of contraceptives (“Adolescent Reproductive Health,” 2008).

In 2006, the U.S pregnancy rate increased 3.5% to 41.9. Teen pregnancy prevention programs, such as Advocates for Youth and the National Campaign to Prevent Teen Pregnancy, have tried to address the 2006 increase in the pregnancy rate with calls for programs which encourage teens to make healthy and mature decisions about sex: wait to initiate sex, have only one sexual partner, use condoms and other effective contraceptives (“Adolescent Reproductive Health,” 2008). Teens certainly need good guidance on sexual health issues. Over 20% of teens never use condoms or other effective contraceptives. Fifty percent of teen age pregnancy occurs within the first six months of the initiation of sex. A sexually active teen not using effective contraceptives has a 90% chance of becoming pregnant in one year (Dangal, 2005). The National Health Objectives for 2010 include the goals of increasing the proportion of intended pregnancies to 70% and increasing the proportion of females (and their partners) who use effective contraceptives to 100%. The consistent and correct use of effective contraceptives is the best strategy for reducing unintended pregnancies and sexually transmitted infections for sexually active teens (Bensyl, Iuliano, Carter, Santelli, & Gilbert, 2005).

Teenage pregnancy has a very significant educational, social, and economic impact on the teenage mother and the child. Risk factors for teenage pregnancy include living in poverty, coming from a single parent household, having a mother who was a teenage mother, having a sister become pregnant, and being a victim of sexual abuse. Teen behaviors that increase the risk of pregnancy include having sexually active friends and peers, early dating, dating older men, use of alcohol, and having a negative outlook on school and future career prospects (Dorrell, 1994; “Teen Pregnancy Prevention,” 2005; Thompson & Caulfield, 1998). In contrast to pregnancy after age 20, teenage pregnancy is associated with mothers less likely to complete high school. Girls who become pregnant before age 17 have less than a 25% chance of graduating from high school (Dorrell, 1994). Teenage mothers are more likely to live in poverty, are more likely to be a single parent and remain a single parent, and have less chance of receiving child support from the child’s father. Pregnant teens are less likely to receive appropriate prenatal care, less likely to gain appropriate weight during pregnancy, and more likely to smoke during pregnancy. They have a higher rate of delivery complications, including toxemia, hemorrhage, and death (“Adolescent Reproductive Health,” 2008).

The babies of teenage mothers are more likely to be born premature and at low birth weight. The children of teenage mothers are more likely to struggle with reading and mathematics, repeat a school grade, be victims of abuse and neglect, be in foster care, and not graduate from high school. The adolescent/youth offspring of teenage mothers are more likely to give birth as teens, be in jail or prison, and be unemployed (“Teen Pregnancy,” n.d.).

Factors associated with teens delaying the initiation of sexual intercourse include living with two parents in a stable home environment, attending church regularly, and living in a family with increased income. Factors associated with regular use of effective contraceptives include success in school, a positive outlook on the future, anticipation of future career success, and a stable relationship with a partner (Dorrell, 1994).

PREVENTING TEEN PREGNANCY

Teen pregnancy is a problem that will never be completely eradicated from society. Nonetheless, there are several steps that families, schools, and communities can take to reduce its incidence. Most teen pregnancies are unintentional. There are several correlations to teen pregnancy. Disadvantaged youth are three to four times more likely than advantaged peers to experience teen pregnancy. There is also a positive correlation between poor academic ability and achievement and teen pregnancy. Teens who see hope for a successful future are less likely to get pregnant (Bempechat, 1989).

One way to overcome the feelings of hopelessness experienced by teens is to get guidance counselors more directly involved in students’ mental and emotional well-being. Counselors can even discuss topics concerning family relationships outside of school. Counselors can provide proactive guidance, working towards mentally and emotionally healthy students. With a more positive self-esteem and an optimistic outlook on the future, students will have a much greater chance of achieving academic success (Boley, 1994).

A straight forward method of preventing teen pregnancy is educating students about all aspects of sexual health. Unfortunately, due to the controversial nature of teenage sexuality, sex education is not receiving a great deal of attention in schools at the current time. On average, six to ten hours is spent annually on sex education at the junior/senior high level. Less than twenty percent of schools that provide sex education discuss interpersonal relationships across genders or avoiding unwanted pregnancy. Barth, Middleton, and Wagman (2001) recommend a social and cognitive approach to educating teens about pregnancy. This approach highlights four key factors that determine whether or not a decision such as choosing to use birth control will be made. First, teens must understand how to use birth control. Second, teens must believe that they will be able to actually use the birth control. Third, teens must know that the birth control will prevent pregnancy. Last, teens must experience the benefit of correctly using birth control. According to Social Cognitive Theory, teens must understand and embrace these four components before they will become consistent users of effective birth control methods (Barth, Middleton, & Wagman, 2001).

Students must be explicitly taught each of these four key factors. They will not know how to use birth control unless they are educated. Teens will not understand why to use birth control unless they fully understand how pregnancy occurs and how different methods of birth control work. Lastly, teens will not experience the benefit of birth control unless they are given access to it and are able to use it consistently and correctly thus successfully preventing unintended pregnancy.

Unbiased sex education information must be available to young people. According to Melissa Gross (1997), librarians should provide unbiased information regarding sexual health issues. The can also provide lists of available community resources devoted to medical and psychological aspects of teenage pregnancy. Sixty-four percent of parents interviewed in a survey conducted for Planned Parenthood indicated that they felt they had no control over their children’s sexual behaviors. Eighty-five percent of parents interviewed felt that sex education should be taught in schools (Bonjean & Rittenmeyer, 1987). Bonjean and Rittenmeyer suggest that sex education be integrated into home economics classes that already cover topics such as child development, family planning, and interpersonal and intrapersonal relationships. A national survey from 2002 found that “teens who received comprehensive sex education were sixty percent less likely to report becoming pregnant or impregnating someone than those who received no sex education” (Comprehensive Sex Education,” 2008, para. 6). Pediatric obstetrician-gynecologist Dr. S. Paige Hertweck of the University of Louisville points out that teens are more likely to participate in unsafe sex if they are taught abstinence and not educated on effective birth control methods (“Doctors denounce abstinence,” 2005). If schools foster an environment of open communication between students and teachers concerning all topics related to teen pregnancy, an atmosphere of trust, learning, and growth will naturally occur.

An atmosphere of open communication is also important in strengthening social skills of teens in regards to sexual behaviors. Barth, Middleton, and Wagman (2001) report that teenage girls often have poor strategies for communicating a desire not to participate in sexual activity. Seventy-five percent of girls report the reason for having sex as their boyfriend’s desire to do so (“The Reasons Teens Get Pregnant,” n.d.).

While the majority of teen pregnancies are unplanned, fifteen percent are intentional. Ruchman and Jemmott (1997) found that girls who wanted to get pregnant had lower scores on the mother-daughter relationship assessment. Teenage girls’ whose mothers have completed high school are less likely to desire a pregnancy. The significant factor was number of siblings. The more siblings a teen had, the less likely she was to wish for a pregnancy of her own. School guidance counselors can help students cope with emotionally challenging issues surrounding teen pregnancy in order to dissuade young girls from intentionally getting pregnant. The West Virginia Department of Education, Office of Educational Research and Improvement, (1987) recommended parent education programs to help parents fulfill the role of primary educator and support them as they support their teens.

Teen pregnancy may not be a social issue that we as a society can prevent 100% of the time. However, through open communication, consistent and detailed sex education, and emotional support, we can lead teens down a safe path for making informed decisions.

SUPPORTING PREGNANT AND PARENTING TEENS

Reducing the incidence of teenage pregnancy through education of teens on all sexual health issues is a primary goal of our schools and our society, but after conception the focus needs to shift to supporting teen parents. Providing support to pregnant and parenting teens has become the responsibility of schools, community service organizations, and state agencies. Teen pregnancy creates many educational, social, and economic issues for society. Teen mothers are not completing school. Their lack of education adversely affects their job prospects, often resulting in the inability to support themselves and their children. This creates a financial burden for all members of society. Teen parents without support and guidance often do not have the skills or knowledge to adequately care for their children, leading to even more responsibilities for the schools and society in the future.

The National Research Council reported in 1987 the following:
For each year of school completed by a teenage mother, the likelihood of her children repeating a grade will be reduced by as much as 50 percent. One in five children lives with a mother who has not completed high school. The chances of that child’s dropping out of school are two to three times higher than those of a child with a mother who has completed high school. (Dorrell, 1989, para. 18)
The U.S. Department of Education Office for Civil Rights reported in 1991 the following:
Every year nearly 500,000 teens give birth. Almost half of the unmarried teens who have a child before the age of 18 will never complete high school…. Forty-three percent of the females who drop out do so because of pregnancy, parenthood, or marriage…. Teenagers who become mothers double their risk of ending up on welfare. (p. 3)

Even with prevention programs in place, teen pregnancy is still having a profound impact on our society. According to Wanda Pillow, a professor of educational policy at the University of Illinois at Urbana-Champaign, “People are uncomfortable with teenage sexuality, particularly female sexuality, and pregnancy is an embodiment of that. Rather than deal with the issues related to the teen mother, what we retreat to every time is” prevention (Chamberlain, 2004, para. 10). When the teen pregnancy has not been prevented, support of the pregnant teen and teen mother becomes the paramount issue.

A major step to assist teens in receiving an education during and after pregnancy was the passing of Title IX in 1972. This “statute prohibits sex discrimination in any program or activity receiving federal financial assistance” (Belsches-Simmons, 1985, p. 7). The statue also states the following:
Institutions shall not discriminate against or exclude any person on the basis of pregnancy, childbirth, termination of pregnancy, or recovery therefrom, or establish or follow any rule or practice which discriminates or excludes; shall treat disabilities related to pregnancy, childbirth, termination of pregnancy, or recovery therefrom in the same manner and under the same policies as any other temporary disability or physical condition. (Belsches-Simmons, 1985, p. 7)

Title IX mandated that schools could no longer prevent pregnant students from receiving any and all of their education programs. A student could no longer be expelled for being pregnant. Schools which offered pregnant students and teen mothers special instructional programs were required to provide these programs on a voluntary basis only, rather than insisting or forcing pregnant students and teen mothers to attend these programs, as had been done prior to Title IX. These programs had to be comparable to the regular classes offered to non-pregnant students. Upon returning to school after the birth of a child, the student must be allowed to return to regular academic classes in the regular setting, along with returning to regular status in any extracurricular activities (Office of Civil Rights, 1991). Spurred on by Title IX, schools and community service organizations began a long process of developing and implementing programs that would support teens through pregnancy and the early stages of parenting.

The roles of school administrators, teachers, and counselors have become more prevalent in the success and retention of teens in school during and after pregnancies. School administrators have the responsibility to encourage their district superintendents and school boards to establish policies that will assist the schools in educating and providing other services to pregnant and parenting teens. Administrators also can gather and relay data to school boards and superintendents on the effects of teen pregnancy and teen parenting on districts’ drop-out rates, which might encourage more actions and policies to reduce future drop-outs. Administrators also need to ensure that faculty members have access to materials and information that they can utilize to assist pregnant or parenting teens. Teachers need to be willing and enpowered to reach out to pregnant teens to support them in their pursuit of education. Students who have dropped-out of school need teachers to assist them in returning and completing school. Frequently, teachers are the first to notice or hear that a student is pregnant. Teachers should communicate this information to school counselors and administrators so all involved can encourage and support the student to stay in school. School counselors can support pregnant teens and teen mothers by providing guidance on the educational options and information on school and community support services. School counselors can also assist students in communicating with their families regarding pregnancy and their subsequent needs (Office of Civil Rights, 1991).

Bonjean and Rittenmeyer (1987) propose the following:
Three sets of goals should guide the development of programs to deal with the multifaceted problem of teenage pregnancy. The first set deals with efforts to prevent or decrease adolescent pregnancies. The second set includes efforts aimed at minimizing the consequences of adolescent pregnancy. The third set includes efforts to provide resources and support to help adolescent parents assume their role as parents and to become productive citizens in their community. (p. 22)

Bonjean and Rittenmeyer’s first goal was addressed in the preceeding section, Prevention of Teenage Pregnancy. The second goal, that of minimizing the negative consequences of teenage pregnancy, has lead to the development of programs that educate teens on the importance of early detection of a pregnancy along with the importance of prenatal care and proper nutrition. Pregnancy causes enormous stresses for a young teen. Teens need to have access to counseling to assist them with the many difficult decisions of pregnancy, including adoption, abortion, or keeping and raising the child. Teens need support and counseling when dealing with their families and how the pregnancy will affect the entire family unit. Teens also need to feel supported and be given ample opportunity to continue with their education during pregnancy and after the birth of the child (West Virginia State Department of Education, 1987).

The third goal, that of supporting teen mothers after the birth of the child, has largely been handled by community agencies. However, schools can also partner with community service organizations to provide services to the teens in their school districts. One focus of these services is to ensure that mother and child are receiving post-natal health care. The programs also provide parenting classes to ensure teen parents are educated and prepared to care for their infant child. Affordable daycare for the infant is crucial, so that teen mothers can return to school to complete their education. Unfortunately, affordable childcare is often an issue because funding for such programs is limited or nonexistent. According to a 1992 survey conducted by the Missouri State Teachers Association, only nine states funded extended-day childcare (Dorrelll, 1994).

Job training and placement are important in helping teen parents set career goals and become capable of financially providing for themselves and their children. Lastly, ongoing education on pregnancy prevention, including the consistent use of effective contraception methods, is crucial to avoid further pregnancies for teens (Bonjean and Rittenmeyer, 1987).

One example of a model program that has taken on the role and responsibility to ensure the education and health and safety of teen mothers and infants is the New Futures School. This is a program in the Albuquerque, New Mexico public school system. The program provides an alternative education program for pregnant teens and offers services in school such as prenatal health care, day care for the infant, and job counseling and training. The program has a 92% graduation rate and a one-year repeat pregnancy rate of 6-8%, which is much lower than the national average of 18- 25%. The program has also reduced the number of low birth weight babies by 50% (Weiner, 1987). This program is funded and supported by local agencies such as the Albuquerque Public Health Service and the University of New Mexico School of Medicine, as well as the state of New Mexico. The success of the New Futures School in Albuquerque and similar programs, such as the New Lives Program in Fort Worth, depends on adequate funding and strong partnerships with other community service organizations and local and state governments.

MORAL IMPLICATIONS

Our research findings point to the fact that teen pregnancy is a serious social, educational, and economic issue in the United States today. The most democratic approach to dealing with teenage pregnancy is to educate teens in all areas of their sexual health and to teach the skills and knowledge that will assist them in making responsible decisions. Schools should provide a multi-faceted approach to sexual health education, including accurate and complete information on abstinence, effective birth control methods, and the negative consequences of teen pregnancy and parenthood. Students will then have the knowledge they need to make responsible decisions. Ultimately, it is an individual's decision when and how he or she will engage in sexual activity. We believe teenagers can make a mature and responsible decision to have sex. However, we believe sexually active teens must also make mature and responsible decisions to consistently use effective birth control methods. Teenagers should be made aware that abstinence is the only way to be completely protected from sexually transmitted diseases and pregnancy. They should also be taught where to obtain contraceptives and how and why (especially why!) to effectively use them. Teens must understand all of the potential consequences of engaging in unprotected sex, including sexually transmitted diseases, pregnancy, and emotional stress. Teens need to be taught about the various responsibilities that come with having a child and also how to care for themselves and a child should they become pregnant. Resources must be made available to pregnant and parenting teens. It is paramount that affordable daycare be provided so that parenting teens can complete their education. If schools provide a great deal of support and easily accessible knowledge to teens regarding their sexual health, teenagers will be more likely to make responsible decisions, resulting in a decrease of teen pregnancies in the United States today.

TEEN PREGNANCY IN THE NEWS

http://www.time.com/time/world/article/0,8599,1815845,00.html

REFERENCES

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