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Teenage Pregnancy
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Teenage Pregnancy
Ramiro Molina Cartes ⭈ Electra Gonzalez Araya
Centro de Medicina Reproductiva y Desarrollo Integral de la Adolescencia (CEMERA), Facultad de Medicina,
Universidad de Chile, Santiago, Chile
Abstract
Teen pregnancy is a social problem not resolved in developing and some developed countries.
Adolescent fecundity has become the most exact bio-demographic and health indicator of develop-
ment. In developing countries that are expected to follow the sexual behaviour patterns of devel-
oped countries, without offering the levels of education and services for adolescents, the
consequences will be adolescent fecundity and STI prevalence increase. The ignorance about sexu-
ality and reproduction both in parents, teachers and adolescents increases the early initiation of
coital relations and of unwanted pregnancies. Extreme poverty and being the son or daughter of an
adolescent mother are risk factors of repeating the early pregnancy model. The application of pre-
dictive risk criteria in pregnant adolescents to facilitate the rational use of Health Services to dimin-
ish the maternal and perinatal mortality is discussed as well as the social factors associated with
adolescent pregnancy as socioeconomic levels, structure – types and characteristics of the family,
early leaving school, schooling after delivery, female employment, lack of sexual education, parental
and family attitudes in different periods of adolescent pregnancy, adolescent decisions on preg-
nancy and children, unstable partner relationship and adoption as an option. Social consequences
are analyzed as: incomplete education, more numerous families, difficulties in maternal role, aban-
donment by the partner, fewer possibilities of having a stable, qualified and well-paid job, greater
difficulty in improving their socioeconomic level and less probability of social advancement, lack of
protection of the recognition of the child. Finally, based on evidence, some measures that can reduce
adverse consequences on adolescent mothers, fathers and their children are suggested.
Copyright © 2012 S. Karger AG, Basel
Region/country Higher adolescent fecundity rate Region/country Lower adolescent fecundity rate
Africa Africa
Congo RD 222 21 Burundi 55 20
Liberia 219 6 Botswana 52 44
Niger 196 11 11.2 Mauritius 41 76 43.2
Guinea-Bissau 189 10 Rwanda 40 17
Mali 179 8 Egypt 39 59
Chad 164 3 Swaziland 33 46
Sierra Leone 160 5 Morocco 19 63
Uganda 152 24 11.6 Tunisia 7 63 55.6
Guinea 149 9 Algeria 7 61
Mozambique 149 17 Libyan Arab 3 45
Jamahiriya
Latin America and Caribbean Latin America and Caribbean
Nicaragua 113 72 Costa Rica 71 80
Dominican Republic 108 61 Colombia 65 78
Guatemala 107 43 62.2 México 65 71 74.0
Honduras 93 65 Uruguay 61 77
Venezuela 90 70 Chile 60 64
Brasil 89 77 Perú 60 71
Panamá 83 – Argentina 57 65
El Salvador 81 67 71.5 Cuba 47 73 55.8
Ecuador 83 73 Haiti 46 32
Jamaica 78 69 Trinidad and Tobago 35 38
Asia Asia
Bangladesh 125 58 Israel 14 68
Nepal 115 48 Malaysia 13 55
Afghanistan 113 19 42.6 Kuwait 13 52 57.2
Laos People’s DR 72 32 Oman 10 24
India 62 56 China 8 87
Palestinian 79 50 Singapur 5 62
occupied territory
Yemen 71 23 Hong Kong 5 84
Timor-Leste RD 54 10 34.8 Republic of Korea 4 81 70.0
Philippines 47 51 Japan 3 54
Cambodia 42 40 Democratic 1 69
Republic of Korea
Europe Europe
Bulgaria 40 42 Finland 9 77
Romania 32 70 Spain 9 66
Serbia 25 41 61.4 Greece 9 76 72.6
United Kingdom 24 84 Germany 9 70
Estonia 21 70 Norway 8 74
Region/country Higher adolescent fecundity rate Region/country Lower adolescent fecundity rate
United Nations for populations Activity. The State of World population. 1995 and 2008. www.unfpa.org
Adolescent fecundity has become the most exact biodemographic and health indi-
cator of development levels in many countries.
On comparing five countries of the Latin American and Caribbean Region with
the 6 developed countries with lower infant mortality rates in 2008 and their evolu-
tion since 1995, there is a 10-point difference between Sweden and Uruguay, a 2-point
difference with Cuba and 4 points with Chile. These differences do not reflect differ-
ences in development.
Nonetheless, when comparing the adolescent fecundity rates between Sweden and
Uruguay there is a difference of 56 points, 42 with Cuba and 55 with Chile.
Adolescent fecundity gives an almost unequivocal reflection of the differences betw-
een developed and developing countries. This reflection also means that the solution is not
circumscribed to contraception in adolescents, but that there are many actions to be taken
that affect adolescent fecundity apart from poverty and underdevelopment (fig. 1, 2).
Fig. 1. Infant mortality rates in selected countries: 1995 and 2008. United Nations for populations
activity. The state of world population, 1995 and 2008. www.unfpa.org.
Costa Rica
100 93 92 Trinidad&Tobago
Cuba
80 Chile
64 Uruguay
60 60 60 61 Sweden
60 56
France
42 Finland
39
40 33 35 Germany
27 27 Canada
24
20 13 13 13 15 UK
9 9 9 USA
5 7 7
2
0
–20
–24 –22
–27
–31 –31
–34
–40
–42 –44
–49
–60
–66
–80
Fec rate 1995 Fec rate 2008 % Decreasing
Fig. 2. Fecundity rates of 15- to 19-year-olds in selected countries 1995–2008. United Nations for
populations Activity. The state of world population, 1995 and 2008. www.unfpa.org.
9 and 50% in females and 15 and 65% in males, depending on the characteristics of
the adolescents. In the 1985–1987 National US Survey, some 80% of male adolescents
had had their first sexual experience before the age of 20, as was the case with 75% of
females of the same age group (table 2).
As can be seen in practically all the countries with comparative DHS surveys,
there is a fall in the age of the first sexual relation and an increase in contraceptive
Country and years Fecundity rate Mean age Mead age at Age of first % contraceptive % current
15–19 for 1st child 1st marriage sexual relations use at 1st sexual contracep-
relation* tive use**
Bolivia to Dominican Republic: ORC Macro. 2000 Measure DHS STAT compiler http://www.measuredhs.com
Chile: Fourth National Survey of the National Youth Institute 2006. http://www.INJUV.gov.cl/index2.html
Sweden to USA: The Alan Guttmacher Institute. Darroch J, Frost J, Susheela Sing and study team. Teenage Sexual and repro-
ductive Behaviour in Developed Countries. Can More Progress Be Made? Ocasional report No. 3, November, 2001. New
York, Washington.
* Contraceptive use before the first birth.
**Use among married women.
*** Use with first sexual relation and use among currently sexually active adolescents and youngsters.
Introduction
There are doubts regarding the criteria of selection and management of pregnant
adolescents. Some consider that any pregnancy in single women of under the age of
19 is a high obstetric and perinatal risk. Others do not agree with this criterion and
consider that not all pregnant adolescents are at risk, but find it difficult to apply cri-
teria that allow for their classification according to risk factors.
The application of predictive risk criteria in pregnant adolescents would facilitate
the rational use of health services in accordance with their own organization and the
reality of the resources available. Those systems with adequate structures between
the different levels of complexity of the health care system would find that an instru-
ment of this kind would be easy to apply and validate, by means of the variables of
each reality. Those systems that do not have upgrades in terms of levels of complex-
ity or those that only offer preferential health care to a given level would also find an
Pregnancy 652
No pathology 364 55.8
Evidence of pathology 288 44.2
Obstetric 77.4
Infectious and parasitic 8.7
Urogenital 4.5
Cardio respiratory and digestive 3.5
Nutrition 2.1
Neurological and Psychiatric 2.1
Other diagnoses 1.7
Total 100.0
Delivery 652
No pathology 407 62.4
Evidence of pathology 245 37.6
Bearing-down detention 26.9
Fetal-pelvic disproportion 22.9
Problems related to placenta and cord 19.2
Pregnancy-induced hypertensive syndrome 15.1
Fetal distress 11.4
Lesion of soft parts 2.8
Other diagnoses 1.7
Total 100.0
Newborn 652
No pathology 413 63.3
Evidence of pathology 239 36.7
Jaundice 28.5
Infections and sepsis 15.9
Asphyxia and RSD 11.7
Hemolytic Illness and Rh and Cl group 10.9
Polyglobulia 9.2
Obstetric trauma 8.4
Small for gestational age (SGA) 7.5
Cord-related problems 4.2
Other diagnoses 3.3
Total 100.0
Results
Of the variables analyzed, 11 refer to the personal characteristics of the adolescent, 4
to indicators of health care and gestational morbidity and 4 to the progenitor of the
pregnancy and to the family of the adolescent.
Age group RR CL RR CL RR Cl
11–14 years 1.22 0.94–1.58 1.29 0.99–1.69 0.79 0.54–1.17
15–16 years 1.11 0.92–1.33 0.94 0.76–1.16 1.03 0.84–1.27
17–19 years (reference) 1 1 1
Parental filiations
Recognized by both parents 1 1 1
(reference)
Recognized but not legally 0.89 0.71–1.12 0.95 0.75–1.21 0.90 0.69–1.17
Not recognized or orphan 0.78 0.50–1.21 0.79 0.48–1.30 0.78 0.46–1.32
Instruction level
3rd, 4th or University 1 1 1
(reference)
1st–2nd secondary school 1.31 0.92–1.84 0.98 0.70–1.35 1.05 0.76–1.45
5th–8th Primary School 1.26 0.91–1.75 0.99 0.73–1.34 0.89 0.65
1st–4th Primary School 1.73 * 1.21–2.46 0.97 0.67–1.42 0.82 0.54–1.23
Adolescent attitude at beginning of pregnancy
Positive (reference) 1 1 1
Negative 1.34 0.89–2.30 1.18 0.75–1.85 1.01 0.66–1.56
Indifferent 1.11 * 1.21–3.69 1.32 0.68–2.53 1.49 0.84–2.65
Adolescent attitude at the end of pregnancy
Positive 1 1 1
Negative 1.08 0.78–1.49 1.11 0.78–1.57 1.04 0.71–1.52
Indifferent 1.32 * 1.00–1.74 1.10 0.77–1.58 0.96 0.63–1.45
Order within the family
5th–8th (reference) 1 1 1
2nd–4th 0.98 0.77–1.25 0.96 0.73–1.26 1.10 0.87–1.40
1st 1.03 0.80 1.11 0.84–1.47 1.14 0.84–1.56
Pregnancy sexual condition
Voluntary (reference) 1 1 1
Seduction 1.13 0.73–1.72 0.85 0.46–1.58 0.88 0.48–1.63
Rape 1.25 0.88–1.77 1.80 * 1.38–2.35 1.12 0.70–1.77
Age of menarche
9–11 years 1.36 0.90–2.06 1.26 0.82–1.96 1.09 0.69–1.71
12–14 years 1.20 0.82–1.76 1.21 0.81–1.81 1.14 0.76–1.70
15–17 years 1 1 1
Gynecological age
1 year 1.14 0.78–1.66 1.20 0.80–1.81 1.00 0.66–1.51
2 years 0.78 0.54–1.14 1.15 0.82–1.61 0.70 0.46–1.05
3 years 0.95 0.72–1.26 0.84 0.61–1.17 0.72 0.52–0.98
4 years 0.87 0.65–1.16 0.90 0.65–1.23 0.74 0.54–1.01
5 years 0.92 0.70–1.21 1.01 0.75–1.36 0.75 0.56–1.02
6 years and + (reference) 1 1 1
Table 4 shows that the significant personal characteristics, associated with the risk
of morbidity in pregnancy (RR > of 1 and p < 0.05) were: indifferent attitude at the
onset of pregnancy and at the end of pregnancy and school level ranging between 1st
and 4th grade.
The variables associated with risk of morbidity at delivery were: pregnancy result-
ing from rape and a nutritional level described as having lost weight or overweight
according to brachial perimeter and estimation of muscle mass. The variables associ-
ated with morbidity at delivery were: a height of 1.50 or under and obesity.
Table 5 shows that the risk of pregnancy pathology is associated with the condition
of 10 or more prenatal controls. The precocity of the initiation of prenatal control
is also a risk factor in the newborn baby. These results are confusing, since in this
experience early prenatal control is conditions greater risk of detection of pathology.
This result occurs in models in which prenatal control is routine. As expected, there
is a higher risk of delivery pathology and for the newborn baby in the antecedent of
pregnancy and delivery pathology.
Table 6 analyses the characteristics of the progenitor of the pregnancy and the fam-
ily of the adolescent. We can see that the only significant variable related to a higher
risk of morbidity is being a student or being a member of the military service associ-
ated with a higher risk of pregnancy morbidity. There are no significant differences in
the rest of the groups with or without evidence of pathology.
All these variables (17 during pregnancy, 18 at delivery and 19 in the newborn)
were included in the multifactorial analysis, the results of which are summarized in
table 7. The risk variables during pregnancy are the same as those described for stu-
dent partner or military service and the attitude of the adolescent at the onset of preg-
nancy. In this last variable, the positive attitude is expressed as protective (β–0.90),
so the negative attitude needed to appear as reciprocal to consider the risk. Two new
variables appear, a significant one is the age of menarche. The more advanced the age
of menarche the lower the risk of pathology (β –0.15). The age of menarche should be
approximately 11 years.
RR CL RR CL RR Cl
Prenatal visits
1–3 1 1 1
4–6 1.13 0.84–1.53 1.26 0.91–1.75 1.14 0.82–1.60
7–9 1.29 0.97–1.72 1.24 0.90–1.72 1.20 0.86–1.67
10 and + 1.37 * 1.00–1.86 1.35 0.96–1.92 1.31 0.92–1.88
Gestational age at first control
7–15 weeks 0.93 0.63–1.37 1.07 0.71–1.63 1.55 * 1.01–2.38
16–20 weeks 1.03 0.72–1.47 1.17 0.81–1.72 1.75 * 1.17–2.61
21–25 weeks 1.09 0.76–1.54 1.20 0.82–1.77 1.57 * 1.04–2.37
26–30 weeks 1.03 0.72–1.48 1.18 0.80–1.74 1.40 0.92–2.15
31–40 (reference) 1 1 1
Current pregnancy pathology
No – 1 1
Yes – 1.36 * 1.13–1.65 1.40 * 1.15–1.71
Current delivery pathology – – 1.58 * 1.30–1.92
RR Cl RR Cl RR Cl
Partner activity
Stable labor (reference) 1 1 1
Occasional labor 1.20 0.92–1.57 0.86 0.65–1.14 1.31 0.98–1.74
Student/army service 1.53 * 1.20–1.96 1.07 0.83–1.39 1.30 0.97–1.73
No activity 1.05 0.76–1.46 1.14 0.85–1.53 1.20 0.85–1.69
Partner attitude
Positive 1 1 1
Negative 1.05 0.87–1.27 0.95 0.76–1.19 0.81 0.64–1.02
Indifferent 0.71 0.45–1.12 1.31 0.94–1.82 0.61 0.35–1.05
Family attitude beginning prenatal control
Positive 1 1 1
Negative 0.99 0.80–1.21 0.97 0.78–1.21 0.75 0.60–0.93
Indifferent 0.77 0.45–1.30 1.01 0.63–1.61 0.75 0.44–1.26
Family attitude at end prenatal control
Positive 1 1 1
Negative 1.09 0.91–1.31 0.94 0.77–1.16 1.00 0.81–1.25
Indifferent 0.91 0.56–1.49 1.22 0.82–1.81 1.13 0.71–1.80
Pregnancy1
Partner activity student/army 0.978 0.257 14.51 0.0001 0.157 increases the risk
service 0.467 0.277 2.86 0.090 0.041 increases the risk
occasional work
Age of menarche older menarche age (–) 0.159 0.078 4.08 0.0043 (–) 0.0064 lower age is the risk
Brachial muscle large brachial area (–) 0.0004 0.0002 3.56 0.059 (–) 0.055 small brachial area is the risk;
area at 20 weeks thinness is the risk
Adolescent positive attitude (–) 0.904 0.553 2.67 0.102 (–) 0.036 indifferent or negative attitude
attitude is the risk factor
beginning
pregnancy
Delivery2
Pregnancy seduction and rape 0.855 0.185 13.54 0.0036 0.122 in the analysis, infinite risk
sexual situation appears when the name of the
partner is unknown
Stature the higher stature (–) 0.034 0.019 2.91 0.088 (–) 0.097 the risk is the lower stature
Newborn3
Stature the higher stature (–) 0.053 0.020 6.78 0.009 (–)0.097 stature 1.50 m or less is the
risk
Secondary 1–2 years middle 0.481 0.231 4.35 0.037 0.068 conflict of pregnant student
education level
Partner activity student and army 0.384 0.230 2.80 0.094 0.040 high risk of abandonment
service
Delivery existence of 0.419 0.218 3.69 0.055 0.058 existence of pathology
pathology pathology
1
Sensibility: 50.3; specificity: 74.5; correct: 63.9; false (+): 39.3; false(–): 34.3.
2
Sensibility: 53.8; specificity: 60.2; correct: 57.5; false(+): 49.7; false(–): 36.5.
3
Sensibility: 60.8; specificity: 55.0; correct: 57.5; false(+): 49.7; false(–): 34.8.
For the delivery, the model selected two variables for predicting risk of morbid-
ity. Rape once again appears as a strong risk factor. It should be noted that in a more
detailed analysis of this variable, when the aggressor is unknown to the victim, risk
becomes infinite, which rarely occurs in medicine, because it becomes a certainty.
The other variable was stature. Tallness is protective (β –0.034). Small stature is a
risk factor. The specificity of these two variables reached 60.2%.
The model selected four variables for the risk of morbidity in the newborn. Stature,
which once again is a protection against morbidity; higher stature (β –0.05). Smaller
stature is recorded as a risk factor.
The model selected a new variable, which is 1st and 2nd year secondary education.
Once again the activity of the partner – student or in the military service – appears
as a risk factor, a variable that is repeated in pregnancy. Delivery pathology is also a
risk factor, although it is a late predictive factor. The specificity of these four variables
reached 55%.
In short, the model selected a total of 10 variables, with four corresponding to preg-
nancy, two to delivery and four for the newborn baby. Of the latter, delivery pathol-
ogy is discarded as it is a late risk predictive factor in primary and secondary levels of
healthcare. There are two variables that are repeated as predictive risk factors; activity
of the partner, for pregnancy and the newborn baby, and stature at delivery and in the
newborn baby.
In order to design a predictive risk model to be applied at different levels of com-
plexity, predictive risk factors were reorganized according to their p value, as can be
seen in table 8.
To these factors, we can add two additional factors that were not significant in the
study, but which do imply risk from a clinical point of view. These variables are: age 16
or under and being unmarried in the case of some regions or countries. Another risk
factor to be considered is the apparition or existence of a prior obstetric or pregnancy
related pathology, which follows the same clinical criteria applied to adult pregnant
women.
* Pregnancy pathology pregnant adolescent of they enter to the system for the
high or median obstetric primary health care system and are
* Pregnancy as consequence
and perinatal risk referred immediately to second level
of sexual abuse
of complexity care; application of
*Partner: student/army
local clinical guidelines
service/occasional labor
*Stature of 1.50 m or less
*Age of menarche: 11 years
old or less
Thinness
pregnant adolescent of medical care attendance at primary
* Two years of secondary
undetectable risk level of complexity; greater number
school level
of visits and close coordination with
*Single, without partner second level of complexity for
*More than 17 years old adequate references
*Indifferent or negative
attitude at the beginning of
pregnancy
* All pregnant adolescents
until the age accepted by
the local programme
Adolescent pregnancy is a phenomenon that appears in all social groups, but its
characteristics, causes and consequences differ from one social group to another. It
is possible that in higher socio-cultural sectors this event is kept anonymous and its
outcome is solved by decisions made within the family. While in the poorer sectors,
the medical and social implications of this phenomenon are more acute.
Socioeconomic Level
Between 64 and 86% of adolescents who get pregnant come from low socio-economic
sectors. These groups are characterized by presenting other risk factors such as pro-
miscuity problems, overcrowding at home, lack of social welfare systems, employment
instability of the head of the household and of other family members. This determines
income that is irregular and insufficient to satisfy the basic needs of the family.
In low socioeconomic levels principally, in addition to what has been described
above, adolescent pregnancy is associated with lack of life projects and of profes-
sional, vocational, labor and family projects. They feel undervalued not only by their
families, but by society as well, and have low levels of self-esteem so that the only
status that gives them value as persons is maternity, which then becomes an objective
of life.
These adolescents present unsatisfied needs of affection that lead them to look
for the satisfaction of these needs in their partners. They also present deficient lev-
els of communication and/or conflictive emotional relations with their parents and
other family members, and to some degree or other belong to groups that are at risk.
The families are characterized by lack of proper schooling in the parents, and family
members have unsatisfied needs of affection.
Sometimes, with a certain frequency, there exist histories of adolescent pregnancy
among close family members such as mothers, sister or grandmother. In these fami-
lies, we can also see a high degree of undervaluation of the female and a certain degree
of social marginality. An important sociocultural factor that favors adolescent preg-
nancy is that there are communities that condemn adolescent sexuality but accept
early pregnancy like something natural or magical.
Age
Age distribution of adolescents according to age at pregnancy
Chile 1993–2003
Age n %
11 years 17 0.004
12 years 218 0.05
13 years 1.953 0.47
14 years 9.451 2.3
15 years 28.994 6.9
16–19 years 378.936 90.3
11–19 years 419.569 100
Schooling n %
Median schooling is between 5th to 8th grade primary school. Although the
schooling level of this group is not deficient when compared with the population of
this age group, it was found that the last grade completed corresponded to an age that
was lightly higher than the expected age for this level.
Activity
Pregnant adolescents leave school early and join the labor world early and in dis-
advantageous conditions. Most stay at home caring for younger siblings and doing
household chores instead of their mothers, especially when the latter are the bread-
winners of the family.
Distribution of adolescents according to activity when becoming pregnant:
More than half of the adolescents were studying when they became pregnant,
a third had left school and did nothing and 12% had become a member of the
workforce.
The continuation of the school education of pregnant adolescents will be one of
the great difficulties that they will have to face in the immediate future. Most of them
can never go back to school. Pregnancy and maternity are still one of the main causes
of school desertion in this period. In a follow-up study of 651 pregnant adolescents
controlled at CEMERA, 55% were studying when they became pregnant and only
69% stayed on at school after giving birth.
Unplanned Pregnancy
The risk of pregnancy in the first 6 months of unprotected sex is very high. Most of
these pregnancies are unplanned, unexpected and initially unwanted. They start their
sex lives without contraceptive protection. The reasons for this behavior are:
– Misinformation regarding the risks of pregnancy.
– Fear of the collateral effects of contraceptive methods created by myths and false
beliefs spread by family and peers.
– Lack of support from the male.
– Unexpected and unplanned sex.
– Lack of cognitive skills to understand the consequences of early maternity or
paternity.
– Delay in looking for information on the initiation of sexual activity.
– Double messages regarding the use of contraceptives and being sexually active in
our society.
– Adolescents from low socioeconomic groups can perceive that they have little to
lose with an early pregnancy because there is nothing that will make their social
mobility possible and for this reason, they will make no effort to avoid pregnancy,
– No access to sex orientation and contraception services.
Attitude When she knows she is pregnant At the onset of control At the end of control
n % n % n %
Family Characteristics
The families of pregnant adolescents are usually defined as severely dysfunctional
families both in terms of organization and composition, they are also defined as dis-
organized in they way in which they structure their family activities, in which they
state their standards and share responsibilities.
In terms of structure, they are frequently single parent families with a high propor-
tion of female heads of families owing to separation, paternal desertion, widowhood
or because they are girls born out of wedlock.
There are often different ways of family structure in successive stages of the vital
cycle of the family, which can produce enormous instability in the family’s composi-
tion and organization, with the corresponding lack of role fulfillment. The natural
history of the process generally begins with the marriage or initial living together of
the mother, when a given number of children are born; this is followed by paternal
desertion and by the mother becoming the head of the family. But in the long or short
term, the mother has a new partner, and this male is expected to assume a pater-
nal and supportive role. Nonetheless, the stability of this new relationship is usually
rather fragile as it is based more on the need for survival of the family group, and ends
in separation. The mother is once again alone and responsible for all her children,
which have now increased in number and needs.
There are frequently negative substitute parental figures like stepfathers or mother’s
lover and/or alcoholic, drug addicted and or violent fathers, grandfathers, or brothers.
In general, they are families that have unsatisfied affection needs and deficient
communication especially regarding sexual issues.
Incomplete Education
The laws that protect the continuity of the education of pregnant schoolgirls are an
efficient tool to encourage them to finish their education. But, school maternity gen-
erates rejection among the parents of other schoolchildren. Advanced pregnancy
makes attending school more difficult and becomes even more difficult after the birth
of the baby.
Measures That Can Reduce Adverse Consequences on Adolescent Mothers and Their
Children
Adolescent mothers and fathers should be guided to make their own decisions regard-
ing their child.
When the Adolescent Mother Decides to Give Her Child for Adoption
When they decide to keep the child, she should feel that this is a responsible act to give
the child a life that she cannot or does not want to give it. She should think of adoption
as a responsible act of her maternity. She should receive guidance from a professional or
institution that is well aware of the adoption process and can help her with it.
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