one in three young women will have been pregnant at least once by the time she is twenty

A village would be nice but it takes long-acting contraception TEENS, PREGNANCY, BIRTHS AND PREVENTION Dyan Aretakis, UVA Teen Health Center

Births to year olds in the United States /1, ,408198,222183,327157,209138,920

Teen Birth Decline in Virginia The 30% decline in births to girls ages produces estimates that: There has been a 5% improvement in the states poverty rate for children under age six A 5% improvement in the proportion of children under age six living with a single mother. Accomplished by reducing the teen birth total by 24,000 from

15–17 yo birth rates increase in 2006 Birth rates for white, black and hispanic teens all increased from ; 3%, 5%, 2% respectively, the first increase in 15 years Virginia16.9/10002,617/total # Richmond42.0/ Newport News25.5/ Charlottesville23.5/ Albemarle10.9/ Harrisonburg44.1/ Page County6.4/10003

Issues preceeding a teen pregnancy Early-maturing girls Childhood sexual abuse (65% of teen moms) Dating violence (8 – 57%) School issues High rates of sexually transmitted diseases Mental health issues Poverty

What are the risks in teen births? 1. Preterm birth – less than 37 weeks Youngest age; biology or SES? Especially if close to menarche Unmarried/unplanned 2. Low birth weight 3. Preeclampsia 4. Neonatal mortality (Preterm birth/low birth weight) and postneonatal mortality (disadvantaged infant environment) 5. Postpartum depression – 50% 6. Child Abuse 7. Child growth and development 8. Economic 9. Family 10. Rapid repeat pregnancy 11. Intimate Partner Violence (20%)

Socioeconomic status or being a teen? Controlling for socioeconomic conditions eliminates some differences in LBW among teens and older moms It is access to care or just being a teen? Teens more prone to delaying care and then AFFORDING care

Impact of teen births School Readiness Family Mental health

School readiness – children of teen parents ECLS – K Looks at these measures: Cognition and knowledge Language and communication Approaches to learning Emotional well-being and social skills Physical well-being and motor development Playing Catch-up: How Children born to teen mothers fare,

School readiness – children of teen parents Children born to teen mothers begin kindergarten with lower levels of school readiness Differences seen especially in cognition, knowledge and language development Children of mothers who are 18 or 19 are not any better prepared Children of mothers in their 20s and older fare the best

School readiness – children born to teen mothers Delaying a pregnancy until a young woman is in her 20s helps her establish education, employment, marriage However simply delaying a pregnancy until a young woman is 20 is not enough She must make progress in her own life economically and educationally to parent successfully

Family effects – children born to teen mothers 80% of teen mothers live at home one year after giving birth Mothers of teen moms found to be less affectionate and more critical of all their children after a teen birth in the household. 59% of teen mothers under age 18 drop out of high school Younger siblings learn negative behavior by modeling their older siblings (who are teen parents) Younger siblings have more negative attitudes toward school and careers following their older siblings Younger girl siblings affected, boy siblings not

Mental Health Issues Teen moms twice as likely to have depression compared with adults moms African American teens twice as likely as white teen moms Often also a history of intimate partner violence Teen mom depression increases risk of child abuse/neglect; interpersonal conflict; adverse effects on childs intellectual development and psychosocial functioning

Mental Health Issues in teen births Treating teen moms depression is better for the child Trying to find services for teens is depressing esp with additional mental health diagnoses Risk of repeat pregnancy within 24 months is 40% higher than nondepressed teen moms Teen depression underdetected and inadequately treated, explained away as teen behavior

Preventing the Risks of Teen Births Routine health care and early prenatal care Identify other health risks including type II diabetes, sexually transmitted diseases, abnormal pap smears, anemias, asthma, eating disorders, sexual violence/IPV Emphasis is on prenatal care before the 7 th month Saves $2300/infant when LBW avoided. Age appropriate care with emphasis on pregnancy/parenting education. Include home visiting, mental health treatment and school based programs. Prevent 2 nd pregnancy through long acting contraception

A village would be nice..... Schools with childcare Faith communities Affordable/accessible health care providers Pre-K programs Mental health services Free Child care Job training Stable and supportive family environment

Or you can….. Postpone a first pregnancy through long acting contraception