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Adolescent Pregnancy: Sexual and Reproductive Health

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International Handbook of Adolescent Pregnancy

Abstract

The authors are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this chapter and they do not necessarily represent the decisions or policies of the World Health Organization. Addressing the sexual and reproductive health needs and problems of adolescents is a crucial element of the World Health Organization (WHO) Global Reproductive Health Strategy. In many parts of the world, the sexual and reproductive health needs of adolescents are either poorly understood or not fully appreciated. Evidence is growing that this neglect can seriously jeopardize the health and future well-being of young people. Sexual activity during adolescence (within or outside marriage) puts adolescents at risk of sexual and reproductive health problems if they do not have access to the needed information, education and services. These problems include early pregnancy (intended or otherwise), unsafe abortion, sexually transmitted infections (STIs) including human immunodeficiency virus (HIV), and sexual coercion and violence. In addition, in some cultures, girls face genital mutilation and its consequences. This chapter looks at the sexual and reproductive health issues related to adolescent pregnancy from the point of view of the continuum of care. The continuum of care is an approach promoted by WHO and in the context of reproductive, maternal, newborn, and child health (RMNCH). This continuum of care includes integrated service delivery from pre-pregnancy to delivery, the immediate postnatal period, and childhood. In the context of adolescent pregnancy, the continuum of care means that provisions should be made to ensure access and quality services before the pregnancy (such as interventions to improve nutritional status and health to reduce the likelihood of health problems in the mother and baby), during the pregnancy (antenatal, intra- and immediate postnatal care, as well as safe abortion and post-abortion care), and after the delivery to ensure proper care for the adolescent mother and her baby. The care for pregnant adolescents, thus, is a joint responsibility of families, communities, health sector as well as other sectors. It is a person-centered care that involves adolescents in its design, planning, and monitoring and understands holistically their physical, emotional, and social concerns.

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References

  • Ahman, E., & Shah, I. H. (2011). New estimates and trends regarding unsafe abortion mortality. International Journal of Gynecology and Obstetrics, 115, 121–126.

    Article  PubMed  Google Scholar 

  • Agwu AL, Fairlie L (2013). Antiretroviral treatment, management challenges and outcomes in perinatally HIV-infected adolescents. Journal International AIDS Society, 16, 18579.

    Google Scholar 

  • Baltag, V. (2008). Advancing reproductive health of young people in the European region. Medycyna Wieku Rozwojowego, 12, 521–530.

    PubMed  Google Scholar 

  • Bearinger, L. H., Sieving, R. E., Ferguson, J., & Sharma, V. (2007). Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. The Lancet, 369(9568), 1220–1231.

    Article  Google Scholar 

  • Bhutta, Z. A., Dean, S. V., Imam, A. M., & Lassi, Z. S. (2011). A systematic review of preconception risks and interventions. Karachi: The Aga Khan University.

    Google Scholar 

  • Birungi, H., Obare, F., van der Kwaak, A., & Namwebya, J. H. (2011). Maternal health care utilization among HIV-positive female adolescents in Kenya. International Perspectives on Sexual and Reproductive Health, 37, 143–149.

    Article  PubMed  Google Scholar 

  • Bond, V., Chase, E., & Aggleton, P. (2002). Stigma, HIV/AIDS and prevention of mother-to-child transmission in Zambia. Evaluation and Program Planning, 25, 347–356.

    Article  Google Scholar 

  • Bott, S. (2001). Unwanted pregnancy and induced abortion among adolescents in developing countries: Results of WHO case studies. In C. P. Puri & P. F. A. Van Look (Eds.), Sexual and reproductive health: recent advances, future directions (pp. 351–366). New Delhi: New Age International Limited.

    Google Scholar 

  • Center for Disease Control and Prevention. (2006). Recommendations to improve preconception health and health care. United States: A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. (Rep. No. MMWR 2006; 55). GA: Center for Disease Control and Prevention.

    Google Scholar 

  • Central Statistical Agency Ethiopia and ICF International. (2011). Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA, Central Statistical Agency and ICF International.

    Google Scholar 

  • Department for International Development/UK Aid. (2012). Choices for women: Planned pregnancies, safe births and healthy newborns. The UK’s framework for results for improving reproductive, maternal and newborn health in the developing world. London: Department for International Development.

    Google Scholar 

  • DiClemente, R. J., Wingood, G. M., Crosby, R. A., Rose, E., Lang, D., Pillay, A., et al. (2004). A descriptive analysis of STD prevalence among urban pregnant African-American teens: Data from a pilot study. Journal of Adolescent Health, 34, 376–383.

    PubMed  Google Scholar 

  • DiClemente, R. J., Wingood, G. M., Rose, E., Sales, J. M., & Crosby, R. A. (2010). evaluation of an HIV/std sexual risk-reduction intervention for pregnant African American adolescents attending a prenatal clinic in an urban public hospital: Preliminary evidence of efficacy. Journal of Pediatric and Adolescent Gynecology, 23, 32–38.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Health Council of the Netherlands. (2007). Preconception care: A good beginning. The Hague: Health Council of the Netherlands.

    Google Scholar 

  • Ickovics, J. R., Niccolai, L. M., Lewis, J. B., Kershaw, T. S., & Ethier, K. A. (2003). High postpartum rates of sexually transmitted infections among teens: pregnancy as a window of opportunity for prevention. Sexually Transmitted Infections, 79, 469–473.

    Article  CAS  PubMed  Google Scholar 

  • Institut de Statistiques et d’Études Économiques du Burundi (ISTEEBU), Ministère de la Santé Publique et de la Lutte contre le Sida [Burundi] (MSPLS), & ICF International. (2010). Enquête Démographique et de Santé Burundi 2010. Bujumbura, Burundi, ISTEEBU, MSPLS, et ICF International.

    Google Scholar 

  • Inter-Agency Task Teamon HIV and Young People. (2008). Overview of HIV Interventions for Young People. Guidance brief. Retrieved November 20, 2012 from http://www.unfpa.org/public/cache/offonce/home/iattyp/pid/2265;jsessionid=616BDD4D8A612812EEF92A8024692476.jahia02

  • Jack, B. W., Atrash, H., Coonrod, D. V., Moos, M. K., O’Donnell, J., & Johnson, K. (2008). The clinical content of preconception care: An overview and preparation of this supplement. American Journal of Obstetrics and Gynecology, 199(6 Suppl 2), S266–S279. doi:10.1016/j.ajog.2008.07.067

    Article  PubMed  Google Scholar 

  • Jewkes, R., Sen, P., & Garcia-Moreno, C. (2002). Sexual violence. In E. G. Krug, L. L. Dahlberg, J. A. Mercy, A. B. Zwi, & R. Lozano (Eds.), World report on violence and health. Geneva: World Health Organization.

    Google Scholar 

  • Jewkes, R., Vundule, C., Maforah, F., & Jordaan, E. (2001). Relationship dynamics and teenage pregnancy in South Africa. Social Science and Medicine, 52, 733–744.

    Article  CAS  PubMed  Google Scholar 

  • Kothari, M. T., S. Wang, S. K. Head, & Abderrahim,N. (2012). Trends in Adolescent Reproductive and Sexual Behaviors. DHS Comparative Reports No. 29. Calverton, Maryland, USA: ICF International

    Google Scholar 

  • Lewis, G. (2001). Why mothers die 1997–1999? The confidential enquiries into maternal deaths in the United Kingdom. London: RCOG Press.

    Google Scholar 

  • Ministry of Health & UNFPA. (2004). Needs assessment of obstetric fistula in Kenya. Final Report. Ministry of Health, Kenya, and UNFPA.

    Google Scholar 

  • Mofenson LM, Cotton MF (2013). The challenges of success: adolescents with perinatal HIV infection. Journal International AIDS Society Jun 18 16, 18650.

    Google Scholar 

  • Niccolai, L. M., Ethier, K. A., Kershaw, T. S., Lewis, J. B., & Ickovics, J. R. (2003). Pregnant adolescents at risk: Sexual behaviors and sexually transmitted disease prevalence. American Journal of Obstetrics and Gynecology, 188, 63–70.

    Article  PubMed  Google Scholar 

  • Norris, S. A., Osmond, C., Gigante, D., et al. (2012). Size at birth, weight gain in infancy and childhood, and adult diabetes risk in five low or middle-income country birth cohorts. Diabetes Care, 35, 72–79.

    Article  PubMed  Google Scholar 

  • North, C. et al. (2006). An Assessment of Services for Adolescents in Prevention of Mother-to-Child Transmission Programs. Youth Research Working Paper No. 4. In: Family Health International. Research Triangle Park, NC: Family Health International, Youth Net Program.

    Google Scholar 

  • Panchaud, C., Singh, S., Feivelson, D., & Darroch, J. E. (2000). Sexually transmitted diseases among adolescents in developed countries. Family Planning Perspectives, 32, 24–45.

    Article  CAS  PubMed  Google Scholar 

  • Partridge, S., Balayla, J., Holcroft, C. A., & Abenhaim, H. A. (2012). Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: A retrospective analysis of 28,729,765 U.S. deliveries over 8 Years. American Journal of Perinatology, 29(10), 787–793. doi:10.1055/s-0032-1316439

    Article  PubMed  Google Scholar 

  • Patton, G. C., Coffey, C., Sawyer, S. M., et al. (2009). Global patterns of mortality in young people: A systematic analysis of population health data. The Lancet, 374(9693), 881–892.

    Article  Google Scholar 

  • Reynolds, H. W., Emelita, L., & Tucker, H. (2006). Adolescents’ use of maternal and child health services in developing countries. International Family Planning Perspectives, 32(1), 6–16.

    Article  PubMed  Google Scholar 

  • Sawyer, S. M., Afifi, R. A., Bearinger, L. H., et al. (2012). Adolescence: A foundation for future health. The Lancet, 379(9826), 1630–1640. doi:10.1016/S0140-6736(12)60072-5

    Article  Google Scholar 

  • Sedgh, G., Singh, S., Shah, I. H., et al. (2012). Induced abortion: Incidence and trends worldwide from 1995 to 2008. The Lancet, 379(9816), 625–632. doi:10.1016/S0140-6736(11)61786-8

    Article  Google Scholar 

  • Shah, I. H., & Åhman, E. (2012). Unsafe abortion differentials in 2008 by age and developing country region: High burden among young women. Reproductive Health Matters, 20(39), 169–173.

    Article  PubMed  Google Scholar 

  • Silverman, J. G., Raj, A., & Clements, K. (2004). Dating violence and associated sexual risk and pregnancy among adolescent girls in the United States. Pediatrics, 114, 220–225.

    Article  Google Scholar 

  • Singh, S., Darroch, J. E., Ashford, L. S., & Vlasshoff, M. (2009). Adding it up: The costs and benefits of investing in family planning and maternal and newborn health. NY: Guttmacher Institute and United National Population Fund.

    Google Scholar 

  • Temin, M., & Levine, R. (2009). Start with a girl: A new agenda for global health. Washington, D.C.: Center for Global Development.

    Google Scholar 

  • UK aid and Bill and Melinda Gates Foundation. (2012). Landmark Summit Puts Women at Heart of Global Health Agenda Global leaders unite to provide 120 million women in the world’s poorest countries with access to contraceptives by 2020. UK aid and Bill and Melinda Gates Foundation.

    Google Scholar 

  • UNFPA and Engender Health. (2003). Obstetric fistula needs assessment report: Findings from nine African countries. NY: EngenderHealth.

    Google Scholar 

  • United Nations. (2005). World youth report 2005. Young people today, and in 2015. NY: United Nations.

    Google Scholar 

  • United Nations. (2009). World population prospects: Highlights of the 2008 revision. Working Paper No ESA/P/WP.210. NY: United Nations Department of Social and Economic Affairs, Population Division.

    Google Scholar 

  • United Nations. (2010). Global Strategy for women’s and children’s health provides the platform for joint action. NY: United Nations.

    Google Scholar 

  • United Nations. (2011). Millennium Development Goals report 2011. NY: United Nations.

    Google Scholar 

  • United Nations Commission on Population and Development. (2012). Monitoring of population programs, focusing on adolescents and youth. Report of the Secretary-General. New York: United Nations Economic and Social Council.

    Google Scholar 

  • Varga, C., & Brookes, H. (2008). Factors influencing teen mothers’ enrollment and participation in prevention of mother-to-child HIV transmission services in Limpopo Province, South Africa. Qualitative Health Research, 18, 786–802.

    Article  PubMed  Google Scholar 

  • Viner, R. M., Ozer, E. M., Denny, S., Marmot, M., Resnick, M., Fatusi, A., et al. (2012). Adolescent health 2 adolescence and the social determinants of health. The Lancet, 379, 1641–1652.

    Article  Google Scholar 

  • WHO, UNICEF, UNFPA, World Bank, & UNAIDS. (2010). H4 + Working with countries to improve maternal and newborn health. Retrieved November 20, 2012, from WHO. http://www.unfpa.org/webdav/site/global/shared/documents/safe%20motherhood/Resource%20Kit/H4%20Pamphlet.pdf

  • WHO Regional Office for Europe. (2011a). Evidence for gender responsive actions for the prevention and management of HIV/AIDS and STIs. Young people’s health as a whole-of-society response. Copenhagen: WHO Regional Office for Europe.

    Google Scholar 

  • WHO Regional Office for Europe. (2011b). Evidence for gender responsive actions to prevent and manage adolescent pregnancy. Young people’s health as a whole-of-society response. Copenhagen: WHO Regional Office for Europe.

    Google Scholar 

  • WHO Regional Office for Europe. (2011c). Evidence for gender responsive actions to prevent violence. Young people’s health as a whole-of-society response. Copenhagen: WHO Regional Office for Europe.

    Google Scholar 

  • WHO Regional Office for Europe. (2012). Social determinants of health and well-being among young people : health behaviour in school-aged children (HBSC) study : International report from the 2009/2010 survey. Copenhagen: WHO Regional Office for Europe.

    Google Scholar 

  • World Health Organization. (2002a). Essential care: Practice guide for pregnancy, childbirth and newborn care. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2002b). WHO antenatal care randomized controlled trial: Manual for the implementation of the new model. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2003). Towards adulthood: Exploring the sexual and reproductive health of adolescents in South Asia. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2004a). Adolescent pregnancy. Issues in adolescent health and development. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2004b). Reproductive health strategy to accelerate progress towards the attainment of international development goals and targets. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2004c). Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000 (4th ed.). Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2006). Obstetric Fistula: Guiding principles for clinical management and programme development. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2006a). Integrated management of adolescent and adult illness (IMAI) modules. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2006b). Pregnant adolescents: Delivering on global promises of hope. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2006c). Promoting and safeguarding the sexual and reproductive health of adolescents. Policy brief. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2007). Adolescent pregnancy: Unmet needs and undone deeds. A review of the literature and programmes. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2008). Global burden of disease 2004 update. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2010). 10 facts on obstetric fistula. Geneva: World Health Organization (internet source). http://www.who.int/features/factfiles/obstetric_fistula

  • World Health Organization. (2010a). Adolescent job aid. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2010b). Preventing intimate partner and sexual violence against women: Taking action and generating evidence. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2011a). Early marriages, adolescent and young pregnancies. Report by the Secretariat. Executive Board, 130th Session (Geneva, 1st December 2011), Document EB130/12. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2011b). Global health sector strategy on HIV/AIDS. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2011c). Intimate partner violence during pregnancy. Information sheet. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2011d). Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008 (6th ed.). Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2011e). WHO Guidelines for preventing early pregnancy and poor reproductive outcomes in adolescents in developing countries. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2011f). Youth and health risks. Report by the Secretariat. Sixty-fourth World Health Assembly, document A64/25, 28 April 2011. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2011g). Youth and health risks. Resolution. Sixty-fourth World Health Assembly, resolution WHA64.28, 24 May 2011. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2012a). Meeting to develop a global consensus on preconception care to reduce maternal and childhood mortality and morbidity, 6–7 February, 2012, Geneva. Meeting report (third draft, June 2012). Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization. (2012b). Safe abortion: Technical and policy guidance for health systems (2nd ed.). Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2012c). Early marriages, adolescent and young pregnancies. Report by the Secretariat. Executive Board, 130th Session (Geneva, 1st December 2011), Document EB130/12. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2013a). HIV and adolescents: Guidance for HIV testing and counselling and care for adolescents living with HIV. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2013b). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (2013c). Female genital mutilation. Fact sheet N°241. Geneva: World Health Organization. http://www.who.int/mediacentre/factsheets/fs241/en/

  • World Health Organization (2013d). Every Woman, Every Child: Strengthening Equity and Dignity through Health: the second report of the independent Expert Review Group (iERG) on Information and Accountability for Women’s and Children’s health.

    Google Scholar 

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Acknowledgments

I gratefully acknowledge Elizabeth Mason, Director, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization for reviewing the draft and providing useful suggestions.

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Authors and Affiliations

  1. Department of Maternal, Newborn, Child and Adolescent Health, Cluster for Family, Women’s and Children’s Health, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland

    Valentina Baltag

  2. Department of Reproductive Health and Research, Cluster for Family, Women’s and Children’s Health, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland

    Venkatraman Chandra-Mouli

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  1. Valentina Baltag
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Correspondence to Valentina Baltag .

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Editors and Affiliations

  1. University of Oklahoma, Tulsa, Oklahoma, USA

    Andrew L. Cherry

  2. University of Central Florida, Orlando, Florida, USA

    Mary E. Dillon

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Disclaimer: The authors are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this chapter and they do not necessarily represent the decisions or policies of the World Health Organization.

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Baltag, V., Chandra-Mouli, V. (2014). Adolescent Pregnancy: Sexual and Reproductive Health. In: Cherry, A., Dillon, M. (eds) International Handbook of Adolescent Pregnancy. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-8026-7_3

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