DEFINITION

It is called a pregnancy in the adolescence to the pregnancy that happens in the young women younger than 19 years.

CAUSES, INCIDENCE AND FACTORS OF RISK

The causes of the pregnancy in the adolescence are politically debatable, of big emotional load, and numerous. Many factors must be examined, in addition to the obvious cause that is that the adolescents support sexual relations without the suitable contraception measurements. Since there is no effective contraception to 100 %, the abstinence is the surest way to prepare the pregnancy.

The statistics show that 18 % of the American adolescents has experienced the sex before 15 years of age. Also, this number grows up to 66 % of not married adolescents who have sexual experiences before 19 years. Different studies have showed that at the age of 20 years, 75 % of the women and 86 % of the American males are sexually assets. The porqué the adolescents practise the sex, and porqué they do it without effective contraception methods, it is a topic of ardent discussion. The suggested reasons are those who continue.

The adolescents become fertile approximately 4 or 5 years before being emotionally mature.

The today adolescents grow surrounded with a culture where partners, television, movies, music, and magazines transmit often clear or secret messages in which the sexual relations without being married (especially those that involve adolescents) are common, recognized and, sometimes, waited.

Normally education is not offered in the hearth, the school or the community on the responsible sexual behavior and specific clear information about the consequences of the sexual exchange (including the pregnancy, sexually transmitted diseases and psychosocial effects). Therefore, big part of the "sex education" that the adolescents receive comes across misinformed filters or partners without forming.

The adolescents who choose to be sexually assets limit themselves often in his contraceptive options to the information of his partners, paternal, financial, cultural, and political influences as well as also to their own development that is limited (since he is earlier a physicist that emotional).

The incidence of the pregnancy in adolescents grows. The percentage of births in adolescents not married in the United States has increased in 74,4 % between 1975 and 1989.
 

In 1.990 there were 521.826 living births of adolescent mothers, what represents 12,5 % of all the births in the United States during the above mentioned year. Of these adolescent mothers, 19.4 % had a child once and 4,0 % had given birth two times.
When it was compared with other industrialized nations, the United States have the highest valuation of pregnancy, abortion, and adolescents births, although the statistics as for the sexual activity is similar to that of other countries. It is believed that in the United States, at the age of 20 years, 40 % of white women and 64 % of black women will have experienced at least 1 pregnancy.

The potential risk for the adolescent girls of coming aquedarse pregnant women include:

• The early sexual contacts (the age 12 years collaborates with 91 % of opportunities to be pregnant before 19 years, and the age of 13 years collaborates with 56 % of pregnancies during the adolescence).
• The early use of the alcohol and / or other drugs, including products like the tobacco, to go out of the school, the lack of a group of support or few friends.
• The interest lack in the school, family, or community activities.
• To perceive few ones or no opportunity for the success.
• To live in communities or schools where the early pregnancies are common and to consider it to be a norm more than a cause for his interest.
• To grow in impoverished conditions.
• To have been a victim of an attack or sexual abuse, or when his mothers in turn have given birth to them before 19 years.

PREVENTION

Models exist for the prevention of the adolescent pregnancy. The programs tend to focus them in particular or use an approaches combination. Most of the programs of adolescents for the prevention of the pregnancy use the methods that are in the following categories.

The abstinence educational programs encourage the postponement of the beginning in the sexual contacts until the person is mature and sufficiently skillful to handle the sexual activity of a way responsible and capable of managing and of taking responsibility before a potential pregnancy.

There are programs based and focused in the knowledge of the adolescent on his body and normal functions as well as also giving information detailed on of contraceptive.

Other more clinical programs in schools, focused to lead easier to the information, advised by sanitary assistants, and contraceptive services.

The partner who advises programs normally assembles adolescents, acquaintances and the people more major to facilitate discussions that explore the feelings and the attitudes on the physical impulses faced in the relations, then he encourages other adolescents to be resisted before his partner and the social pressures to go so far as to be involved sexually. These programs tend to take more than one experimental example, helping the adolescents to personalize the risks. They also teach the use of certain contraceptive methods of barrier playing and other methods, for when they go so far as to be sexually active. The monitor of the program has to include also these adolescents already involved in sexual activities, to demonstrate his experiences inside the sexual relations and all the information that it is necessary to obtain about the contraceptive ones of use.

SYMPTOMS OF PREGNANCY

The pregnancy symptoms include:

• lacking in the menstrual period
• depletion
• increase of the size of the bosoms
• abdominal distension
• morning sickness and vomiting
• sickness and faints

TESTS AND TEST

The adolescent can or cannot admit having had sexual relations.

There are changes of weight normally (commonly a profit but there can be a loss if the morning sickness and vomiting are important). The examination can show increase of abdominal volume. It is possible to feel the top of the womb and this one is increased. In the pelvic examination the vaginal walls turn out to be discolored or of bluish or purple color, the cervix reblandecido, and there is a softening and enlargement of the womb.

• The pregnancy tests in urine and / or prints are a blood commonly.
• A study can be done with ultrasounds to confirm or to verify the pregnancy as well as precise dates.

TREATMENT

The abortion is a potential option but the states change with regard to the aptitude of not married adolescent to obtain legally these means to end with a pregnancy without the paternal assent. In case of married adolescents the assent of the husband can be needed. To give to the babies in adoption is another option. but most of the pregnant adolescents choose to continue his pregnancy and to remain with his baby.

The prenatal care early and adapted to a program specializing in pregnancy of adolescents a more healthy baby assures. Smoking, I use of alcohol, drugs abuse must be dissuaded hardly, and the support methods should offer to help the pregnant adolescent to take such behaviors. The suitable alimentacinó must insure herself by means of the education and the availability of social resources. The appropriate exercise and the suitable sleep should be informed also appropriately. The contraceptive information and the services are important. The adolescents must be reasonable and helped to remain in the school or in educational programs that will allow them I will entrust of his child financially, in addition to whom it is more healthy emotionally. The care of the children in nursery schools of accessible form is an important factor in adolescent mothers who continue the school and / or I work.

PROGNOSIS

The women who have his first son during the adolescence have more probabilities of having more entire children. And these children also less probabilities to receive the support of his biological parents, to complete his education, the work in some type of vocation, and to establish the independence and financial safety adapted to be provided by themselves. The married adolescent mothers are more capable to experience divorces (80 %) that the married women who postpone his pregnancy up to 20 years at least.

COMPLICATIONS

The pregnancy in the adolescent collaborates with the highest risk of illness and death for both mother and baby.

The adolescents pregnant have a much higher risk of such serious medical complications like the toxemia, hypertension, important anemia, premature childbearing, and / or previous afterbirth. The death risk for 15-year-old or younger mothers is a 60 % major than that of 20-year-old mothers.

The babies of adolescent mothers have from 2 to 6 times more of probabilities of having low birth weight that those who are born of 20-year-old mothers or more. This is almost always for being premature babies, but the delay of the growth intrauterino (inadequate growth of the fetus during the pregnancy) is also a factor. The adolescent mothers are more given to demonstrate such behaviors like smoking, I use of alcohol. or I abuse drugs; inconsistent and poor feeding; or multiple sexual couples. This can put the baby in a high risk of inadequate growth, infections, or chemical dependency. The risk of death of the baby during the first year of life increases as regards the age of the mother, 20-year-old minor is.

WHEN TO CALL HIS DOCTOR

Call to ask for an appointment if the pregnancy symptoms happen in an adolescent.

Call to be advised with regard to methods of birth control or another information than to wish, particularly if an adolescent faces the pressure of some partner or has personal thoughts of committing itself in the sexual activity, or if an adolescent has already interfered in the sexual activity with or without contraception.

WHAT DOCTOR CAN TREAT ME?

• GYNECOLOGISTS
• SERVICES OF SOCIAL WORK

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