Adolescent Pregnancy is a Serious Social Problem

The global adolescent birth rate has declined from 65 births per 1000 women in 1990 to 47 births per 1000 women in 2015 [1]. Despite this overall progress, because the global population of adolescents continues to grow, projections indicate the number of adolescent pregnancies will increase globally by 2030, with the greatest proportional increases in West and Central Africa and Eastern and Southern Africa.


Introduction
The global adolescent birth rate has declined from 65 births per 1000 women in 1990 to 47 births per 1000 women in 2015 [1]. Despite this overall progress, because the global population of adolescents continues to grow, projections indicate the number of adolescent pregnancies will increase globally by For some adolescents, pregnancy and childbirth are planned and wanted. In some contexts, girls may face social pressure to marry and, once married, to have children. Each year, about 15 million girls are married before the age of 18 years, and 90% of births to girls aged 15 to 19 years occur within marriage.

Sexual relationships
Adolescents face barriers to accessing contraception including restrictive laws and policies regarding provision of contraceptive based on age or marital status, health worker bias and/or lack of willingness to acknowledge adolescents' sexual health needs, and adolescents' own inability to access contraceptives because of knowledge, transportation, and fi nancial constraints. Additionally, adolescents face barriers that prevent use and/or consistent and correct use of contraception, even when adolescents are able to obtain contraceptives: pressure to have children; stigma surrounding non-marital sexual activity and/or contraceptive use; fear of side effects; lack of knowledge on correct use; and factors contributing to discontinuation (for example, hesitation to go back and seek contraceptives because of negative fi rst experiences with health workers and health systems, changing reproductive needs, changing reproductive intentions).
In some situations, adolescent girls may be unable to refuse unwanted sex or resist coerced sex, which tends to be unprotected. Sexual violence is widespread and particularly affects adolescent girls: about 20% of girls around the world experience sexual abuse as children and adolescents. Inequitable gender norms and social norms that condone violence against women put girls at greater risk of unintended pregnancy.

Prevention of adolescent pregnancy
More young people of diverse demographic characteristics are having sexual relations at younger ages; they have more Siniša Franjić* Faculty of Law, International University of Brcko District, Brcko, Bosnia and Herzegovina, Europe options for preventing pregnancy; they have more alternative pregnancy resolutions; and fewer marry to legitimize a non-marital birth while choosing to become a parent [2].
As the likelihood of a teenager having sex and of a pregnant teenager who bears a live infant becoming a single mother each have grown over the years, social work and other social science researchers have changed their understanding of teen pregnancy and parenthood.
Sexuality is a dynamic concept and is about much more than sexual activity and sexual orientation alone [3]. It includes what being male or female means to us and how we express our gender; how we feel about our bodies, about our appearance and about physical pleasure; whom we are attracted to and what we choose to do about it; and, if we have intimate relationships, how we behave with our partners. Our ability to reproduce comes from our sexual behavior and our feelings about our sexuality and sexual identity can be deeply affected by our sense of our own fertility.
Because it appears that a disproportionate number of the women who abandon or kill their newborns are young, the problem must be considered alongside the larger issues of teen pregnancy and adolescent sexuality [4]. Teenage pregnancy rates in the United States dropped almost 30 percent in the 1990s; the most recent data suggest that both teenage pregnancy and birthrates are at an all-time low. Still, teen pregnancy is not an uncommon occurrence. The United States has the highest rates of teen pregnancy and birth in the western industrialized world. Each year, around 750,000 women and girls between 15 and 19 years of age become pregnant; more than one-half will give birth, and nearly one-third will have an abortion.
A major reason for the decline in teen pregnancy is that contraceptive use has increased. Contraception and abortion became more readily available in the mid-1960s and 1970s, breaking the link between sex and reproduction. Now women, like men, could choose whether or not to become a parent and could engage in sex solely for pleasure without the looming fear of unwanted pregnancy. At around the same time, comprehensive sex education in schools began to shift away from preparing adolescents for marriage and parenthood and discouraging premarital sex. Sex educators began to treat marriage as one context among many in which sex could take place. A focus emerged on teaching young people how to manage the "risks" of sex, driven in part by concern about HIV/AIDS and a perceived crisis in teenage pregnancy.
Adolescent pregnancy is in part the failure of society, the home, school, church, and health community to adequately teach sex education. Prevention begins with understanding and knowledge [5]. People are particularly sensitive and defensive about sex education. The physical body, attitudes, and powerful feelings aroused particularly in adolescence need to be discussed in the home and in the schools from the earliest time of a child's education. Sexual feelings are neither bad nor good. They are a part of the very essence of our being as are our sciences, history, philosophy, and fi ne arts.

Contraception
Teens in the United States hear mixed messages about sexuality from the people and institutions around them [6].
These norms focus on different sexual behaviors, like sex, contraception, abortion, or pregnancy. But sexuality norms coming from the same people are often internally confl icting, too. People communicating a practical rationale may say, "Don't have sex, but use contraception." The moral rationale is equally contradictory, saying, "Don't have an abortion, but don't become a teen parent." Metanorms about how to treat teen parents are also inconsistent, often encouraging teens both to shun and to support them.
Even though sexuality norm sets are internally contradictory, they are still social norms, which means that people who violate them experience social sanctions. It's clear from interviewees that families, peers, schools, and communities all strategize to control teens' behaviors and bring them in line with their particular norm sets. Their norm enforcer strategies are different depending on the power they have over teens, but young people feel this control keenly and work to achieve their own goals while avoiding sanctions.
The ideal contraceptive would be 100% effective, free of all side effects, completely reversible, and independent of sexual intercourse [7]. It would also be inexpensive and easily available without the need for medical or nursing involvement. No such contraceptive yet exists and all the currently available methods involve some degree of compromise. For some couples, the prevention of a pregnancy may not be the most important consideration and they may therefore be content to use a less effective contraceptive that has the advantage of fewer side effects. It should also be remembered that some forms of contraception may not be acceptable because of cultural or religious beliefs.
Throughout the long history of fi nding ways to control fertility, strong moral sentiments, religious beliefs, legal constraints, and gender relations often limited the provision of advice and methods of birth control [8]. Victorian values, sexual prudishness, moral objections to birth control, and political gamesmanship often made it diffi cult or impossible to obtain and use safe and effective contraception. In addition to the religious and moral beliefs limiting the availability of contraception, economic barriers also prevented (and to a certain extent still prevent) many women from obtaining safe and effective methods of birth control.

Health results of teen pregnancy
Teenage parenthood is perceived to be both a cause and consequence of social exclusion [9]. Teenage parents are more likely to be unemployed, live in poverty, and to give birth to low birth-weight babies, who as toddlers are likely to be at increased risk of childhood accidents. This link with social exclusion means that teenage parents are themselves likely to be in poorer health, have poorer access to health and social support and experience poorer health outcomes for themselves and their babies. While some teenagers view their pregnancy as positive and fulfi lling, others reveal negative consequences.
Research reveals that young parents experience poorer health and social outcomes, which is linked to inadequate access to appropriate care and support.
In the professional and medical sense, adolescent pregnancies represent risky pregnancies [10]. Physical and mental growth and maturity of personality are not completed. There is an increased risk of abortion, premature delivery, fading growth, gesture development. These pregnant women are, as a rule, weakly controlled because very often pregnancies are hidden from the ambience. This group is known for its high incidence, conditionally, sexually opposed diseases. The most common infections are Chlamydia trachomatis, human papillomavirus, Mycoplasma, Trichomonas vaginalis. These infections can increase the risk of abortion and premature birth. So young a body, along with uncompleted physical growth, is additionally diffi cult to adapt to the new needs that require pregnancy.
The uterus did not reach its full "maturity", which increases susceptibility to infections. Increased blood vessel loading may lead to gestational development, a condition of mother and child risk, with increased blood pressure and child growth lag

Social consequences of adolescent pregnancy
Adolescent pregnancy can also have negative social and economic effects on girls, their families and communities.
Unmarried pregnant adolescents may face stigma or rejection by parents and peers and threats of violence. Similarly, girls who become pregnant before age 18 are more likely to experience violence within marriage or a partnership. With regards to education, school-leaving can be a choice when a girl perceives pregnancy to be a better option in her circumstances than continuing education, or can be a direct cause of pregnancy or early marriage. An estimated 5% to 33% of girls ages 15 to 24 years who drop out of school in some countries do so because of early pregnancy or marriage.
Based on their subsequent lower education attainment, may have fewer skills and opportunities for employment, often perpetuating cycles of poverty: child marriage reduces future earnings of girls by an estimated 9%. Nationally, this can also have an economic cost, with countries losing out on the annual income that young women would have earned over their lifetimes, if they had not had early pregnancies.

Termination of pregnancy
According to some, abortion is a matter of a woman's right to exercise control over her own body [14]. Moralists who judge actions by their consequences alone could argue that abortion is equivalent to a deliberate failure to conceive a child and, since contraception is widely available, abortion should be too. However, much controversy surrounds the cognitive ability of adolescents to make similar decisions. Thus, the counselor or therapist working with an adolescent who announces her pregnancy has even more of a responsibility to assure that the adolescent is capable of making such a diffi cult decision.
Although there has been a trend to grant adolescents some limited legal rights, for example, in adjudicating juvenile criminal actions, the opposite trend has been witnessed in adolescent abortion cases where minors are required to obtain permission from or notify at least one parent or else be prepared to justify their secrecy by going before a judge in a special bypass procedure. Despite the testimony of psychologists about adolescent competence to make such decisions, the legal fi eld has supported parental notifi cation as a minimum standard. It appears that public policy differs from scientifi c knowledge in this case.

Conclusion
Approximately 16 million girls aged 15 to 19 years and 2.5 million girls under 16 years give birth each year in developing regions. These are the fi gures that worry, and when teenagers engage in sexual relationships, they do not think about the consequences. The consequences for health can be terrible. Therefore, it is necessary to invest much in the prevention of reproductive health. Prevention should not only be directed at preventing sexually transmitted diseases and preventing pregnancy in adolescence because it should be geared towards adopting attitudes about responsible sexual behavior. This primarily refers to the delay in the beginning of the sexual life of young people because too early accession into sexual relationships can seriously harm the health.