Teenage Pregnancy and the Impact on Health Care Systems
Teenage pregnancy is defined as a pregnancy occurring in a young woman who is 19 years of age or younger.
Though the rate of adolescent pregnancy has declined over the past few decades, it remains a significant public health issue in many developed countries.
Teenage mothers tend to be less educated, have lower incomes, and are more likely to raise their children as single parents compared to older mothers.
Children of teenage parents are also at higher risk for health and developmental problems. As such, adolescent pregnancy can have significant social and economic costs for the mother and child as well as implications for health care systems.
Prevalence of Teenage Pregnancy
According to statistics from the United States, the teenage pregnancy rate reached its peak in 1990 with an estimated 116.9 pregnancies per 1,000 women aged 15-19. Since then, the teenage pregnancy rate has declined steadily.
As of 2017, the adolescent birth rate dropped to 18.8 births per 1,000 women. Factors that contributed to this decline include increased use of contraception, delayed onset of sexual activity among adolescents, and changing attitudes toward teen pregnancy.
Still, approximately 194,377 babies were born to women aged 15–19 in the United States in 2017 alone. Though the United States teenage pregnancy rate has declined, it remains the highest teen pregnancy rate in the developed world—about twice as high as the United Kingdom, four times as high as Germany and France, and over eight times higher than Japan.
Impact on Educational Attainment
One of the most significant impacts of teenage pregnancy is curtailed educational attainment. On average, only about 50% of adolescent mothers earn a high school diploma by 22.
In contrast, approximately 90% of women who did not give birth during their teenage years will graduate high school. The lack of education presents significant challenges later in life by limiting employment opportunities, financial stability, and resources needed for raising a family.
The children of teenage mothers are also more likely to struggle academically, exhibit behavioral problems, and face incarceration compared to children born to older parents.
These impacts create a cycle of decreased socioeconomic status that is difficult to overcome across family generations.
Economic Impact on Individuals and Society
In addition to educational impacts, teenage pregnancy greatly influences economic outcomes on both the individual and societal levels.
Approximately 60% of adolescent mothers live in poverty, with almost 25% relying on public assistance within the first year of giving birth. The hardship continues even as teenage mothers enter their 20s and 30s.
By age 35, over half of women who gave birth as teenagers live below the poverty line. Even if they can complete high school and secure employment, the average income deficit ranges from $700 to over $3,000 annually compared to those who did not have children as teenagers.
With lower incomes, paying for necessities is challenging—let alone attaining skills or education needed to obtain better-paying jobs.
For society at large, teenage pregnancy accounts for over $9 billion per year in economic burden, according to estimates from the National Campaign to Prevent Teen Pregnancy.
Teenage mothers contribute to this cost through loss of tax revenue given lower incomes and reliance on publicly-funded programs such as the Supplemental Nutrition Assistance Program (SNAP) and Medicaid.
Health Risks for Mothers and Infants
Separate from social implications, teenage pregnancy creates significantly more significant health risks for both the mother and child.
Teenage mothers are more likely to experience preeclampsia—a dangerous elevation in blood pressure during pregnancy.
They also face a higher risk of sexually transmitted infections like Chlamydia, given more significant numbers of lifetime partners.
Babies born to teenage mothers have a 35% higher risk of preterm birth and subsequent health complications.
The risk of low birth weight is 20% higher compared to babies born to women in their 20s and 30s.
Sadly, stillbirth and infant mortality rates are also considerably higher for children born to teenage mothers. The health risks pose severe immediate and long-term implications for both mother and child.
Interventions to Reduce Teenage Pregnancy Rates
Given the enormous societal costs, high health risks, and long-term hardship associated with teenage pregnancy, investing in evidence-based interventions is crucial.
Comprehensive sex education programs in schools that include accurate information on abstinence, contraceptives, sexually transmitted infections, and pregnancy have been consistently shown to delay the onset of sexual activity, increase the use of birth control, and decrease the number of partners among adolescents who are already sexually active. Access to contraceptives is also a vital intervention.
A landmark study in St. Louis provided free reversible contraceptives to teenagers and demonstrated profound benefits over time.
Teenage births declined by 40%, adolescent abortions by 42%, and the juvenile pregnancy rate overall dropped by 58% compared to the control region.
The results suggest improving accessibility and education regarding birth control—without necessarily changing sexual behavior itself—can still mitigate the risks of teenage pregnancy.
From a policy standpoint, advocating for comprehensive sex education programs and contraceptive access can have meaningful public health impacts on adolescents.
Impact on Health Care Costs and Utilization
Given the health risks and complications commonly associated with teenage pregnancy, economic costs to the healthcare system are substantial as well.
Babies born to adolescent mothers often require lengthy hospital stays after birth, which contributes to over $2 billion in annual hospital costs alone to care for mothers and infants.
More extended hospitalizations incur more significant expenses related to medical staff, postpartum care, and treating health complications in premature babies that require neonatal intensive care admission.
Outpatient costs for regular pediatric visits, vaccines, medications, and unplanned emergency costs compound the economic burden exponentially over subsequent years, given the increased risks these children face.
With higher rates of publicly-funded pregnancies, the financial responsibility ultimately lies upon taxpayers and government health plans like Medicaid.
In 2010 alone, 326,000 births were funded by Medicaid, which totaled $12.5 billion when aggregating expenses from prenatal care, delivery, postpartum visits, and one year of infant care.
With evidence-based interventions like sex education and contraceptive access demonstrating the potential to reduce teenage pregnancy rates considerably, upfront investment reaps longer-term societal savings manifested through healthcare costs.
Though abstinence promotion and stricter abortion policies are politically controversial interventions as potential solutions, the existing data disputes the efficacy or ethics of those specific approaches.
Alternatively, fact-based, compassionate policies funding comprehensive sex education and contraceptive access can achieve public health goals while mitigating healthcare spending burdens on limited state and federal resources.
Conclusion
While teenage pregnancy rates in developed countries like the United States have fallen over recent decades, they remain the highest in the world, which signals room for considerable improvement through targeted interventions.
Given the array of risk factors teen mothers and their children face—including health complications, lower educational attainment, and poverty—safeguarding adolescent wellbeing is an investment that yields dividends across generations.
Although politically controversial, evidence-based strategies like comprehensive sex education and increased contraceptive access demonstrate the potential to reduce teenage pregnancy rates dramatically.
With profound societal costs due to healthcare spending, public assistance programs, and loss of productivity and tax revenue, reducing adolescent pregnancy rates produces economic benefits as well.
As such, it should be deemed a priority public health issue meriting collaborative, compassionate policy action devoted toward supporting healthy families and communities for all citizens.