1 CHAPTER I THE PROBLEM INTRODUCTION: According to the Philippine News Centre (2009), the Philippines have the highest

number of teenage pregnancy in South East Asia. The sexual revolution has ushered in a period in which the average adolescent experiences tremendous pressures to have sexual experiences of all kinds In addition to that, United Nation Population Fund Agency (2011) reported that South East Asias six major economies, the Philippine ranks first with a pregnancy rate of 53 of 1000 women aged 15-19years old. Teenage is a vulnerable time for pregnancy because the developmental tasks of pregnancy are superimposed on those of adolescence (Erikson, 1963). The developmental tasks of the average adolescent are fourth folds: to establish a sense of self worth or a value system, to emancipate from parents and to adjust to a new body image and to choose vocation (Erikson, 1963). Teenage pregnancy in which the developmental stage is the intimacy versus role confusion, where teenage are longing for belonging and attachments to others. It is the crucial time where teenage are more prone to have an intimate relationship with the opposite sex. Sexual misinformation is equally shared in the group. Parents at home and teachers in school feel equally inadequate or uneasy to discuss the topic of sex with youngsters. The problem mounts because the barkada (gang) has a more profound influence than parents do and they exert pressure and expect the adolescent to conform to the rest of them.

2 Pregnancy is not the only consequence of sexual intimacy among teenagers. Sexually transmitted infections (STIs) are most likely to infect because most teenagers are not faithful to their partnersand if one relationship fails, there is always another one and even some girls even claim that they engage in casual sex with acquaintances(UNPF, 2009). During the United Nations International Childrens Emergency Fund presentation of the State of the Worlds Children, Dr. Eric Tayag reported that in 2010, one out of three HIV patients is from the 15-24year-old bracket. This is the reason why the researchers opted to study this topic, in order for us to know all the possible effects of women having been pregnant during their teenage life, the risks of it are and to determine how a teenager cope with the possible changes that happened unto her life and to come up to a solution that could help the government in promoting and implementing new program in order to decrease the rate of teenage pregnancy and mortality. Hence, if we will not conduct any research about this, the percentages of early pregnancy will probably increases as time goes by. More teenagers will involve in premarital sex and it will put their health onto risk.

3 Research Framework: a.) Conceptual Framework INPUT Variables 1. Profile of the respondents regarding their age, number of children and educational attainment 2. Factors that influence respondents to engage in premarital sex 3. Reasons why premarital sex increases 4. Effects on their health on women having been pregnant during their teenage life 5. Risk on women having been pregnant during her teenage life 6. Difference of parenting between early motherhood and women having their child on their right age 7. Individual, familial and educative impacts on women having their child on their teenage life. 8. Nursing health teaching can be formulated based on the results. Use of Questionnaires Observation Process OUTPUT Health Education on why teenage pregnancy increases in one 2 Cugman, Cagayan De Oro City

decrease teenage pregnancy

Figure 1.Schematic Diagram about Health Effects on Women having been Pregnant during their Teenage Life in Zone 2 Cugman, Cagayan de Oro City:A Basis for Nursing Health Education

4 b.) Theoretical Framework: The researchers utilized Sister Callista Roys Adaptation theory in which Andrews & Roy (1991) state that the person can be a representation of an individual or a group of individuals. Roy's model sees the person as "a biopsychosocial being in constant interaction with a changing environment". The person is an open, adaptive system who uses coping skills to deal with stressors. Roy sees the environment as "all conditions, circumstances and influences that surround and affect the development and behaviour of the person" (Andrews & Roy, 1991). Roy describes stressors as stimuli and uses the term residual stimuli to describe those stressors whose influence on the person is not clear (Andrews & Roy). The theory will be applied in the research because teenagers are the most susceptible in all the issue in this generation. Being exposed in all the stressor like peer pressure, friends and more exposed in sex issues is the main problem in teenage years and finding a way in coping to this stressor can be tough. Sister Callista Roys Adaptation theory is very significant in order to understand adaptation as a part of coping after teenage pregnancy that they experience and maintain a well-being Environment is the number one factor that contributes to the large population that causes teenage pregnancy. It molds teenagers to be curious of everything that is going on around them. In it they can visualize and wonder why is it being done? Lots of teenagers nowadays commit to premarital sex because of what they see is the television and in the social media. Teenagers are those people who are so active in the social media wherein they can be influence by what they see. Furthermore, indirect environmental factors, however, also affect teen sexual risk-taking, either by decreasing motivation to avoid sex or through other mechanisms. For example, teens

5 are more likely to engage in unprotected sex and become pregnant when they live in communities with lower levels of education, employment, and income and thereby have fewer opportunities and encouragement for advanced education and careers; when their parents also have low levels of education and income; when they live with only one or neither biological parent and believe they have little parental support; when they feel disconnected from their parents or are inappropriately supervised or monitored by their parents; when they have friends who obtain poor grades and engage in nonnormative behaviors; and when they believe their peers are having sex and are failing to use contraceptives consistently.

Statement of the Problem: The researchers would like to determine the health effects on both physical and psychological effects on women having been pregnant during their teenage life in Zone 2 Cugman, Cagayan De Oro City. The result will then be used as a basis for nursing health education. The specific objectives are as follows: 1. What are the profile of the respondents regarding on their, A. Age B. Number of Children C. Educational Attainment 2. What are the factors that influence them to engage in premarital sex? 3. What are the reasons why premarital sex increases? 4. What are the effects on their health on women having been pregnant during their teenage life?

6 5. What is the risk on women having been pregnant during her teenage life? 6. What are the difference of parenting between early motherhood and women having their child on their right age? 7. What are the individual, familial and educative impacts on women having their child on their teenage life? 8. What nursing health teachings can be formulated based on the result.

Significance of the study The result of this study will be to benefit and help the following: Cugman Community. Be aware of the increasing number of teenage pregnancy on their community and find a solution on how to prevent further increase of teenage pregnancy in their area. Barangay Health Workers. To make more programs or activities that would further educate the teenagers about issues of teenage pregnancy and to provide an activity for teenagers to keep them more active in the community. Teenagers. Be more responsible of all their actions and to be aware of what might happen if they engage in premarital sex especially at a young age, and for them to think first before engaging into something that they may regret in the future. Parents. Have awareness about the psychological and physical effects of women having been pregnant during their teenage life. And helps them to guide all their children and educate them about all the possible effects of women having been pregnant during their teenage years.

7 Department of Health. Determine actions and future procedure and construct programs on how to decrease the number of teenage pregnancy in our country. Principal of the School in Cugman. Be aware and help all the students to be educated of the possible risk of women having been pregnant during their teenage life. College of Nursing. Be aware and give them more knowledge about possible risk of women having been pregnant during their teenage years, which they could impart that to the people in the community and also to their patients. Nursing Students. To be more aware about why teenage pregnancy increases and enables them to help individuals, especially teenagers, to be aware of the possible risk on their health when they will engage in premarital sex.

Scope and Limitation The researchers aim to determine the psychological and physical health effects of a women having been pregnant during her teenage life. The study will cover teenage women ranges from 12-19 years of age because it is the age bracket of teenage years and even women at an old age but got pregnant on their teenage life residing at zone 2 Cugman, Cagayan de Oro City. The respondents will be given a questionnaire for them to be answered, free of charge. The researchers choose this kind of title Health Effects on women having been pregnant during their teenage life in Zone 2 Cugman, Cagayan de Oro City: Basis for Nursing Health Education for the researchers to be able to know more about the physical and psychological changes and effects of early pregnancy on the life of a teenager.

8 The research study will only cover 50 women as respondents at Zone 2 Cugman, Cagayan De Oro City who got pregnant during their teenage years (12-19 years old). This research will be conducted on the month of January 2012. The information will only vary only the collected data by the help of the questionnaires that is free of charge. Definition of Terms Presented here is the definition of terms that is used lexically. Education according to http://dictionary.reference.com/browse/education it is the act or process of imparting or acquiring general knowledge, developing the powers of reasoning and judgment, and generally of preparing oneself or others intellectually for mature life. Health- http://en.wikipedia.org/wiki/Health it is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain Life according to http://dictionary.reference.com/browse/life?s=t it is the condition that distinguishes organisms from inorganic objects and dead organisms, being manifested by growth through metabolism, reproduction, and the power of adaptation to environment through changes originating internally. Nursing according to http://en.wikipedia.org/wiki/Nursing it is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care, training, and scope of practice.

9 Pregnant according to http://en.wikipedia.org/wiki/Pregnancy it is the fertilization and

development of one or more offspring, known as an embryo or fetus, in a woman's uterus. Premarital Sex according tohttp://medical-

dictionary.thefreedictionary.com/Premarital+sexit is asexual intercourse between two people who are not married to each other. The specific legal definition varies from jurisdiction to jurisdiction. In some, both persons are unmarried; in some, one is unmarried; in some, the charge is adultery rather than fornication if the woman is married, regardless of the man's marital status. Teenage according to http://simple.wikipedia.org/wiki/Teenager it is a young person whose age is between thirteen and nineteen (13-19). They are called teenagers because their agenumber ends in "teen". Someone aged 18 or 19 is also considered a young adult. Teenage Pregnancy- according to http://en.wikipedia.org/wiki/Teenage_pregnancy it is pregnancy in a female under the age of 20 (when the pregnancy ends). A pregnancy can take place at any time after puberty, which technically begins about two weeks before menarche (first menstrual period). In healthy, well-nourished girls, menarche normally takes place around the ages 12 or 13. It is the stage at which a female becomes potentially fertile. Women- http://en.wikipedia.org/wiki/Woman it is a female human. The term woman is usually reserved for an adult, with the term girl being the usual term for a female child or adolescent.

10 CHAPTER II Review of Related Literature and related studies This chapter presents and discusses various related literature and studies of the research in thematic form, which provide the researchers an evidence of what are already known and are related to the present study. RELATED LITERATURE

Teenage Pregnancy Issues in Our World Today

The rate of teenage pregnancy is on a high increase mostly in developing countries causing low educational levels, poverty, early and forced marriage, which supposed not to be so. We have to fight against this so that our girls will be well equipped educationally and be able to make a rightful choice in terms of marriage.

Parents Need To Do To Avoid Teenage Pregnancy

Parents in our world today shy away from responsibilities, which is the uppermost thing in life and pursue just the shadow. Parents put our careers first instead of taking time to put all we can to make sure that our teenagers get all the protection and guidance they need from us at their early stage. How can I be a friend to my own teenage son or daughter? It may sound difficult but its easy and pays a lot. First and foremost, get close to your teenage daughter by giving answers to all her questions when being asked, if she as a teenager finds it difficult to ask, force it out from her by asking some questions yourself.

11 As a parent you need to talk about sex with your teenager, do not shy away from it, tell them what sex is all about and how good and bad it is to have sex. How do I start this? Its easy; you as a parent can start by talking generally about sex and relationships, naming all the reproductive organs and their functions. Go through your teenagers lesson notes and find out what he/she is been taught, even if you have nothing to contribute, as a parent use your initiatives and say something

Causes Of Teenage Pregnancy?

In our world today most especially in the developing country, teenage pregnancy is as a result of traditional roles and early marriage, because teenage pregnancy is seen as a blessing and a proof that the young woman is fertile. In most cases, poverty contributes to this, when one does not have someone to take care of her at her early age.

In the developed world, the causes of teenage pregnancy is different in the sense that it is mostly outside marriage and carries lots of social stigma. Thus, adolescent sexual behavior is one of the causes of teenage pregnancy. In our world today, having sex before 20yrs is the in thing, it is even the normal all over the world and this brought about high levels of adolescent pregnancy which creates sexual relationship among teenagers without the provision of comprehensive information about sex.

The in-take of drugs, alcohol etc contributes a lot to teenage pregnancy meanwhile as a teenager you may not be ready for sexual intercourse at that moment but being intoxicated with drugs and alcohol makes you to be involved in unintended sexual activity just because sex at that

12 time is less emotionally painful and embarrassing to avoid this, eradicate anything alcohol or drugs.

Furthermore, sexual abuse is also one of the causes of teenage pregnancy. Rape as a sexual abuse has more effect in the life of our teenage girls causing unwanted sex and teenage pregnancy.

Conclusively, age discrepancies also causes teenage pregnancy in the sense that a teenage girl with a partner much older than herself is more likely to get pregnant more often than a girl that have a partner of a close age, as she prefers having the children than abortion since she is not educated enough to use contraceptives.

Teenage Pregnancy Issue in Our World Today

Teenage age can be said to be the transitional stage whereby human being develops that is between childhood and full adulthood. This also represents the period of time a boy or girl is biologically an adult but not to full maturity emotionally.

Pregnancy can be referred to as the process whereby a female carries live offspring from the time of conception to childbirth. It is also the state of being pregnant, that is the period starting from conception to the birth of the baby when a woman carries a developing fetus in her womb (Uterus).

Having known the full meaning of this two (Teenage age and Pregnancy), Teenage pregnancy then can be defined as a girl that is under-aged becoming pregnant with a baby. In

13 some countries if a girl is not up to 18 years and become pregnant with a baby it is called teenage pregnancy though teenage age differs from one country to the other.

In our world today, we all noticed that that there are many changes in our young girls today, most of them having their first menstrual periods at very early age which was not so before meaning that the average age of first pregnancy has been declining and will continue to do so.

In this aspect, the first ovulation is irregular until after some time and because of this irregularities in ovulation and fertile days, our girls are confused about their body temperature, remain adamant and unserious towards the dangers of early pregnancy.

Teenage pregnancy carries social stigma in many cultures of a developing country and it is mostly outside of marriage. It brings about high risk of poverty, illiteracy or lower educational levels and ones it happens, such girl will ever have a mark that hinders her progress in future. Well as we go ahead, we will learn how to get this to a stop so that our young girls will stop falling victim of this stigma.

http://teenage-pregnancy-issues-in-our-world.blogspot.com

Teen pregnancies in the Philippines

The Philippine Daily Inquirer stated that, the sexual revolution has ushered in a period in which the average adolescent experiences tremendous pressures to have sexual experiences of all kinds. Filipino teens get a higher exposure to sex from the Internet, magazines, TV shows, movies and other media than decades ago, yet without any corresponding increase in information

14 on how to handle the input. So kids are pretty much left to other kids for opinions and value formation when it comes to sex.

Statistics shows that 10 percent of all women aged 15-19 and 19 percent of those who have had sexual intercourse become pregnant and one-fourth of teenage mothers have a second child within two years of their first. (Philippine Daily Inquirer, 2009).

In 2008, the National Demographic and Health Survey (NDHS) showed that some 5.6 million of female teenagers got pregnant and 92% of these teens, the pregnancy was unplanned and the majority (78 percent) did not even use contraceptives the first time they had sex.Whilst, World Bank (2009) studied and reported that the Philippines ranked as one of the top 10 countries with an increasing number of teenage mothers. Seven out of 10 Filipina mothers are adolescents, most of them below 19 years old.

In a study conducted by the American Medical Association, it was found out that babies born to women who do not have regular prenatal care are four times more likely to die before the age of one year.Nearly four in 10 teen pregnancies (excluding those ending in miscarriages) are terminated by abortion. There were about 274,000 abortions among teens in 1996.

These medical complications include pregnancy-induced hypertension/pre-eclampsia, significant anemia, placenta previa, premature birth/prolonged labor, low-birth weight infant with underdeveloped organs, and post-partum depression.

Death rate from pregnancy complications is higher for 15 years old and younger. (Health & Home, 2007).

15 The British government launched a new campaign to spread family planning to millions of women in the developing world. A report from Save the Children, due to be released today, found that "girls under 15 are five times more likely to die in pregnancy than women in their 20s". The prevention of teenage pregnancies through the use of contraception would save many thousands of lives, adds the report. "The issue of children having children and dying because their bodies are too immature to deliver the baby is a global scandal," said Justin Forsyth, chief executive

Teenage Birth Rate Rises for First Time Since 91

By GARDINER HARRIS WASHINGTON, Dec. 5 the birth rate among teenagers 15 to 19 in the United States rose 3 percent in 2006, according to a report issued Wednesday, the first such increase since 1991. The finding surprised scholars and fueled a debate about whether the Bush administrations abstinence-only sexual education efforts are working.

The federal government spends $176 million annually on such programs. But a landmark study recently failed to demonstrate that they have any effect on delaying sexual activity among teenagers, and some studies suggest that they may actually increase pregnancy rates.

16 Spending tens of millions of tax dollars each year on programs that hurt our children is bad medicine and bad public policy, said Dr. David A. Grimes, vice president of Family Health International, a non-profit reproductive health organization based in North Carolina.

Robert Rector, a senior research fellow with the Heritage Foundation, said that blaming abstinence-only programs was stupid. Mr. Rector said that most young women who became pregnant were highly educated about contraceptives but wanted to have babies.

President Bush noted the long decline in teenage pregnancyrates in his 2006 State of the Union address, saying, and Wise policies such as welfare reform, drug education and support for abstinence and adoption have made a difference in the character of our country.

The White House did not respond to requests for comment Wednesday.

In a speech last year, Senator Hillary Rodham Clinton said that rates of teenage pregnancy declined during the Clinton administration because of a focus on family planning.

Teenage birth rates are driven by rates of sex, contraception and abortion. In the 1990s, teenage sex rates dropped and condom use rose because teenagers were scared of AIDS, said Dr. John S. Santelli, chairman of the department of population and family health at Columbia University.

But recent advances in AIDS treatments have lowered concerns about the disease, and AIDS education efforts, which emphasized abstinence and condom use, have flagged.

17 Perhaps as a result, teenage sex rates have risen since 2001 and condom use has dropped since 2003. Abortion rates have held steady for a decade, although numbers from 2005 and 2006 are not available. Kristin A. Moore, a senior scholar at Child Trends, a non-profit childrens research organization, said the increase in the teenage birth rate was particularly alarming because even the 2005 rate was far higher than that in other industrialized countries. Its really quite disappointing because we werent close to reaching our goal, Dr. Moore said. The lone bright spot in Wednesdays report, issued by the Centers for Disease Control and Prevention, was that the birth rate for girls 14 and under dropped to 0.6 percent per 1,000 from 0.7 percent. Birth rates rose 3 percent among teenager ages 15 to 17 and 4 percent among those ages 18 and 19.

The largest increase came among black teenagers, but increases were also seen among whites, Hispanics and American Indians. Birth rates among Asian teenagers continued to drop.

Unmarried childbearing reached a record high in 2006, according to the disease control centers, with unmarried mothers now accounting for 38.5 percent of all births. Births among teenagers and unmarried women tend to lead to poor outcomes for their children.

Helping to prevent these pregnancies was the reason advocates pushed for the wide availability of the morning-after pill known as Plan B. The Food and Drug Administration

18 approved sales of Plan B without a prescription in August 2006, too late to have any effect on that years birth rate.

Mr. Rector of the Heritage Foundation said that teenage and unmarried birth rates were driven by the same factors: young women with little education who are devoted to mothering but see no great need to be married. We should be telling them that for the well-being of any child, its critically important that you be over the age of 20 and that you be married, he said. That message is not given at all.

Dr. Santelli of Columbia said that many abstinence-only educational efforts tended to emphasize that contraceptive often fail. They scare kids about contraception, he said.

The report also found that the Caesarean delivery rate continued its rise, increasing 3 percent in 2006 to 31.1 percent of all births, a record. In recent years, women who have had one birth by Caesarean have often been discouraged from having subsequent births vaginally. And there is some evidence that a growing number of women are requesting Caesareans to avoid pain or vaginal stretching.

The American College of Obstetricians and Gynecologists published a position paper last month stating that some Caesareans-upon-request should be discouraged. Women who have multiple Caesarean births are more likely to suffer uterine rupture and other serious consequences.

19 Dr. Robert Freeman, a professor of obstetrics and gynecology at the University of California, Irvine, said that managed-care companies no longer discouraged Caesareans and malpractice fears often led doctors to opt for Caesarean at the first hint of trouble. These numbers are bad news, Dr. Freeman said, and I think its only going to get worse. For the first time since 1971, the nations overall fertility rate rose past the replacement rate, increasing 2 percent in 2006 to 2,101 births per 1,000 women. Women of almost every age had more children last year than the year before, except girls under 15 and women over 45.

http://www.nytimes.com/2007/12/06/health/06birth.html?_r=1&ref=teenagepregnancy

Teenage Pregnancies Rising in Philippines

Alastair McIndoe - Straits Times Indonesia

Manila. At a counselingcenter for pregnant teenagers run by local authorities in the Philippine capital's Cubao district, nurseLizelHermosilla helps and offers advice to about three girls daily in an examination room painted sunny yellow.

"They are mostly from poor families and their numbers are rising," said Hermosilla, as she ran a finger down a long list of names and addresses.

Government statistics on adolescent pregnancies released last month show a similarly disturbing picture on a national scale.

20 The total number of annual births changed little over the preceding 10 years. But the number of teenage pregnancies has risen 70 percent, from 114,205 in 1999 to 195,662 in 2009.

Based on data compiled from birth certificates, of the 1.75 million live births in 2009, the latest review year, over 11 per cent were by teenage mothers. The numbers have climbed steadily every year over the period.

"Adult fertility rates are coming down across all age groups, but not for teenagers," said JuniceMelgar, director of the women's rights group Likhaan.

Ignorance and poverty, which cause large numbers of children to drop out of school, are the main drivers of persistently high rates of teenage pregnancies in the Philippines.

According to one survey, only 15 percent of adolescents said they discussed sex with their parents, a subject considered taboo in many households.

Landmark legislation is in the pipeline to allow 'age-appropriate' sex education to be taught from age 11 in the country's 55,000 state schools, as part of wider measures in a Responsible Parenthood Bill.

The Bill is on the agenda in both chambers of Congress, and is among a dozen pending laws President Benigno Aquino wants passed quickly.

But it is fiercely opposed by the politically influential Catholic Church for violating church doctrine forbidding artificial contraception methods.

21 The church hierarchy fears that sex education will lead to more promiscuity among the young - a fear proponents of the Bill say is unfounded because the curriculum will be based on promoting moral values as well as the facts of life.

However, survey after survey shows that even in this Catholic-majority country, ordinary Filipinos want access to state-funded family planning health services.

In a poll published in August by Social Weather Stations, 73 percent of respondents agreed with the statement: "If a couple wants to plan its family, it should be able to get information from the government on all legal methods."

To Hermosilla, a devout Catholic, sex education should be at the forefront of efforts to cut teenage pregnancies. "We see girls in here as young as 13 and 14, and many come to us only when they are four or five months pregnant," she said.

The Teen Health Centre in Cubao is a rarity in the Philippines. It was set up as part of Quezon City council's decision to adopt many of the measures contained in the Bill.

In May, another centre was opened in Commonwealth, one of the city's poorest districts. Patients at both centers get free check-ups, vitamins and sympathetic counselling. Terminating a pregnancy is not a legal option in the Philippines, which outlaws abortion.

Although not a formal rule, teenagers are required to leave school and study outside "once the bump shows", said Hermosilla.

22 The teenage pregnancy rate in the Philippines is the highest among Asean's six major economies at 53 births per 1,000 women aged between 15 and 19, according to the United Nations Population Fund's 2011 annual report released last week.

The rate for Singapore was five, and the Asia-Pacific average was 34.Congressman Waldon Bello, a strong supporter of the Bill, believes mandatory sex education should 'definitely' bring down the level of teenage pregnancies.He is optimistic the Bill will be passed. At the end of the day, he said, lawmakers will realize this is a historic vote.

"They will not want to go down in history as having opposed a measure that is so badly needed and that most Filipinos want," he added.

http://www.thejakartaglobe.com/international/teenage-pregnancies-rising-in-philippines/476769

Teen pregnancies in PH increased by 70% in last 10 years, says United Nation Population Fund Agency

InterAksyon.com, citing information from the United Nation Population Fund Agency (UNFPA), reports that while Philippine government statistics on female adolescent pregnancies reveal that "the number of teenage pregnancies rose 70 percent, from 114,205 in 1999 to 195,662 in 2009." It was pointed out in a GMA News Online report that with this increase, the Philippines now "has one of the highest teenage pregnancy rates in the Association of Southeast Asian Nations (ASEAN)." The UNFPA further noted: "Based on data compiled from birth certificates, of the 1.75 million live births in 2009, the latest review year, over 11 percent involved teenage mothers."

23 In an interview on Monday, April 23, UNFPA country representative Ugochi Daniels said "the rising number of teenage pregnancies in the country is an area of concern that the agency is giving serious attention to, exposing as it does adolescent girls (10 to 19 years old) to high risk."

According to the report, Daniels added that "a strong advocacy campaign is needed to educate and advise young Filipinas about the dangers posed by early pregnancies, and to inform them about reporductive health in general."

http://www.spot.ph/newsfeatures/50963/teen-pregnancies-in-ph-increased-by-70-in-last-10years-says-united-nation-population-fund-agency

US and UK are top in teenage pregnancy rates

ZosiaKmietowicz

More teenage girls in the United States and United Kingdom become pregnant than anywhere else in the developed world, because they are poorly prepared for life in a modern and sexualised society, says a report out this week.

The United States has topped a table of teenage pregnancy rates put together by Unicef'sInnocenti Research Centre in Italy, which looked at births among teenagers in 28 of the world's wealthiest nations.

Altogether, 52 out of every 1000 girls aged between 15 and 19 in the United States gave birth, while the United Kingdom topped the list in Europeand came second overallwith just

24 over 30 births in 1000 teenagers. At the other end of the scale Korea, Japan, Switzerland, the Netherlands, and Sweden had a rate of less than seven births per 1000 teenagers.

The researchers estimated that in the next 12 months at least 1.25 million teenagers in the world's wealthiest countries will become pregnant and three quarters of a million will become mothers. And, according to specially commissioned research from the University of Essex, teenagers who keep their baby are twice more likely to end up living in poverty than those who delay motherhood.

The eightfold difference in birth rates can be partly explained, the report says, by the move away from traditional family values in some countries to what the researchers call a socio-sexual transformation where sexual imagery permeates all aspects of life and teenagers are under greater pressure to experiment with sex. But the report adds that equally important is how these countries prepare their young people to cope with modern life.

Some countries, such as Sweden, the Netherlands, Denmark, Finland, and France, have travelled far down the road from traditional values, but they have also made successful efforts to prepare their young people to cope with a more sexualised society.

By comparison the United States and the United Kingdom are secretive and embarrassed about contraceptive services. After interviewing young people about sexual services, the UK government's Social Exclusion Unit concluded: The universal message received from young people is that the sex and relationship education they receive falls far short of what they would like to equip them for managing relations as they grow into adulthood.

25 By tackling teenage births governments have the chance to reduce poverty and its perpetuation from one generation to the next, says the report.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123322/

When Reality Hits the Effects of Teenage Pregnancy

Trying to distinguish the effects of teenage pregnancy is a complex task given the difficulty in separating pre-existing conditions and those that are a direct result of adolescent pregnancy. Despite this complication, though, there is a large amount of research which shows that a pregnant teenager will encounter a great deal of negative effects. First and foremost of these effects of teenage pregnancy is the emotional stress of being pregnant at such a young age and of having to make a decision as to what to do about the pregnancy.

Teenage mothers are more likely to drop out of school than their peers who are able to avoid pregnancy. Statistics from 1997 show that only 41% of adolescents who have children before they reach 18 years of age graduate from high school, compared to 61% of adolescents from similar backgrounds who delay pregnancy until at least 20 or 21 years of age.

Because many teenage mothers drop out of school, another of the effects of teenage pregnancy is their lack of necessary job skills to be successful in the work force. Many teenage mothers then become dependent on public assistance. Over 75% of all unmarried teen mothers go on welfare within 5 years of the birth of their first child. On the flip side, though, some studies have shown that for teenagers who live in poverty, getting pregnant and being supported by the father of the child could be a survival mechanism to avoid an even more hopeless situation.

26 Adolescent mothers may not have adequate parenting skills and could harm the psychosocial development of their child, resulting in another one of the effects of teenage pregnancy. Studies show that teenage mothers do not provide their children with stimulation through touch, smiling, and verbal communication, nor do they seem sensitive to their childs needs. Furthermore, children of teenage mothers are more likely to suffer from poor nutrition. Many adolescents, in addition, show a great deal of anger towards their child and rely heavily upon punishment. Indeed, the incidence of developmental disabilities and behavioral issues is higher in children of teenage mothers.

When these children grow up, they often exhibit poor academic performance, failing to graduate, being held back, and scoring poorly on standardized tests. Daughters of teenage mothers are more likely to fall into the trap of teen pregnancy themselves and sons of teenage mothers are three times more likely to go to prison.

Effects of teenage pregnancy also include health risks for the mother and the child. Indeed, women aged 15-19 experience four times the risk of maternal mortality compared to 25 to 29 year old women. The risk is even higher for girls aged 10 to 14 and the children of these adolescent are more likely to fall sick or die in infancy.

http://www.preparents.com/teenage/permalink.php?article=effects+of+teenage+pregnancy.txt

27 Rise in teenage pregnancy due moral values breakdown

By Michael Andrew W. Yu

A PRIEST said Monday that the increase of teenage pregnancy cases is due to the breakdown of moral values.

Msgr. Rey Monsanto, Jesus of Nazarene Parish priest and Archdiocese consulter, said the surge of teenage pregnancy, especially to those who are still in high school and college, in the country is alarming.

He said the schools, parents and religious sector probably did not impart proper values to the children. Maybe the exposure of youths in media like in films, particularly television shows in the international scene, did not give proper values, he said. It is really a show of a breakdown of moral values. The solution would be on the moral grounds since morality is being questioned.

Monsanto said contraceptives like condoms, pills and other means is not a solution to the surge of teenage pregnancy and moral breakdown. In fact, it would increase moral breakdown since the youth will become dependent on contraceptive use, he said.

Monsanto said he was sent to New Mexico in relation to teenage pregnancy problem and that some would no longer enter in schools.

28 The community and the local government unit in the area were alarmed and so they put up a school in order for the youth to undergo schooling. The youth were allowed to bring their children to schools for breastfeeding in proper time, he said.

With this, he urged the youth to understand and know moral values because it is important. The schools should also impart right moral values, he added.

Earlier, the National Youth Commission expressed alarm on the surge of teenage pregnancies in the country, based on the report of the United Nations Population Fund (UNFPA).

According to the UNFPA, teenage pregnancy in the Philippines increased by 70 percent over the past 10 years.It added that the country ranks first with a pregnancy rate of 53 in every 1,000 women aged 15 to 19 among Aseans six major economies. In the NYCs National Youth Assessment Study, it was revealed that unplanned pregnancy is one of the main reasons why young people do not finish their education.

http://www.sunstar.com.ph/cagayan-de-oro/local-news/2012/05/01/rise-teenage-pregnancy-duemoral-values-breakdown-219196

RELATED STUDIES

Teenage Pregnancy in South Africa: With a specific learning in School-Going Learners The transition to parenthood is a major event in the lifespan of any individual, but takes on special significance when it precedes the transition to education, work, citizenship and marriage that collectively offer the skills, resources and social stock necessary for individuals to succeed as parents. Although alternative pathways to parenthood occur and are tolerated to some

29 extent, institutional support for parenthood is still geared towards a traditional sequencing of transitions. HIV and AIDS is now recognized as the primary reproductive health concern for adolescents, overtaking the long-standing emphasis on adolescent fertility. Yet childbearing among teenagers remains a common social and public health concern worldwide, affecting nearly every society. Teenage fertility establishes the pace and level of fertility over a womans entire reproductive life span. This has an impact not only on womens health, but on the socioeconomic status and general well-being of the population. Despite public health literature and family planning services treating HIV and pregnancy as distinct, they share many common antecedents, chief amongst which is unprotected sex. Furthermore, there is evidence that pregnancy and lactation increase the susceptibility to HIV infection through immunological changes induced during pregnancy. Even though teenage fertility has been the subject of substantial debate in the social science research and policy circles, concern has not emanated from the increased risk that pregnancy confers to HIV. While current political and media depictions imply that South Africa (hereafter referred to as SA) is confronted with an escalating epidemic of teenage pregnancies, available data suggests that it is an area in which substantial progress has been made since democracy. Yet teenage pregnancy has grown in significance as a social construct and come to represent one of several indicators of burgeoning adolescent delinquency, sexual permissiveness and moral decay.

30 Education is central to the development of young people as it prepares them for the world of work and for life. As young people spend longer periods in education, as part of the natural course of development, sexual experimentation and maturity is increasingly coinciding with secondary schooling. For most, it remains at the level of experimentation and if sex occurs, indications are that it is more likely to be protected when young people are still at school. However, for a minority, it results in unwanted pregnancy, HIV and other sexually transmitted infections. This has implications for continued educational opportunities. In a rights-based society, young girls who fall pregnant should not be denied access to education and this is entrenched in law in SA through the Constitution and Schools Act of 1996. In 2007, the Department of Education released Measures for the Prevention and Management of Learner Pregnancy. Not without controversy, the guidelines continue to advocate for the right of pregnant girls to remain in school, but suggests up to a two-year waiting period before girls can return to school in the interest of the rights of the child. Any proposed shift in policy and practice needs to be informed by a well-rounded understanding of the context of teenage pregnancy. METHODS The study involved a desktop review of literature supported by secondary data analysis to provide an overview of research on the prevalence, determinants and interventions for teenage pregnancy. Although the study focused on pregnancy, the detailed trends presented in the report are on fertility. Understanding the distinction between pregnancy and fertility is essential. Fertility rates refer only to pregnancies that have resulted in live births while pregnancy rates include both live births and pregnancies that have been terminated. Before the introduction of the termination

31 of pregnancy legislation, fertility closely approximated pregnancy rates. Since the legalisation of abortion, however, this can no longer be assumed to be the case. Trends in pregnancy rates in SA cannot be accurately estimated for two reasons. Firstly, it is not known whether pregnancies that were terminated early on are well-captured in survey data and school record systems. Secondly, a comprehensive national register of abortion is not maintained in the country. SA lacks vital statistics on fertility, pregnancy and abortion. Nevertheless, fertility rates could be reliably estimated from Census data and the Demographic and Health Surveys. For the purposes of this study, trends in teenage fertility were investigated in three stages: (1) Mapping the overall trends in fertility in SA; (2) Documenting trends in teenage fertility relative to overall fertility; and (3) Analysing learner pregnancies reported through the Education Management Information System (EMIS). The literature review focused on studies dated between 2000 and 2008 but included seminal works prior to 2000. In view of the high rates of HIV infection among young people in SA, sexual behaviour of adolescents has received much national scholarly interest. The literature review was able to draw on four national studies conducted to understand youth sexual behaviour. Secondary analysis was also conducted on the HSRC 2003 Status of Youth Survey, a nationally representative study of more than 3 500 young people aged between 18 and 35 years. The purpose of the secondary data analysis was to identify factors that are associated with early pregnancy. This included family structure, type of childhood residence, childhood poverty and school dropout.

32 Teenage pregnancy and young parents research brief Introduction In the UK, teenage pregnancy is widely considered to be a problem and negative preconceptions about teenagers suitability to be parents are common. Stories in the media talk of the teenage pregnancy epidemic and tend to focus on an urgency to cut teenage pregnancy rates and "tackle" the teenage pregnancy problem. The Teenage parents: Whats the problem? document challenges the view that teenage pregnancy is a problem with some compelling evidence and arguments (Duncan et al 2010). The paper cites a study that assessed the differences between miscarrying and successful teenage pregnancies, which found that teen birth has little impact upon qualifications, employment or earnings by the time teenagers turn 30 (Ermisch and Pevalin 2003). The document also warns against describing teenage parents as a homogenous group that is separate from other mothers. It says: like older mothers, they are proud of their children; they aim to put them first; and they encounter familiar dilemmas in reconciling care commitments with making a living and reaching accommodations with partners and other family members. (Duncan et al 2010). However, there is a wealth of evidence that teenage parents and their children are at an increased risk of experiencing poor mental and physical health, poverty and social exclusion. The Department for Children, Schools and Families Getting Maternity Services Right for pregnant teenagers and young fathers document summarizes the complexities of assessing the root causes of negative outcomes for teenage parents and their children: There has been considerable debate over whether poor outcomes for teenage mothers and their babies are a consequence of the mothers age, or of her often disadvantaged circumstances, or of limited

33 uptake of antenatal care. Current research suggests that all three factors can contribute to poor outcomes, but that timely access to appropriate care and support can help to overcome the risks of poor outcomes and can maximize young peoples potential for achieving a healthy and happy transition to parenthood. (DCSF 2009) Most research concludes that the problems associated with young motherhood are more to do with the social and educational background of these young women than their age when they become pregnant (Hall and Hall 2007). However, it is likely that teenage pregnancy is both a cause and a result of exclusion, poverty and inequality (TPIAG 2010). Adolescents in industrialized countries have typically micronutrient-poor, carbohydraterich diets, so a significant proportion of pregnant teenagers have an inadequate intake of key pregnancy nutrients. Many of them also have erratic and unhealthy eating patterns (Stanner 2001). About Teenage Eating, a comprehensive study investigating pregnant teenagers and nutrition, found that half the pregnant teenagers that took part had low gestational weight gain and iron deficiency (anemia). The study was also the first to highlight the extent of poor vitamin D status in pregnant adolescents, finding that a third were vitamin D deficient. Over a fifth of the teenagers who took part were thought to have low folate levels. This could be because fewer than half of the participants reported taking folic acid supplements during early pregnancy and very few took supplements during the third trimester (Baker et al 2009). Poor intake of micronutrients during pregnancy is thought to contribute to teenagers' increased risk of having small for gestational age (SGA) babies. Interestingly, obese teenagers

34 also have an increased risk, but there has been very little research as to why. These findings highlight how important it is that teenagers have a healthy diet during pregnancy. It has been suggested that teenagers propensity to have SGA babies is because they are still growing and therefore have more acute nutritional needs than older women. However, the largest study to investigate the impact of maternal growth in pregnancy found that growing teenagers were less likely to have SGA babies than non-growers. The most likely reason for this is that teenagers who are still growing are doing so because they have a better nutritional status (particularly higher folate levels). Teenagers who have less nutritious diets are not meeting the extra nutritional needs of their pregnancy. They are therefore less likely to continue growing and their baby is also more likely to be SGA (Jones et al 2009). Studies investigating teenage mothers and SGA babies have found that customized birth weight percentiles (based on maternal characteristics, such as Body Mass Index (BMI), ethnicity, gestational diabetes and gestation age) are particularly useful for teenagers (Baker et al 2009). Healthy Start, which replaced the means tested elements of the former Welfare Food Scheme, provides weekly vouchers for fruit, vegetables or milk and vitamins to eligible pregnant women and families with young children. All pregnant women under 18 are eligible for Healthy Start from the 10th week of pregnancy. If a woman turns 18 during her pregnancy, she can still receive vouchers until her baby is born. Once the baby is born, she can continue to claim vouchers if she is awarded one of the qualifying benefits or tax credits (DCSF 2008). Social trends suggest that binge drinking is likely to be a bigger issue than chronic alcoholism for teenagers. Binge drinking is thought to increase the risk of Sudden Unexpected

35 Infant Deaths (SUIDs) (Hall and Hall 2007). Alcohol is also associated with girls having sex at a younger age, unwanted sex and unprotected sex. Teenagers are much more likely to be smokers than older women. They are three times more likely to smoke before or during pregnancy than women aged 35 and above. Figures from 2005 show that 45 per cent of women aged 20 or under smoked throughout pregnancy compared with the national average of 17 per cent. Of the teenage smokers, 34 per cent gave up during pregnancy compared with the national average of 49 per cent of smokers (DCSF 2008). Smoking during pregnancy is estimated to contribute to 40 per cent of all infant deaths and to teenagers higher chance of having a low birth weight baby (25 per cent higher than older mothers) (DCSF 2007). Teenagers are a third less likely to breastfeed than older women. Figures from 2005 showed that 51 per cent of mothers who were 20 or under breastfed, compared with a national average of 77 per cent. Teenagers are also much less likely to continue breastfeeding. Only 34 per cent of teenagers who initiate breastfeeding are still breastfeeding one week after birth, and only seven per cent at six months (five times lower than the rate for women aged 35 and over) (Bolling 2007). Education Teenage mothers participation in education, employment or training (EET) beyond the compulsory school leaving age is very low, with only about 30 per cent of young women being in EET, compared to nearly 90 per cent of all 16 to 19 year olds. Although many young mothers have had negative experiences of education, they generally have a strong desire to provide a positive future for their child, and recognise that their own education will help them achieve this (DCSF 2007).

36 The Care to Learn scheme covers teenagers childcare costs while they are in education and has proved to be valuable (Directgov 2010). There are concerns, however, that it doesnt continue for over 19 year olds (Hall and Hall 2007). Postnatal depression (PND) Teenage mothers are three times more likely than older mothers to develop PND, with around 40 per cent of young mothers affected (Ermisch and Pevalin 2003). Social isolation and high rates of relationship breakdown are primary causes of PND in teenagers. Poor housing often further contributes to poor emotional health and wellbeing (DCSF 2007). Depression in the first year of life is associated with impairments in child development, particularly affecting boys. It seems therefore logical to identify women at risk of depression in pregnancy. The Family Nurse Partnership (FNP) suggest the use of the Adolescent Wellbeing SCALE to identify perinatal and postnatal depression in teenagers, though it was not designed specifically for use in pregnancy (DH 2010, Hall and Hall 2007). A fathers negative behaviour is a risk factor for PND in the mother. On the flip side, a good, supportive relationship with the babys father helps to protect the young mother from PND (DCSF 2008). A report by the Teenage Pregnancy Independent Advisory Group (TIAPG) has raised concerns that babies of teenage parents are more at risk of witnessing domestic violence. It also says that support service staff are often not confident and adequately trained to identify domestic violence in teenage relationships, so young parents do not receive coordinated and planned care and support (TPIAG 2010). www.womenshealthmatters.org.uk.

37 Young parents often have unstable and volatile relationships with each other. Relationship problems between couples are a significant cause of stress during pregnancy, which can affect an unborn baby (DCSF 2008). In 2005, 60 per cent of mums in England who were under 20 were lone parents (DCSF 2007). Only a third of mothers who are under 20 experiences a stable relationship throughout pregnancy and the three years after birth (compared to 88 per cent of older mothers). A further 49 per cent experience a change in their relationship status over this period (compared to 10 percent of older mothers). The high rate of relationship breakdown between young parents is often followed by a loss of contact. Fathers commonly cite financial problems and conflict with the mother and her parents as reasons for this. Mothers are more likely to complain of fathers disinterest, antisocial behavior and substance abuse as reasons for seeking to exclude them from involvement with the child (Hall and Hall 2007). In England, the Common Assessment Framework (CAF) has been put in place to identify and plan support for young peoples needs. With the consent of the young person, information is shared between the agencies, where more than one agency is involved in supporting them. One practitioner coordinates the support as the lead professional (DCSF 2010b). www.brook.org.uk www.education.gov.uk [pdf file, accessed July 2010]

38 SYNTHESIS The rate of pregnancy is on a high increase mostly in developing countries causing low educational levels, poverty, early and forced marriage, which is not supposed to be so.

Parents in our world today shy away from responsibilities, which is the uppermost thing in life and pursue just the shadow. Parents put their careers first instead of taking time to put all they can to make sure that their children especially teenagers get all the protection and guidance needed from them at their early stage or age.

American Nurses Association also added and found out that babies born to women who is at early age are four times likely to die before age of one year. UNFPA country representative Ugochi Daniels also said to his interview that the rising number of teenage pregnancy in the country is an area of concern that the agency is giving serious attention to, exposing as it does adolescent girls (10-19 years old) to high risk.

In addition to that, the teenage pregnancy rate in the Philippines is the higest among Aseans six major economies at 53 births per 1000 women aged between 15-19 according to the United Nation Population Funds 2011 annual report released just this year.