Black teenage pregnancy: An obstetrician's viewpoint

Abstract

The Black pregnant teen is a microcosm of the impact of society on the most vulnerable. Who is the pregnant adolescent? What racial and ethnic connotations are implied? What is the quality of her progeny? What health risks and mortality attend Black pregnant adolescents? What measures are indicated to address teen pregnancy? Health providers must more intensively address the essentials of the socio-medical phenomenon of Black teenage pregnancy.

The United States leads other developed countries of the world by substantial margins in births to teenagers, ranging from 3/1,000 in Japan to 52/1,000 in the United States. In 1983 in New York City, 40,000 teenagers became pregnant resulting in 14,000 births, 20,000 abortions, and 6,000 miscarriages. Sixty-six percent of the births occurred in areas with large concentrations of residents of lower socioeconomic status. Special attention, then, needs to be focused on both pregnancy prevention and early prenatal care in these high risk areas.

Most teenagers do not intend to become pregnant. There are suggested racial differences regarding both the intention of becoming pregnant and teen births. Twenty percent of pregnant teenagers conceive during the first sexual expsoure and fifty percent become pregnant within the first six months. The younger the age at initiation of intercourse, the greater the likelihood of pregnancy. The desire to terminate a teen pregnancy is more closely associated with socio-economic status than ethnicity.

The course of pregnancy in teenagers is more likely to be complicated by a variety of clinical problems than in adults. Further, the maternal mortality rate in pregnant black teenagers is significantly higher than in white teenagers. The younger the pregnant teenager is, irrespective of ethnicity, the higher the maternal mortality and morbidity rates.

Future directions which are indicated vary. Further, it will take concerted effort by all segments of society to eliminate unplanned pregnancies, which continue to prove devastatingly costly.