Teenage Pregnancy

Angela Steele

Sexual Behaviour

• Australian Research Centre in Sex, Health & Society

National survey of Australian Secondary students and

sexual health 2013-2,000 students surveyed

• 69% of students have experienced sexual activity

• 34% of students had experienced sexual intercourse

• 59% of sexually active students who experienced sexual

intercourse used a condom

Data

• According to the latest figures available from the

Australian Bureau of Statistics (ABS) released in 2012,

the number of young women that gave birth in Australia

at 19 years-of-age and under was 11,344.

• This was out of a total of 301,697 Australian births so

approximately 3.7 % of the total births.

Data

• At the national level, the teenage fertility rate in 2010

was 16 babies per 1,000 women aged 15-19 years

however the rate differs amongst the states and

territories.

• In 2010, Victoria and the Australian Capital Territory

recorded the lowest teenage fertility rates in Australia

(both 9 babies per 1,000 women), while the Northern

Territory recorded the highest (48 babies per 1,000

women).

Data

Data-age

• The majority of births to teenage mothers in Australia in 2010 were to women aged 18 and 19 years (28% and 44% respectively), which is reflected in the fertility rates for women at these ages.

• In 2010, the fertility rates for women aged 18 and 19 years were 21 babies per 1,000 women and 33 babies per 1,000 women respectively.

• In comparison, only 4% of births to teenage mothers were to women aged 15 years or younger, resulting in a fertility rate of 3 babies per 1,000 women aged 15 years.

Data-Age

Age Number

15 & Under 392

16 932

17 1,917

18 3,190

19 4,913

Data-International Comparison

Country Year Number per 1,000 births

US 2009 39.1

NZ 2011 26.0

Canada 2008 13.0

Australia 2008 8.9

France 2008 7.0

Italy 2008 7.0

Japan 2008 5.0

Diversity

Diversity

• Adolescent mothers and their infants are a diverse group

with diverse outcomes

• The complexity is aligned with social disadvantage and

mental health issues

• Young women with pre-existing psychopathology

particularly depression and conduct disorders are more

likely to become pregnant

Teenage Pregnancy

• 15% of teenagers plan their pregnancy

• Pluralistic society

• Most are aware of contraceptive options

• 40% unintended

• 45% failed contraception

• Poor access

• Medicare

Teenage Pregnancy-Clinic Profile

• Over 40% of women that choose to parent young will

experience the following risk factors;

• Mental illness

• Homelessness

• Domestic Violence

• Drug and Alcohol use

• Single

• Social isolation

• Poor education outcomes

Social Isolation

Teenage Pregnancy

• According to The Australian Institute of Health and

Welfare (2008) identifies that there have been an

increase in the number of adolescent mothers in the

most vulnerable groups particularly Aboriginal and Torres

Strait Islander people

• Poor socio-demographic groups

• Less likely to be engaged in Education

Teenage Pregnancy

• Assessment of risk factors and protective factors

• HEADS assessment

• Social assessment

• ANC local hospital

• Tertiary care depends on complexity

• Community supports

• Age specific services

Mental Health

• Study 1: Found that young women tend to partner with

young men with similar risk issues such as mental illness (Quinlivan, et al 2004)

• Study 2: Antenatal maternal-fetal attachment

(Rowe, et al, 2005)

• Study 3: Development of a mental health screening tool (Judd, et al, 2009)

• Study 4: Maternal-infant attachment (Nicolson, 2013)

Birth Outcomes

• Hospital Data from The Women’s Hospital (2011) found

that young women were more likely to have;

• Preterm birth

• Low birth weight babies

• Low BMI

• Smoke

• Bottle feed

• Have a baby that is admitted to NICU

Birth Outcomes

• Environmental issues

• Not directly related to adolescence

• Smoking

• Poor ANC

• Poor access to services

• Circumstances of poverty

• Poor nutrition

Teenage Pregnancy

Case Study 1

• Presented pregnant at 15 years, birthed at 16

• Family issues, single

• Good antenatal attendance and birth outcome

• Supportive mother

• Linking into Education

• Peer Support worker

• Nursing Degree

Case Study 2

• Access to health workers

• Adoption

• Antenatal care

• Supportive partner

• Good birth outcome

• Ongoing social support and follow up

Case Study 3

• Child protection

• Sex industry from age 12

• Heroin use age 14

• Pregnant-stable on methadone

• Psychiatric symptomology

• Psychosocial support

• Good antenatal attendance

• Good birth outcome

Case study 3 continued

• 2nd pregnancy

• Stable on methadone

• Good antenatal care

• Paediatric follow up

• Attachment issues

• Birth outcome good

• Follow up

• Collaborative post birth care and support

• LARC

Health Services

• Age specific

• Child birth education

• Consistent workers

• Access

• Support

• Non-judgmental

• Ongoing community supports linked in antenatal period

• Ongoing postnatal supports

• Mental Health services

COSMOS

• Review of Teenage Pregnancy Services at The Women’s

Hospital

• Feedback from consumers

• Continuity of care and carer

• 1:1 midwife support

• 24 hour access to midwife

• Evaluation ongoing

• Breast feeding rates increased

Maternal Attachment

• Antenatal attachment

• CBE

• Mental health

• Ongoing assessments

• Ongoing supports

• GP

• MCHN

• Age specific support groups

Teenage Pregnancy

• Prevent 2nd pregnancy

• Education

• Contraception antenatal period

• Postnatal LARC

• Follow up

• FPV

Teenage Pregnancy

• Diversity

• Case by case assessment

• Ongoing community supports

• Mental health services

• Non-judgmental

• Child raising independently

• On-line information

Education

Questions?