This is awareness campaign report during health teaching in a rural community within the Philippines to increase awareness of increasing trend of teenage pregnancy especially among low poverty income and less educated residents in a certain community in the Philippines

1. PETER JAMES B. VITUG
Family and Community Medicine
Pre-Resident Report
PREGNANCY PREVENTION
IN ADOLESCENTS

2. Introduction
Teenage Pregnancy
 Also known as Adolescent Pregnancy
 Pregnancy in human females under 20 years of age
 Can take place in pubertal females
Teen pregnancy"(2004) in Encyclopedia of women's health.

3. Incidence
 Annually 13 million children are born to women under age 20
worldwide
 90% in developing countries
 Complication of pregnancy and Childbirth – leading cause of mortality
among women between ages 15 to 19 years old
Save the Children Fund, UK 2019; https://www.savethechildren.org/

4.  Among young adult women age 20 to 24, 43 percent are already mothers
Results of the 2013 National Demographic and Health Survey (NDHS)
 One in ten young Filipino women age 15-19 has begun childbearing:
8 percent are already mothers
 One in five (19 percent) young adult Filipino women age 18 to 24 years had
initiated their sexual activity before age 18.
 Survey reveals that 15 percent of young adult women age 20 to 24 had their
first marriage or began living with their first spouse or partner by age 18.
in Philippines setting

5. Adolescent Pregnancy
 Major public health problem with lasting repercussions
 Community programs, responsible sexual behavior education, and
improved contraceptive counseling and delivery.
 Family physician plays a key role by engaging adolescent in confidential,
open, and nonthreatening discussions of reproductive health, responsible
sexual behavior and contraceptive use
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam
Physician. 2004 Oct 15;70(8):1517-1524/

6. Causes of Teenage Pregnancy
The Lack of Education on Safe Sex, Peer Pressure, Drugs, Alcohol and
Unprotected Sexual Intercourse
A sexually active teenager who does not use contraception has a 90%
chance of becoming pregnant within one year
Potential behavior pattern for a teenage girl becoming pregnant include:
 Early dating behavior
 High-risk behaviors
 Lack of support group
 Unhealthy environment at home
 Stress and depression
 Delinquency and criminal behavior
 Exposure to domestic and sexual violence
 Financial constraints
Allen, C., (2003).”Peer Pressure and Teen Sex

7. Impact of Teenage Pregnancy
 Less likely to graduate
 Low self-esteem and symptoms of depression
 Behavior and substance-abuse problems
 Lack resources to fully foster the emotional development and
enrichment of their children’s lives
Children of adolescent mothers are at greater risk of preterm birth, low birth
weight, child abuse, neglect, poverty, and death.
Infant mortality rate (i.e., deaths in infants younger than one year per 1,000
live births) is higher in children of teenage mothers than in other children
Mayor's. (2004)."` pregnancy and childbirth are leading causes of death in teenage girls in developing countries".

8. Save the Children Fund, UK (2019); https://www.savethechildren.org/

9. Effects of Adolescent Pregnancy
Health Effects
 Higher risk for anemia
 Pregnancy-induced hypertension
 Lower genital tract infections
 low birth weight babies
Social Effects
 Isolation guilt
 Stress
 Depression
 Low self esteem resulting in lack of interest in studies
 Limited job prospects and
 Lack of a support group or few friends to name just a few.
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

10. ON THE CHILD
 Psychosocial development
 Developmental disabilities
 Behavioral problem
 Poor academic performance
ON THE MOTHER
 Affect one's education
 Drop out of high school
 Employment and social class
Impact on Adolescent Pregnancy
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

11. Strategies for Prevention
 Aim to improve the use of contraception and to modify the high-risk
behaviors associated with teenage pregnancy and STDs.
A. Youth Social Development
 target social and psychologic skills that are necessary to avoid high-risk
behaviors
 adolescents who delay sexual activity have high educational aspirations,
peers with similar norms, and parent-child relationships
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

12. Seattle Social Development Project
Designed to increase students’ social skills and attachment to school and family.
Eighteen elementary schools were assigned to receive intensive training or the usual
education curriculum.
Teachers and parents received annual training in proactive classroom management,
problem- solving skills, child behavior management, and drug use prevention in
adolescents
RESULT: 93 percent of the 349 participants intervention group compared to control group
 Had their first sexual experience later
 fewer lifetime sex partners
 fewer pregnancies
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

13. Children’s Aid Society - Carrera Program
600 disadvantaged New York City adolescents 13 to 15 years of age
RESULTS: 79 percent of participants at three years showed that the girls in the
intervention group had lower odds of being sexually active and of having been
pregnant
Teen Outreach Program (TOP)
695 high school students were randomized by classroom to TOP or no intervention.
Program participants had lower self-reported rates of teen pregnancy, school failure, course
failure, and school suspension at one year.
The program’s success might be a result of mentorship as well as increasing self-esteem
through volunteerism
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

14. B. Abstinence-only Program
Only certain way to avoid unmarried pregnancy, STDs, and associated
health problems; they may not teach about, endorse, or promote
contraception use.
Postponing Sexual Involvement (PSI) program
Five-session program taught by trained adults or teenagers.
7,340 students with varied racial backgrounds were assigned randomly to intervention
or control groups and were followed for up to 17 months.
RESULT: No significant difference in pre- and post-intervention self-reported scores on
the initiation of sex, frequency of sex, number of sex partners, use of condoms and
other birth-control methods, or reported pregnancy rates.
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

15. C. Comprehensive Sex Education Program
Emphasizes abstinence as the most effective method of preventing pregnancy
and STDs
Discuss contraception as the appropriate strategy for persons who are
sexually active.
A review of 28 well-designed experimental studies found that most comprehensive sex-
education programs do not adversely affect the initiation or frequency of sexual activity, the
number of sex partners, or the reported use of condoms and other contraceptive methods.
Successful programs vary in their approach. Program characteristics that are important in
reducing risky sexual behaviors by teenagers
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

16. As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

17. C. Sex and Contraceptive Counseling
Success in this regard could have a profound impact on teenage pregnancy rates:
85 percent among young couples who are sexually active for one
year without using contraception, and 15 to 30 percent of
sexually active teenagers do not use contraception.
Encouraged to engage all young people—boys and girls—in
open, nonjudgmental, and confidential discussions during
regular office visits.
Counseling should include complete and medically
accurate information on responsible sexual behavior.
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

18. As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

19. Family members are encouraged to be actively involved in sex education
efforts
AAFP and AAP recommend that physicians offer adolescent opportunity to
have their examination and counseling sessions separate from their parents
and guardians.
Confidentiality as “an agreement between patient and provider that information discussed
during or after the encounter will not be shared with other parties without the explicit
permission of the patient.” (Society for Adolescent Medicine)
AAFP, AAP, and AMA, recommends informing adolescents and their parents about the
requirements and limits of confidentiality, because some patients may refuse to give accurate
medical information without it
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

20. The AAFP, AAP, and AMA also advise to stress abstinence as the only
certain way to prevent pregnancy and STDs.
However, if an adolescent chooses to become sexually active, he or she must be
counseled on appropriate contraceptive options
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

21. As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

22. As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

23. American Cancer Society now recommends that cervical cancer screening
be delayed until three years after the onset of vaginal intercourse or no later
than 21 years of age.
Centers for Disease Control and Prevention recommends that all sexually active
women 25 years of age and younger undergo annual screening for chlamydial
infection.
AAP recommends intermittent screening for high-risk behaviors and STDs, and frequent
monitoring of the patient’s satisfaction with and ability to adhere to the plan.
Contraception adherence should be discussed at each visit
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

24. AAP advises physicians to educate all sexually active adolescents about the
availability and use of emergency contraception.
Emergency contraception is intended only for emergency use, is not as effective in preventing
pregnancy as regularly used hormonal methods, and does not protect against the transmission of
STDs.
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

25. C. Counseling Male Adolescents
Teenage boys typically experience first intercourse at a younger age and have
more sex partners than teenage girls.
Most adolescent health clinics and education programs target the health of girls, with fewer
interventions aimed at boys.
A 1993 survey of publicly funded family planning clinics indicated that only 6 percent of
patients were male. Adolescent boys desire information about STDs, contraception,
pregnancy, and sexual health, but as few as 32 percent of sexually active boys receive this
information from their health care providers.
For an adolescent boy, the primary motivating factors for condom use include not only
pregnancy and STD prevention, but also partner desires, his perception of his ability to use
condoms
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

26. Several medical organizations endorse efforts to prevent teenage pregnancy and STDs.
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

27. These guidelines are summarized and serve as a model for family physicians’ roles in
teenage pregnancy and STD prevention.
As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam Physician. 2004 Oct 15;70(8):1517-1524/

28.  This adolescent period is hazardous for adolescent health due to absence of
proper guidance and counselling.
 Family has a crucial role in shaping the adolescents behavior.
 They have to ensure a safe, secure, and supportive environment for the
adolescents.
 Family members in the community to be informed and educated about this
problem.
 A positive and encouraging attitude has to be developed among the family
members and parents.
 School teachers should be trained on adolescent health.
Conclusion

29.  As-sanie., et al, 2004: Pregnancy Prevention in Adolescents, Am Fam
Physician. 2004 Oct 15;70(8):1517-1524/ www.aafp.org
 Teen pregnancy"(2004) in Encyclopedia of women's health.
 Mayor's. (2004)."` pregnancy and childbirth are leading causes of death in teenage girls in
developing countries".
 The national campaign to prevent Teen Pregnancy, (2001).
 https://psa.gov.ph/
References