Adolescent pregnancy and sexual abuse.

Abstract

Up to 60% of pregnant teens in the US have histories of child sexual abuse. The pregnancy may be a direct result of an episode of abuse or may be linked to common sequelae of child sexual abuse including young age at initiation of sexual intercourse failure to use contraception prostitution physically assaultive relationships and abuse of drugs and alcohol. Women with histories of sexual abuse are significantly more likely than their nonabused peers to experience suicidal ideation during pregnancy and deliver a preterm low-birth-weight infant. Research indicates that the majority of sexually active adolescents under 15 years of age are coerced to have intercourse. Boyfriends who are 5-10 years older than their girlfriend have been found to be responsible for over half of teen pregnancies. Concerns about the role of predatory adult men in teenage childbearing have led to calls for rigorous enforcement of statutory rape laws. However such a strategy may deter sexually active and pregnant teens from seeking medical care or social services for fear of having to reveal the age and identity of their partners. Preferable would be training of health care professionals to recognize and support adolescent girls who are experiencing nonvoluntary sex and subsequently at risk for unplanned pregnancy. A thorough sexual history including sensitively framed questions about child sex abuse should be obtained from all sexually active adolescents. With support and counseling pregnant teens with a history of abuse who elect to continue the pregnancy have an opportunity to learn to protect themselves and their future children from further abuse.