Adolescent Pregnancy: Can We Solve the Problem?

Abstract

In this issue of the Proceedings (pages 1061 to 1066), Van Winter and Simmons address the problem of adolescent pregnancy with the con­ cept of comprehensive care. Although this is not a new approach, the proposal deserves atten­ tion. The management of adolescent pregnancy is an important issue not only to the individual woman but also to society in general because of the magnitude of this problem in the United States. The Alan Guttmacher Institute! places teenage pregnancy rates in the United States at the highest level among western nations-96 per 1,000 for women between the ages of 15 and 19 years. The reasons for this high rate are not entirely known; however, some proposed expla­ nations include lack of knowledge about contra­ ceptives and cultural differences that may pro­ mote teenage motherhood as a desirable goal. Other reasons for our high rate ofteenage preg­ nancy are listed in Table 1. As with all public health issues, primary pre­ vention is the most desirable goal. Community­ and school-based clinics are one approach to primary prevention, but such clinics have not always been welcomed by administrators, espe­ cially if the focus was on human reproduction and issues related to sexual behavior. In fact, our society's unwillingness to face these issues has necessitated such measures as changing curricular titles from "sex education" to "family life education." This unwillingness to confront these issues is also partially responsible for our failure, thus far, to reduce adolescent pregnancy rates. Consequently, the issue has become a