The Relationship Between Sexual Experiences, Sexual Abuse and Teenage Pregnancy in A Large Inner City Population.

Abstract

<h3>Background</h3> It is known that many adolescents experience unwanted or coercive sexual acts. One in 5 to 6 females^{1 2} experience sexual abuse as a child or adolescent with many short and long term consequences, one of which is pregnancy. The objective of this study is to identify how often teenage pregnancies are perceived by the mother to be a result of an abusive sexual experience, and to evaluate the relationship between sexual experience, sexual abuse and teenage pregnancy in a large inner city population. <h3>Methods</h3> We identified pregnant females aged 19 years or younger presenting for prenatal care at the University Health Center Obstetrics Clinic during a 6 month recruiting period. Consent was obtained, and the identity of the participants shielded by coding the questionnaires numerically. A multiple choice/fill in the blank questionnaire surveyed the mothers regarding their past sexual experiences. A registered nurse was available after completion of the questionnaire to answer questions, to distribute information regarding sexual abuse. community resources and shelters, and to identity ongoing abuse and refer these panicipants to the Social Services Department. Descriptive and inferential analysis, including Fischer's Exact Test was performed. <h3>Results</h3> One hundred and sixty adolescents completed questionnaires. Demographic data revealed the panicipants to be 92% African American and 99% unwed with an age range of 14–20 years and an average age of 18.4 years. Ninety four percent reside in the inner city. Ninety four percent have completed less then a high school education and 72.5% were unemployed. Seventy-nine and one half percent reported no birth control usage. Pregnancy as a result of consensual sex was reported by 96% of the respondents. Current pregnancies were a result of unwelcomed or abusive sexual experiences in 6 (4%) of the participants. Thirteen (8.1%) reported previous unwelcomed sexual experiences (sex due to partner/peer pressure, sexually explicit photographs, and sex while intoxicated), and 47 (29.4%) reported previous abusive sexual experiences (rape, incest, fondling, sex with a person in a position of power: priest, teacher, babysitter). Forty percent of the panicipants who answered questions suggesting previous abusive sexual experiences did not recognize these experiences as abusive. <h3>Conclusions</h3> Unwelcomed or abusive sexual experiences resulted in pregnancy in only 4% of the study population. However. over one third (37.5%) reported a history of unwelcomed or abusive sexual experiences. and forty percent of these teenagers did not recognize the abuse. Having identified a significant history of unwelcomed and abusive sexual experiences in this study group we must uncover more clearly the risk factors leading to abuse, educate teens to identity abusive situations, and equip them with the resources to seek treatment and prevent recurrences.