In the movie Juno, the title character must make a choice – a choice that nearly 750,000 teenage girls face each year.
Juno, a quirky, witty 16-year-old girl, has just discovered she is pregnant. She is nervous, worried about what her friends and family will think, and confused, trying to decide her next steps.
Teenagers facing the prospect of unplanned pregnancy must decide whether to keep their children, have an abortion, or – like Juno – give them up for adoption. But they don’t need to make these choices alone. Support services and organizations dedicated to the health of women and children exist to provide these teenagers with the right information to make the correct choice.
Newly Discovered Pregnancy
When teenagers discover they are pregnant, it seems like the end of the world and, in a way, it is but only as they've known it.
Where a teenager was previously concerned with social functions, playing sports, or schoolwork, she must now concentrate on safeguarding her health and the health of her baby. In many ways, a pregnancy pushes a teenager to adulthood, despite the teenager’s conflicting social needs.
A teenager who just found out she is pregnant is scared, confused, and might feel like an outcast among her friends and family. She also might not wish to tell her parents because she is afraid they will express disappointment or anger.
But teenagers don't need to feel alone in this struggle. Health centers are available for teens who wish to receive confidential and efficient consultation and support about their pregnancies. Health center services vary by location, but finding one is easy at findahealthcenter.hrsa.gov.
By visiting a local health center, teenagers receive information about all of the options available for pregnancy, such as parenting, adoption, or abortion.
Organizations Offering Help
Each state has organizations who offer help to pregnant or parenting teenagers.
Contact these organizations to learn how you can make a difficult situation much easier on the mother, the family and the baby.
Teenagers who choose to keep their babies face emotional, financial, and physical challenges that will change their lives forever.
For instance, teen pregnancies are more associated with premature deliveries, low-birth weight babies, neglect, and increased diseases from not having babies immunized, according to the Office of Adolescent Pregnancy Programs.
Because teenagers are often frightened and unsure of what to do when they discover they are pregnant, they are less likely to seek effective prenatal care. According to womenshealth.gov, babies of mothers who do not receive prenatal care are three times as likely to suffer low birth weight, and five times more likely to die than those born to mothers who received prenatal care.
Despite their fears, it is important for teenagers to visit a local health center as soon as they realize they are pregnant in order to ensure a healthy pregnancy.
Prenatal care involves regular doctor checkups and consultation to ensure the mother makes the right lifestyle, food, and health care choices during pregnancy. During the first prenatal visit, the doctor will ask about girl’s health history, family history, and conduct a complete physical examination including a pelvic exam and Pap test. The doctor will also check blood pressure, height and weight, and calculate the due date of the baby.
Every state provides support for mothers seeking affordable prenatal care. To find the closest program, call 1-800-311-BABY (1-800-311-2229).
In addition to receiving proper prenatal care, teenagers must learn proper parenting skills, and ensure they are making healthy choices during pregnancy.
For young, first-time mothers, the idea of pregnancy and childbirth is daunting, and navigating the health factors and future planning seems impossible. But compassionate, effective support programs exist for these teens.
One program, the Nurse-Family Partnership (NFP), provides home visits by registered nurses beginning in the second trimester of pregnancy. The NFP reaches 15,000 women each year with a median age of 19 in 22 states. The program focuses on helping girls to engage in prenatal care, improve diets, reduce use of cigarettes and alcohol, and develop a future plan for education and work.
According to its website, participants of the NFP program have shown a 79% reduction in child neglect, a 56% reduction in emergency room visits, and an 84% increase in labor force participation.
The study “Improving the Delivery of Prenatal Care and Outcomes of Pregnancy: A Randomized Trial of Nurse Home Visitation,” published in the Journal of Pediatrics, examined groups of girls who received home visitation from nurses, as well as girls who didn’t receive support during pregnancy.
Conducted by David L. Olds and others, the study found that girls who used the NFP program became more aware of community resources, attended more childbirth classes, made greater dietary improvements, and had healthier babies compared to the group not receiving care. Results from the study show girls who participated in the program gave birth to babies who were an average of 395g heavier.
By taking advantage of the support services available to them, teenagers protect their health and the health of their babies.
Because raising a child as a teenager is often associated with high costs and negative consequences, some teenagers choose to carry the child until term, and then give the child up for adoption.
While the adoption process was more popular in the past, only 5% of today’s pregnant teenagers choose this option, according to “Adoption as an Option for Unmarried Pregnant Teens,” published in Adolescence.
The study, conducted by Marcia Custer, indicated teenagers are less likely to put their children up for adoption because of the mental strain placed on the birth mother. Custer interviewed 21 pregnant adolescents during pregnancy and after they gave birth to find their viewpoints on adoption.
Custer found that one of the biggest negatives the adolescents associated with adoption was the perceived guilt and psychological discomfort they would feel after giving up their children. One of the subjects was quoted as saying, “It would be terrible. I couldn't handle it. You know – walking around 10 years later after I gave her up, wondering is that my kid – is she still alive?”
While a teenager might feel relief at the financial and social burdens lifted from her by placing her child up for adoption, feelings of loss and guilt are natural as well, according to “The Impact of Adoption on Birth Parents,” from the Child Welfare Information Gateway. Because there is shame surrounding unplanned pregnancies, a teenager putting her child up for adoption might feel guilty about “rejecting” the child.
To combat this psychological discomfort, pregnant girls must visit with a therapist or counselor about the options surrounding pregnancy and adoption. With the help of a counselor, teenagers receive knowledge about child adoption agencies, lawyers, and the grieving process after birth.
In most states, adoptive agencies provide free counseling throughout the pregnancy and for as long as needed after the child’s birth. Through the support of counselors, friends, and family, teenagers learn to accept the loss and grief associated with adoption, and continue to pursue life goals like education and eventually, careers.
Teens can find resources about adoptive agencies organized by state at the National Foster Care & Adoption Directory.
In some cases, a teenager decides to terminate the pregnancy rather than parenting the child or placing the child up for adoption.
This teen feels unprepared for the responsibilities of pregnancy, or is financially disadvantaged and unable to provide for the child. Others wish to avoid the social stigma that is associated with teen pregnancy, and are embarrassed and unwilling to continue the pregnancy.
In 2006, 29.3% of pregnant white teenagers, 22.9% of pregnant Hispanic teenagers, and 41% of pregnant black teenagers terminated their pregnancies, according to the Guttmacher Institute, a reproductive-health think tank.
When considering abortion, teenagers must confront differing opinions from their parents, significant others, and friends. By meeting with counselors and doctors at health centers who provide information about the emotional and physical consequences of abortion, teenagers receive unbiased knowledge to assist them in their decisions.
In Pregnancy and Abortion Counseling, authors Joanna Brien and Ida Fairbairn state that counselors should fully explore with their clients the emotions and outcomes of abortion. Counselors discuss the teenager's social situation, including family relationships and the relationship with the father. They also explore how the teenager feels about being pregnant and the choices they must make. Many teenagers feel lost and alone during the pregnancy, so counselors must present an open and safe environment when discussing these subjects.
The counselor must also discuss the possibility of post-abortion counseling with a teenager. There are many conflicting studies about emotional disturbances girls experience after abortion. Many girls feel they made the right decision and experience relief, while some others might feel a sense of loss and regret.
Teenagers experiencing these wide-ranging emotions should look for services and programs specifically aimed at counseling women post-abortion.
For example, Exhale, a talk line staffed by peer counselors, offers free counseling and support to anyone going through the abortion process. A teenager calling Exhale might feel overwhelmed and distraught about the abortion, but doesn't feel able to talk to parents or friends about the situation. Exhale's service allows a teenage girl to express these emotions, and gives the girl advice on how to channel the emotions positively, such as through art, exercise, prayer, or keeping a journal.
The talk line service can be contacted at 1-866-4-Exhale (1-866-439-4253)
If you're interested in assisting teenagers with the difficult choices related to pregnancy, you may want to request information from schools offering programs in mental health counseling or psychology.
Balancing Prevention with Support
School programs and national campaigns are quick to focus on the largely negative outcomes of teenage pregnancy, so much so that a pregnant teen often feels like an outcast of society.
Most federal funding of pregnancy programs specifically focus on preventing the pregnancy, citing low graduation rates of teen mothers, higher neglect of babies, and the financial burdens of raising a child.
But what of the teenagers who are already pregnant? Don't they deserve support?
To meet this need, President Barack Obama has established the Pregnancy Assistance Fund, a competitive state grant program that will appropriate $24 million each year for programs that support pregnant and parenting teenagers until 2019.
President Obama said the fund is aimed at “reducing unintended pregnancies, and making adoptions more available, and providing care and support for women who do carry their child to term.”
Currently the fund has been awarded to 17 states, funding a variety of programs.
For example, in Massachusetts, $1.6 million was awarded to the Massachusetts Department of Health to implement the Massachusetts Pregnant and Parenting Teen Initiative, targeting pregnant high school students. The initiative seeks to provide teen mothers and fathers with health services, emotional support, and health education.
And in Montana, $1 million has been directed toward the Montana Healthy Teen Parents project, which provides for pregnant teenagers in high school. The project implements flexible schooling for parents, parenting skills education, and referrals to quality prenatal care.
While federal focus will most likely always be targeted at preventing pregnancies, support programs are available for teens who are pregnant or parenting.