Medicine, Teen Pregnancy, and Bristol Palin

The big story this week, after news broke that John McCain had selected Alaska governor Sarah Palin as his running mate (and soulmate, apparently), was that her daughter 17 year old Bristol Palin is 5 months pregnant. As I am currently on my Ob/Gyn rotation, I wondered what additional risks being pregnant as a teenager carries. 

Per the American Academy of Child and Adolescent Psychiatry, teenage pregnancies carry many risks for the teen mother and her child:

Adolescents who become pregnant may not seek proper medical care during their pregnancy, leading to an increased risk for medical complications. Pregnant teenagers require special understanding, medical care, and education--particularly about nutrition, infections, substance abuse, and complications of pregnancy. They also need to learn that using tobacco, alcohol, and other drugs, can damage the developing fetus. All pregnant teenagers should have medical care beginning early in their pregnancy.

Teen pregnancies themselves have been declining in recent years, but have started to rise again:

Teen pregnancy rates in the United States declined steadily from 1991 to 2005—from 60 out of 1000 teenagers in 1991 to 40.5 out of 1000 in 2005. In 2006, however, the teen pregnancy rate increased to about 42 out of 1000. Approximately one-third of young women in the United States become pregnant during their teens. More than 80% of teen pregnancies are unintended and unintentional. The highest teen birth rate occurs in Hispanic women (83 out of 1000 in 2006).

Apparently, the Aleutian women are holding their own. Heh, anyway interestingly, this decline is attributed to sex education, which McCain and Palin oppose: 

Declining teen pregnancy rates are thought to be attributed to more effective birth control practice and decreased sexual activity among teens. The most dramatic reduction in teen pregnancy—23%—has occurred among African American teenagers.

Going back to the baby, it faces risks beyond merely those to its health:

In addition to increased health risks, children born to teenage mothers are more likely to experience social, emotional, and other problems. These problems include the following:

• Children born to teenage mothers are less likely to receive proper nutrition, health care, and cognitive and social stimulation. As a result, they are at risk for lower academic achievement.
• Children born to teenage mothers are at increased risk for abuse and neglect.
• Boys born to teenage mothers are 13% more likely to be incarcerated later in life.
• Girls born to teenage mothers are 22% more likely to become teenage mothers themselves

Overall, a sad situation, one that would strain any family. Hopefully, some will benefit from the increased awareness of the problems of teen pregnancy due to this situation. 

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