Teens and Pregnancy

By Dr. Hatem Hatem 

Teen birth rates in the United States have declined to the lowest rates seen in seven decades, yet we still rank highest among developed countries.  In 2014 that equated to just under 250,000 babies born to women aged 15-19 years of age.  These statistics highlight the fact that teens need regular health care services for comprehensive sexual and reproductive health counseling, which would include the importance of delaying the initiation of sexual activity and what their contraceptive options are.  

The decline in teen pregnancies is attributed to the increase in the number of teens that have never had sex, combined with increases in contraceptive use among sexually active teens.   However, eighty-two percent of adolescent pregnancies are unplanned, accounting for one fifth of all unintended pregnancies in the United States, a statistic that indicates an unmet need for acceptable, reliable, and effective contraceptive methods for adolescents.

During healthcare visits to address contraceptive options, adolescent patients are provided with confidential, private, respectful and culturally competent services, convenient office hours, and complete information.  Sexual history taking and counseling may best be had privately between the teen and the provider. Other times during the visit it may be important to include the teen’s parents or guardians.

Healthy adolescents may safely use any form of highly effective contraceptives, including long acting reversible contraceptives (LARC).   A potential way to improve contraceptive access and use, and possibly decrease unintended pregnancy rates, is to allow over-the-counter access to oral contraceptives (OCs).   Screening for cervical cancer or sexually transmitted infections is not medically required to provide hormonal contraception.  Emergency contraception may be used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Emergency contraception is available over the counter and is effective in preventing pregnancy within 120 hours after unprotected intercourse, but is most effective if used within 24 hour.

While it can be a tough subject to broach or initiate services for, it is beneficial that the conversation be had and education provided to teens regarding sexual and reproductive health and delaying initiation of sexual activity.  These services can be provided through your local women’s health provider and with some primary care providers, as well as, guidance and information for parents and guardians to help them talk with their teens about sex, pregnancy, and contraception. When the time comes, counseling on which contraception method would be best and how to use that method correctly and consistently should be provided at a visit.    As you approach these tough discussions, please don’t overlook your healthcare provider as a reliable resource for information and services.


 Dr. Hatem Hatem is an OB/GYN at Calais Regional Medical Services.  He provides a full complement of women’s health services from adolescence to mature adulthood.  CRMS OB/GYN offers care for preventative services, maternity, incontinence, infertility, menopause, pelvic floor disorders and more.  Article resources: CDC and ACOG.