Adolescents in any country who become pregnant face severe health risks whether they are married or not. Adolescents are not fully physically developed: at menarche a young woman's pelvis has not finished growing. Therefore, pregnancy and birth at a young age hold pose serious risks for both mother and child. Mothers under 20 suffer more complications in pregnancy and delivery than women who bear children at age 20 or later. Deaths from anaemia, eclampsia and obstructed labour are more common in young mothers. If the mother is small as well as young, she is likely to give birth to a small, weak baby whose chances of survival are equally small. The infants of adolescent mothers have a higher incidence of low birth weight, prematurity, stillbirth, and perinatal mortality. In addition, young women, particularly if they are unmarried, often have less access to ante-natal care so that potential problems are not noticed or treated.
In some societies unmarried adolescent girls who give birth are social outcasts, while in other societies - where having a child also may represent a rite of passage into adulthood - young girls are pressured into pregnancies in order to prove their fertility, although they may not yet be socially or psychologically prepared for the responsibilities of parenthood.
A teenage pregnancy can have dire consequences for the economic future of the teenager and her child. In many societies, pregnant students are forced to leave school. Some therefore secretly seek abortions, with all the attendant risks, in order to avoid expulsion. Even if pregnant students are allowed to continue their schooling, few succeed in completing their education. This, in turn, leads to employment in low paying positions, unemployment or reliance on public support. As a result, mother and child are more likely to suffer from poor nutrition and health care.
There are over 500 million young people aged 15 to 19 in the world and their numbers will continue to grow for at least another century. Increasing sexual activity amongst the young is one cause of the increase in adolescent pregnancies. Other contributing factors include the migration of young people to towns and cities in search of jobs and a better lifestyle; this causes a loss of family support and may erode traditional customs which discourage pre-marital parenthood. Homeless or unemployed adolescents are more likely to be exposed to sexual exploitation.
Although the extent of pregnancy among young women is not know with precision, it is believed that in many countries, industrialized and developing, each year between 5 and 10 percent of all 15 to 19 year olds become pregnant; in some parts of Africa the figure is over 20%. Worldwide, 15 million teenage women give birth each year, accounting for up to one-fifth of all births. The vast majority of these births are in developing countries. Also worldwide, pregnancy related complications are the main cause of death among 15 to 19 year old women.
According to data from the World Fertility Survey, over half of all women aged 25-29 had their first birth before the age of 20 in: Benin, Ghana, Kenya, Senegal, Jordan, Sudan, Yemen, Indonesia, Bangladesh, Pakistan, Dominican Republic, and Jamaica. In the Caribbean, almost 60% of first babies are born to women under 19, and half of these are born to mothers under 17 years of age. In Indonesia, 41% of women have their first baby before they reach 17 years of age. The Russian teenage pregnancy rate is very high and, despite the high rate of abortions, 5.5% of adolescents actually give birth. In Bangladesh, where girls as young as 12 are married, one-fifth have had a baby before they are 15, and 80% before 20.
In the USA, more than a million teenage girls become pregnant every year, about 30,000 of them under 15. A 1993 study of American teenagers showed that in one year an estimated 10 million will engage in sexual intercourse resulting in 1 million pregnancies, 406,000 abortions, 134,000 miscarriages and 490,000 births, of which about 64% (313,000) will be to unmarried mothers. A 1990 study showed that 32% of 14 and 15 year old American girls had already had sexual intercourse, while 17% of 17 to 18 year olds had had four or more partners.
In the UK, slightly more than half the local health authorities have special contraceptive services for young people.
Young people are not being given much support to make responsible decisions. Biology is explained to them, but nothing of whether they are ready for sexual intercourse. Very few of those who end up as single parents ever intended to do so. What is sad is that for some girls, the baby is the only possible way of giving their lives emotional meaning. Family life may have been unhappy; their relationships with boys may not have been particularly loving and affectionate; they have little positive to look forward to in terms of jobs or careers. Motherhood is portrayed as a woman's essential role, and it is not surprising they begin with a rosy view of it.
Most societies protect children and prolong childhood by setting a fairly high age for legal maturity. They don't compel children to work, they don't send 8 year old boys to the army, they don't allow girls to marry at 12. They grant children rights but don't burden them with responsibilities. Protecting children like this will not stop them from trying such adult pursuits as smoking, drinking, and sexual intercourse. But it is a recognition that children should be protected from the consequences of their precocity. Adults must intervene, drastically if necessary, to provide this protection.
There is no association between first teenage pregnancy and adverse outcome after taking into account contributing factors, such as socioeconomic status and whether the teens smoked – a leading cause of such complications. The modest increased risk demonstrated by other studies may be due to environmental factors. But whereas first teenage pregnancies are not at significantly increased risk of complications, second teenage pregnancies are. Nonsmoking teenage girls who give birth a second time have nearly three times the risk that their babies would be stillborn or premature than women in their twenties. Other unexplored socioeconomic reasons may play a role in causing this elevated risk. A biological explanation is also plausible: that human biology evolved so that girls did not begin to ovulate and conceive until later than today's teens, and then breastfed long enough to prevent a second pregnancy from occurring again so soon. It could be argued, therefore, that a second teenage pregnancy is an un-physiological event, and that this may explain the observed association with adverse outcome.