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Unintended Teenage Pregnancy

Osher Ben-Or, Certified Midwife
15 June 2024

Teenage pregnancy is a pregnancy of a 15 to 19 year old female. If she has told you about it, you can be proud of yourselves for her being able to confide in you, and for seeking your help and support. Help her, make sure that she is really pregnant and accompany her to the necessary tests at the gynecologist. Because the girl is very young, ruling out sexual abuse is important before everything else. In the case of sexual abuse, it is important to seek help and support and reassure her for sharing information with you on this sensitive issue.

Naturally, a teenage pregnancy is a complex situation, not just for the young girl but for the whole family. To help her make the decision, it is a good idea to consult medical and mental professionals to assess the various options, decide whether to terminate or continue the pregnancy, raise the newborn child or offer them up for adoption. Every decision has various consequences and effects, and you should take as much time as possible to help your daughter make the best decision for her.

A teenage pregnancy may result in physical risks and complications, such as eclampsia and pre-eclampsia, premature birth (before week 37 of pregnancy), a low birth weight that may pose developmental challenges, anemia during pregnancy and postpartum infections.

Pregnancy in general has mental aspects but a teenage pregnancy has aspects that may be particularly complex, because the girl is in a period of physical and emotional change and in a process of personal development and maturation regardless of the pregnancy. A pregnant girl may experience increased stress and anxiety, fear and loneliness, depression (a teenage mother is at greater risk for depression during and after pregnancy) and studies show that she has a higher risk of not graduating on time and not acquiring academic education or a profession for the future. This may of course lead to reduced employment prospects and financial difficulty.

Teenage pregnancy refers to girls and women under the age of 20 who are pregnant. Pregnant girls, at the age of 19 or younger, face a twofold risk: both biologically and mentally-socially.

The situation in Israel

Israel’s birth rate at the age of 15-19 has been decreasing in the last twenty years. 3.4% of all births in 2000 were to girls of this age, compared to approximately 1.5% of all births in 2020.
In contrast, the number of pregnancies among teenage girls was much higher, with about 33% of girls deciding to terminate their pregnancy.

The importance of parental communication, accompaniment and support

When your daughter tells you that she is pregnant, it is important to recognize that she needed a lot of strength and courage to approach you and tell you about it. She may be scared of the situation she is in, of your reaction, and anxiety over the possibilities of knowing or not knowing that she has now. Most teenage pregnancies are unplanned and unwanted. Therefore, most parents do not come ready for the situation of their daughter being pregnant at that age. Adolescence is a vulnerable stage in development, the period of transition from childhood to physical, psychological and social maturity. Your daughter, who is still at this sensitive age, now needs stability, resilience, flexibility and understanding more than ever. Your ability to contain her and her situation in the near future may also build up and strengthen your ties with her and help her be a strong, powerful woman.

It is natural for you to find it difficult and experience various emotions such as disappointment, anger and worry too. Later, it is also advisable for you to seek help from professionals to cope with the situation, but for now it is important to remember that more than anything, your daughter needs you to be stable and able to help her cope with the situation. It is important how you can help her and respond in a regulated, calculated manner. Hug her and give the feeling that talking to you about it rather than hiding it was the right thing to do, despite the difficulty. It is important for you to give room for the sense of relief and even pride about your daughter going to you and seeking your help. She probably trusts you to support her, not judge her and help her make the right decisions for her about terminating or keeping the pregnancy. If she felt that she could not turn to you, she might have chosen to cope with the choice alone and possibly choose an illegal and probably unsafe abortion.

When you can transmit calmness and security to your daughter, tell her that you are happy and appreciate that she has come to you. Ask where whom she had sexual intercourse with, and because she is very young, it is a good idea to rule out sexual abuse before everything. If it is a case of sexual abuse, it is important to provide help and support and reassure her for sharing this sensitive issue with you.

It is not important to go together for a medical checkup to verify the pregnancy, check the pregnancy age and perform blood tests. Ask for information about the possibilities your daughter currently has. In such situations, the physician will refer you to a social worker (or other party in the field) who will talk to your daughter and will be able to evaluate her mental state and feelings about each of the possibilities she has and how to act depending on the choice made.

It is important to refrain from talking on her behalf to medical and professional parties, unless she has explicitly asked you to do so or feels difficulty or inability to speak. After you get all the information and know all the options, talk to her at home and consider the consequences of each option together. Ask and check with her what she feels about each of the options, what she wants and chooses.

In general, the options are:

  • Termination of pregnancy (the abortion type depends on the pregnancy age).
  • Continuing the pregnancy and raising the child.
  • Continuing the pregnancy and offering the newborn up for adoption.

Each of the options can involve physical and mental pain. Please note that in addition to your own support, support and care in the mental health field may also benefit your daughter.

If the decision to continue the pregnancy is made, you already know that this decision has physical, mental and social consequences. Help your daughter understand her decisions and provide her support.

If your daughter suspects that she is pregnant, or you fear that she is pregnant, you can monitor general signs of pregnancy such as late period, but it is worth remembering that this is the classic sign of pregnancy, in adolescence, girls often experience irregular periods, and this may not be a certain sign of pregnancy. Your daughter may experience physical phenomena such as nausea, vomiting, sudden, intense revulsion over certain foods, nipple and breast tenderness, fatigue, frequent urination, irregular mood swings, weakness and dizziness, weight gain and a swollen abdomen.

If one or more of these signs occur and in general if pregnancy is suspected, you can check this using two diagnostic tests: a home pregnancy test (a urine stick test, available at any pharmacy), and a blood pregnancy test, the referral for which has to be requested from your daughter’s attending physician. If the result of one of these tests is positive, it is necessary to go to a gynecologist for evaluation and performing an ultrasound scan for verifying the age of the pregnancy.

Teenage pregnancy has many consequences for the young mothers and their children. Pregnancy at these ages is pregnancy that may be more challenging than pregnancy at more advance ages, and sometimes may have certain complications too. If the pregnancy is continued, frequent medical follow-up is needed.

Pregnancy and birth complications are related to the girl’s body still developing, and the younger the girl, the greater the risk during pregnancy and birth itself.

In addition, if it is unplanned pregnancy, the meaning is that the girl probably did not go through pre-pregnancy preparations that would help for the development of a healthy pregnancy, such as changing of pregnancy-endangering habits (smoking, drugs and alcohol), and she has probably not taken nutritional supplements such as folic acid, which is vital for preventing defects in fetuses and newborns.

The possible complications

  • Eclampsia and pre-eclampsia: pregnant teenagers are at increased risk for developing eclampsia and even pre-eclampsia.
  • Early delivery: giving birth before week 37 of pregnancy is considered early delivery. The earlier the infant is born, the greater the chance of preterm complications manifesting in disorders in breathing, digestion, sight, cognitive and other disorders.
  • Low birth weight: may cause developmental challenges.
  • Anemia: teenage girls are more prone to anemia during pregnancy, which may adversely affect their general health and that of the unborn child.
  • Infections: pregnant girls are at increased risk for postpartum endometritis and systemic infections.

Important: a pregnant girl has a greater chance of spontaneous delivery combined with a lower risk of a cesarean section, a lower risk of diabetes and gestational diabetes.

Pregnancy is a mentally and emotionally complex condition for any woman, particularly in the case of an adolescent girl who is at a time of physical and mental changes and a process of personal development and maturation irrespective of pregnancy. Aspects that must be taken into account include:

  • Increased stress and anxiety: pregnancy may cause a feeling of stress and anxiety, difficulty in balancing of feelings and significant changes that she undergoes, between her studies and social life.
  • Sense of fear and loneliness: mainly if there is no parental support or other significant adult who can be confided in and trusted. This is compounded by the unusual situation, which most of her girlfriends are unlikely to be in, and her friends who have difficulty understanding what she is going through. The social stigma and prejudices may adversely affect her social state and cause her to feel loneliness and difficulty.
  • Depression: teenage mothers are at increased risk of depression during and after pregnancy.
  • Future disadvantages: teenage mothers are at a greater risk of not graduating from their studies and acquiring academic education or a profession for the future. This may of cause lead to reduced job prospects and financial difficulties.