Childbirth in human females under the age of 20
Medical condition
Teenage pregnancy, also known as adolescent pregnancy, is pregnancy in a female under the age of 20. 
Worldwide, pregnancy complications are the leading cause of death for women and girls 15 to 19 years old. The definition of teenage pregnancy includes those who are legally considered adults in their country. The World Health Organization defines "adolescence" as the period between the ages of 10 and 19 years. Pregnancy can occur with sexual intercourse after the start of ovulation, which can happen before the first menstrual period ("menarche"). In healthy, well-nourished girls, the first period usually takes place between the ages of 12 and 13.
Pregnant teenagers face many of the same pregnancy-related issues as older women. Teenagers are more likely to experience pregnancy complications or maternal death than women aged 20 or older. There are additional concerns for those under the age of 15 as they are less likely to be physically developed to sustain a healthy pregnancy or to give birth. For girls aged 15–19, risks are associated more with socioeconomic factors than with the biological effects of age. Risks of low birth weight, premature labor, anemia, and pre-eclampsia are not connected to biological age by the time a girl is aged 16, as they are not observed in births to older teens after controlling for other risk factors, such as access to high-quality prenatal care.
Teenage pregnancies are related to social issues, including lower educational levels and poverty. Teenage pregnancy in developed countries is usually outside of marriage and is often associated with a social stigma. Teenage pregnancy in developing countries often occurs within marriage and approximately half are planned. However, in these societies, early pregnancy may combine with malnutrition and poor health care to cause medical problems. When used in combination, educational interventions and access to birth control can reduce unintended teenage pregnancies.
In 2023, globally, about 41 females per 1,000 gave birth between the ages of 15 and 19, compared with roughly 65 births per 1,000 in 2000. From 2015 to 2021, an estimated 14 percent of adolescent girls and young women globally reported giving birth before age 18. The adolescent birth rate is higher in lower- and middle-income countries (LMIC), compared to higher- income countries. In the developing world, approximately 2.5 million females aged 15 to 19 years old have children each year. Another 3.9 million have abortions. It is more common in rural than urban areas.
In 2021, 13.3 million babies, or about 10 percent of the total worldwide, were born to mothers under 20 years old.
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Definition.
The World Health Organization defines adolescence as the period between the ages of 10 and 19 years.
The mother's age is determined by the easily verified date when the pregnancy "ends", not by the estimated date of conception. Consequently, the statistics do not include pregnancies that began at age 19, but that ended on or after the woman's 20th birthday. Similarly, statistics on the mother's marital status are determined by whether she is married at the end of the pregnancy, not at the time of conception.
History.
Teenage pregnancy, with conceptions normally involving girls between ages 16 and 19, was far more normal in previous centuries, and common in developed countries in the 20th century. Among Norwegian women born in the early 1950s, nearly a quarter became teenage mothers by the early 1970s. The rates have steadily declined throughout the developed world since that 20th-century peak. Among those born in Norway in the late 1970s, less than 10% became teenage mothers, and rates have fallen since then.
In the United States, the Personal Responsibility and Work Opportunity Act of 1996 included the objective of reducing the number of young Black and Latina single mothers on welfare, which became the foundation for teenage pregnancy prevention in the United States and the founding of the National Campaign to Prevent Teen Pregnancy, now known as Power to Decide.
Effects.
According to the United Nations Population Fund (UNFPA), "Pregnancies among girls less than 18 years of age have irreparable consequences. It violates the rights of girls, with life-threatening consequences in terms of sexual and reproductive health, and poses high development costs for communities, particularly in perpetuating the cycle of poverty." Health consequences include not yet being physically ready for pregnancy and childbirth leading to complications and malnutrition as the majority of adolescents tend to come from lower-income households. The risk of maternal death for girls under age 15 in low and middle income countries is higher than for women in their twenties. Teenage pregnancy also affects girls' education and income potential as many are forced to drop out of school which ultimately threatens future opportunities and economic prospects.
Studies have examined the socioeconomic, medical, and psychological impact of pregnancy and parenthood in teens. Life outcomes for teenage mothers and their children vary. Other factors, such as poverty or social support, may be more important than the age of the mother at the birth. Many solutions to counteract the more negative findings have been proposed. Teenage parents who can rely on family and community support, social services and child-care support are more likely to continue their education and get higher paying jobs as they progress with their education.
A holistic approach is required in order to address teenage pregnancy. This means not focusing on changing the behaviour of girls but addressing the underlying reasons of adolescent pregnancy such as poverty, gender inequality, social pressures and coercion. This approach should include "providing age-appropriate comprehensive sexuality education for all young people, investing in girls' education, preventing child marriage, sexual violence and coercion, building gender-equitable societies by empowering girls and engaging men and boys and ensuring adolescents' access to sexual and reproductive health information as well as services that welcome them and facilitate their choices".
In the United States one third of high school students reported being sexually active. In 2011–2013, 79% of females reported using birth control. Teenage pregnancy puts young women at risk for health issues, economic, social and financial issues.
Teenager.
Being a young mother in a first world country can affect one's education. Teen mothers are more likely to drop out of high school. A 2001 study found that women who gave birth during their teens completed secondary-level schooling 10–12% as often and pursued post-secondary education 14–29% as often as women who waited until age 30.
"Young motherhood" in an industrialized country can affect employment and social class. A 2009 study found that teenage girls who are pregnant or are mothers are seven times more likely to commit suicide than other teenagers.
According to the National Campaign to Prevent Teen Pregnancy, nearly 1 in 4 teen mothers will experience another pregnancy within two years of having their first. Pregnancy and giving birth significantly increases the chance that these mothers will become high school dropouts and as many as half have to go on welfare. Many teen parents do not have the intellectual or emotional maturity that is needed to provide for another life. Often, these pregnancies are hidden for months, resulting in a lack of adequate prenatal care and dangerous outcomes for the babies. Factors that determine which mothers are more likely to have closely spaced repeat births, include marriage and education. The likelihood decreases with the level of education of the young woman – or her parents – and increases if she gets married.
Child.
Early motherhood can affect the psychosocial development of the infant. The children of teen mothers are more likely to be born prematurely with a low birth weight, predisposing them to many other lifelong conditions. Children of teen mothers are at higher risk of intellectual, language, and socio-emotional delays. Developmental disabilities and behavioral issues are increased in children born to teen mothers. One study suggested that adolescent mothers are less likely to stimulate their infant through affectionate behaviors such as touch, smiling, and verbal communication, or to be sensitive and accepting toward their needs. Another found that those who had more social support were less likely to show anger toward their children or to rely upon punishment.
Poor academic performance in the children of teenage mothers has also been noted, with many of the children being held back a grade level, scoring lower on standardized tests, and/or failing to graduate from secondary school. Daughters born to adolescent parents are more likely to become teen mothers themselves. Sons born to teenage mothers are three times more likely to serve time in prison.
Prenatal care.
Maternal and prenatal health is of particular concern among teens who are pregnant or parenting. The worldwide incidence of premature birth and low birth weight is higher among adolescent mothers. In a rural hospital in West Bengal, teenage mothers between 15 and 19 years old were more likely to have anemia, preterm delivery, and a baby with a lower birth weight than mothers between 20 and 24 years old.
Research indicates that pregnant teens are less likely to receive prenatal care, often seeking it in the third trimester, if at all. The Guttmacher Institute reports that one-third of pregnant teens receive insufficient prenatal care and that their children are more likely to have health issues in childhood or be hospitalized than those born to older women.
In the United States, teenage Latinas who become pregnant face barriers to receiving healthcare because they are the least insured group in the country.
Young mothers who are given high-quality maternity care have significantly healthier babies than those who do not. Many of the health-issues associated with teenage mothers appear to result from lack of access to adequate medical care.
Many pregnant teens are at risk of nutritional deficiencies from poor eating habits common in adolescence, including attempts to lose weight through dieting, skipping meals, food faddism, snacking, and consumption of fast food.
Inadequate nutrition during pregnancy is an even more marked problem among teenagers in developing countries. Complications of pregnancy result in the deaths of an estimated 70,000 teen girls in developing countries each year. Young mothers and their babies are also at greater risk of contracting HIV. The World Health Organization estimates that the risk of death following pregnancy is twice as high for girls aged 15–19 than for women aged 20–24. The maternal mortality rate can be up to five times higher for girls aged 10–14 than for women aged 20–24. Illegal abortion also holds many risks for teenage girls in areas such as sub-Saharan Africa.
Risks for medical complications are greater for girls aged under 15, as an underdeveloped pelvis can lead to difficulties in childbirth. Obstructed labour is normally dealt with by caesarean section in industrialized nations. In developing regions where medical services might be unavailable, it can lead to eclampsia, obstetric fistula, infant mortality, or maternal death. For mothers who are older than fifteen, age is not a risk factor, and poor outcomes are associated more with socioeconomic factors rather than with biology.
Antenatal care.
In 2022, UNICEF noted that:
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The agency noted regional disparities, noting that in West and Central Africa, "48 percent of newborns to adolescent mothers had a postnatal contact as compared to 52 percent of newborns to all mothers".
Economics.
The lifetime opportunity cost caused by teenage pregnancy in different countries varies, from 1% to 30% of the annual GDP, with 30% being the figure in Uganda. In the United States, teenage pregnancy costs taxpayers between $9.4 and $28 billion in 2016, due to factors such as foster care and lost tax revenue. A 2014 study estimated that an increase in economic productivity from ending teenage pregnancy in Brazil and India would be worth $3.5 billion and $7.7 billion respectively.
Less than one third of teenage mothers receive any form of child support, vastly increasing the likelihood of turning to the government for assistance. The correlation between earlier childbearing and failure to complete high school reduces career opportunities for many young women. One study found that, in 1988, 60% of teenage mothers were impoverished at the time of giving birth. A 2002 study found that nearly 50% of all adolescent mothers sought social assistance within the first five years of their child's life. 
A 1999 study of 100 teenaged mothers in the UK found that only 11% received a salary, while the remaining 89% were unemployed. Most British teenage mothers live in poverty, with nearly half in the bottom fifth of the income distribution.
Risk factors.
Culture.
Rates of teenage pregnancies are higher in societies