Teenage pregnancy
Teenage pregnancy: statistics
Teenage pregnancy increased 57% from 1980 to 1992, an average increase of 4% per year. From 1992 to 1998, the pregnancy rate among girls aged 14 to 17 remained stable – between 19 and 20 per thousand girls – and then declined during the following five years to stabilize at 16,6 per thousand girls in 2003.
Pregnancy rate among girls under 18 by outcome, Québec, 1980-2003
Live births and stillbirths: Demographic data,
MSSS and ISQ2 – Les services sociaux et de santé pour
prévenir les grossesses à l’adolescence et leurs
conséquences.
Abortions: RAMQ, dossier R-12 and unpublished data from CLSC and
institutions offering abortions without fee for-service, totals:
MSSS.
Miscarriages: RAMQ, MSSS dossier R-12.
Population : Statistics Canada.
Calculations : Madeleine Rochon, Direction des études et analyses, MSSS.
Effects of teenage pregnancy
Of those teenage girls who choose to continue their pregnancy, a large proportion are from a disadvantaged or dysfunctional socio-economic background. They are increasingly young and, in many cases, were themselves born to teenage mothers (Charbonneau et al. 1989, in Cardinal Remete 1999; Morazin 1991). They generally occupy underpaid and undervalued work positions (Charbonneau et al. 1989, in Cardinal Remete 1999). These young women can nevertheless be very good mothers if they receive proper support.
According to Loignon (1996), teenage mothers often face the following consequences: social isolation, poor life habits, low education level, maltreatment, stress, and depression. Likewise, studies in Canada and the United States have shown that young mothers are at greater risk of leaving school or attaining a lower level of education, and therefore reaching professional dead-ends or missing out on job opportunities; these factors increase the likelihood of using employment insurance benefits (Tipper 1997). Although some teenage mothers can receive help from their family and those close to them, the scene is not particularly bright.
Source: Sexpression Vol.1 No 2, Winter 2005, page 2
The role of young fathers
What little literature exists on teenage fatherhood paints a similarly bleak picture of young fathers. Among others, Des Rosiers-Lampe and Frappier (1981) demonstrate that teenage fathers do not involve themselves very deeply in their new role, which may seem too onerous (Cardinal Remete 1999). Furthermore, the young man often leaves the child’s mother during pregnancy or during the two years after birth (Loignon 1996).
Some young women choose to keep the baby to make up for a lack of affection, and do not want the father around. In other cases, the young man must face hostility from the young woman’s family, even if he wants to be involved in caring for the child (Loignon 1996). Contrariwise, young men often do not want to be involved or recognize their role as parent (Loignon 1996). But despite the scarcity of data and studies on teenage fatherhood, it seems plausible that some teenagers take their paternal role very seriously and fully assume their new responsibility.
Source: Sexpression Vol.1 No 2, Winter 2005, page 3
Resistance to contraception use
Most authors agree that one of the factors in teenage pregnancy is resistance to contraception (Loignon 1996; Dufort, Guilbert, and St-Laurent 2000; Cromer et al. 1997). Resistance to contraception takes one of two forms: either no contraceptive is used, or a contraceptive is used improperly.
Improper use generally involves one of three problems:
- delay between the beginning of sexual activity and the use of the contraceptive (Balassone 1991, in Dufort, Guilbert, and St-Laurent 2000);
- inconsistent use of contraceptives (Bilodeau, Forget, and Tétreault 1994; Brindis et al. 1994, in Dufort, Guilbert, and St-Laurent 2000);
- premature interruption of contraceptive use (Oakley et al. 1991, in Dufort, Guilbert, and St-Laurent 2000). Thus, in the case of the contraceptive pill, inconsistent or improper use of the pill (forgotten doses, incorrect sequence, or poor synchronization in beginning a new pack) is a failure to follow the prescription and thereby constitutes premature interruption (Rosenberg et al. 1995).
Source: Sexpression Vol.1 No 2, Winter 2005, page 3
Contraception difficulties
Loignon (1996) lists 21 difficulties that teenagers face with regard to contraception. Here, we have listed the main ones, which also lend themselves most easily to group training and discussion activities.
Fear of asserting oneself and fear of rejection
According to Loignon (1996), lack of self-esteem and self-confidence leads teenagers to consent to unprotected sex. Often, the young woman fears that she will be rejected by her partner if she refuses to have unprotected sex or insists that he use a condom (Loignon 1996).
However, it should not be forgotten that, in some cases, it may be the young man who is afraid to bring up the subject of contraception with his partner.
Source: Sexpression Vol.1 No 2, Winter 2005, page 4
Early sexual relations
Young people often reach sexual maturity before psychosocial maturity; some therefore are sexually active before they are psychosocially mature (Tremblay 2001). The average age for one’s first sexual relations is now 15 years old, three to four years earlier than the preceding generation (Bourque 2002). Since teenagers are now beginning their sexual lives earlier, they are not necessarily properly equipped – cognitively, emotionally, or socially – to deal with the difficulties and manage the risks associated with sexuality (Nakkab 1997, in Tremblay 2001; Turcotte 1994, in Tremblay 2001; Peterson et al. 1995, in Tremblay 2001).
Source: Sexpression Vol.1 No 2, Winter 2005, page 4
Inability to anticipate or prepare for sex
A teenager “in the moment” does not have enough time to consider and organize contraception (Loignon 1996). It is therefore necessary to encourage teenagers to preventatively adopt contraceptive behaviour.
Source: Sexpression Vol.1 No 2, Winter 2005, page 4
Lack of motivation
According to Loignon (1996), taking the pill every day requires strong discipline, especially when sexual relations are highly infrequent. Even though it is easy to take the pill, teenagers can often be forgetful – teenage girls on the pill forget to take it an average of three times per month (Balassone 1989, in Dufort, Guilbert and St-Laurent 2000). Moreover, compliance depends on the person’s motivation to use this contraceptive method. Motivation can be undermined by fear of side effects and health consequences stemming from personal anxiety or environmental factors such as the opinions of others (Deijen et al. 1997).
As for condoms, a recurring scenario is observed in which condoms are often used at the beginning of the relationship but are abandoned once the partners consider the relationship stable. Intervention with teenagers must take this reality into account (De Visser and Smith 2001).
Source: Sexpression Vol.1 No 2, Winter 2005, page 4
Myths about pregnancy and contraception
The prevalence of these myths supports ignorance about the risks of pregnancy (Loignon 1996).
Here are some of them:
- A woman cannot become pregnant the first time she has sex.
- A girl cannot become pregnant if she has not yet had her first menstrual period.
- It is impossible to become pregnant during one’s period.
- There is no risk of pregnancy if the man withdraws before ejaculating.
- A woman cannot become pregnant if she does not have an orgasm.
- Having sex standing up or with the woman on top prevents pregnancy.
Source: Ça Sexpression Vol.1 No 2, Winter 2005, page 5
Interventions
The health and social safety network has numerous initiatives at the provincial, regional, and local levels, many with partners such as the education network, to:
- Promote safe and healthy sexual behaviour among young people and prevent teenage pregnancy;
- Offer support in making a decision concerning whether to abort or to carry the pregnancy to term;
- Support young parents.
The Ministère de la Santé et des Services sociaux (MSSS) has invested large amounts of money in these initiatives.
Promotion of safe and healthy sexual behaviour among young people and preventing teenage pregnancy
Effective measures to prevent teenage pregnancy depend heavily on sex education in school, including promotion of equality in romantic relationships. This is because school is one of the main environments for socialization of young people. The family, the community, and friends also have important roles to play in sex education.
Healthy Schools
A large proportion of sex education is carried out through the school system, in interventions carried out under the Healthy Schools program. The health promotion and prevention activities that make up Healthy Schools are integrated into regular school activities and are intended for all students, including youth at risk. These activities work proactively on the main individual factors (such as self-esteem, social skills, and sexual behaviour) and environmental factors (family, school, and community environments) that affect the educational success, health, and well-being of children and teenagers. These measures help to prevent many problems that affect young people, including teenage pregnancy.
At present, the Healthy Schools approach is being implemented in all regions of Québec; its implementation is based on close cooperation with the education network.
In 2004-2005, the MSSS earmarked $4 million for preventive services for school-age youth.
$11,000 goes to producing and distributing the magazine Sexpression, in collaboration with the sexology department of the Université du Québec à Montréal (UQAM); its goal is to prepare teaching staff and other personnel to provide sex education.
The
document Sex Education in the Context of Education Reform,
the fruit of cooperation between the Ministère de l’Éducation,
du Loisir et du Sport and the MSSS, puts forward a teaching approach
in accordance with the Quebec Education Program. Among other subjects,
the document deals with self-respect, emotional and romantic life,
egalitarian relationships, and prevention of sexual exploitation.
Personnel from the education network and from youth teams at health
and social services centres (CSSSs) have received training on how
to use this document properly to help provide quality sex education
in schools.
Besides the importance of clear and coherent messages tailored to a youth audience regarding a positive and respectful attitude to sexuality and interpersonal relationships, risk behaviours, and protection methods, the approach also promotes multidimensional interventions involving youth, schools, parents, and the community as well as clinical services.
Youth clinics
Youth clinics offer interventions to prevent teenage pregnancy, counselling services, and education activities on sexuality, STI and blood-borne infection prevention, and counselling on family planning. Youth clinic services exist in nearly all regions of Québec, established by CSSSs in close collaboration with the school network and local organizations.
Other healthy sexuality awareness activities
The MSSS has supported the production and distribution of various informational tools for youth-oriented sex education, such as the following:
- Les années papillon, a sex education video produced by Vidéofemmes, targeted at grade 5 and 6 students, and aiming to help build their critical thinking, self-knowledge, and responsibility for their own sexuality;
- A tour for the play Pas de bébé, pas de bébittes by the Parminou theatre troupe, about preventing STIs, blood-borne infections, and teenage pregnancy;
- HIV/AIDS and STI awareness and prevention activities for high-school students, organized by Ruban en Route;
- Drogue, alcool, sexe et risques et sexualité, a video for teenagers and young adults produced by UQAM;
- Élysa, a website set up by UQAM to answer questions about sexuality, in collaboration with Tel-Jeunes, which deals with young people’s questions regarding sexuality.
The MSSS has invested nearly $200,000 in producing and distributing these tools.
Front-line general services
Front-line services such as developmental support for teenagers, psychosocial counselling, and crisis intervention, are provided at CSSSs.
Over the last two years, the MSSS has invested some $8.5 million in improving social services for youth.
Furthermore, the Ministère has implemented an expanded program for access to emergency oral contraception (EOC). Through this program, women can obtain the morning-after pill directly from a pharmacist without needing a physician’s prescription. The pharmacist’s consultation is covered by the Régie de l’assurance maladie du Québec (RAMQ) and is therefore free to all women with a Medicare card.
In 2003, $525,000 was invested in EOC-related services; more than 10% of the cases involved teenagers.
The
Collège des médecins du Québec has started an
initiative on prevention of unwanted pregnancies, involving the preparation
and distribution of a template protocol for nurses and physicians
on collective prescription of hormonal contraception. These collective
prescriptions, currently in preparation, aim to improve access to
contraception.
Other interventions aim to provide the necessary support and information to help teenage girls and their partners make informed decisions regarding the outcome of pregnancy and preserve their physical and psychological integrity.
Teenage girls also have access, as do all women in Québec, to elective abortion services. These are offered in all regions of Québec. Abortion rates were 12.6 per 1,000 teenage girls in 2003, down from previous years (12.8 per thousand in 2002, 13.8 per thousand in 2001, and 14.0 per thousand in 2000.)
Since 2001, the MSSS has allocated a recurring sum of $2.7 million to improve access to elective abortion.
Support for pregnant teenagers and young parents
Services targeted at young parents are available in all of Québec’s CSSSs. They aim to:
- Give young families the support they need to promote optimum development of their children and improve their living conditions;
- Prevent and reduce social adjustment difficulties and developmental delays in children;
- Reduce intergenerational transmission of health problems and social problems such as abuse, neglect, and violence towards children;
- Promote safer sexual behaviours and family planning.
This support for young parents is offered from the twelfth week of pregnancy and continues intensively until the child is five years old. Among the main features are home visits by a CSSS social worker. Initiatives from all community resources also contribute to supporting young parents and their children.
In order to offer young parents the best possible services, a continuing training program and intervention guides have been developed for social workers and community partners. Also, a research team is intensively studying the implementation of support services for young parents, with their short, medium, and long-term effects.
Every year, the MSSS invests some $26 million in supporting young parents.
Since the implementation of the support program for young parents, more than 4,000 young families have benefited from its services.
The Ministère de l’Emploi et de la Solidarité sociale, the MSSS, and the Association québécoise d’établissements de santé et de services sociaux have joined forces to offer financial aid to destitute pregnant teenagers who are receiving young parents’ support services but who do not have any financial resources to respond to their needs.
Resources
These resources provide support for planned or unplanned pregnancy, contraception, and sexuality.
- Info Santé
www.msss.gouv.qc.ca/info-sante
- Tel-jeunes: telephone hotline
Tel.: 514-288-2266 (Montréal region)
Tel.: 1-800-263-2266 (toll-free elsewhere in Québec)
www.tel-jeunes.com (in French only) - S.O.S. Grossesse
418-682-6222 (Québec City region)
1-877-662-9666 (toll-free elsewhere in Québec)
http://pages.globetrotter.net/sosgrossesse/ (in French only) - Grossesse Secours
(514) 271-0554 (Montréal region)
www.grossesse-secours.org (in French only) - S.O.S. Grossesse Estrie
Tel.: 819-822-1181
Tel.: 1-877-822-1181 (toll-free elsewhere in the Estrie region)
www.sosgrossesseestrie.qc.ca (in French only) - Fédération du Québec pour le
planning des naissances (FQPN)
Tel.: 514-866-3721
www.fqpn.qc.ca (in French only) - Kids Help Phone: help line and reference tool
(bilingual)
Tel.: 1-800-668-6868 (toll-free)
www.kidshelpphone.ca/en/ - Ligne-parents: telephone hotline and support services
Tel.: 1-800-361-5085 (toll-free)
Websites about sexuality:
- www.msss.gouv.qc.ca/its
- www.jcapote.com(in French only)
- www.unites.uqam.ca/dsexo/index.htm
- www.sexualityandu.ca
- www.not-2-late.com
*The mention of a Website or link on this site does not imply an official endorsement by the Ministère de la Santé et des Services sociaux.
Documents
Magazine
- Affective
and sexual dependence - A phenomenon to discuss with youth
Sexpression, Vol. 1, No 1, Winter 2005. -
Teenage pregnancy: an ongoing phenomenon
Sexpression, Vol. 1, No 2, Winter 2005. -
Embracing other cultures : Sex education for a multicultural clientele
Sexpression, Vol. 1, No 3, Winter 2005. - Le petit Magazine et le magazine Rayon X(in French only)
