Adolescent Pregnancy
The United States unintended pregnancy rate is 147 per 1,000 in sexually active women 15-17 years of age and 162 per 1,000 in sexually active women aged 18-19, significantly higher than in similarly developed nations (Finer, 2010; Singh & Darroch, 2000). Women with a mother or sister who has experienced teenage pregnancy are significantly more likely to experience teenage pregnancy themselves (East, Reyes, & Horn, 2007; Magnusson, Masho, & Lapane, 2011). Across all races and ethnicities, early menarche significantly increases the probability that an adolescent will experience pregnancy (Dunbar, Sheeder, Lezotte, abelea, Stevens-Simon, 2008). Additionally, low socioeconomic status, Black race or Latina ethnicity are also associated with unintended pregnancy (Gillespie, Ahmed, Tsui, & Radloff, 2007; Magnusson et al., 2011). Homeless youth constitute an specially ulnerable population with regards to adolescent pregnancy with reported rates ten times the national average Winetrobe et al., 2013; Kost & Henshaw, 2014). Barriers to the reduction of adolescent pregnancy may be largely attitudinal: ambivalence to pregnancy has been documented as high as 30% in urban females and odds of ambivalence increase with eported depression (Chernick, Kharbanda, Santelli, & Dayan, 2012; Francis, Malbon, Braun-Courville, Lourdes, & Santelli, 2014). therattitudes such as low self-worth and hopelessness are also associated with attempted pregnancy (Fedorowicz, Hellerstedt, Schreiner, & Bolland, 2014). Though overall teen pregnancy and birthrates have decreased in recent years, initiatives focused on pregnancy reduction can continue to build on these successes. The National Initiative to Prevent Teen Pregnancy successfully reduced teen pregnancy by a third during the decade after its founding in 1996; the initiative now has been expanded to focus on unintended pregnancy as there have not been significant gains in this area (National Campaign to Prevent Teen Pregnancy, 2015). Other initiatives, such as The President’s Teen Pregnancy Prevention Initiative, focus on communities with the highest rates of adolescent pregnancy with the aim to reduce teen birth rates by 10%, delay first sex, increase the use of effective means of contraception, and reduce the overall teen pregnancy rate (SIECUS, 2012). In addition to initiatives explicitly focused on pregnancy prevention, initiatives that focus on early childhood education and youth development in the form of academic support, after school programs, and community service also show promise for the reduction of adolescent pregnancy; a recent systematic review found a pooled 39% reduction (Harden, Brunton, Fletcher, & Oakley, 2009).