Teenage Pregnancy in London Borough of Lewisham

Introduction

The subject of teenage pregnancy remains one of the most crucial social and health issues that many societies continue to try to mitigate. According to WHO, these are pregnancies that occur among people before they reach the age of 20 years. Consequently, there has been a campaign to reduce teen birth rates and promote health equity among members of society. However, it mainly occurs among adolescents that are poor, uneducated, and live in rural areas.

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The following capstone project paper, therefore, delves into these issues. The major mandate is to come up with meaningful recommendations and interventions that can curb this urban health problem. Consequently, the capstone project paper will include several segments. The rationale will discuss the primary reasons that make teenage pregnancy a critical issue in the London Borough of Lewisham. The next section will explore teenage pregnancy in the context of urban settings. It will look at various health determinants associated with the problem of teenage pregnancy.

The subsequent section will discuss the public health consequences; these are the impact of early pregnancies on society. The next section will include strategies and interventions aimed at curbing the issue. It will provide a discussion of the London Borough in its quest to deliver support. The last part is the recommendation and conclusion. It will highlight the relevant proposals and make a conclusion regarding the subject of teenage pregnancy.

Rationale

According to statistics, an estimated 16 million girls ranging from the age of 15 to 19 give birth every year. Eleven percent of the total births in the world can be attributed to teenage girls between the ages of 15-19 (World Health Organization, 2014 p.1). This percentage is a large segment that includes millions of births that occur throughout the world. However, these populations are higher in developing countries. A majority of the population in the world today live in urban cities. Despite the high percentage of teenage births occurring in middle and low-income countries, there is also a significant portion that urban cities face in developed countries.

Teenage pregnancy due to its causes and consequences continues to be one of the urban health issues that need to be addressed by concerned persons. In London, there was a 52.9% rate per 1,000 compared to 46.9 rates per 1,000, which are the national rates according to a survey conducted in 2008 (‘Addressing teenage pregnancy in Lewisham’ 2008). The rate of teenage pregnancies in London has not decreased over the years like it did in other parts of England.

Ten local authorities in England experience high teenage pregnancy rates and seven of these local authorities are in London with Lewisham being one of them (‘Addressing teenage pregnancy in Lewisham’ 2008). In 2009, according to a report by the office of national statistics, Lewisham had the third highest teenage pregnancy rate among the Boroughs in London. This report also revealed that Lewisham had the fifth-highest teenage pregnancy rate in England (‘LEWISHAM: Borough has third-highest teen pregnancy’ 2009).

Additionally, teenage pregnancy was greater among whites followed by blacks and finally Asians and Hispanics, who had a very low prevalence rate. Among the black minority, however, 40% of births were teenage births (‘Teenage pregnancy’ n. d.). This rate is high compared to other racial groups. On a global scale, teenage pregnancy rates are higher among blacks. America has a 37% teenage pregnancy prevalence in the black community.

The critical point, however, is the fact that teenage pregnancy is an urban health issue. Teenage pregnancy is the second cause of mortality for young individuals globally. Moreover, there is an estimated number of three million teenagers between the age of 15 and 19 who procure an abortion (World Health Organization, 2014 p.1). The babies of teenage mothers face a greater risk of dying than women past the age of adolescence.

Consequently, WHO emphasizes that teenage pregnancy remains one of the crucial contributors to maternal and child mortality. It also perpetuates an infinite sequence of poor health and poverty worldwide. Teenage pregnancy results in low education levels as most teenage mothers opt to drop out of school after delivering to take up the responsibility of parenthood. Leaving school results in little academic qualifications making young mothers lose academic competitiveness in the world today (‘Health risks to the baby’ n. d.).

Teenage pregnancy is an urban health issue since it is connected to a higher percentage of births of low weight and premature babies. This connection often results from the fact that teenagers do not seek prenatal care throughout their pregnancy. They often seek this care in the last three months to deliver. Premature babies grow up to have many health complications due to the insufficient development of their organs. Teenage abortions make up 14% of unsafe abortions performed worldwide, which often results in approximately 68,000 deaths annually (UNICEF, 2008, p.2).

The process of delivery for teenagers is often followed by numerous complications as their pelvic bones are less developed. Most teenagers end up with health complications such as obstetric fistula and some tear in the birth canal, which affects urine and fecal control. It is apparent that teenage pregnancy is a health issue, and its adverse impacts are felt not only by teenage mothers and their children but by society as a whole. These are the reasons why the London borough of Lewisham faces an urban health issue of teenage pregnancy. This prevalence supports the sick city hypothesis, whereby the high population density in urban areas makes the places a breeding ground for the various health problems.

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Urban Context and Determinants

In urban contexts, teenage pregnancy is determined by several issues. The highest cause of teenage pregnancy is adolescent sexual behavior (UNICEF, 2008, p.1). This behavior often arises from peer pressure among teenagers who want to explore what sex is all about. Most teens are curious about sex. In urban setup, teenagers spend much of their time on social media and watching films. Technology has played a great role in propagating teenage sexual behavior. Teens in urban cities engage with technology more than they do with their parents and teachers. Research has proven that teenagers spend 45% on social media and watching films and videos (Media Literacy, 2016, p.1).

A majority of the films shown on televisions, movie theaters, and movie stores do not take much consideration of their content with regards to the audience that they target. When teenagers watch films and videos on social media that have sexual content, they develop a curiosity to try it out on their own. In most instances, the media poses a positive attitude towards sex and its fundamentality in a heterosexual relationship without putting into consideration the teenage audience. This exposure to media causes adolescent sexual behavior.

Adolescent sexual behavior also results from the fact that fewer parents want to engage their teenage children and educate them about sex. In the urban context, most parents are busy doing one job after another to meet up the expenses of raising children (UNICEF, 2008, p.1). Families no longer spend quality time together. Globalization has created numerous demands for parents to improve their education, experience, and exposure levels. Teenagers, therefore, find themselves confused where they have to reveal on their own what sex is and when it is appropriate. The majority of parents have left parenting responsibilities to the media and friends of their children who are also in most cases teenagers (Media Literacy, 2016, p.1). Teenagers, therefore, end up experimenting and learning about sex for themselves leading to unintended pregnancies.

Peer pressure is another cause of adolescent sexual behavior. Teenagers between the ages of 10 and 17 comprise a higher percentage of youngsters. Adolescents are at a stage in which they experience attraction towards the opposite sex (Mothiba & Maputle 2012). Teens begin to experience changes in their bodies that identify their sex and gender. It is at this point in the development that adolescents fall under the influence of peer pressure; they want a sense of recognition and often want to feel like they belong to their peers.

They, therefore, engage in sex because it is a cool thing and their peers are trying it out. At this point in life, guidance and advice are critical for them. They end up making ignorant mistakes if they are not handled well. Peer pressure is one of the leading causes of adolescent sexual behavior and the number one cause of teenage pregnancy (Shaffer & Kipp 2009, p.64).

Alcohol and drug abuse is another determinant of teenage pregnancy in urban setups. Substance abuse often begins during the teenage years and develops over time to an irrevocable addiction. In cities, parties happen all the time (Mushwanaa et.al, 2015, p.14). The majority of teenagers attend parties that are often out of bounds for their age. The police often collect false IDs from teenagers between the ages of 15-17 who pretend to be 18 and over to buy alcoholic drinks and engage in parties that are organized in the pubs for adults. This life of revelry often results in teenage pregnancies, in some instances as a result of engaging sexually with adults who think the teenagers are grownups.

Peer pressure instigates alcohol and drug abuse. Teens condemn themselves to live a life of drug and alcohol abuse. Poor parenting is another cause of drug and alcohol abuse. Substance abuse causes teenagers to engage in sex even without knowing as they do this when they are drunk in most instances. The use of alcohol and drugs also causes the loss of self-control and may lead to a life of promiscuity (Langille, 2007, p.1602). Alcohol and substance abuse is, therefore, a determinant of teenage pregnancy in urban contexts.

Poor educational engagement and achievements are another significant cause of teenage pregnancy. Education comes with exposure. The global authorities have set standards that school systems have to meet in different nations of the world (Langille, 2007, p.1601). Education today includes certain courses on reproductive health systems, especially in junior and senior high schools. If a teenager does not get an opportunity to engage in these types of education, they fail to understand the dynamics of sex and reproductive health.

They do not understand how to use contraceptives and what their effects are. Such teens have a risk of engaging in premarital sex that leads to teenage pregnancies. In most cases, some teens decide that they do not want to attend school without the consent and support of their parents (Mushwanaa et.al, 2015, p.17). Such teenagers are often unruly, rude, and disobedient. They end up engaging in risky activities which include sex. Teens that have fewer academic achievements even when they are participating in educational programmes are also more exposed to teenage pregnancies.

Between the ages of 10-19 in a regular setting the teenagers should be more involved in their education than in any other activity. Learning changes their minds, energy, focus, and concentration on productive activities. Teens who do not participate well in academic programmes, therefore, have much energy and focus that they nowhere to apply (Gyan, 2013, p.24). When teenagers lose the urge to participate actively in the educational responsibilities made available for them at this age, they end up getting involved in risky activities.

Among such activities would be exploring unprotected sex, which in turn leads to teenage pregnancy. The high rate of teenage pregnancies among blacks is linked to poverty, unstable families, and second-generation teenage pregnancies. The majority of black families have parents who do casual jobs that cause their children to live a relatively financially handicapped life. Poverty is a fundamental cause of teenage pregnancies as some teenagers engage in early sex to get money or drop out of school due to a lack of fees that causes them to end up beginning adulthood earlier (Gyan, 2013, p.24).

40% of teenage births are either second-time births from existing teenage mothers or from teenagers that were born and brought up by teenage mothers. The high prevalence of teenage pregnancies among the black minority, therefore, replicates itself and operates in the stated sequence.

Global statistics indicate that family violence levels are higher in black families, further explaining why blacks have high rates of teenage pregnancies (‘Teenage pregnancy’ n. d.). The above-discussed determinants are the most prevalent in urban contexts, such as the London Borough of Lewisham. The dynamics of urban life, which includes exposure to a lot of information, busy lifestyles, access to media communication, and a revelry culture, contributes to the above-described determinants of teenage pregnancies. These support the sick city hypothesis that states that the development and features of urban life become a breeding ground for health issues.

Health Impacts and Consequences

Teenage pregnancy as an urban health problem has implications that the population, individuals, and health service institutions and providers feel. The general population is directly affected by teenage pregnancies. It is important that the world population is growing at higher rates. Some countries are already putting some measures in place that would provide control over the population growth. Studies have proven that if there would be a reduction in the number of adolescent girls giving birth, the overall population growth would significantly reduce.

These studies imply that with the absence of teen births, the populace of the world would be lower, causing more social and economic development (Hofferth 1987). A reduced number of individuals would ensure focused use of the available health resources which would improve the quality of health service provision. This argument implies that teenage births negatively impact the health of the population.

Most teenagers who get pregnant often drop out of school and fail to pursue careers. As a result, the community does not have enough experienced and skilled labour. For instance, the health sector and nursing continually face significant shortages in developed countries, England being among them (Fan, 2014, p. 643). If the teenagers that drop out of school every year as a result of pregnancies would not drop out of school, then these countries would not experience a shortage of workers, especially in the health sector. When hospitals are lacking employees, the quality of healthcare provided to the population is reduced which has negative health impacts on the general population.

The health services become of a lower quality than they would have been without teenage births. National governments often assign a budget for health providers to their population. The enormous amount spent often covers the basic health provisions in health facilities. These statistics include teenage mothers and children making the services be distributed by officers over a larger population.

The services would be better if teenage mothers and children were not significantly adding to the population that needs health care. It is also worth observing that with many people demanding concern and treatment, the health professionals and practitioners get overwhelmed taking into consideration their lower numbers in ratio to the population that needs medical attention. When these professionals are worn out, the quality of the service that they offer is correspondingly below par (Fan, 2014, p.701).

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If the number of teenage mothers and their children that need attention would significantly reduce, then these professionals will focus on a smaller population of patients, which will improve the quality of their services. 11% of the total births in the world are teenage births. If this percentage can be considerably reduced, then it is evident that a lot will change in the health sector to the benefit of the general population (World Health Organization, 2014, p.1).

The individuals who experience teenage pregnancy feel the greatest share of health complications and consequences. Approximately 9% of teenage births are premature births. The majority of teenage births often result in babies who are of lower weight than expected at birth, which is somewhat below 5.5 pounds. Premature and low weight births often include children who are born when all the body organs have not yet fully developed. Having undeveloped organs can result in serious health complications in the child’s life.

These complications include brain hemorrhage and respiratory distress syndrome. Poorly developed body organs also lead to difficulty in the control of blood sugar levels and body temperature. The children also have a high risk of being mentally retarded. These kids have a greater chance of dying at birth or in the early stages as infants, contributing significantly to the infant mortality rates.

The mothers, on the other hand, are more likely to be malnourished as they do not have finances for accessing proper prenatal care. The malnourishment effect may also be a result of the incapability of their bodies to support the biological processes that occur during pregnancy. Pregnant teenagers also have a greater risk of developing pregnancy-related hypertension, anemia, placental complications, and high blood pressure (‘Tween and teen health’ 2015). Teenage mothers lose much weight during pregnancy in many instances. There are also complications that occur during birth that can result from weak pelvic bones. This can lead to obstetric fistula and tearing of the birth canal.

In most instances, the birth canal is not developed enough to allow delivery. The teenager, therefore, experiences significant friction when undergoing the usual delivery process. The tearing of the birth canal also results in instances, where the body system of the teenage mother cannot control fecal and urinal release from the body. The parents are also more likely to have contracted STIs and HIV/AIDS since most of them engage in unprotected sex either unintentionally or ignorantly (Menken, 2010, p.61). Most teenage mothers are more likely to die during delivery because of their undeveloped reproductive tracts. The deaths of teenage mothers contribute to 25% of the world's maternal mortality rates.

Critique of Interventions

Numerous proposals have been brought forward to help curb the rising rates of teenage pregnancies. Over the years, the World Health Organization has tirelessly formulated policies to help control teenage pregnancies and their adverse effects on society and health. The local government of Lewisham has also over the years implemented policies and programmes aimed at curbing the high rates of teenage pregnancy in the borough. The positive impacts of these policies and programmes are evident. However, the challenge is that even after their implementation teenage pregnancy rates remain an urban health issue the effect of which is still widely felt.

This persistent existence of teenage pregnancy rates, therefore, means that these policies are partially ineffective. An example of intervention is the sexual health strategy in Lewisham that was rolled out for implementation between 2014 and 2017 (‘LSL sexual health strategy action plan’ 2014). The technique is good and will go a long way in improving the health of the people of Lewisham.

This policy is geared towards improving the quality of the local health services and making them readily accessible to individuals (’ LSL sexual health strategy action plan’ 2014). Easy accessibility and quality health care is a good strategy that will reduce the health impacts that teenage pregnancy has on the population of teenage mothers and their children. However, the main issue is not the accessibility of quality health services but the pregnancy rates themselves. Access to quality health care does not directly impact the reasons why teenagers engage in premarital sex and get pregnant; it offers a solution to teenagers who are already pregnant.

This strategy only improves the accessibility of prenatal care and postnatal care. Moreover, this bill does not focus on the issue of teenage pregnancy, but the general health conditions of the people of Lewisham. To address the problem, in particular, the local authorities should instead include policies and strategies that focus directly on teenage pregnancy issues.

Lewisham's local government also introduced the Teenage Pregnancy Programme. This agenda is run and financed by several public agencies from governmental ones to private sector organizations (Teenage pregnancy programme, 2014, 2). Health institutions also play significant roles in this programme. The plan was initiated to provide support for young people. It also works towards the reduction of teen pregnancies and the support of teenage parents who are subject to various risk factors (Teenage Pregnancy Programme, 2014, P.4). This programme has been effective in creating a downward trend in the teenage conception rates in Lewisham.

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However, Lewisham remains among the leading boroughs in teenage pregnancy. The challenge with the effectiveness of this programme is that it focuses only on young people. Teenagers between the ages of 15-17 are under parental care. Being under parental care means that parents are viable stakeholders in any programme aimed at discouraging these young people from engaging in sexual behavior. The plan fails to address individual issues that lead to teenage pregnancy. Instead, it improves health support which seeks to curb teen pregnancy rates. The course should include measures that address factors such as drug abuse, parental concern, peer pressure, and teen education and academic achievements.

The World Health Organization has also introduced a policy that bans marriages before the age of 18 and declares them illegal (Kenney & Mazza 2014). This guiding principle is effective in sub-Saharan Africa and extremely rural areas where marriage occurs among teenagers. It partially helps in discouraging teenage pregnancies. It is, however, not efficient in the urban context where a majority of teenagers who get pregnant are not in a marital relationship. In many instances, young people ages 15 to 17 are not married in city environments. In this case, this policy proves ineffective in urban environments.

The World Health Organization also works to reduce coerced sex among teenagers. This strategy is implemented in conjunction with the law enforcement agencies of different nations that belong to the United Nations. This approach involves arrests of any individuals that coarse teenagers to engage in sex (World Health Organization, 2011, p.3). It has effectively reduced sexual abuse and molestation in middle and low-income countries.

However, its applicability in developing countries is still limited. Another challenge in its application is the fact that in most cases of teenage pregnancies the fathers of unborn babies are often minors of the same age as the teenage mother. In some instances, teenagers cannot identify the fathers of their unborn children. Therefore, it still does not address the roots of teenage pregnancies and lacks effectiveness. Additionally, this strategy does not consider the role of the deceived teenager and the parents.

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Recommendations and Conclusion

This capstone project report makes recommendations that are based on the causes of teenage pregnancy. If the causes of teenage pregnancy can be effectively dealt with, then this health issue would cease to be a primary concern in urban centres and nations globally. First, the national government can decide to launch a strict crackdown on fake ID providers and drug suppliers who make drugs accessible for teenagers. Such an operation will reduce alcohol and substance abuse among teens. Alcohol and drug abuse results in risky behaviors, which lead to premarital sex among adolescents. In this way, the government would have significantly reduced the risk of teenage pregnancy among adolescents.

Local government can also pass a law that allows no parent to work more than two jobs a day, in particular the female parent. Fewer engagements will provide time for parents to interact with their children. Parents will, therefore, be able to control what their children watch, who their friends are, and what they engage in on a daily basis. This recommendation is practical and will ensure that teenagers do not watch films and videos with inappropriate sexual content. It will also regulate alcohol and drug abuse among adolescents and will ensure teens do not influence each other to engage in negative behaviours.

The availability of children will inculcate the right attitude towards education, which will encourage teenagers to study more as they get exposed to the realities of teenage sex and pregnancy. The local authority should offer educational support to teens who have parents who cannot afford their school fees. By the provision of education, the teenagers will be discouraged from engaging in sex for money and from assuming the responsibilities and, hence, the lifestyle of an adult.

In conclusion, the capstone project paper dedicated to teenage pregnancy proved that it is a real health issue. Teenage pregnancy causes a lot of adverse social, economic, and health impacts not only relevant to the teenagers involved but to the general population and the government. Teenage pregnancy can only be dealt with when its causes are actively addressed by society. Once the determinants are reduced and potentially eliminated, Lewisham can face a future with lower teenage pregnancy rates.

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