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How to Curb Teenage Pregnancies: A Medical Perspective
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11891 |
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CURRENT ISSUES
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8 / 1987 |
1,884 Words |
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Reginald C. Tsang, M.D.
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The problem of adolescent pregnancy is a national disgrace. When I make rounds in the neonatal intensive care nursery, I find that on some days, half of the infants are from adolescent pregnancies. Death and severe disabilities are part of the unsung consequences of adolescent pregnancies.
There are more than one million teenage pregnancies a year, costing $16.6 billion. These are stark numbers, sad numbers.
The time has come to face the problem squarely. It has always been puzzling why we do not have the lowest rate of infant mortality in the world. In fact, we are 17th in the world for infant morality, in spite of our having the most sophisticated technology and the greatest medical advances on this planet. The truth is that there is a linear relationship between national infant mortality rates and the rate of teenage pregnancies.
Japan has the world's lowest rate of teenage pregnancies (1 percent) as well as the lowest infant mortality rates. The U.S. average teenage pregnancy rate, in contrast, is 14 percent. Reducing the teenage pregnancy rate in the United States will significantly reduce the number of low-birth-weight infants and drop infant mortality rates dramatically, too.
In pediatrics, we are constantly reminded of the tremendous value of prevention. Certainly contraceptives are a possible way of preventing pregnancy; to the extent that this can be achieved it would be good. But is that too late? We have always emphasized that to prevent any disease, we go back to the basics, and the basic cause of teenage pregnancy is teenage sex. How are we to deal with this problem?
It is commonly said that we cannot stop teenage sex; therefore we give up on this problem. However, we used to also say that we could not stop smoking, we could not stop drunken driving, and we could not stop people from eating large amounts of cholesterol and having coronaries. Yet over the last five years, information campaigns have begun to attack many of these subjects that were once taboo.
It took only two years for two dedicated mothers, motivated by the deaths of their children caused by drunken drivers, to galvanize the nation, state after state, to pass drunk-driving laws. People said, "It can't be done," "It's impossible," "How can you ever change people's drinking habits?" Nevertheless, what "cannot be done" is often simply a mind-set. Something can be done.
Physicians, it is sometimes said, should not talk about "morality," but we actually do it all the time. Every day in the nursery I talk about morality, living, dying, treating or not treating very sick infants. Medicine has always involved basic moral-ethical issues.
Smoking and drinking can be moral issues, too, but they are also health issues. They lead to tremendous disabilities; they kill children. Adolescent pregnancies lead to dying and dead babies; it's a moral issue. If we don't want to call it a moral issue, then we can call it a medical issue. Whatever we want to call it, we are dealing with life-and-death issues and the terrible problems that beset the infant that is born. There must be methods to curb this
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