Teenage Pregnancy and Quality of Care

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Teenage pregnancy remains a challenge to both developing and developed countries. According to the World Health Organization, around 12 million girls below the legal age of 18 give birth annually, while 10 million teenage girls give birth annually in developed countries (WHO, 2020). Teenage pregnancy exposes young girls and unborn babies to severe safety problems, including anaemia, low birth weight, a high risk of infant mortality, cephalophelvic disproportion, and high blood pressure. Additionally, adolescent mothers may face eating disorders, frequent bleeding, hyperemesis gravid arum, and breast fissures. Due to low socioeconomic status in developing countries, complicated births and pregnancies are the leading cause of death. Besides, out of the 5.9 million abortions conducted every year, 3.9 million are unsafe and can lead to death or birth complications that may affect the adolescent mother or the child (WHO, 2020). This shows that teenage pregnancy has adverse safety events that can significantly affect the adolescent mother, child, family, or society.

Pregnancy testing is an essential part of ensuring safe delivery. However, a study conducted in the US showed low pregnancy testing rates among teenagers. This has contributed to many teens in the emergency department during childbirth. However, teenagers shy away from seeking healthcare services despite these symptoms, which expose them to more danger and complications in giving birth hence reducing the quality of care. 10% of pregnant teenagers denied having sexual activity, making it difficult for healthcare providers to provide the needed care—16% of the 130 million healthcare emergency visits concerning adolescent pregnancy (Thirukumar et al., 2020). This shows that most teenage pregnancies are handled in the emergency department.

The US has the highest number of teenage pregnancies among developed countries. During pregnancy, the common complications are low birth weight at 18.2%, preterm at 7%, and hypertensive disorder at 5% (Thirukumar et al., 2020). Other studies have shown that preterm labor is the main complication during teenage pregnancy. Another significant incidence was the caesarean section which was prevalent in adolescent births at a rate of 16% (Thirukumar et al., 2020). These complications require hospitalization of the adolescent mothers to get attention and specialized care. The treatment and care needed for these conditions and procedures are quite expensive, making teenage pregnancy a costly process. A study by Beam et al. (2020) has shown that children born at 24 weeks gestation were found to have the highest cost of care in the US, with an average expenditure of $600,000, while those born with low birth weight had an average expenditure of $114,0000 and those with preterm status had an average of $76,000. The rate of preterm births in the US for teenagers is 9.5%, and although the rate has been decreasing, this shows that there is a significant population that suffers from the high healthcare costs related to teenage pregnancies (Beam et al., 2020). This shows that adolescent pregnancy complications can have adverse financial outcomes for the family and society based on care costs.

US State Board Nursing Practice Standards

One of the main practices that the Center for Diseases (CDC) has done is developing innovative ways to prevent teenage pregnancies. One of the practices is providing contraceptive and reproductive health services for adolescents. Therefore, the clinical officers and other healthcare professionals provide culturally diverse and friendly reproductive healthcare services to the youths and ensure that they are easily accessible (CDC, 2019). Healthcare professionals have ensured that they link pregnancy prevention programs and healthcare facilities that provide reproductive health to teens. This ensures that teens can access pregnancy prevention information from the healthcare centers. For instance, reproductive health should be offered to youths at the first visit to avoid requiring them to back again. Clinics have also adopted inconvenient hours for testing and providing preventing reproduction education to the youths, such as evenings to allow those from school to attend.

The federal government developed the Teen Pregnancy Prevention Program, which has funded over 200 grunts in different states. The program uses evidence-based studies to roll out programs based on reducing teenage pregnancy. State agencies and other no-profit organizations have provided grants to Teenage Prevention Programs to serve in the high-risk regions. For instance, the State of Illinois was given a grant of $2 million to provide teenage prevention programs in areas outside Chicago in 2019 (Office of Population Affairs, 2022). There are also laws enacted to protect the adolescents that get pregnant, such as the law that requires teenage mothers to complete school. The law requires paternity and child support to be paid. There is a $20 million bonus for the five states that successfully reduce teenage pregnancies and abortions.

How These Policies Can Provide Guidance in Addressing Care Quality, Patient Safety, and Costs

Since teenage pregnancy is the source of all these problems, preventing causes of teenage pregnancy through more policing and provision of education can help overcome this healthcare disparity. Although there are not many policies regarding the quality of care and cost of teenage pregnancies, the policies on preventing teenage pregnancies can be used to provide guidance (Cheah, 2019). The cost of education and provision of contraceptives is much lower than the cost of giving adolescent childbirth. Therefore, the most effective method of ensuring the quality of care, patient safety, and costs is conducting campaigns to prevent teenage pregnancies.

Effects of Local, State, and Federal Policies on Teenage Pregnancy

Most of the local, federal, and state government interventions are based on reducing the number of teenage pregnancies and are not focused mainly on the adolescent mothers or the care they receive. Instead of focusing on improving the quality of care, they receive in healthcare centers, state and federal laws offer grants and bonuses to reduce teenage pregnancies. Some of the policies regarding the adolescent mother’s well-being are her right to complete school and their right to paid paternity and child support (Center For Diseases Control and Prevention, 2019). There are no policies covering their health concerns during delivery, such as the complications they are likely to experience and how the government can subsidize the cost of adolescent childbirth. Maybe this is ignored to discourage teens from adolescent pregnancies.

Strategies to Improve Quality of Care Enhance, Patent Safety, and Reduce Costs

The first action should be to enforce the law on child support across the US. According to the current regulations, when a female teenager gets a baby, they should be allowed to continue with their studies until they complete school. For the male teens, if they get children out of wedlock, they should provide child support. However, without the strict implementation, the female teenagers find themselves left alone in providing care to their children. A study conducted in Macedonia by Rexhepi et al. (2019) showed that the strict implementation of child support laws reduces the number of teenage pregnancies. Therefore, if the law on child support is strictly implemented, the male adolescents will not risk impregnating their female counterparts out of wedlock to avoid child support, hence reducing the number of teenage pregnancies.

The other policy should be regarding the insurance and costs of childbirth. The government should seek ways of subsidizing teenage childbirth without encouraging the youths to get teenage pregnancies (Sawhill, 2022). This can be done by providing loans such as student loans for childbirth to cover the cost of childbirth, which will then be repaid after the teenagers reach the legal age. This would ensure safe deliveries of teenage pregnancies, reduce the risks of abortions, and increase the quality of care while discouraging teens from adolescent pregnancy.

The US government should develop policies that educate teenagers on safer pregnancy-keeping processes to enhance patient safety. For instance, pregnant teenagers should take Folic acid supplements to reduce the child’s chances of brain and spine complications (CDC, 2018). They should also regularly visit the hospitals for clinical check-ups to ensure that the baby is safely growing. These measures will reduce the possibility of childbirth complications, increase safety, and reduce the overall cost.

Available Sources of Benchmark

Different studies have proven that their interventions are affecting teenage pregnancies. For instance, a study by Fingar & Hambrick (2018) showed that teenage education and the provision of contraceptives could reduce adolescent pregnancies. Proper insurance policies help to ensure better quality care for adolescent childbirths. Developed countries have fewer childbirth complications than developing counties due to the socioeconomic differences between the countries. Therefore, providing insurance to teenagers who get pregnant can help to enhance care. Finally, following CDC pregnancy processes such as taking Folic acid during pregnancy help to ensure childbirth safety and reduces the possibility of complications. That is why the CDC advocates for all pregnant mothers to take at least one 400 grams tablet of Folic Acid during pregnancy to reduce the chances of childbirth complications.

References

Beam, A. L., Fried, I., Palmer, N., Agniel, D., Brat, G., Fox, K., Kohane, I., Sinaiko, A., Zupancic, J. A. F., & Armstrong, J. (2020). Estimates of healthcare spending for preterm and low-birthweight infants in a commercially insured population: 2008–2016.Journal of Perinatology, 40(7), 1091–1099. Web.

CDC. (2018). Folic Acid. Centers for Disease Control and Prevention. Web.

Center For Diseases Control and Prevention. (2019). Health Care Providers and Teen Pregnancy Prevention. Web.

Cheah, I. G. S. (2019). Economic assessment of neonatal intensive care. Translational Pediatrics, 8(3), 246–256. Web.

Fingar, K., & Hambrick, M. (2018). Teen Hospital Stays for Childbirth, 2004-2013. Web.

Office of Population Affairs. (2022). Teen Pregnancy Prevention (TPP) Program | HHS Office of Population Affairs. Opa.hhs.gov. Web.

Rexhepi, M., Besimi, F., Rufati, N., Alili, A., Bajrami, S., & Ismaili, H. (2019). Hospital-Based Study of Maternal, Perinatal and Neonatal Outcomes in Adolescent Pregnancy Compared to Adult Women Pregnancy. Open Access Macedonian Journal of Medical Sciences, 7(5), 760–766. Web.

Sawhill, I. V. (2022). What Can Be Done to Reduce Teen Pregnancy and Out-of-Wedlock Births? Brookings; Brookings. Web.

Thirukumar, M., Thadchanamoorthy, V., & Dayasiri, K. (2020). Adolescent Pregnancy and Outcomes: A Hospital-Based Comparative Study at a Tertiary Care Unit in Eastern Province, Sri Lanka. Cureus. Web.

WHO. (2020). Adolescent pregnancy. Who.int; World Health Organization: WHO. Web.

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