Teenage pregnancy: trends, contributing factors and the physician's role

• Published in: Canadian Medical Association journal (CMAJ) Vol. 176; no. 11; pp. 1601 - 1602
• Main Author: Langille, Donald B
• Format: Journal Article
• Language: English
• Published: Canada CMA Impact Inc 22-05-2007; CMA Impact, Inc; Canadian Medical Association
• Series: Public Health
• Subjects: Adolescent; Adolescent Behavior; Adult; Canada - epidemiology; Contraception Behavior - trends; Female; Forecasts and trends; Health aspects; Humans; Patient Rights; Physician's Role; Physician-Patient Relations; Physicians; Pregnancy; Pregnancy in Adolescence - prevention & control; Pregnancy in Adolescence - statistics & numerical data; Prevention; Risk factors; Roles; Sex education; Sexual behavior; Teenage pregnancy; Teenagers; Trends; United States - epidemiology; Canada; United States; United Kingdom > UK; United States > US; Wales
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.070352

Rates of teenage pregnancy vary by country, but because of reporting differences, international comparisons can be difficult. In 2002, the latest year for which international data are available for comparison, Canada had a pregnancy rate of 33.9 per iooo females aged 15-19,* much lower than the rate that year in England and Wales5 and the United States6 (Table i). From 1994 to 2002, the rate of teenage pregnancy declined substantially in both Canada and the United States,4·6 but it increased slightly in England and Wales5 (Table i). In 2002 the rate of therapeutic abortion in Canada was 18.4 per iooo females aged 15-19," again lower than the rates in England and Wales5 and the United States,6 but not substantially so (Table i). One can conclude, therefore, that Canadian teenagers become pregnant less often than those in England and Wales and the United States but more often choose to terminate the pregnancy. Reasons for the decline in teenage pregnancy in aie United States were examined in a study using data from the National Survey of Family Growth in the years 1995 and 2002. The proportion of females aged 15-19 who reported using an oral contraceptive at last intercourse, alone or in combination with other methods, increased dramatically during this period, from 32% to 49%. The proportion who reported using an injectable long-acting hormonal contraceptive (e.g., DepoProvera) also increased, from 8% to 10%. Reports of using no contraception at last intercourse decreased, from 34% to 18% of respondents. The authors concluded that improved contraceptive use was the main factor behind decreased rates of teenage pregnancy in the United States; it explained all variability in pregnancy risk among respondents aged 18-19, 3^though decreased sexual activity played a minor role among those aged 15-17/ Similar studies have not been conducted in Canada; however, data from a national survey in 2002 suggest that contraceptive use also plays an important role here. In that survey, 39% of Canadian females in grade 9 and 54% in grade n reported using oral contraception at last intercourse; 8% and 6% respectively reported using no contraception, and 7% and 11% reported using the withdrawal method, either alone or in combination with other methods.8