Pregnant teenager help

Pregnant Teen | The American Pregnancy Association

Being a pregnant teen can be overwhelming, confusing, and scary. You are not alone; there are around 500,000 pregnant teens in the USA every year. As a pregnant teen, you might be wondering how to break the news to your boyfriend and your parents, what you will choose for your pregnancy, how this will affect you finishing school, what your friends will say about you, or about how you will be able to provide for your baby.

The good news is there are resources, services, and support just for you. The first step is to begin care for your pregnancy and to seek help. Maybe you haven’t confirmed your pregnancy yet, but have missed a period or have questions about your symptoms.

Our toll-free teen pregnancy hotline, 1-800-672-2296, and chat button below are here just for you. Our pregnancy educators are ready to help you figure out you if you’re pregnant, help you get a free and confidential pregnancy test and offer you a safe place to talk about your pregnancy options.

Let’s look at what it is like being a pregnant teen, how to determine if you are pregnant, breaking the news to your boyfriend and parents (and tips on how to talk with them), making a choice for your pregnancy, resources available to you, and much more. We’ve included links to some of our other articles for more in-depth information.

Before you psych yourself out, the first thing you need to do (if you haven’t already) is to find out if you are pregnant or not. Don’t assume you are pregnant just because you missed your period. The only way to know is to take a pregnancy test. You’ll want to wait until seven day safter you miss your period to ensure an accurate result. You can purchase a urine test at your local pharmacy or retail store, or go to a local testing center for a free one. Blood tests must be done at a clinic or by your doctor. Visit our Pregnancy Symptoms or Pregnancy Tests pages for more information. Call or chat with us and we’ll help you find a free testing center. After you have a positive pregnancy test, your next step is to make sure the pregnancy is viable (possible to carry to term) and not an ectopic pregnancy or a probable miscarriage. You can do this with an ultrasound. Many of the free testing centers also offer free ultrasounds, or your doctor can perform one. If the pregnancy is viable, then you have some decisions to make (see below).

Sharing the News as a Pregnant Teen

Once you confirm the pregnancy, telling others that you are pregnant is probably going to be very difficult. However, it is crucial to do so because it is by telling people you can find support and get access to care. You can start by making a confidential toll-free call or chat to our helpline. Our pregnancy educators have been the first person someone has told many times, so please don’t hesitate to talk to us. You may also find it helpful to speak with a confidential educator at a pregnancy center or through your school nurse or counseling office. As hard as it may be, you will need to plan on sharing the news with at least one of your parents. Because you are probably still living at home or still financially dependent on your parent(s), they will likely be the one(s) helping and supporting you in whatever decision you make for your pregnancy.

Talking to your parents

Most pregnant teens are scared to share the news with their family. We have a few suggestions on breaking the news to your parent(s):

Realize that this was probably not their plan for their teenage daughter; try not to be defensive about how you ended up in this situation. If you are humble and apologize for disobeying their rules/expectations, then you and your parents may be able to start with a cleaner slate.
Your parent(s) are undoubtedly going to ask you who the father is, and they are going to want to know if he plans to help you care for a child. If you have a relationship with the baby’s father and would like to continue it, ask him what he thinks/how he feels so that you can have an answer for your parent(s), as well as for yourself.
Most parents will consider a teen pregnancy irresponsible; so, show them that you are taking responsibility for your actions by coming up with a plan. These plans don’t have to be set in stone but make sure you have concrete ideas about prenatal care, how you will provide (jobs), if/how you plan to finish school, child care, where you will live, and the list goes on. This shows them that you are thinking ahead and behaving responsibly.
Your parents may have an idea about what choice they think you should make for your pregnancy. Remember that ultimately, it is up to you. If you’ve already made your decision, let them know. However, don’t be afraid to discuss with them as to why you’ve chosen what you did (they are going to want to hear your reasons anyway).
Your parent(s) may bring up some points that you had not thought about, so be prepared to LISTEN, too!
Don’t roll your eyes, storm off, or tune them out! They have been through at least one pregnancy before (you) and undoubtedly have some helpful information and wise insights to share with you.
Try not to set your expectations too high or too low. Not every “I’m pregnant” talk with parents is going to go well, and not all of them are going to go badly. Remember, you won’t know precisely how they’ll react until you break the news (even if you say that you’re sure of it). Some parents will be angry at first, but loosen up when it gets time for them to meet their grandson or granddaughter. Plus, they’re going to find out eventually because it’s quite challenging to hide in the second half of pregnancy. If you wait until then to tell them and get care, that can be dangerous for you and the baby.

As a first time pregnant teen, this will be the first time you have this talk with your parents. More than likely, this is their first time to talk about teen pregnancy as well.

Talking to your boyfriend

As a newly confirmed pregnant teen, you might also be wondering how to talk to your boyfriend. It’s possible you’ve already been talking to him about the possibility, or you are going to take a test with him present. If you take one on your own, here are some suggestions on how to tell him. We’ve also included thoughts on how to talk about what you (and he) wish for the pregnancy. As a pregnant teen, this is probably your first pregnancy. Remember, this is most likely his first time as well. Don’t forget to ask his opinion too – ultimately, the decision is yours, but the choice you make here could make or break your relationship. The baby does have half his DNA too!

Try to break the news as calmly as possible in person and not over a phone call or text (if you are long-distance, then a video call might be a better option). If you aren’t sure of what his reaction will be, it might be helpful to have the conversation in a public place but make it a place that both of you feel comfortable.
Many guys will face some denial about the situation initially. It might be a good idea to either bring the positive pregnancy test/results with you if you took one on your own, or to bring a new test and offer to take with him present. This way, he can see immediate proof.
He may need a few minutes to process what you’re telling him. You can take this time to explain what you are thinking or feeling about the situation, or you can give him some time to think in silence.
Don’t assume that he already knew that pregnancy was on the table – he might not have had any clue at all. Try not to hold this against him, as he might not have noticed anything different.
Try to keep calm throughout the whole conversation. He’s the one getting hit with big news at this moment, he may not be as emotionally controlled. (That doesn’t excuse any bad behavior or attitude he might have, but it may explain some of it.)
Don’t throw the blame all on him (unless intercourse was forced – in which case please talk to your parents and the police) – you both made the adult decision to have sex, and thus both of you are now facing the consequences. Try not to be defensive either, as that never helps a conversation go better.
Try to be as clear as possible when you explain what you’re thinking or feeling about the pregnancy. What choice for the pregnancy are you leaning toward? Why? Have you told your parents? When did conception likely occur? Vagueness can lead to misunderstandings and then arguments, so avoid that if possible.
Talking and decisions about the future of your relationship or the possibility of parenting together may not happen in this initial conversation. You both may be too full of emotion and shock to be able to make educated, long-term decisions at the moment. Don’t feel pressured to get all your plans finalized in this one conversation, and don’t pressure him to decide what he wants right away.
If the situation escalates and you fear for your safety or for his safety, excuse yourself and take some time to calm down or to let him settle his emotions. Don’t leave without an explanation; let him know that you’d like to continue the conversation later when you both are at a better emotional level.

You are more than likely a pregnant teen for the first time, and the same goes for him as well. If your relationship has been around for a while and you both know each other’s parents, you may want to plan a family meeting after you initially share the news with your boyfriend. Ideally, you both would have already made a decision about the pregnancy and about your relationship (how it will continue or if it will not).

Pregnancy Decisions as a Pregnant Teen

It is quite possible that you are questioning what to do with this pregnancy. Will you carry the baby to term, consider adoption, or look at termination through an abortion procedure? The first thing to remember is that it is your pregnancy – no one should pressure you into anything. Whether it is a parent, friends, your boyfriend, or some other person/group, no one should make you feel that you have to make the decision they want you to make. The options are there whether anyone tells you about them or not. You may find someone who tells you that you are a horrible person if you abort, and that is not true. You may get someone else who tells you that it is only a blob of tissue, which isn’t true either, with the heart starting to beat by day 21. There have been studies showing that a majority of women who get abortions feel that they didn’t have enough information to make an informed choice for their pregnancy. It is important to know all the resources available to you – without being aware of these, you may falsely think that there is no help for someone in your position.

Embrace Grace is a judgement-free support group organization developed to help young people with unplanned pregnancies. There’s probably one near you.

Choice 1: Parenting

You’re young, might not have a job yet or have graduated from high school, but that does not mean that you have no chance as a parent. Parenting can be very challenging but also extremely rewarding. There are many successful teen moms whose children grow up happily and normally. There are a lot of programs that can help you get on your feet and provide for a child, such as Medicaid for prenatal care, WIC for help eating healthy and for baby formula/breastfeeding assistance, food stamps to help you keep food on the table, housing assistance to bring your living expenses down, and much more. Here are a few topics on parenting that you may find helpful:

different types of parenting
how to be a single parent
things you need as you prepare for your due date

With parenting, you’ll have to speak to your boyfriend and your family about what this will look like. Will your boyfriend, help you raise the child, or will you have to pursue child support? Will you be able to stay with your parents or have to get your place? There’s a lot to think about when considering parenthood, but it is possible to sort through all these questions. Check out our Issues & Challenges article to learn more about the journey through pregnancy.

Choice 2: Adoption

There is also the option for adoption. Many teenagers feel that they cannot give a child the life they desire for them, and that is where adoption comes in. There are a lot of couples that are in a more stable time in life that are not able to parent children for one reason or another who desperately want a child. You could help make that a reality for these hopeful parents! Plus, the adoption agency or adopting family will typically cover the medical costs of your pregnancy. You have the option to keep in contact with the adoptive family, or to go through the adoption anonymously. Here are some other topics you might find useful:

adoption in the eyes of the birth parent(s)
questions to ask yourself when considering adoption
different types of adoption
financial help with adoption
And much more here.

We also encourage you to sit down with an adoption agency or professional to get a better idea of what adoption might look like for you.

Choice 3: Abortion

Abortion is the process of terminating a pregnancy. Depending on the age of the baby, there are different procedures available to you through medical or surgical abortions. Many women who choose abortion do so because they do not feel like there is any other option for their pregnancy. We encourage you to never decide out of fear, or because you feel forced to because of your situation or people around you! Before you choose, learn more about the options and resources that are available.

Remember that if you are a minor, you may need your parents to sign off on an abortion procedure. Contact a teen pregnancy center in your area to find out more about the laws in your state.

Help for a Pregnant Teen

As we noted earlier, there are approximately 500,000 new pregnant teenagers every year, meaning there is a need for specialized care. You may not know it, but there are usually school programs for pregnant teens allowing you to finish school. There are maternity homes just for teenagers to have a special place to get away and receive care, especially if there are any problems at home.

Abortion used to be the number one option selected by teenagers, but more and more young women are discovering that they can overcome the odds and succeed, either as a parent or through adoption. It is not easy, but there is help, resources, and support specifically for pregnant teens. You have to start somewhere to find what is available to you! That is why we suggest visiting a pregnancy center, talking to your parents, or calling our helpline so that you have an idea of a good next step toward choosing your pregnancy, or so that you can get information about helpful resources.

Prevention and Statistics

Though teen pregnancy rates in the United States have steadily dropped since 1991 and are now at record lows (reaching a new record low each year since 2009), they are still higher than the rates in many other developed countries. The latest data from the CDC revealed an average of 22.3 births per 1000 females (age 15-19) in 2015. It is important to remember that this number does not include aborted babies and pregnancy losses, and thus, the pregnancy rate (vs. birth rate) is higher than 22.3/1000. Around 30% of teen pregnancies end in abortion. Some people have postulated that increased availability of abortions is to blame for fewer births from teen pregnancies, but the abortion rates have stayed relatively the same. Many researchers believe that access to birth control/contraception is the reason for this drop in teen pregnancies. Don’t want to be a pregnant teen? Whether that means condoms, education about ovulation/fertility, or hormonal birth control, no method is 100% effective at preventing pregnancy and/or preventing the spread of sexually transmitted infections (STIs). The only entirely effective way to avoid pregnancy and diseases is to abstain from sexual intercourse and contact (abstinence). For more information on birth control and natural family planning, please check out the topics below:

Abstinence
Natural family planning (NFP)/fertility awareness
Male condoms and female condoms
Withdrawal/”pull-out method”
Spermicide
Cervical cap and diaphragm
Hormonal birth control:
- pills
- shot/injection
- patch
- ring
- implant
- intrauterine device (IUD)
Non-hormonal copper IUD
Emergency contraceptives/”morning after” pill

Hormonal birth control (including the morning after pill) works in three different ways: (1) prevents ovulation/release of egg, (2) thickens cervical mucus, making it more difficult for sperm to travel through to reach an egg, and (3) makes implantation of a fertilized egg difficult by thinning the uterine lining. Ethical considerations mostly come into play with the third action – with the belief that life begins at conception, hormonal birth control technically could terminate a pregnancy in its earliest stages. So, as you make your choices about how to prevent pregnancy, consider these actions.

Want to Know More?

Teen Pregnancy Challenges
Healthy Teen Pregnancy
Week-By-Week Pregnancy E-Newsletter.

Compiled using information from the following sources:

1. Centers for Disease Control and Prevention (CDC): NCHS Data Briefing “Continued Declines in Teen Births in the United States, 2015.”

https://www.cdc.gov/nchs/data/databriefs/db259.pdf

2. Guttmacher Institute: Teen Pregnancy (United States).

https://www.guttmacher.org/united-states/teens/teen-pregnancy

3. Guttmacher Institute: “U.S. Teen Pregnancy, Birth, and Abortion Rates Reach the Lowest Levels in Almost 4 Decades.”

https://www.guttmacher.org/news-release/2016/us-teen-pregnancy-birth-and-abortion-rates-reach-lowest-levels-almost-four-decades

Supporting Pregnant and Parenting Teens

Pregnant and parenting teens often face challenges balancing their school, work, and home lives with being a new parent. Teen parents are at increased risk for dropping out of school, unemployment, poverty, mental health issues, and child care concerns. Ensuring that adolescent parents receive adequate social, emotional, medical, and academic support is essential to the parent and the baby’s future. On this page, find information on expectant and parenting teens in out-of-home care and ways to support them. Resources include State and local examples.

Addressing the Needs of Pregnant and Parenting Youth in Foster Care: A Primer on Interagency Collaboration for Children’s Bureau Grantees
Capacity Building Center for States (2019)
Explains the services offered to pregnant and parenting youth in out-of-home care by the John H. Chafee Foster Care Program for Successful Transition to Adulthood and the Adolescent Pregnancy and Parenting Program. This tip sheet provides strategies for using both programs together to improve outcomes for pregnant and parenting youth in out-of-home care.

Challenges, Benefits Found in Providing Home Visiting Services for Pregnant and Parenting Foster Youth
Chapin Hall (2021)
Presents the results of a study that shows adolescent parents in foster care needing additional support, and one way to provide this support is through community-based home visiting programs. Outcomes from these interventions show positive effects in the areas of parent-child attachment, child and maternal health and development, parenting skills, and social support.

Connecting the Dots: A Resource Guide for Meeting the Needs of Expectant and Parenting Youth, Their Children, and Their Families
Center for the Study of Social Policy (2019)
Offers information on interventions and services for expectant and parenting youth involved with the child welfare system to help improve parent and child well-being outcomes.

Helping Teen Parents and Their Children Build Healthy Futures
HealthyChildren. org (2017)
Discusses teen parenting, including how to prepare teens for parenthood, the importance of getting young fathers involved, what to expect in the future, and more.

Leveraging the Family First Prevention Services Act for Older Youth: Prevention Provisions
American Bar Association (2019)
Explains provisions of the Family First Prevention Services Act that will impact older youth, including the use of title IV-E funds to provide services to youth in foster care who are pregnant or parenting.

What Are Some Strategies for Supporting Pregnant and Parenting Teens in Foster Care?
Casey Family Programs (2018)
Examines challenges faced by child welfare agencies that are working with pregnant and parenting teens in foster care and discusses effective programs for this population that aim to ensure the healthy development of the teen parent and the child.

When Your Teen is Having a Baby
KidsHealth. org
Provides information for parents whose teens are pregnant or recently became parents. The website includes information on what parents may be feeling, what teens may be feeling, and special considerations for pregnant teens.

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For Young Parents
ShiftNC
Shares information on the education and medical rights of pregnant and parenting teens in North Carolina who are currently in school. The resource also offers information on where teen parents can access support resources such as, finding child care, finding support groups, financial benefits, and recommendations to stay healthy.

Overview of Policies and Considerations for Case Managers Working With Foster Youth Who Are Parenting
Florida Institute for Child Welfare
Presents a guide for child welfare caseworkers in Florida on working with pregnant or parenting youth who are transitioning out of the foster care system.

Parent Connection
Family Services
Highlights the Parent Connection program in Wisconsin designed to support teen parents and their children that offers the following programs, Parents as Teachers for teen parents, teen parent mentoring program, fatherhood programs, and young parent group and workshops.

Pregnant and Parenting Youth
Washington State Department of Children, Youth & Families (2019)
Provides guidance to child welfare workers engaged with expectant or parenting teens to ensure a successful transition to adulthood.

Providing Home Visiting to Parents in Care: The Illinois Pregnant and Parenting Youth in Care Home Visiting Pilot Experience
Children’s Home & Aid
Describes a home visiting program in Illinois that serves pregnant and parenting youth in care and links to a full report on the outcomes of the pilot program.

Teen Parenting
Los Angeles County Department of Children and Family Services
Offers information on supports for pregnant and parenting teens, especially those involved with child welfare services, in L.A. County, California.

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Teenage pregnancies

Magnitude of the problem

Approximately 21 million pregnancies occur each year among girls aged 15-19 in developing countries, and approximately 12 million of them end in childbirth ¹ . At least 777,000 births in developing countries registered among adolescent girls under the age of 15 ² .

An estimated 11.6% decline in adolescent birth rates worldwide over the past 20 years ⁵ . At the same time, there are large differences in this indicator between regions. For example, the adolescent birth rate is 7.1 in the countries of East Asia, and in the countries of Central Africa it reaches 129.5 ⁵ .

There are also huge differences within regions. In 2018, the total adolescent birth rate in Southeast Asia was 33 ⁶ . At the same time, the value of this indicator fluctuated from 0.3 in the Democratic People's Republic of Korea Republic to 83 in Bangladesh ⁵ .

Huge differences exist even within countries. For example, in Ethiopia, the total fertility rate ranges from 1.8 in Addis Ababa to 7.2 in the Somali region, with the proportion of women aged 15-19 years having a first birth ranging from 3% in Addis Ababa to 23% in Afar district ⁷ .

Although the adolescent birth rate is estimated to be declining worldwide, the actual number of adolescent births is not declining due to a large – and in some parts of the world increasing – the number of young women aged 15-19years ⁸ . The largest number of births occur in East Asia (95,153) and West Africa (70,423) ⁹

Overview

Teenage pregnancy is a global problem affecting high, middle and low income countries. Globally, however, teenage pregnancy is more likely to occur in marginalized populations and is often due to poverty, lack of education and employment opportunities ¹⁰ .

Several factors contribute to the occurrence of teenage pregnancies and births. In many societies, girls are forced to marry early and have children ^11,12,13 . In the least developed countries, at least 39% of girls go married before the age of 18, and 12% before the age of 15 ¹⁴ . In many places, girls choose to become pregnant due to limited educational or employment opportunities. In such societies, motherhood importance is attached to which marriage or union and childbearing may be the best limited option available ¹² .

Adolescents who would like to avoid pregnancy may be unable to do so due to lack of knowledge and misconceptions about where they can get contraceptives and how to use them15. Teenagers face barriers in access to contraceptives, including restrictive laws and policies regarding the provision of contraceptives based on age or marital status, biased attitudes by healthcare professionals and/or reluctance to recognize the sexual health needs of adolescents, and due to adolescents' own inability to access contraceptives as a result of lack of knowledge, lack of transportation and financial constraints. In addition, teenagers may not have the capacity or discretion to ensure the correct and consistent use of contraceptive methods. There are at least 10 million unwanted pregnancies among adolescent girls every year in developing countries aged 15-19years ¹ .

Another cause of unwanted pregnancies is sexual violence, which is widespread with over a third of girls in some countries reporting that their first sexual experience was coerced ¹⁶ .

Health implications

Early teenage pregnancy has serious health implications for teenage mothers and their babies. Complications of pregnancy and childbirth are the leading cause of death among girls aged 15-19years worldwide, with low- and middle-income countries accounting for 99% of the world's maternal deaths among women aged 15-49 ³ . Adolescent mothers (aged 10-19 years) are at higher risk of eclampsia, postpartum endometritis and systemic infections than women aged 20-24 years ⁴ . In addition, adolescent girls aged 15-19 experience approximately 3.9 million unsafe abortions each year, contributing to maternal mortality, morbidity and long-term ill health ¹ .

Childbirth at an early age increases the risk for both mothers and their newborns. Children born before age 20 are at higher risk of low birth weight, prematurity and severe neonatal illness ⁴ . In some countries, frequent pregnancy at a young age is of great concern, as it creates additional health risks for both mother and child ¹⁷ .

Socio-economic impact

Social consequences for unmarried pregnant adolescents may include stigmatization, social rejection or violence from partners, parents and peers. Girls who become pregnant before the age of 18 are more likely to experience marital or partner violence ¹⁶ . Pregnancy and childbirth during adolescence often causes girls to drop out of school. Although efforts are being made in a number of countries to allow them to return to work after the birth of a child, this may seriously limit their future educational and employment opportunities ¹⁹ .

WHO activities

In the early stages of achieving the Millennium Development Goals, prevention of teenage pregnancy and its associated mortality and morbidity, as well as prevention of HIV infection and HIV-related mortality among adolescents and young people, was not given sufficient attention due to presence of competing priorities ²⁰ . During this period, WHO collaborated with partners to raise awareness of adolescent issues, expand the body of evidence and the epidemiological basis for action, including the development of WHO guidance on the prevention of early pregnancy and adverse outcomes in adolescents in developing countries ²¹ , developing and testing program support tools, capacity building and pilot initiatives in a small but growing number of countries that recognize the need to address adolescent health concerns. As the world moves towards achieving the Sustainable Development Goals, adolescents are placed at the center of the global health and development agenda ²¹ .

While WHO continues its advocacy, evidence-gathering, tool development and capacity-building efforts, the focus is now on scaling up activities at the country level. WHO is working closely with partners within and outside the United Nations system to contribute to efforts around the world to prevent children from becoming wives and mothers. WHO's work is aimed at expanding the evidence base for action and supporting the use of evidence in well-designed and effectively implemented programs at the national and subnational levels. For example, WHO is collaborating closely with UNICEF, UNFPA and UN Women on a global program to accelerate action against child marriage ²² . WHO is also collaborating with the Family Planning 2020 global partnership, which aims to ensure that 120 million additional women and girls have access to contraception by 2020.

Nongovernmental organizations play a leading role in preventing teenage pregnancy in many countries carrying out bold and innovative projects. The number of successful national programs led by governments, for example in Chile, Ethiopia and the United Kingdom, is currently small but growing ²³ . These countries show what can be achieved with sound scientific knowledge combined with strong leadership, management and perseverance. They set an example and inspire other countries to urgently achieve realistic goals and take necessary actions.

Bibliography

(1) Darroch J, Woog V, Bankole A, Ashford LS. Adding it up: Costs and benefits of meeting the contraceptive needs of adolescents. New York: Guttmacher Institute; 2016.

(2) UNFPA. Girlhood, not motherhood: Preventing adolescent pregnancy. New York: UNFPA; 2015.

(3) Neal S, Matthews Z, Frost M, et al. Childbearing in adolescents aged 12–15 years in low resource countries: a neglected issue. New estimates from demographic and household surveys in 42 countries. Acta Obstet Gynecol Scand 2012;91: 1114–18. Every Woman Every Child. The Global Strategy for Women`s, Children`s and Adolescents` Health (2016-2030). Geneva: Every Woman Every Child, 2015.

(4) WHO. Global health estimates 2015: deaths by cause, age, sex, by country and by region, 2000–2015. Geneva: WHO; 2016.

(5) Ganchimeg T, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. bjog. 2014;121(S Suppl 1):40-8.

(6) UN DESA, Population Division. World Population Prospects: The 2017 Revision, DVD Edition. New York: UN DESA; 2017 UNDESA, Population Division. World Population Prospects, the 2015 Revision (DVD edition). New York: UNDESA, Population Division, 2015.

(7) UNFPA. Adolescent pregnancy: A review of the evidence. New York: UNFPA, 2013.

(8) UN DESA, Statistics Division. SDG Indicators: Global Database. New York: UN DESA: 2017.

(9) Every Woman Every Child. The Global Strategy for Women`s, Children`s and Adolescents` Health (2016-2030). Geneva: Every Woman Every Child; 2015.

(10) UNICEF. Ending child marriage: Progress and prospects. New York: UNICEF, 2013

(11) WHO. Global and regional estimates on violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva: WHO; 2013.

(12) WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Trends in maternal mortality: 1990 to 2015: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: WHO; 2015. Filippi V, Chou D, Ronsmans C, et al. Levels and Causes of Maternal Mortality and Morbidity. In: Black RE, Laxminarayan R, Temmerman M, et al., editors. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016 Apr 5. Chapter 3.

(13) Kozuki N, Lee A, Silveira M, et al. The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality: A meta-analysis. BMC Public Health 2013;13(Suppl. 3):S3.

(14) World Bank. Economic impacts of child marriage: Global synthesis report. Washington, DC: World Bank; 2017.

(15) WHO. Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries. Geneva: WHO; 2011.

(16) Raj A, Boehmer U. Girl child marriage and its association with national rates of HIV, maternal health, and infant mortality across 97 countries. Violence Against Women 2013;19(4).

(17) WHO. Making health services adolescent friendly: Developing national quality standards for adolescent friendly health services. Geneva: WHO; 2012.

(18) WHO. Global Accelerated Action for the Health of Adolescents (AA-HA!): Guidance to support country implementation. Geneva: WHO; 2017.

(19) WHO. Global standards for quality health care services for adolescents. Geneva: WHO; 2015.

(20) WHO. Core competencies in adolescent health and development for primary care providers: including a tool to assess the adolescent health and development component in pre-service education of health-care providers. Geneva: WHO; 2015.

(21) UNESCO. International Technical Guidance on Sexuality Education: An evidence-informed approach for schools, teachers and health educators. Paris: UNESCO; 2009.

(22) UNESCO. Early and Unintended Pregnancy & the Education Sector: Evidence Review and Recommendations. Paris: UNESCO; 2017.

(23) United Nations General Assembly. Resolution adopted by the General Assembly on 25 September 2015: Transforming our world: the 2030 Agenda for Sustainable Development. New York: United Nations; 2015.

A service to help underage mothers has been created in St. Petersburg

You can talk about morality and morality as much as you like, but here is a fait accompli: the pregnancy of a minor. Where can a Petersburg girl who finds herself in such a difficult situation turn? First of all - to the City Consultative and Diagnostic Center for Children "Yuventa" (reproductive health). This center, which has already celebrated a quarter of a century since its birth and has become the country's first center for the protection of reproductive health of adolescents, provides a wide range of medical, social and psychological assistance. Obstetricians-gynecologists, psychotherapists, psychologists, social work specialists work with the girl. By the way, stereotypes about the huge number of abortions among minors are still strong in society. This hasn't been the case for a long time. "Adolescent" abortions in the general structure occupy only one percent. And the “peak in abortions” falls on women aged 30-35, that is, much more conscious.

If a young woman decides to continue the pregnancy, she is registered with the antenatal clinic at the place of residence. But there are additional opportunities: maternity hospital N 10 specializes in managing pregnancy and childbirth.

- When a pregnant woman first comes to us, we do our best to gradually develop a sense of security and joy from the upcoming motherhood. Only properly trained professionals conduct such a pregnancy. Depending on the situation, a pregnant woman may be offered either day care if she continues to attend school, or inpatient antenatal care. Consultations of a psychologist, a social worker and a lawyer help to understand the social aspects of future motherhood. Girls attend physiotherapy exercises, which take place in the maternity hospital's gym using the most modern techniques. This is fitball, and Pilates, even yoga for pregnant women. When childbirth begins, the girl is taken to a separate ward "Little Mom". If she wants, any person close to her can be with her. In the maternity hospital, everything is done to ensure that after the birth, the young mother goes home with her child - happy and healthy, - explains Lada Ivanova, the head physician of the maternity hospital. - Prevention of social orphanhood is one of our main tasks. In difficult situations, we always get help from the Commissioner for Children's Rights in St. Petersburg, Anna Mityanina. For many years we have not a single refusal of a child.

If the mother and child are accepted by the family, everything is fine. And if not? Or does the mother have no housing at all - for example, she is from an orphanage, but she has not yet received separate housing as required by law? Such mothers, who turned out to be unnecessary both to relatives and to the father of the child, will always be accepted by the department of social rehabilitation "Little Mom", which is a division of the St. Petersburg State Budgetary Institution "Crisis Center for Women", subordinate to the Committee on Social Policy of St. Petersburg. By the way, St. Petersburg was the first to open such a division in the country. Currently, the department is designed for 29places, and this is enough for the city. Young mothers with children are here, depending on the situation, from six months to a year (but the period can be extended if necessary). How effective assistance is can be understood from one fact: in the 22 years of the unit's operation, there have been only nine cases of child abandonment. Marina Grechishkina, director of the Crisis Center, told RG about this. Even young mothers who find themselves in a difficult life situation do not refuse twins. The age of the wards is from 13 to 18 (in exceptional cases they can take a little older).

Conditions at "Little Mama" are excellent. Each girl has her own room with good furniture, a changing table, a crib. Shared living room with playpen for kids and TV for moms. Everything is arranged in such a way that a girl who has experienced painful (both physiologically and psychologically) pregnancy and childbirth can relax, gain strength and, of course, get used to her child. Young mothers are provided with five meals a day. Organized round-the-clock duty of specialists to work with families and medical staff.

At first, girls can do practically nothing. Don't swaddle the baby, don't feed him. But time goes by, and you look - yesterday's helpless girl can already quite cope with the duties of a mother and mistress of her small house.

"Little Mom" assists in solving the housing problem. There are no special problems with orphans: upon reaching adulthood, they relatively quickly receive from the city not even a room in a communal apartment, but a separate good apartment. It is more difficult with girls-mothers from dysfunctional families. It is often very difficult to allocate meters to a mother with a child if many people live in the apartment without it.