Editing Teenage pregnancy (section)

===Lack of contraception===
{{main|Birth control}}

Adolescents may lack knowledge of, or access to, conventional methods of preventing pregnancy, as they may be too embarrassed or frightened to seek such information.<ref name="pollingdata"/><ref name="britsexed">Slater, Jon. (2000). "[https://web.archive.org/web/20070703000657/http://www.unesco.org/courier/2000_07/uk/apprend.htm Britain: Sex Education Under Fire]." ''The UNESCO Courier'' Retrieved 7 July 2006.</ref> Contraception for teenagers presents a huge challenge for the clinician. In 1998, the government of the UK set a target to halve the under-18 pregnancy rate by 2010. The Teenage Pregnancy Strategy (TPS) was established to achieve this. The pregnancy rate in this group, although falling, rose slightly in 2007, to 41.7 per 1,000 women.<ref>{{cite journal|author1=Adams, A. |author2=D'Souza, R.|year=2009|title= Teenage contraception|journal= General Practice Update|volume= 2|issue=6|pages= 36–39}}</ref>

Young women often think of contraception either as 'the pill' or condoms and have little knowledge about other methods. They are heavily influenced by negative, second-hand stories about methods of contraception from their friends and the media. [[Prejudice]]s are extremely difficult to overcome. Over concern about side-effects, for example [[weight gain]] and [[acne]], often affect choice. Missing up to three pills a month is common, and in this age group the figure is likely to be higher. Restarting after the pill-free week, having to hide pills, drug interactions and difficulty getting repeat prescriptions can all lead to method failure.<ref>{{cite journal|author1=Adams, A. |author2=D'Souza, R.|year=2009|title= Teenage contraception|journal= General Practice Update|volume= 2|issue=6|pages= 36–39}}</ref>

In the US, according to the 2002 [[National Survey of Family Growth]], sexually active adolescent women wishing to avoid pregnancy were less likely than older women to use contraceptives (18% of 15–19-year-olds used no contraceptives, versus 10.7% for women aged 15–44).<ref name=trusell&Wynn>National Surveys of Family Growth{{cite journal | vauthors = Trussell J, Wynn LL | title = Reducing unintended pregnancy in the United States | journal = Contraception | volume = 77 | issue = 1 | pages = 1–5 | date = January 2008 | pmid = 18082659 | doi = 10.1016/j.contraception.2007.09.001 | url = http://www.arhp.org/publications-and-resources/contraception-journal/january-2008 | access-date = 8 September 2008 | archive-date = 19 August 2018 | archive-url = https://web.archive.org/web/20180819115227/http://www.arhp.org/Publications-and-Resources/Contraception-Journal/January-2008 | url-status = dead | url-access = subscription }}</ref> More than 80% of teen pregnancies are unintended.<ref name=speidel>{{Cite journal | doi = 10.1016/j.contraception.2008.06.001| title = The potential of long-acting reversible contraception to decrease unintended pregnancy| journal = Contraception| volume = 78| issue = 3| pages = 197–200| year = 2008| last1 = Speidel | first1 = J. J. | last2 = Harper | first2 = C. C. | last3 = Shields | first3 = W. C. | pmid=18692608}}
</ref> Over half of [[unintended pregnancy|unintended pregnancies]] were to women not using [[contraceptives]],<ref name=trusell&Wynn /> most of the rest are due to inconsistent or incorrect use.<ref name=speidel /> 23% of sexually active young women in a 1996 ''[[Seventeen (American magazine)|Seventeen]]'' magazine poll admitted to having had [[Safe sex|unprotected sex]] with a partner who did not use a condom, while 70% of girls in a 1997 ''[[Parade (magazine)|PARADE]]'' poll claimed it was embarrassing to buy birth control or request information from a doctor.<ref name="pollingdata"/>

In 1995, the [[National Longitudinal Study of Adolescent Health]] surveyed 1,027 students in the US in grades 7–12 to compare the use of contraceptives among Whites, Blacks, and [[Hispanic]]s. 36.2% of Hispanics said they never used contraception during intercourse, compared to 23.3% of Black teens and 17.0% of White teens who did not use contraceptives during intercourse.<ref name="Sterling 2009 19–28"/>

In a 2012 US study, over 1,000 females were surveyed to find out factors contributing to not using contraception. Of those surveyed, almost half had been involved in unprotected sex within the previous three months. These women gave three main reasons for not using contraceptives: trouble obtaining birth control (the most frequent reason), lack of intention to have sex, and the misconception that they "could not get pregnant".<ref>{{Cite journal | pmid = 22555219| year = 2012| last1 = Biggs| first1 = M. A.| title = Unprotected intercourse among women wanting to avoid pregnancy: Attitudes, behaviors, and beliefs| journal = Women's Health Issues| volume = 22| issue = 3| pages = e311–8| last2 = Karasek| first2 = D| last3 = Foster| first3 = D. G.| doi = 10.1016/j.whi.2012.03.003}}</ref>

In a 2011 study for the [[Guttmacher Institute]], researchers found that from a comparative perspective, however, teenage pregnancy rates in the US are less nuanced than one might initially assume. "Since timing and levels of sexual activity are quite similar across [Sweden, France, Canada, Great Britain, and the US], the high U.S. rates arise primarily because of less, and possibly less-effective, contraceptive use by sexually active teenagers."<ref name="DJE">{{cite web|last=Darroch|first=Jacqueline E.|title=Teenage Sexual and Reproductive Behavior in Developed Countries: Can More Progress Be Made?|url=http://www.guttmacher.org/pubs/eurosynth_rpt.pdf|publisher=The Alan Guttmacher Institute|access-date=14 February 2011|author2=Jennifer J. Frost |author3=Susheela Singh }}</ref> Thus, the cause for the discrepancy between rich nations can be traced largely to contraceptive-based issues.

Among teens in the UK seeking an abortion, a 2007 study found that the rate of contraceptive use was roughly the same for teens as for older women.<ref>{{cite news| url=http://news.bbc.co.uk/1/hi/health/6279601.stm | work=BBC News | title=Teenage pregnancy myth dismissed | date=22 January 2007 | access-date=25 May 2010}}</ref>

In other cases, contraception is used, but proves to be inadequate. Inexperienced adolescents may use [[condom]]s incorrectly, forget to take [[combined oral contraceptive pill|oral contraceptives]], or fail to use the contraceptives they had previously chosen. [[Pearl index|Contraceptive failure rates]] are higher for teenagers, particularly poor ones, than for older users.<ref name=Besharov>{{Cite journal | doi = 10.1016/S0190-7409(97)00022-4| pmid = 12295352| title = Trends in Teen Sexual Behavior| journal = Children and Youth Services Review| volume = 19| issue = 5–6| pages = 341–367| year = 1997| last1 = Besharov | first1 = D. J. | last2 = Gardiner | first2 = K. N. | citeseerx = 10.1.1.673.5213}}</ref> Long-acting contraceptives such as [[intrauterine device]]s, subcutaneous [[contraceptive implant]]s, and contraceptive injections (such as [[Depo-Provera]] and [[combined injectable contraceptive]]), which prevent pregnancy for months or years at a time, are more effective in women who have trouble remembering to take pills or using barrier methods consistently.

According to ''Encyclopedia of Women's Health'', published in 2004, there has been an increased effort to provide contraception to adolescents via family planning services and school-based health, such as HIV prevention education.<ref name="Teen Pregnancy"/>

A 2025 study, using Swedish data, found that the introduction of the birth control pill could explain half of the decline in teenage pregnancy following its introduction.<ref>{{Cite journal |last=Ragan |first=Kelly Suzanne |date=2025 |title=The Power of The Pill: Evidence from Oral Contraceptive Sales* |url=https://academic.oup.com/ej/advance-article-abstract/doi/10.1093/ej/ueaf017/8026880?redirectedFrom=fulltext |journal=The Economic Journal |doi=10.1093/ej/ueaf017 |issn=0013-0133|url-access=subscription }}</ref>