Teen Pregnancies: Crisis in Schools

We will see an immediate increase in teen pregnancies in schools as States legislate against abortion. Specialties School Article


Teen Pregnancies: Crisis in Schools

Public health nurses' roles are changing.  Young pregnant girls attending schools will need advocates. School nurses and counselors will need up-to-date information and resources.

We will see an immediate increase in teen pregnancies in schools as states legislate against abortion. Accurate rates of abortions are not available. Most statistics are several years behind, plus they do not include chemically induced abortions. The Charlotte Lozier Institute for research reports over 50% are now chemically induced.1 Worldwide, only 17.5% of women 15-19 years old kept their babies.2

Early Pregnancy Problem in Teens

Teens can experience many issues during pregnancy3

  • They may fail to recognize the signs of pregnancy.
  • They could be in denial.
  • They fear body image changes.
  • They are afraid to tell their parents.
  • They delay in getting a proper pregnancy diagnosis.
  • They often use an over-the-counter product to determine pregnancy. 
  • They lack prenatal care.
  • They often lack the cognitive skills to problem solve.
  • They may lack the guidance needed to plan for their future adequately.
  • They often drop out of school.
  • They fail to make realistic expectations of their partner’s future role4.

Be on Guard for Self-Harm

Many teen girls lack the cognitive skills to focus forward. They cannot see a way to solve their problems. They are at high risk for self-harm. They need to receive guidance with understanding. They need emotional help. Emphasize abortions are a medical procedure, and they could put their life at risk. School counselors can be a good resource for emotional issues5

Students also need to be encouraged to continue their education.

Late Pregnancy Problems in Teens

Pregnancies in teenage women are classified as high risk by The American College of Obstetricians and Gynecologists.5,6

  • They most often deliver before 37 weeks. 
  • Adolescents under 16 are twice as likely to have low birth weight babies.
  • (< 5.5 pounds).
  • Their babies can experience severe respiratory complications.
  • They are also at elevated risk for cerebral palsy.
  • Their baby often has chronic cognitive deficits.
  • Chronic problems can contribute to the baby being abused or neglected.
  • These babies are at a higher risk for infant mortality.7

Limit exposure to tobacco smoke

School nurses should educate pregnant teens on the dangers of smoking while pregnant. Many of these girls are classified as risk-takers. They may be tobacco smokers or use marijuana. Improved coping skills need to be taught to discourage smoking. There is a connection between maternal smoking and perinatal loss due to premature ruptured membranes. Smoking is also associated with low birth weights.8

SIDS (sudden infant death syndrome) increases when babies are exposed to secondhand smoke.3 Many women quit smoking during their pregnancy. After delivery, the stress of life changes can trigger them to return to smoking. After delivery, clients need to be reminded about their baby's secondhand smoke risks. 

State Laws Need to Change for Sex Education Classes

We need to improve sex education in schools to reduce pregnancies in our young. Today, it is obvious teens are sexually active. National statistics predict one out of every four girls will have had an abortion before graduation. It is time for a change.

When I worked as a school nurse, I was surprised to discover our local sex education classes were 100% focused on abstinence. There was a state law requiring the curriculum to emphasize abstinence. Our state board of education approved all curricula for sex 'ED' of education. To revise the curriculum to include pregnancy prevention, the teachers had to “prove” that the majority of class time is spent on abstinence. The instructor excluded pregnancy prevention from their presentations to avoid litigation.  At that time, every state had laws that required an emphasis on abstinence with no provisions for contraceptives.

Research shows the best method for preventing teen pregnancy is a combination of education with access to contraceptives.9

The CDC recommends students receive advice from trusted authorities like doctors and school counselors.10

At that time, every state had laws that required an emphasis on abstinence. 

Due to recent changes, I can see a crisis quickly developing with our school-age girls. We need to do a better job of educating our children and providing for their current needs.

Resources for Teen Pregnancy

Public health nurses need to know the resources available in their area. Although community resources may be limited, they can change quickly. 

Planned Parenthood is shifting its services to better provide for the current needs. They offer the abortion pill where it is legal and can provide the morning-after prescription.

Since the psycho-social consequences of a child born to young mothers are less than optimal, adoption should be encouraged. Agreements can be made early to assist in healthcare costs. 


This crisis in teen pregnancy will happen quickly. Public health nurses need to be advocates with accurate knowledge, current resources, and the awareness that self-harm is possible. Sex education classes need to include pregnancy prevention.


1Charlotte Lozier Institute Abortion Reporting: Toward a Better National Standard

2WHO: Adolescent pregnancy

3Pregnancy in Special Populations, Maternal, Neonatal, and Women’s Health Nursing, Texas, 2002, Thompson Learning Inc, CHAPTER 19, pp 544-545.

4Healthline Media: Teenage Pregnancy

5Healthline Media: What Are the Effects of Teenage Pregnancy?

6ACOG: Having A Baby

7Healthline Media: What should you expect during prenatal visits?

8ACOG: Having A Baby, Frequently Asked Questions

9The Cochrane Collaboration: Interventions for preventing unintended pregnancy among adolescents

10CDC: Preventing Pregnancies in Younger Teens infographic


Best For Teens: 5 Organizations That Help Teenage Pregnancy

Planned Parenthood Stands for Care

Healthy Teen Network

Covenant House

Generation Her

Birthright International

Julie RN retired CDE specializes in RN Diabetes Educator, outpatient clinic, public health.

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Specializes in CNA telemetry progressive care ICU.

Love this was a perfect mix of information well done

Julie RN retired CDE

1 Article; 4 Posts

Specializes in RN Diabetes Educator outpt clinic, public health.

Thank you.

I've been there and I'm sure this will become a crisis.

I would expect (predict) that there will be girls trying to abort on school property.  It's a nightmare.

Plan Parenthood recently reported that over 20% of girls get pregnant before graduation.  Many of them drop out of school to never return.  Think of how many lives will be impacted. 

Specializes in School nursing.

Which state are you in that does abstinence only education?

I'm a school and health teacher - proud comprehensive sex educator for 9 years! I love teaching it and giving students information to have power in their own bodies. 

I would also note early pregnancy detection is key because this means this student has options on the table for some states (like mine, I'm in MA) that mean that they don't have to continue the pregnancy (and the earlier they are aware, the more options they have). But that can require parental consent, depending on the age. 

But prevention is key, which means students need access and information about contraceptives, including access to free condoms. I can give them out to grades 7-12, the policy that we do so in our student handbook. I wish every school did.

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