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The purpose of this paper is to assess the situation of accessibility to reproductive health rights, and the conditional factors of accessibility to such rights of adolescents.

A qualitative method was used to extract information from 80 informants. Data were collected through in-depth interview, focus group discussion, observation, data recording, audio recording and the review of related documents during August to October 2016.

Adolescents had not accessed to their right on informing of their decision making; information and education; health; confidentiality and privacy; and treating with equity and no discrimination. Also, the conditional factors influenced to the accessibility on such rights were lacking of knowledge on reproductive health and negative attitude toward this matter among the people concerned. There were still no regulations or policies on the performance of authority agencies and the factors on social dimensions, traditions, customs, sexual culture and religion.

The findings from this study would be a help to promote the accessibility for adolescents to reproductive health rights under the Prevention and Solution of Adolescent Pregnancy Problem Act, B.E. 2559 (2016) specific on standard criteria reproductive health services from hospitals and the involvement from Ministry of Education for the development of sex life skill and reproductive health for the teacher.

The purpose of this paper is to assess the effect of delaying first pregnancy in reducing burden of unintended pregnancy (UP) among married adolescent girls in urban slums of Bangladesh.

This cross-sectional survey was conducted among 783 married adolescents in five urban slums of Bangladesh during January 2013–January 2014.

Half of the respondents’ first pregnancy was reported as unintended. Of the respondents, 58 percent with no school education had experienced UP which was 38 percent among respondents with eight year’s education. Respondents who did not willingly agreed to their marriage experienced more UP (61 percent) than those who were agreed/got married by their own choice (51 percent). Respondents having five years of age difference with their husbands experienced more UP (58 percent) than those with ten years of age difference (46 percent). Respondents aged 14 years at first conception experienced 63 percent UP, while the respondents aged 18 years had 35 percent UP experience. Of the respondents, 66 percent who became pregnant within one year of marriage reported their pregnancy as unintended which was 29 percent among those who delayed their first pregnancy for three years.

Significant association was observed between pregnancy intention with respondents’ educational status (p=0.03), age difference with husbands (p=0.02), age at first conception (p<0.01) and delaying first pregnancy (p<0.001).

As numerous scholars have noted, the law takes a strikingly incoherent approach to adolescent reproduction. States overwhelmingly allow a teenage girl to independently consent to pregnancy care and medical treatment for her child, and even to give up her child for adoption, all without notice to her parents, but require parental notice or consent for abortion. This chapter argues that this oft-noted contradiction in the law on teenage reproductive decision-making is in fact not as contradictory as it first appears. A closer look at the law’s apparently conflicting approaches to teenage abortion and teenage childbirth exposes common ground that scholars have overlooked. The chapter compares the full spectrum of minors’ reproductive rights and unmasks deep similarities in the law on adolescent reproduction – in particular an undercurrent of desire to punish (female) teenage sexuality, whether pregnant girls choose abortion or childbirth. It demonstrates that in practice, the law undermines adolescents’ reproductive rights, whichever path of pregnancy resolution they choose. At the same time that the law thwarts adolescents’ access to abortion care, it also fails to protect adolescents’ rights as parents. The analysis shows that these two superficially conflicting sets of rules in fact work in tandem to enforce a traditional gender script – that self-sacrificing mothers should give birth and give up their infants to better circumstances, no matter the emotional costs to themselves. This chapter also suggests novel policy solutions to the difficulties posed by adolescent reproduction by urging reforms that look to third parties other than parents or the State to better support adolescent decision-making relating to pregnancy and parenting.

Adolescent pregnancy stands as a societal challenge, compelling young individuals to prematurely discontinue their education. Conversely, an expansion of high school education can potentially diminish rates of adolescent pregnancy, given that educational attainment stands as the foremost risk factor influencing sexual initiation, the use of contraceptive methods during initial sexual encounters and fertility. The aim of this paper is to analyze the impact of the implementation of the public educational policy introducing full-time schools (FTS) for high schools in the state of Ceará, Brazil, on early pregnancy rates.

Using the difference-in-differences method with multiple time periods, we measured the average effect of this staggered treatment on the treated municipalities.

The main result indicates a reduction of 0.849 percentage points in the teenage pregnancy rate. Concerning dynamic effects, the establishment of FTS in treated municipalities results in a 1.183–1.953 percentage point decrease in teenage pregnancy rates, depending on the timing of exposure. We explored heterogeneous effects within socioeconomically vulnerable municipalities, yet discerned no impact on this group. Rigorous tests confirm the robustness of the results.

This paper aims to contribute to: (1) the consolidation of research on the subject, given the absence of such research in Brazil to the best of our knowledge; (2) the advancement and analysis of evidence-based public policy and (3) the utilization of novel longitudinal data and methodology to evaluate adolescent pregnancy rates.

Around one in five girls in Kenya, aged 15 to 19 years old are either pregnant or have given birth. Of 47 counties, adolescent pregnancy is highest in Narok, where about 40% of girls aged 15 to 19 years old have begun childbearing. This study aims to explore drivers to sexual activity, access to sexual and reproductive health (SRH) services and barriers to contraceptive use among adolescents in Narok County, Kenya to inform the design of SRH interventions and safeguard young people’s rights to sexual health.

A cross-sectional mixed methods study was conducted in December 2019. Quantitative data were collected through structured questionnaires among girls aged 15 to 19 years old who were either pregnant or had given birth and those who had not and boys aged 15 to 19 years old. Qualitative data were collected through focus group discussions with adolescent girls and boys and through structured key informant interviews with parents, community leaders and health workers.

The mean age at first sexual intercourse for both genders was 15 years. While the majority of girls and boys knew where to access SRH services, few used contraception during their last sexual activity. There was no significant difference in the condom or other contraceptive methods use between girls who had begun child bearing and those who had not (p = 0.549 and p = 0.563, respectively). Key drivers for sexual activity among young people were poverty and peer pressure. Cultural practices such as female genital mutilation and early marriage contributed to early sex. Community attitudes toward contraception discouraged young people from taking up contraceptives.

This mixed methods study explores the drivers of adolescent pregnancy in Narok, Kenya, the county with the highest rates of adolescent pregnancy; twice the national pregnancy rates. Understanding the drivers of pregnancy and the underlying human rights violations will help policymakers and health leaders to design interventions which will improve outcomes.

Purpose – This chapter describes the “Teen Alliance for Prepared Parenting–SPIN” (TAPP-SPIN) unwanted pregnancy prevention intervention for pregnant/parenting adolescents and their adult parent(s) in primarily African American and Latino communities in the District of Columbia (DC).

Methodology/approach – We augment TAPP services with SPIN Video Home Training (VHT)11Called Video Interaction Guidance in the United Kingdom., an intervention to build Parent–Child Connectedness (PCC). SPIN VHT aims to (1) improve adult–teen interaction to strengthen the supports teen parents need to continue to progress toward life success and (2) build the teen's ability to engage in warm, attuned, and skillful parenting of her child.

SPIN VHT uses a guided, strengths-based analysis of videotaped parent–child interactions to identify examples of the parent's competencies that support the child's well-being and optimal development. Collaborative review of an edited collection of video helps guide participants to integrate what has been effective into their daily patterns of interaction and communication.

Findings – The randomized experiment compares TAPP to TAPP-SPIN with a sample of 400 15- to 18-year-olds and their parents (dyads). After a baseline survey, we collect follow-up data at 6, 12, 18, and 24 months post-baseline. We collect outcome data on health information-seeking, pregnancy prevention communication, cognitions related to parenting and subsequent pregnancy, improved parenting, and clinical outcomes including subsequent pregnancy.

Social implications – The TAPP-SPIN intervention aims to advance the state of pregnancy prevention research in a population facing multiple health disparities.

Originality/value of chapter – This chapter describes the first ever randomized controlled trial of the SPIN approach to improving PCC.

This paper aims to evaluate the effectiveness of nutrition interventions conducted in pregnant adolescents and their implications for future research.

The papers in this systematic study were searched through PubMed, PMC, the Cochrane Library (Trial), ScienceDirect and Google Scholar that were published from 2000 to 2019. An experimental study using a randomized controlled trial (RCT) or non-RCT among pregnant adolescents aged 10-19 years were inclusion criteria for this study. While exclusion criteria were studies published before 2000, non-experimental study and non-English-language studies.

A total of 14 studies were identified in this review. Six studies provided interventions in the form of nutrition and health education and seven studies provided interventions in the form of nutritional supplementation (calcium, vitamin D, iron-folate, lipid-based nutrient supplements and multi-micronutrient powder. One study provided dietary intervention. The interventions in pregnant adolescents in the form of education and nutritional supplementation effectively increased the knowledge and nutrition of pregnant adolescents and decreased low birth weight (LBW) and premature birth. The impact on birth outcomes was still quite diverse. Some of the studies in this review were conducted without a comparison group, a small sample size and conducted in health-care facilities.

This systematic review implies a future nutrition intervention for pregnant adolescents is needed to improve nutritional status of pregnant adolescents and birth outcome. Future research using double blind RCT method with bigger sample size and various nutritional outcome are wide open to be developed.

Interventions in pregnant adolescents effectively increased the knowledge and nutrition of pregnant adolescents and decreased LBW and premature birth. The program implementation in the community needs to be improved so that the effectiveness of the program remains optimal as in healthcare facilities.

Pregnancy is a time of great physiological change. For this reason, the diet of the mother needs to be tailored and carefully managed. For teenagers, the physiologic adjustments are two‐fold; adolescent growth and physiological changes of pregnancy both need to be taken into consideration. The purpose of this paper is to establish whether pregnant teenagers change their diet after conception and which nutritional adjustments are most likely to be made.

In total, 40 closely‐matched Caucasian participants (20 pregnant and 20 non‐pregnant) were recruited from Wythenshawe Hospital, south Manchester and a local high school within the same district. Each participant was asked to complete a background information questionnaire and four‐day food record diary.

Study findings indicate that the diet of pregnant teenagers are substantially better than that of non‐pregnant adolescents. With the exception of vitamin D, intakes of all nutrients are higher in pregnant adolescents compared to non‐pregnant teenagers (p < 0.05), particularly calcium and iron (p < 0.01). Although under‐reporting must be taken into consideration, the diets of both pregnant and non‐pregnant teenagers appear to be deficient in folate and iron. Nutrition interventions are required to improve the diet of adolescents and reinforce the diet of pregnant teenagers.

Although care is taken to exclude incomplete food diaries, a degree of under‐reporting must be taken into consideration when interpreting these findings.

This appears to be the first UK study to compare the dietary habits of pregnant and non‐pregnant adolescents.

The primary aim of this chapter is to explore stigmatization, stress, and coping among adolescent mothers and to identify positive coping mechanisms that not only resist stigmatization but also generate positive affect.

Fifty-two pregnant and parenting adolescents in an urban county in the Midwestern United States were recruited to participate. A journaling tool was developed and used to allow participants to express their thoughts and concerns in a real-time, reflexive manner. Data were coded at different “nodes” or themes. Concepts, such as stigma, stress, strength, and empowerment were operationalized into key words and “themes” based on previous published literature. Key phrases were used to code the journaling data.

Adolescent mothers used positive reappraisal of life circumstances to create a positive self-image and resist the stress of stigma and parenting. Overcoming stereotypes and success in parenting were reappraised as “strength,” which allowed the young women to feel empowered in their caregiving role.

The chapter also contributes to the sociological literature on positive coping responses to stigma and stress. Indeed, very few studies have employed the sociological imagination of pregnant and parenting adolescents by describing not only their lives but also seeking their understanding and explaining their lives sociologically. This chapter also has direct implications for several health care providers, including nurses and social workers. For example, nurses and social workers are a vital part of the healthcare team for pregnant and parenting adolescents, and they often serve as the link between the adolescent, her family and significant others, and healthcare and social service agencies.

This chapter described the mechanisms that adolescent mothers use to cope with stress with a focus on how caregiving generates positive affect through the voices of these young mothers themselves. This chapter contributed to the sociological literature on stress and coping. In particular, our findings were also in line with the work of sociologist Antonovsky’s Sense of Coherence concept. SOC is a global measure that indicates the availability of, and willingness to use, adaptive coping resources as a key variable in maintaining health.

The “moral panic” generated by public response to teenage mothering marginalizes the experiences of young women as mothers, with adolescent pregnancy viewed as catastrophic for young women, their families, and society. In this analysis, focused on the experience of a group of teen women from the city of São Paulo, Brazil, the author explores how the integration of a maternal identity, shaped by Brazilian norms of “good motherhood,” with previously existing identities might lead to new aspirations and ambitions for the future or to hopelessness and despair.

Visions of the future were shaped by individual women’s structural circumstances and fell into four rough groups. Well-established adult women expressed their maternal identity through personal ambition, revealing confidence in their ability to provide “the best” for their children. Some adolescent mothers were fortunate enough to be buffered by family resources so that optimistic objectives for the future that pre-dated the pregnancy remained fairly attainable and were compatible with a “good mother” identity. For teens from less well-off families, motherhood resulted in a new-found determination to succeed in school and work, in line with ideals of Brazilian “good mothering” that focus on working hard to benefit one’s children. Women from the poorest households could or would not conjure a vision of the future, faced with the overwhelming challenges of their circumstances. The detailed, longitudinal qualitative data analyzed here reveal how the construction of maternal identity and visions of the future among adolescent mothers are shaped by the embodied experience of motherhood and pre-existing structural forces.