Issue Brief Teen Pregnancy, Parenting, And Dating Violence

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Issue BriefNO. 8 JULY 2009DTeen Pregnancy, Parenting,And Dating Violenceating violence and teen pregnancy areforced to have sexual intercourse and about 60% of teensintricately linked.Research indicates thatwho are physically abused are also sexually assaulted byteen girls who are in abusive relationshipstheir partner.3 Overall, forced sexual intercourse wasare at a greater risk of becoming pregnant. Also, for manyhigher among females, 11.3 percent compared to 4.5teens, the violence and abusive behaviors begin orpercent of males, and many females become pregnant asincrease at the time that they become pregnant. At leasta result of being forced into sexual activity.4 Additionally,one fourth of adolescent mothers, and as many as 50-80abusers may otherwise coerce, threaten, or intimidatepercent, are in abusive relationships before, during or aftertheir partners into engaging in sexual activity. Teen victimstheir pregnancies.1Understanding and responding tomay also acquiesce to sexual intercourse to avoid ansome of the unique needs of those who are abused duringincident of physical violence. While these behaviors areand after pregnancy can greatly impact the services younot obviously violent or abusive, they also increase theprovide, as well as the health and safety of pregnant andlikelihood that an abused teen will become pregnant.parenting teens.Birth Control SabotageLinks Between Teen Dating Violence and TeenPregnancyTeens who are in abusive relationships are often unable toEvidence suggests that teens in abusive relationships aremay force or coerce their partners to have sex without aat a high risk of becoming pregnant. High school girlscondom, or may take away or hide their partner’s birthexperiencing dating violence were found to be 4 to 6 timescontrol pills. Anecdotal evidence suggests that manymore likely than their non-abused peers to have ever beenabusers believe that if a partner is on birth control shepregnant.2The following are some of the factors andmust be cheating and this message often coerces teendynamics in abusive relationships that contribute to thisgirls to stop taking birth control in an effort to appeasehigher rate of pregnancy.their partner. Some abusers intentionally keep theirnegotiate choices about sex and contraceptives. Abuserspartner pregnant is another form of control, since thisForced Sexual Activitymakes it more difficult for a woman to leave therelationship.For many teens, this is because one component of theabuse is sexual violence. According to the CDC, 7.8percent of teen students nationwide have been physicallyRisky Sexual Behavior

2 Teen Dating Violence Technical Assistance CenterIssue Brief No. 8 July 2009Teens in abusive relationships are also moreeffects on the mother and child. In addition,likely to engage in risky sexual behavior that canover one-half of teens in physically abusiveoften lead to pregnancy. These behaviorsrelationships10beinginjuredintheinclude having intercourse before age 15, notabdominal area.using a condom the last time of intercourse, andpregnant are also at a significant risk ofhaving 3 or more sexual partners in the previousdelivering their baby pre-term or delivering a5At least onefourth ofadolescentmothers are inabusiverelationshipsbefore, during,or after theirpregnancies.reportthree months. Teen dating violence victims areTeens who are abused whilelow birth weight baby.11also more likely to begin or increase use ofalcoholordrugs,andsubstanceabusefrequently leads to more sexual risk taking.6Unique Obstacles Experienced byTeen ParentsTeen parents in abusive relationships are facedOnset of Abusewith unique challenges in accessing help andAbuse often starts when a woman becomespregnant. Of women whose pregnancies wereintended, 5.3 percent reported abuse at time ofpregnancy, compared to 15.3 percent of womenwhose pregnancies were unplanned.7 Abusebegins at the onset of pregnancy for a variety ofreasons.An abuser may be jealous of thebaby , angry because the pregnancy wasunplanned or believes that the pregnancyservices. Some of these challenges include:Increased isolation:Abusers frequently isolate victims fromtheir family, and this may be especiallycommon when the victim is pregnant.Because of this isolation, pregnant teensoften have very limited support networks toreach out to should they attempt to leavefollowed too soon after the last pregnancy.8the relationship.Health ConcernsShame and embarrassment associatedIn general, pregnant teens are at a higher risk ofillness and death than their non-pregnant peersbecause of medical complications, ical abuse. They are at a higher risk thanpregnantadultsofdyingexperiencing seriouswhilepregnant,medical complications,such a premature delivery and pregnancyinducedhypertension,p re g n a n c y -re l a t e dandhealthhavingwith being a teen parent:Teens may already feel guilty about beingpregnantorhavingchildrenandconsequently be reluctant to seek services.For some teens, they may even believethat they deserve the abuse because theyare pregnant or parenting, or that serviceproviders will be less willing to help them.otherp ro b l e ms . 9Financial dependence on abusive partner:Experiencing physical abuse during pregnancyThe abusive partner may be providingposes an even greater threat to the well-being ofmoney for prenatal care or childcare, orboth the mother and the baby. Teens who aremay be looking after the child while theabused while pregnant are more likely to abusemother is in school or at work.alcohol or drugs and to receive inadequateThe teen may not want her abuser to beprenatal care, both of which can have damagingput in jail because that would cut off herTeen Pregnancy, Parenting, and Dating Violence

3 Teen Dating Violence Technical Assistance CenterIssue Brief No. 8 July 2009access to childcare or the money for food and“I noticed you have a number of bruises; didshelter for herself and her children.someone do this to you?”Financial burdens may also pose an obstacle“Do you feel safe when you are with yourfor the teen parent in trying to get custody ofdating partner?”children if she does not have a job, housing, orIf the teen answers “yes” to any ofadequate resources to support the children ontheher own.encourage the teen to talk about itquestionsprobingviolence,more. Validate the experiences sheFear of losing custody of children:is going through and connect her toA teen may be reluctant in reaching out to acommunity organizations in yourservice provider and disclosing abuse for fearareathat she will lose custody of her children,violence.especially if the abuser is an adult.If the teen answers “no” or doesn’tthataddressteendatingwant to open up about the abuse,be mindful of any clinical signs thatScreening and Responding to PregnantTeens in Violent Relationshipsmay indicate abuse, like injury toneck, torso, breasts, abdomen, orScreening for Abusegenitals;disorders, anxiety; a partner whofor abuse during the pregnancy and post partumRADARwasdevelopedbywill not leave the teen’s side or whotheis overly protective and answers onMassachusetts Medical Society to assess thesafety and well being of pregnant adolescents.Someteens will disclose violence to a health careprovider if they are asked about it. Interview theteen alone.A – Ask specific and direct questions in a caringand non-judgmental manner. Use language that isteen-friendly, and be aware of your body language.Prior to engaging with the teen about any abusivebehavior she may be experiencing, let the teenknow your role and responsibilities as a mandatedreporter.12 Some questions to ask are:“Have you ever been?”Teen Pregnancy, Parenting, and Dating ViolenceD – Document suspected informationbody map and record all pertinentphysical findings.Document teen’sexplanation for injuries, and write thename of the individual(s) who causedtheinjuries.Beawareofanymandatory reporting requirements asthey vary by state and profession.A – Assess the teen’s safety. Find out ifit is safe for the teento go home,school, and/or work.R–Reviewoptionsandprovidereferrals. If teen patient is in danger,“Are you in a relationship in which you havebeen physically hurt or threatened?”her behalf; substance abuse.about suspected dating violence. Use aRADAR ScreeningR – Routinely screen all pregnant teens.distresssuch as suicidal ideation, eatingProviders who interact with teens should screenperiod.psychologicalStay on thelookout forupcomingwebinars onother issuesaffecting serviceproviders whowork with teensat the TeenCenter website.If not,offer to connect her to communityresources and hotlines. Make a followup appointment to see the teen.13Teens abusedwhile pregnantare at asignificant riskfor healthproblems.

4 Teen Dating Violence Technical Assistance CenterIssue Brief No. 8 July 2009Responding to AbuseEncourage the teen to seek mental healthcare services.One of the most important steps in responding andproviding services to teens experiencing dating violence isto become familiar with and look for the warning signsindicating abuse. Red flags can include a drop l or work, high risk sexual behaviors, depression,Be sensitive to the fact that group counseling optionsfor pregnant and parenting teens may not adequatelyconsider teens who are experiencing dating violence.Also, options for teen dating violence victims may notfully take into account the needs of pregnant and parenting teens.and disordered eating. Look for any signs of physicalabuse or injury, and take seriously reports by the teen thatshe is being physically abused even if there are no visibleinjuries.Coordinating Interventions for Pregnant andParenting TeensEconomic Concerns:Be aware of the practical needs of your parenting teenclients, such as access to transportation, child care,and safe and adequate housing. Offer these kinds ofservices at your organization or connect the teen toorganizations that can help her meet the needs.The other essential aspect of your role as a serviceAdvise your teen client about her options for taking aprovider is to be aware of the different needs that apregnancy leave from work under the Family Medicalpregnant or parenting teen who is experiencing datingLeave Act and/or the policies at her place of employ-violence might have. Talk to the teen about the kinds ofment. If your teen client is a father, advise him aboutservices available and make referrals as needed. Some ofoptions for paternity leave.the most important interventions and resources include:Inform your teen client of public benefits available forparents, including TANF and any other local benefits.Health care:Make sure that the teen receives medical care for anyEducational services:injuries she sustains.Look into the educational options for pregnant and par-Connect her to information about and providers ofenting teens in your local schools, such as whether theprenatal care, as well as infant/child healthcare.school offers ways for teens to take any necessaryRegardless of whether the teen is pregnant ortime off from school but stay on track to graduate orparenting, having both kinds of resources is important.receive a GED. Inform your teen client of her options tocontinue schooling.Legal options:Learn about the availability of parenting classes, em-Advise the teen about the availability of protectionployment referral services, and other educational ser-orders and make referrals to organizations that canvices in your area, and make referrals to your teen cli-assist with filing orders.ent.Inform the teen that other legal issues such aspaternity, custody, and child support are relevant andrefer her to organizations that can help her addressthese matters.Counseling:Teen Pregnancy, Parenting, and Dating Violence

5Teen Dating Violence Technical Assistance CenterIssue Brief No. 8 July 2009Notes1Leiderman, Sally, Cari Almo. “Interpersonal Violence and TeenPregnancy: Prevalence and Implications for Practice and Policy,”Healthy Teen Network (2001).2Silverman, Jay G., Anita Raj, Lorelei A. Mucci, and Jeanne E.Hathaway. “Dating Violence Against Adolescent Girls and AssociatedSubstance Use, Unhealthy Weight Control, Sexual Risk Behavior,Pregnancy, and Suicidality,” American Medical Association, vol 286, no.5 (August 1, 2001).3Malecha, Ann, Judith McFarlane, “Sexual Assault Among Intimates:Frequency, Consequences and Treatments” (2005).4Center for Disease Control, “Youth Risk Behavior Surveillance. UnitedStates, 20005.” tab10 (accessed April 1, 2009).Be aware of the differentneeds that a pregnant orparenting teen who isexperiencing dating violencemight have.5Silverman, Jay G., Anita Raj, Lorelei A. Mucci, and Jeanne E.Hathaway. “Dating Violence Against Adolescent Girls and AssociatedSubstance Use, Unhealthy Weight Control, Sexual Risk Behavior,Pregnancy, and Suicidality,” American Medical Association, vol. 286, no.5 (August 1, 2001).6Id.7National Coalition Against Domestic Violence, “Domestic Violence andPregnancy Fact Sheet,” http://www.vawnet.org/category/Documents.php?docid 615&category id 504 (accessed June 7, 2009).8University of Pittsburg Medical Center (2003). “Abuse DuringPregnancy,” cuments/AbusePregnancy.pdf (accessed June 7, 2009).9Healthline, “Mother Less Than 20 Years Old, “ regnancy? Print true(accessed April 1, 2009).10Covington, Deborah L, Dr. P.H,. Betsy J. Justason, MPH, and Lydia N.Wright, MD. “Severity, Manifestations, and Consequences of ViolenceAmong Pregnant Adolescents,” Journal of Adolescent Health, (2001)11Id.12Mandated reporting varies with profession and state laws. Know yourown ability to keep your client’s disclosures confidential. Be sure tocommunicate upfront before she discloses something that she may wantto keep confidential. If you are unable to maintain the level ofconfidentiality that your teen client desires, connect her to anotherprovider who can.13Pennsylvania Medical Society, RADAR: A Domestic ViolenceIntervention.Teen breakthecycle.orgTeen Pregnancy, Parenting, and Dating ViolenceThis project was supported by Grant No. 2007-TA-AX-K024 awardedby the Office on Violence Against Women, U.S. Department ofJustice. The opinions, findings, conclusions, and recommendationsexpressed in this program are those of the authors and do notnecessarily reflect the views of the Department of Justice, Office onViolence Against Women.

Teen Pregnancy, Parenting, And Dating Violence ating violence and teen pregnancy are intricately linked. Research indicates that teen girls who are in abusive relationships are at a greater risk of becoming pregnant. Also, for many teens, the violence and abusive behaviors begin or increase at the time that they become pregnant.

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