Pregnant teenagers face unique health risks compared to their older counterparts because, for one thing, their bodies are still developing. Research has shown that very young mothers have higher odds of having eclampsia, postpartum blood loss and other complications. It seems likely that limits on abortion access across the U.S. may have long-lasting effects on the health of generations of expectant adolescents. 

Yet in the U.S., which has one of the highest adolescent birth rates among industrialized nations, many resources for teens and their parents, including academic studies and reports, contain scant information about the troubling conditions very young mothers may develop. Many news stories about teen pregnancy and birth trends are also short on the health risks teens may face and the troubling trends among teenagers at risk of getting pregnant. 

In this post, we share story ideas and angles to consider when covering teen pregnancy. Your reporting should highlight more than just prevention efforts. The dearth of information about poor outcomes in materials for the lay public suggests that public health researchers and others charged with creating reproductive health education campaigns for adolescents are missing the mark. That raises urgent questions about the quality of care teenagers get from doctors, nurses and other medical providers. The data suggests that stressful family dynamics, economic hardship, and other social risk factors linked to teen pregnancy aren’t the only significant influences on the wellbeing of those teens. 

Diving into the research

Investigators who authored a 2015 study about complications in labor and delivery observed that “the results show that younger and advanced maternal ages at the time of delivery are associated with greater odds of complications even after controlling for demographics, type of birth, and clinical confounders.”

Notably, the quality-of-care implications may be more significant for certain teen mothers of color, a fact that news stories should address. According to CDC data, non-Hispanic Black, non-Hispanic Native American and Alaskan Native, and Hispanic adolescents 15 to 19 — who represent a significant proportion of American females in that age group — are much more likely to have children than their non-Hispanic white peers. 

But it’s not just teenagers who may be affected by poor care. Among the key findings from a 2020 CDC analysis of infant health trends: 

• Infants born to non-Hispanic Black mothers were much more likely to die from the five leading causes of infant deaths, except SIDS, which was more prevalent among infants born to non-Hispanic white mothers.
• Compared with infants born to non-Hispanic white and Hispanic mothers, Black infants were significantly more likely to die from problems related to preterm birth and low birthweight.
• Infants born to Hispanic mothers had the lowest mortality rate for the five leading causes of death, except maternal complications, which was higher among non-Hispanic white and Black mothers. 

Exploring regional disparities

This story by KFF Health News reporter Sarah Varney hits the mark on a number of counts. She addresses the risks adolescent moms encounter during pregnancy, but also covers other relevant topics about reproductive health, such as access to birth control, sexual activity patterns, and, critically, the recent abortion bans passed by state lawmakers who have made it all but impossible for women in many states to end their pregnancies. 

Varney also spotlights regional disparities to hint at what may be coming down the pike in states with the toughest restrictions. Those disparities raise questions about insurance coverage patterns, access to birth control and the quality of sex education offered in public schools. This sex education tracker from the Guttmacher Institute assesses general sex ed requirements by state and the content covered in the curricula.

When looking at state-by-state data, consider urban and rural patterns and interview public health officials in big cities and counties far from them. The authors of this 2016 CDC report noted that they hadn’t studied what was occurring in less populated areas, where medical services and care may not be as available compared with big cities or even rural communities near metropolitan areas.

To provide readers with more context about the potential physical and mental health problems pregnant teens may develop, ask state officials to provide several years of the following data, broken down by race and ethnicity:

• Chronic conditions such as obesity and diabetes.
• Health conditions in pregnancy.
• Maternal mortality rates.
• Infant mortality rates.

There may be differences in record-keeping practices, and if there are some worth mentioning, that should also be part of the story. That’s crucial because state and federal funding for anything is tied to data. If they change the way they define certain indicators, ask them why. And if they don’t have race and ethnicity data for specific years, ask them when they started collecting it.  

Because the health risks associated with teen pregnancy may be linked to access to care or quality of care, look at state health budgets. Find out how much of the budget is earmarked for teen and adult health services and initiatives, and to maternal health services and initiatives in particular. Also, ask public health officials, doctors, social workers, counselors and other sources who provide services to teen mothers how the rollback of Medicaid eligibility requirements may affect the health of teen moms and their babies who depend on that program for their care. 

Margarita Martín-Hidalgo Birnbaum (@mbirnbaumnews) is AHCJ's Health Equity Core Topic Leader. An independent journalist who has covered health disparities. Birnbaum’s stories have been published by WebMD, American Heart Association News, and American Indian, the magazine of the Smithsonian’s National Museum of the American Indian.