Adolescent Health

Adolescence is a time of exploration and emerging independence; the transition from childhood to adulthood. As teens explore newly accessible choices, they make decisions about lifestyles that may become the habits of a lifetime. Although most teens are healthy, and make a safe transition into adulthood, teens face many risks: substance abuse, sexually transmitted infections, pregnancy, violence, abuse and accidental trauma.

One-fourth of all sexually transmitted infections occur among teens. One in eight women age 15-19 become pregnant each year. Three-quarters of all adolescent deaths are the result of accidental injury or violence. The number of teenagers in the United States reporting emotional, physical and sexual abuse by their partners increases daily.

Barriers to effective adolescent healthcare. Despite these alarming statistics, adolescents remain one of the United States most medically underserved populations. The years between childhood diseases and adult health concerns are routinely ignored. Adolescents are often uninsured or under-insured. Availability of appropriate services is very limited. Other barriers to access include out-of-pocket co-payments, transportation, lack of culturally appropriate care, and confidentiality issues.

Education is an important tool for prevention. For example, a recent national survey of adolescents reported that the average teen does not have enough information about contraception. Three in five of those surveyed said the information they do receive comes too late.

The midwife's role with teens. The midwifery model of care emphasizes education and family-centered care throughout life; making midwives ideal care providers for adolescent women. The complex issues facing teens in today's society demand interdisciplinary attention. CNMs/CMs function well as part of the interdisciplinary team. Midwives promote healthy behaviors and facilitate the development of lifelong positive lifestyle choices. Midwifery care is culturally sensitive and developmentally appropriate, and respects the growing independence, privacy and learning needs of the maturing woman.

The American College of Nurse-Midwives supports the following measures to improve the health and well-being of adolescents in the United States:

• Legislation to increase health education programs (including reproductive education and preventative health care information) in schools and communities that are evidence-based in content, including those that are sensitive to societal as well as public health issues.
  
• Funding of government programs aimed at improving access to care, including: Title X, CHIP coverage of reproductive health benefits, school-based health clinics, Title V (MCH) block grants.
  
• Evaluative research aimed at increasing the practice of evidence-based adolescent health care.
  
• Continued development and implementation of school and community based programs that address prevention, recognition, and treatment of violence against women within a socio-cultural-political context.
  
• Confidentiality between adolescents and their health care providers with encouragement for family and peer involvement, as appropriate to the health and social circumstances of the adolescent.
  
• Networking with other organizations to improve healthy behaviors in adolescents.
  
• Opposition to any limitations on access to essential services, such as STI screening and treatment, family planning, mental health, and education on sexual health.