The reproductive health of the young and the elderly in the United States has medical, social, economic and political ramifications, which are not confined to this one country, but often have global implications. The US possesses vast resources, both scientific and economic, to address health-related issues. In spite of this, seemingly important health crises are not always given the priority that many believe they deserve. When the commitment of the country is focused on the health needs of society the positive impact is impressive. A successful national policy to address teenage pregnancy has yet to be formulated. Management of menopause on the other hand has not only increased the life span of American women but has greatly improved their quality of life.One out of every ten American teenage women becomes pregnant each year. Of these pregnancies occurring in 15 to 19 year olds, approximately eight out of every ten are unintended. Half of these unplanned pregnancies end in abortion, 15% spontaneous miscarriage and 35% in induced abortions. The pregnancy rate in teenage women living in the US is twice as high as in England, France and Canada, three times as high as in Sweden and seven times as high as in the Netherlands [1]. The first coital experience continues to occur at earlier ages in American women. In 1972 twenty eight percent of US women aged 15-19 were sexually active. Seven years later fifty percent of women in this age group were sexually active [2]. Presently by the time American women reach the age of 20 years, seventy percent have become sexually active.Each year there are more than one million teenage pregnancies in the United States. In 1992 teenage mothers accounted for 12.7% of all the live births in this country [3]. The percentage of live births to women under the age of 20 years showed racial and ethnic differences; 10.9% of live births to white women, 22.7% of live births to Afro-American women, 20.0% of live births to Native American women and 5.6% of live births to Asian or Pacific Islander women were to mothers under the age of 20 years. In addition to the live births, approximately 14% of all pregnancies in teen age women end in spontaneous miscarriage and 35 to 51% end as induced abortions.Adolescents have an extremely high rate of unintended pregnancies (81.7%) [4].
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