AN OVERVIEW OF ADOLESCENT PREGNANCY IN RURAL-AREAS

Although explanations for high rates of adolescent pregnancy in the Un ited States are not conclusive, adverse outcomes associated with early childbearing are well-documented. Little is known about the specific circumstances and consequences of adolescent pregnancy in rural areas. This article summarizes a systematic review of literature relevant to pregnancy and pregnancy prevention for rural adolescents for 1980 to 1995. The primary focus of this study was on the eight southeastern st ates in Department of Health and Human Services Region IV. From approx imately 500 relevant citations in the database collected for this revi ew, few dealt explicitly with adolescent pregnancy in rural areas, and an even smaller subset of the literature used empirical data. No data were found that indicated sexual activity was lower among rural teens , or that the risks of adolescent pregnancy and behaviors detrimental to pregnancy outcomes were less common in rural areas. Social isolatio n, lack of educational and economic opportunities, and limited access to health services are key issues with respect to rural youth and thei r healthy development. The relatively fewer numbers of health professi onals in rural areas, weaker infrastructures for transportation and in formation, heightened concerns about confidentiality, low rates of ins urance coverage, and reluctance to accept social services reduce the l ikelihood of rural of insurance coverage, and reluctance to accept soc ial services reduce the likelihood of rural teens receiving adequate p reventive or reproductive care. Future research should address the soc ial circumstances of rural adolescents to design effective interventio ns for teen pregnancy prevention and appropriate reproductive health s ervices for young mother and families in rural areas.