Adolescence is a time during which societal and family values, attitudes, and behaviors are learned. This period in a person’s life is marked by challenges and difficulties in self-exploration and identification. Sexual relationships are especially challenging and difficult for adolescent women and men. Teenage fertility is a reality for most countries that needs to be dealt with effectively. It is necessary that young people are educated about STDs, health risks, and contraception and that societies on the whole are made more aware of teenage sexuality.

In different countries, there are different social attitudes about sex and premarital relationships. This influences an adolescent’s decision making process concerning sex and pregnancy. In the United States from the 1950s, social mores enforced gender roles: women were domestic housewives and men were breadwinners. Women’s sexuality was monogamous, and she was expected to remain committed to her one and only husband. During the 1960s and 1970s, women broke from this rigid stereotype and began to define their own sexuality. With the availability of birth control (the pill) now widespread, women could control their fertility, enabling them to have more power over their sexual choices. The 1980s occurred with an AIDS scare, and sexual relations came with the threat of a terminal disease. Today, gender roles are constantly being challenged and redefined in both developed and developing countries. Across class and ethnicity, it is difficult for young people today to make decisions about sexual activity.

With the rise in urbanization and industrialization, premarital sexual activity began to increase (Luker, 141). This phenomenon is not limited to the United States, but has occurred in most developed and developing countries. With the transition from rural communities to urban centers, many people are postponing the age of marriage. This means that as people prolong their singlehood, premarital sexual activity is increasing, and consequently, so does the number of unintended pregnancies (Alan Guttmacher Institute, 10). Urbanization also signifies the reduction in family ties and social support networks for pregnant teenage women.

Across the world, teenagers make up a significant portion of the population. In most developing countries, adolescents account for just under 25% of the population. This means that a large number of young women in their reproductive years are at a high risk of becoming pregnant. Teenage births count for almost 10% of births worldwide (Alan Guttmacher Institute, 8) and about 1 million teen pregnancies per year in the United States (Luker, 135). In 1972, 25% of 10 million US teenagers were sexually active. As contraceptive use was increasing, so was the number of sexually active teens. Twelve years later, the number of teens had decreased by 10%, but the number of sexually active teens had nearly doubled. These numbers demonstrate the significance of teenage sexual activity and urgency to implement strategies to defer unwanted pregnancies.

The majority of adolescents reported that they did not intend to become pregnant or that they wanted a baby. In the United States, 73% of 15-19 year old women stated that their pregnancies were unplanned and in Asian countries, 22-41% of teenage pregnancies are unintended (Alan Guttmacher Institute, 10). Many young women discussed the issues of becoming pregnant and losing their own childhood. Some of these pregnancies and sexual encounters are not consensual sexual relations. "In Uganda, nearly half (49%) of sexually active primary school girls report being forced to have sexual intercourse, and 22% anticipate receiving gifts or money in exchange for sex. In the United States, 7 in 10 women who have sex before age 14, and 6 in 10 who have sex before they reach age 15, report having sex involuntarily" (Alan Guttmacher Institute, 8).

When young teenage women are challenged with a pregnancy, many times they turn to abortion. This can have deadly consequences depending on how safe the facilities and doctors are that perform the surgery. Over half of all unintended teenage pregnancies in the United States end in abortion (Luker, 154). In the United States, the laws regarding legal abortions change constantly and are not consistent within the nation. Each state has its own legislation about abortion, sometimes limiting access to pregnant teens. In developing countries, access to abortions is limited and sometimes unsafe. It is necessary for women to have access to abortion, to control their fertility and reproductive rights, but to also ensure that a pregnancy is wanted and that the baby will be nurtured and healthy.

There are many correlations between teen pregnancy and race, class, and socioeconomic status. Many women from poorer communities are less likely to be educated. Coming from a lower socioeconomic background also limits the availability to healthcare and prenatal care for pregnant teens because of cost. It is also less likely for a young woman in a lower class to be educated about safer sexual health. "The higher a woman’s level of education, the more likely she is to postpone marriage and childbearing. Adolescents with little schooling are often twice as likely – and sometimes three times as likely – as those with more education to have a baby before their 20^th birthday" (Alan Guttmacher Institute, 11). In order to defer teenage pregnancies, teenagers need to be educated. Because young adults have to negotiate their own sexual territory, it is necessary to provide education about choices, options, practicing safe sex, and sexual health.

Teenage women face daily challenges in dealing with sexuality. Young women continue to be socialized to believe that their space is in the home, raising children and taking care of her husband. Although gender roles have been examined and redefined, the reality is that women remain subordinate to men and women are valued less. Teenage mothers deal with social attitudes about pregnancy, marriage, and relationships and have to find a balance between personal needs and societal pressures. In some developing countries, women are valued much less than men and expected to be "servants" to men. In this instance, it is possible to understand that women are procreating machines to father children for her husband and raise these children into strong, healthy young adults. In a culture that does not cultivate a woman’s sense of self, and created instead the illusion that she is dependent on a man for strength, intelligence, and income, it is no wonder that teenage fertility is high as well as unintended pregnancy. If a young woman is socialized to believe that she is to "service" a man, the decision for a young woman to engage in sexual activity is complicated and intense. There are few resources available for young women to discuss issues of sexuality or guidance from friends or relatives.

Women are also taught to believe that it is their responsibility to take care of birth control. Because most birth control on the market today is targeted toward the female partner, it is assumed that she will take care of it. Women are often times faced with a double bind: they are not supposed to be prepared to have sex, but simultaneously should have birth control available. Contraceptive use also appears to vary according to class. Teenagers with "higher socioeconomic status and educational aspirations" are more likely to use birth control (Luker, 144). Contraceptive use also changes with partners. This effect occurs in adults as well as teenagers. It is also more likely that birth control is used more effectively and more often as the relationship sustains. The social cost of pregnancy is higher as the intimacy of the couple deepens. Older teens are also more likely to use contraception consistently and effectively. This is part illustrates that with more practice, the use of birth control becomes easier and more competent.

There is also the issue of effective sexual education. In developed countries, the messages portrayed through the media, film, television and advertising encourage sexual intercourse, misogyny, and violence. These messages heavily influence a young person’s perception of social relationships and how they are to negotiate their own intimacy with another person. Many times, young women felt pressured by their boyfriends to have sex. For young men, "sexual activity is an indication of maturity and masculinity" (Luker, 140). This causes conflict within a young person in her ability to make decisions regarding sexuality. In schools, teenagers are taught abstinence and some contraceptive use. But even this information is misinformed and misunderstood by many students.

The consequences of teen births are heavy to a young woman. Having a child as a teenager limits educational opportunity, suspends skill training, induces emotional trauma, and restricts financial achievement (Alan Guttmacher Institute, 5). It is necessary to implement educational programs to teach effective use of contraception. It is also critical that young women are empowered to make decisions in the interest of themselves. It is also important to try to increase the status of women so that women are not demeaned to submissive slaves of patriarchal men. It would also be beneficial to educate people about the effects of nutrition and health. This would help to delay menarche in adolescent women, reducing the reproductive years and limiting the chance of pregnancy. Another component to educational programs needs to be the implementation of prenatal care and pregnancy counseling. Teenage women need to know what their options are once they are pregnant, and also need to receive some counseling to support her decision. If more teens are educated about their choices in contraception and sexual activity, it is likely that birth control would be used more often and more effectively.