Teenage Pregnancy and The Effect It has on the Teen, Family and Society as a WholeGoing back throughout the history of the world, teenage pregnancy has always been the norm, until the modern era. In united states almost every year at least from ages 15, teenagers become pregnant..“ The World Health Organization (WHO) states that an estimate of 21,000,000 girls ages 15 to 19 and 2,000,000 ages 15 years become pregnant in developing worlds. Approximately 16,000,000 girls ages 15 to 19 years and 2,500,000 girls under the age of 16 give birth in developing regions as well. However, in 2017, the Centers for Disease Control and Prevention  states that there was a record low number for the U.S teen pregnancy, with a drop (from the previous year) of 8% to 9% for girls aged 15 through 17 years old, and 7% drop for girls ages 18 through 19 years old. They attributed this decline to abstinence or use of birth control methods(Centers for Disease Control and Prevention [CDC], 2017).   Even though pregnancy rates are declining steadily from education and improved access to healthcare in the united states,there are still a record number of teens that are still engaged in sexual activities. According to The Westside Pregnancy Resource Center, peer pressure,single parent house holds among others are contributory factors to teen pregnancies.Irrespective of the reasons, there are immeasurable risks involved(WCPC Home Society [WCPC], 2017).How did it become a problem, a need, an opportunity?      Many teenagers out of peer pressure, lack of parental guidance and from single homes themselves, engage in sexual activities that ends up with unintended pregnancies. Many teenagers have children before the age of 15. The fathers of these children born out of wedlock also are teenagers who themselves are not educated, use drugs, alcohol, are in the welfare system or locked up in various prisons making it difficult for the teenager in question and even harder for the child afterwards. These children end up with multiple health concerns such as low birth weight, abuse, neglect and even death. ”Low birth weight babies are more likely to have organs that are not fully developed; which can result in complications such as bleeding in the brain, respiratory distress syndrome, and intestinal problems”.(CDC, 2017). Other health risks involved. These children born by teenagers suffer developmentally, emotionally, psychologically and physically. They may feel detached as there are no social or family support placing them at higher risks of emulating same patterns as exposure to resources may be limited. Teen mothers may engage in drugs, alcohol usage and suffer depression thus committing suicide or becoming harmful to others or to their wards. Teen mothers also lack the capabilities of nurturing children as they are children themselves thus placing these children at greater risks for neglect,poor academic standards  and various societal problems like alcohol and drug abuse.How did it capture the attention of the decision makers?Teenage pregnancy and birth rates in the U.S. have seen significant declines. “The teenage pregnancy rate declined from 117 per 1,000 in 1991 to 72 per 1,000 in 2004. Similarly, the birth rate decreased by 30.5 percent from 61.8 births per 1,000 females ages 15-19 in 1991 to 40.4 births per 1,000 in 2005, the lowest rate in six decades. This clearly explains a surge in teenager pregnancies and how stringent methods and solutions has to be enacted by the state, communities and healthcare providers in bringing this number down.(National Association of County and City Health Officals [NACCHO], 2017). Public implications, increased medical and societal burden often accompanies teenage childbearing. Recent research shows that teen childbearing costs local, state, and federal taxpayers over 9 billion dollars annually. This estimate includes various public sector costs such as healthcare, child welfare, incarceration, and lost revenue because children of teen mothers pay lower taxes over their adult lifetimes.3 In 2004, taxpayers saved an estimated 6.7 billion dollars from the decline in the U.S. teen birth rate, discussed above. The above estimated figures basically calls for cost effective programs through educational sessions, open clinics and parental involvement to be endorsed to reduce costs incurred in raising and taking care of teenagers and their children. (NACCHO, 2017).Identify the major policy makers involved and discuss their position on this issue.The welfare law enacted in 1996 contained numerous provisions designed to reduce teen or out-of-wedlock childbearing including:A $50 million a year federal investment in abstinence education;A requirement that teen mothers complete high school or the equivalent and live at home or in another supervised setting;New measures to ensure that paternity is established and child support paid;A $20 million bonus for each of the 5 states with the greatest success in reducing out-of-wedlock births and abortions;A $1 billion performance bonus tied to the law’s goals, which include reducing out-of-wedlock pregnancies and encouraging the formation and maintenance of two-parent families;The flexibility for states to deny benefits to teen mothers or to mothers who have additional children while on welfare (no state has adopted the first but 23 states have adopted the second); andA requirement that states set goals and take actions to reduce out-of-wedlock pregnancies, with special emphasis on teen pregnancies.Research attempting to establish a link between one or more of these provisions and teen out-of-wedlock childbearing has, for the most part, failed to find a clear relationship. One exception is child support enforcement, which appears to have had a significant effect in deterring unwed childbearing.(Sawhill, 2019). Discuss nursing involvement and how the issue affects nursing.Nurses are caretakers, educators and case managers. They can create their clinics that has a teen friendly atmosphere. Also, nurses can assure teenagers, their families that all information ascertained will be kept confidential. Rights, responsibilities will be shared. Cultural sensitivity will be inculcated and respect, conveniences and educational services will be individualized to suit everyone in question.Again, if follow professional guidelines that requires teenagers between ages 11 through 16 years adhere to regular scheduled reproductive clinic visits which offers guidance, counseling, educational sessions and done in private, teenagers will be more open and emulate ways to refrain from unwanted sexual activities that often leads to pregnancies and sexually transmitted diseases. Most importantly, when family members are involved especially with teenagers agreeing to this decision, it makes the process of sex education more fruitful as everyone is on the same page. Here, different contraceptive methods can be taught to the teen,families and father in question.All of theses measures provides an overview of the current trends in teen pregnancy as well as enhanced knowledge about CDC’s Evidence-Based Contraceptive Method Guidance and how the guidance can be applied in practice. (CDC, 2017). Advanced nurse practitioners are in the position to advocate for their clients especially in their best interests so as to improve performance and outcome measures. They are the liaison between these teenagers and their families in order to help help create individualized plans to reduce teenage pregnancy rates. They need to find resources, teach continuously and prepare teenagers about the consequences inherent in their actions. APNs have the opportunity to apply evidenced based concepts from research so as to implement effective strategies that promotes optimal levels of functioning ongoing which may in-turn include skills and competencies needed by these teenagers to influence health related choices, policies that would empower the teenager, families and communities to take actions in empowering and improving their healthcare decisions and options.What ethical concerns are related to this issue?There are many ethical issues regarding teenage pregnancy such as sex before marriage, abortion,underage sex, adoption and doctor patient confidentiality.Many in our society of today believe it is unethical for women to have an abortion as life starts at conception. For instance,the pope of the Catholic Church stated that “abortion is a crime of aggression not only against the unborn but also against society” (“National Catholic Report ,” 2018). Young people growing up sexually today experience sharply divergent and conflicted values concerning individual and collective rights and responsibilities. This leaves them often ill-prepared for personal relationships as well as their role as citizens, in a time of volatile social, political, and economic change. Personal and public values are intertwined. To strengthen each we must also strengthen the other, and the mutually reinforcing links between them, in working towards a more democratic, just society. The only potentially universal links are public policies and programs to support people?s basic needs, thereby enabling them to avoid problems (Wong & Checkland, 2019). As healthcare provider, being empathetic, avoiding biases and treating patients according to their needs is paramount to their healing and eventual outcomes. The evolving roles of advanced practice nurse is growing in today’s world. Therefore, biases, discrimination and being judgemental only prevents the solutions that are inherent in preventing or reducing teenage pregnancies.Identify options for resolving the issue:Teenage pregnancy is still a significant health issue. Teenage pregnancy is a public health problem that is usually associated with social exclusion, that eventually leads to poor educational attendance and achievement, poverty, unemployment and poor health of the teenager and baby. Therefore, the need for enacting further or reorganizing various sexual health policies and services in primary care settings so as to meet the teenager’s needs regarding sexual health issues and pregnancy is paramount. As such abstinence is the best  and most recommended policy with regards to a teenagers sex life and method for prevention of unwanted pregnancies or childbirth. Approach to the problem should be multidimensional ie families, communities, and cultural backgrounds should be taken into consideration. Medical issues such as sexually transmitted diseases, socioeconomic burdens such as stigmatization by peers, rejection by family or community and dropping out of school should be addressed. lastly, psychological burden such as anger, anxiety, helplessness, clinical depression should be taught to help combat/eradicate this national health issue.State your preferred solution and provide a rationale to defend your position.If early early education and communication exists between teenagers and their parents or guardians, teenagers will for-see the problems, burdens and dangers in having children early. Abstinence is a sure way. Also, health care providers and the community leaders can establish clinics in schools that will help teenagers get advice about related medical services such as birth control methods and other preventative methods. The stressing of ones beauty, health, self worth by advanced nurse practitioners are of grave importance. Teenagers need to be encouraged that they need not repudiate their values at the whim of their peers. They need to be taught on an ongoing basis that respect for themselves as growing teenagers is important. If teenagers are reminded that not finishing school and having babies are an arduous tasks, they will learn that minimal education only leads to minimal salaries and unsatisfying jobs.The goal of creating programs, clinics should be long term and individualized. Children learn by examples therefore, their families should be involved so that the education instilled in families will remain imbedded in their memories. Parents play a vital role in their children’s lives. They are a mirror that children would quickly emulate even when it does not align with life’s expectancies. It is therefore important that health care providers and the community educate parents, guardians who have teenagers to be involved, discuss freely sex education, its consequences and why abstinence is the best solution. Communication is key and when cordial relationships and positive family values are laid out, teenagers do not have a choice but to freely discuss issues about early dates or ways to avoid pregnancies.