Psychiatric aspects of pregnancy in schoolgirls: a review

This review has searched the literature to examine the hypothesis that illegitimate pregnancy in girls of school going age is an indicator of underlying psychopathology and, in particular, that pregnancy or sexual activity provide a form of gratification for otherwise deprived young girls. Surveys suggest that precocious sexual activity is more common in disadvantaged young teenagers and that pregnant schoolgirls are especially likely to come from large families, and to have unskilled parents. There is a suggestion that the younger groups of pregnant teenagers come from unsatisfactory home backgrounds. However, these conclusions are derived from inadequate studies and should be treated with caution. Relatively few sexually active teenagers use contraceptives but there is no evidence that this represents a subconscious intent to conceive and there is greater support for more straightforward explanations. There is a further suggestion that girls who continue with their pregnancy when the choice for termination is available are more disadvantaged than girls who obtain a termination, although the reasons for this association are not clear. Children born to very young mothers appear to do less well than children born to older mothers. However, it may be that this difference can be attributed to greater overall disadvantages in the younger group rather than to specific age related deficiencies in 'mothering ability'. The problems of schoolgirl pregnancy are compounded by interruption of her schooling and early re-conception. There is evidence that these complications can be lessened by the provision of specially designed intervention programmes.