Preventing Rapid Repeat Teen Pregnancy with Motivational Interviewing and Contraceptive Access: Implementing Teen Options to Prevent Pregnancy (T.O.P.P.)

Although teen births rates in the United States have been on the decline in recent years, they are still the highest in the industrialized world (United Nations 2011). One in six young women in the United States gives birth before she reaches her 20th birthday, and about one in five young mothers goes on to have a second child as a teenager (Martinez et al. 2011; Centers for Disease Control and Prevention 2013). Becoming a teen mother is linked with negative outcomes for both mother and child. For example, teen mothers are more likely than older mothers to experience preterm delivery, receive welfare, and have children with emotional and behavioral problems (Hoffman 2008). Outcomes are even worse when a teen mother has more than one child—especially if a second child comes soon after the first. Teen mothers who experience rapid repeat pregnancies (within 18 months of the prior birth) are less likely to receive prenatal care and more likely to experience a stillbirth, a preterm birth, or a child with a low birthweight (Conde-Agudelo et al. 2006). They are also less likely to stay in or complete school, work or maintain economic self-sufficiency, and have children that exhibit school readiness when older (Klerman 2004).