"The younger the teen girl is when she first has sex, the more likely she had unwanted sex, the more likely that the male is much older than she is, and the less likely that she is able to negotiate use of condoms or obtain hormonal contraception," says Larew.

"Also, if she becomes pregnant, it is less likely that she will obtain early prenatal care and more likely to have complications can occur in the pregnancy and delivery," she says. "Risky behaviors rarely occur alone. Young teens (14 years of age or younger) who are sexually active tend also to smoke, drink, use other drugs, and have delinquent behavior."

Larew says individual teen factors have the biggest influence on teen pregnancies such as:

• Being motivated to achieve higher levels of education and having employment goals in addition to having a goal of being a mother
• Having developed refusal skills
• Having a good knowledge base about contraception and how to negotiate condom use

"Parents need to state their values clearly, encourage abstinence, discourage early dating, dating of older partners, and supervise their teen's social activities. However, very strict monitoring, or what we call authoritarian parenting, increases the risk of pregnancy," Larew says.

Teens usually want to communicate with their parents about issues that are important to them Larew says. "Talk to your teen as early as possible, before puberty. Encourage communication by taking your child's questions seriously and reassuring them that they can talk to you about anything. Answer questions simply and directly. Give factual, honest, and simple answers.

"Take advantage of teachable moments, such as a pet having babies, a news article, or a TV show that can help start a conversation. Listen more than you talk," suggests Larew. "Think about what you're being asked. Confirm with your child that what you heard is in fact what he or she meant to ask."

Larew says it doesn't confuse teens to hear that abstinence is strongly encouraged, but also be educated about contraception and STD protection. "This comprehensive sex education or discussion does not result in teens having sex sooner, having more frequent sex, or increase the number of partners. In fact, most studies show that it has the opposite effect."

Do teens wish they had waited to have sex? "According to 2002 data, of youth 12-19 yrs old, 55 percent of boys and 70 percent of girls wish they had waited longer to have sex," she says.

For more information:

University of Iowa Children's Hospital

Mary Larew, MD