Pregnant and Postpartum Adolescents' Perceptions of the Consequences of Child Abuse

A study of 263 pregnant and postpartum indigent and minority teens was conducted in order to examine their perceptions of the consequences of child abuse and their own child abuse history. Teens identified drug and alcohol abuse and teen suicide as the most serious consequences of abuse. Interestingly, they did not identify pregnancy as a consequence. Twenty-seven percent reported a history of abuse. Identifying behavioral and emotional consequences of abuse is important because it affects both the well-being of the adolescent mother and her child. An experience of abuse and its behavioral consequences may interfere with a teen's ability to benefit from parenting intervention programs. Therefore, parenting programs may wish to consider the necessity of screening for a history of abuse as well as adding components on behavioral problems adolescent mothers are concerned about. Additionally, there is a need to reach out to pregnant, parenting and future parents in other settings such as prisons, psychiatric, and residential centers, since issues of abuse may coexist with other behaviors.     

Substance-Using Pregnant and Parenting Adolescent Girls: Considerations for Preventive Intervention Using a Resilience Lens

Evidence is needed to develop substance use prevention programs addressing the needs of adolescent mothers, yet there remains a paucity of research examining the lived experience and context of substance use among adolescent girls who report the use of substances while pregnant and parenting. This mixed-method research considers substance use and pregnancy simultaneously rather than as separate issues and suggests how findings might inform preventive intervention programming using a lens of resilience theory. Participants were pregnant and parenting adolescent girls in Grades 8 to 12 who reported the use of substances while pregnant or parenting. Fourteen participants completed an interview describing their experience of pregnancy and motherhood and the context of their substance use. Thirty-three participants completed an adapted American Drug and Alcohol Survey describing their substance use. Findings suggest potential strengths and vulnerabilities that could be addressed in preventive intervention approaches for this distinct population of girls.     

A review of the chance to grow project: A care project for pregnant and parenting adolescents

This paper reports on the process and outcome of an innovative program for pregnant and parenting adolescents, the Chance to Grow Project. One hundred sixty-one pregnant adolescents were exposed to intensive decision-making counseling and case management services. These young women were followed for 24 months, as were 87 pregnant teens who served as a comparison group. The results of the analysis suggest a number of important findings. These include a much higher placement for adoption of the babies of the program participants, higher levels of school retention, economic self-sufficiency, and more responsible sexual behavior on the part of the participants. This article describes the Chance to Grow Project in detail and suggests some important practice implications which can be drawn from this analysis.The Chance to Grow Project and its associated evaluation was funded by Office of Adolescent Pregnancy Programs, Office of Population Affairs, Department of Health and Human Services (Federal Grant Number APH 000128-05); Robert H. Brethen Foundation; Christ Child Society; Louise Kramer Foundation; Mathile Family Foundation; Charles McNamee Foundation; Gerald and Carole Miller Family Foundation; Montgomery County Community Human Services; United Way of Dayton; and the University of Dayton.     

High Educational Aspirations Among Pregnant Adolescents Are Related to Pregnancy Unwantedness and Subsequent Parenting Stress and Inadequacy

On the basis of theories of maternal identity development, role conflict, and childbearing motivation, the authors tested whether high educational aspirations among pregnant adolescents are related to the unwantedness of the pregnancy and whether pregnancy unwantedness leads to subsequent parenting stress and inadequacy. Longitudinal data from 100 first‐time‐pregnant, unmarried Latina adolescents (M age = 17.3 years) were analyzed. Results from structural equation path modeling confirmed these associations, with strong educational ambitions related to greater unwantedness of the pregnancy, which led to feeling trapped by parenting at 6 months postpartum, which in turn was related to unaffectionate parenting and feeling inadequate in mothering at 1 year postpartum. The potential long‐term negative consequences of high educational aspirations for pregnant adolescents' adjustment to parenting are discussed.     

Pregnant teens: differential pregnancy resolution and treatment implications

Profiles on three groups of pregnant teens in a comprehensive social service agency were identified: those who followed through with a parenting plan, those who followed through with an adoption plan, and those who switched from an adoption plan to a parenting plan. Pregnant teens who switched plans were identified as high risk in terms of health histories and psychosocial profiles. Since they represent as much as one-third of the total population, service plans must be made for them that focus on these risk areas. This article addresses the identification of new subgroups in the universe of pregnant teenagers, and treatment implications.     

African American Adolescent Girls in Impoverished Communities: Parenting Style and Adolescent Outcomes

The relationship between parenting style and adolescent functioning was examined in a sample of 302 African American adolescent girls and their mothers who lived in impoverished neighborhoods. Although previous research has found that authoritative parenting, as compared with authoritarian, permissive, and disengaged parenting, is associated with positive adolescent outcomes in both European American, middle‐class and large multiethnic school‐based samples, these parenting categories have not been fully explored in African American families living at or near poverty level. Data were collected from adolescent girls and their self‐identified mothers or mother figures using in‐home interviews and self‐administered questionnaires. Parenting style was found to be significantly related to adolescent outcome in multiple domains including externalizing and internalizing behaviors, academic achievement, work orientation, sexual experience, and pregnancy history. Specifically, teens whose mothers were disengaged (low on both parental warmth and supervision/monitoring) were found to have the most negative outcomes.     

Impact of a Group Prenatal Program for Pregnant Adolescents on Perceived Partner Support

This quasi-experimental study compared family formation and perceived partner support among pregnant adolescents in a prenatal care program. Participants were assigned to either an intervention group utilizing centering pregnancy (CP) prenatal care and case management, or to a comparison group receiving case management only. Partners were invited to participate in CP group sessions. This study included 173 predominantly minority pregnant adolescents ages 15–18 years who were enrolled in a prenatal program and followed one month postpartum. Family formation included living and relationship arrangements. Perceived partner support included six domains of perceived social provisions. Data were collected through participants’ self-reports using computer-assisted self-interviews. Changes in family formation and perceptions of partner support from baseline to postpartum did not differ between intervention and comparison groups. Male partners who attended at least one CP session were perceived as more supportive at both the beginning and end of the program than partners who did not attend any sessions. After combining groups, pregnant adolescents reported a significant shift in family formation and increased monetary support from partners from baseline to postpartum. Partner support is important for ensuring positive pregnancy outcomes. Additional strategies are needed to engage young fathers who do not readily provide support during pregnancy.     

Family influences on adolescent sexual and contraceptive behavior

Studies of adolescent pregnancy risk are relevant to understanding responsible adolescent sexual behavior because most investigators have focused on the key proximal determinants of pregnancy--sexual intercourse and contraceptive use--rather than analyzing pregnancy status per se. Lesser pregnancy risk is associated with teens remaining sexually abstinent, postponing onset of intercourse, and having intercourse less often or with fewer partners, as well as by using contraception at first or most recent intercourse and by using contraception consistently over time. Living with a single parent, in a lower SES family, having older sexually active siblings or pregnant/parenting teenage sisters, being a victim of sexual abuse, and residing in disorganized/dangerous neighborhoods all place teens at elevated risk of adolescent pregnancy. Parent-child closeness or connectedness, and parental supervision or regulation of children, in combination with parents values against teen intercourse (or unprotected intercourse), decrease the risk of adolescent pregnancy. Studies about parent-child sexual communication and adolescent pregnancy risk are less conclusive, largely because of methodological complexities.     

Identity Transformation and Family Caregiving: Narratives of African American Teen Mothers

This article explores connections between informal caregiving and identity transformation as experienced by pregnant teens. Based on in‐depth interviews with 51 African American teen mothers, the article examines teens’ pregnancy narratives as an example of narrative repair, illuminating how attending to processes that connect one’s identity to the care of others can work to empower individuals to resist threats to a positive sense of self or a damaged identity. The authors suggest that family caregiving can provide an important context that supports identity transformation not only among pregnant teens as they strive to become good mothers but among those experiencing other types of disruptions to their lives.     

Housing interventions for homeless,pregnant/parenting women with addictions: a systematic review

Family homelessness is a growing problem in North America with most of these families headed by single women. Homeless women also experience high rates of pregnancy and addiction (drugs and alcohol). Housing interventions have been identified as key to addressing the complex needs of pregnant/early parenting, homeless women with addictions. The aim of this systematic review is to determine what housing models and programs for this population yield the best outcomes. We systematically searched 10 databases and retrieved eight articles describing four distinct studies that met the inclusion criteria for this review. Overall, improved outcomes were found for all intervention groups with the most recent and rigorous studies favoring models combining Housing First and case management. However, methodological limitations, study quality, and varied outcomes made comparison across studies difficult. Further research must be done in this area using standardized outcomes and rigorous designs to develop evidence-based best practice guidelines to address the unique needs of this population.     

Teenage Pregnancy and Female Educational Underachievement: A Prospective Study of a New Zealand Birth Cohort

This paper examines the relationship between teenage pregnancy and educational underachievement in a cohort of 520 young women studied from birth to 21 years. Results showed that young women who became pregnant by the age of 18 years were at increased risk of poor achievement in the national School Certificate examinations, of leaving school without qualifications, and of failing to complete their sixth‐form year at high school. In addition, pregnant teenagers had lower rates of participation in tertiary education and training than their nonpregnant peers. Subsequent analyses showed that the links between teenage pregnancy and tertiary educational participation were largely noncausal and reflected the earlier academic ability, behavior, and family circumstances of young women who became pregnant. In contrast, antecedent child and family factors only partially explained associations between teenage pregnancy and high school participation and achievement. After adjustment for these factors, significant associations remained between teenage pregnancy and educational achievement at high school. An examination of the diverse life histories of young women who became pregnant revealed that for the majority of young women, pregnancy occurred after they had left school before finishing. These findings suggest that rates of teenage pregnancy might be elevated among young women who leave school early, rather than rates of early school leaving being elevated among young women who become pregnant during their teenage years.     

A Study of An Alternative School for Pregnant and/or Parenting Teens: Quantitative and Qualitative Evidence

In response to multiple problems faced by pregnant and parenting teens, many alternative school-based comprehensive programs have been established throughout the United States. By collecting data from a sample of enrollees of such a school-based comprehensive program and comparing them with data collected from a sample of non-enrollees, the present study systematically evaluates the program. The results of the study seem to suggest that the program participants were more likely to have higher educational aspiration, better reproductive health outcomes, higher contraceptive use, and more breast-feeding practice and intention than those of their non-participating counterparts. The implications of the study findings for comprehensive school-based program for pregnant and/or parenting teens are discussed.Ruhul Amin is a Senior Fellow at the Center for Health Disparities Solutions and Senior Research Scientist in the Institute for Urban Research, Morgan State University, Baltimore, MD 21239. Dorothy C. Browne is the Director of the Institute for Urban Research, Jamir Ahmed is a research assistant at the Center for Health Disparities Solutions and Takanori Sato is research assistants at the Institute for Urban Research, Morgan State University, Baltimore, MD 21239.     

The Adolescent Family Life Program and Adoption Research

Abstract

The Office of Population Affairs administers the Adolescent Family Life Program. Authorized in 1981, the Adolescent Family Life Act funds adolescent pregnancy prevention programs as well as care programs for pregnant and parenting teens. It also funds research into related issues, including adoption. A primary purpose of the Adolescent Family Life Program is to develop and test approaches that encourage adoption as an alternative to abortion. However, both abortion and adoption rates have dropped since the program was instituted. While existing research has answered some of the questions surrounding adoption, there is need for additional research into the factors associated with adoption. The Office of Population Affairs is actively seeking creative, well-conceived proposals that address some of the as yet unanswered questions.     

Pregnant and Parenting Adolescents’ Perception of Sources and Supports in Relation to Educational Goals

Scant research has directly asked pregnant and parenting adolescents what sources and types of support they feel are important for achieving educational goals, which is important for parenting education programs. The current study examines the most highly valued sources and types of support among 54 pregnant and parenting adolescents attending an alternative school to determine if the valuations of these supports differ depending on level of educational goals. Results reinforce the importance of close formal and informal relationships. The most highly ranked types of support center on childcare whereas the lowest ranked sources deal with the adolescent’s future career. Limitations and implications for the study are discussed.     

Pregnancy risk among older youth transitioning out of foster care

Youth served in the foster care system have higher rates of pregnancy than general population youth; yet we have little information about risk and protective factors to target in order to prevent early pregnancy in this population. We assessed early pregnancy risk and protective factors known for general population adolescents for their relevance to youth in the foster care system. Using data from a longitudinal study of 325 older youth from the foster care system, we examined bivariate and multivariate relationships between these factors and pregnancy between ages 17 and 19 using logistic regression. Models examined the risk for early parenting separately by gender. The pregnancy rate increased by 300% between ages 17 and 19. At 19, 55% of females had been pregnant, while 23% of males had fathered a child. Although this study assessed multiple known factors, few were significant for this high risk group. Females who were not sexually active at age 17 were less likely to become pregnant, but those who reported using birth control were as likely to become pregnant as those who did not. Also, females with a history of arrest were more likely to have a pregnancy between 17 and 19. Males who left the foster care system before their 19th birthday were more likely to make someone pregnant. Youth from the foster care system are at exceptional risk of early pregnancy, regardless of their maltreatment history, religiosity, school connectedness, or academic achievement, particularly in the years between 17 and 19. This high risk group needs pregnancy prevention interventions and access to effective birth control.     

Adolescents' Pregnancy Intentions, Wantedness, and Regret: Cross-Lagged Relations With Mental Health and Harsh Parenting

The authors used cross-lagged analyses to examine the across-time influences on and consequences of adolescents' pregnancy intentions, wantedness, and regret. One hundred pregnant Latina adolescents were studied during pregnancy and at 6 and 12 months postpartum. The results revealed 4 main findings: (a) similar to what has been found in adult women, adolescents' lower prenatal pregnancy intendedness and wantedness predicted initial difficulties in parenting; (b) frequent depression symptoms predicted subsequent lower pregnancy intendedness and wantedness; (c) adolescents' poor mental health and harsh parenting of their child predicted subsequent higher childbearing regret, and (d) high childbearing regret and parenting stress were reciprocally related across time. In addition, adolescents' wantedness of their pregnancy declined prenatally to postbirth, and strong pregnancy intendedness and wantedness were not concurrently related to adolescents' poor prenatal mental health. The findings reveal how adolescents' thoughts and feelings about their pregnancies are influenced by and predictive of their mental health and parenting experiences.     

Latino Adolescent Reproductive and Sexual Health Behaviors and Outcomes: Research Informed Guidance for Agency-Based Practitioners

Latinos are the largest and fastest growing minority youth group in the United States. Currently, Latino adolescents experience higher rates of teen pregnancy compared to any other racial or ethnic group and have disproportionately high levels of sexually transmitted infections and HIV. Latino teens are also affected by a number of social problems such as school dropout, poverty, depression and limited access to healthcare, which contributes to disparities in reproductive health outcomes for this population. Relatively few intervention research studies and programs have been dedicated to reducing sexual risk among Latino youth, despite their particular vulnerabilities in experiencing negative reproductive health outcomes. We provide recommendations for identifying the unique reproductive health needs of Latino youth and specific applied strategies so that agency-based social workers and other providers can develop family-based interventions that improve adolescent Latino sexual and reproductive health.     

Pregnancy Acceptance,Parenting Stress,and Toddler Attachment in Low‐Income Black Families

Questionnaire items tapping feelings about pregnancy were administered to 173 young, low‐income primiparous Black mothers who either were pregnant or had delivered within the past year. A factor analysis indicated that 11 items together measured mothers’ acceptance of the pregnancies that resulted in the births of their first children. Links to mothers’ later parenting stress, warmth, and their toddlers’ attachment security were explored. Pregnancy acceptance was a negative predictor of one aspect of maternal parenting stress (distress resulting from feelings that parenting is burdensome) and a positive predictor of toddler attachment security. It did not, however, predict another aspect of parenting stress (feelings that interactions with children are not enjoyable) or maternal warmth.     

Developing “whole school” bystander interventions: The role of school-settings in influencing adolescents responses to dating violence and bullying

Bystander intervention programs have been introduced as innovative strategies to empower teens to intervene proactively when they witness bullying and dating violence (TDV) in their social environments. While there is promising research on the individual-level factors that influence students' willingness to intervene, there has been limited investigation on how teens' school environments encourage proactive responses. Through analysis of focus group data, this study revealed that teens are reluctant to employ bystander behaviors in any capacity. Some of the school-level factors that influenced their willingness to intervene include: trusting relationships with teachers; the perception that school personnel, rather than students, have more expertise to respond effectively; school environments that were tolerant of dating abuse; and ineffective school policies. Implications for creating “whole-school” responses to bullying and TDV will be discussed.     

Technology-Based Interventions and Trainings to Reduce the Escalation and Impact of Alcohol Problems

There has been a rapid increase in the development of technological innovations to reduce the escalation and impact of alcohol problems among adolescents and adults. Technology-based interventions offer the possibility of reaching individuals who otherwise might not seek treatment, (e.g., those in remote areas, those not perceiving a need for treatment, or others who might resist treatment). This article describes 4 case examples of technology-based interventions for risky drinking: (a) a freely available and interactive Web site that provides individualized feedback and information on risky drinking patterns; (b) a brief intervention for adolescents that provides individualized feedback to teens regarding their alcohol use; (c) a computer-delivered screening and brief intervention for alcohol use among pregnant women; and (d) a simulation program for training social workers in screening and brief intervention. These case examples highlight how technology could have a role in addressing the Alcohol Misuse Grand Challenge.