Teenage Pregnancy

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Lecture 28

• Teenage Pregnancy

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The Witch Amongst Us

• Current beliefs scientific
• Teen childbearing is bad, reproductive and social
  immaturity, babies having babies
  
• Childbearing in the teen years writes the script
  for life, 
  
• Results are poor educational attainment, divorce,
  poor socioeconomic status (SES) and employment
  opportunities.
  
• Postponement of child bearing to mid-twenties
  would be much better, promotes health of baby,
  lowers risk to mother, increases educational
  opportunities, SES, good mate, stable marriage

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The Witch Amongst Us (contd)

• Current beliefs cultural
• There is a witch hunt going on. The witch has
  been identified. She is a young, unmarried
  teenager of poor and often ethnic minority
  background. Her irresponsible, unbridled
  sexuality is producing an insupportable burden on
  social services in the form of entitlements, but
  even more so in the form of producing
  impoverished generations with no future,
  uneducated, no ability to support themselves, and
  in poor health. She is raising angry sons who do
  not respect society at large, and who place even
  higher costs through their drug use, homicide
  rate, and general criminality. If society could
  stop teenage, unmarried reproduction, all the
  problems of our society would be solved in a
  single quick fix.

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Young Single Parenthood as a Common Community
Pattern of Reproduction

• Life history theory
• Teen pregnancy is no longer a rare pattern but a
  different version of the life course in which
  some or all of the components of a particular
  sequence of events deemed appropriate to the
  formation of families are changed.
• The traditional pattern is education, marriage,
  reproduction, work for resources, but for many
  has become reproduction, education, work,
  marriage.
• Our task is to understand why so many young women
  today are choosing to be parents early in their
  life history, 71 of which are non-marital.
  
• Is it possible that these young women are
  responding to some realities in our society that
  make young reproduction a viable option in a life
  history?

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Characteristics of Young Single Parenthood

• Need to ask the following questions
• What is the current trend in teenage pregnancy in
  the United States?
  
• Why are people so concerned about teenage
  pregnancy?
  
• What type of cross-cultural patterning do we see
  with respect to teenage pregnancy?

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Reproductive Strategies Among Individuals of Low
SES

• That poor, minority, young mothers are optimizing
  their reproductive careers does not make it an
  optimal strategy for all women. Given the hand
  that is dealt them for minorities it may be
• Optimal time to have a healthy baby 
• Optimal time for fertility - we have yet to
  evaluate the costs of postponed fertility
  
• Optimal time to get support from family members
  in child care

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Reproductive Strategies Among Individuals of Low
SES (contd)

• Optimal time to combine school and parenthood,
  which may be much easier than trying to combine
  education or work and parenthood later on. Young
  mothers who marry most often tradeoff education
  for reproduction. Young mothers who don't marry
  are more likely to stay in school, graduate from
  high school. In an Oklahoma City sample, of all
  pregnant teens, black women were most likely to
  finish high school
• Little lost in employment opportunities, optimal
  time for employment for unskilled women is 25
  
• Optimal time to find mate, no Mr. Right out there
  waiting for her at age 25

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Reproductive Strategies Among Individuals of Low
SES (contd)

• Young parenthood is no longer associated with
  higher completed fertility (parity), which means
  that active parenting is over by age 25
  
• In fact old Americans have given up high parity.
  Only Americans that have recently immigrated
  think this is a environment of endless
  opportunity with niches for many children. Old
  Americans see it as highly competitive with
  children needing large amounts of investment of
  time, energy, resources. 
• Advantages of short generation length over long
  if help in active parenting is wanted rather than
  money
  
• At least two major ethnic groups in our society
  are combining youthful parenthood with advanced
  training after high school. Blacks and Native
  Americans in dropout rates, college attendance

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Life History Strategies Evolutionary Theory and
Behavioral Ecology

• All sexually reproducing organisms vary their
  number and timing of reproduction in the life
  course in accordance with essential parameters
  
• Distribution of resources in the environment
  necessary for rearing offspring, opportunity
  structure
  
• The availability of suitable mates marriage
  market 
  
• The mortality and morbidity of children relative
  to the mortality and morbidity of adults if life
  expectancy of adults is poor, reproduction is
  hastened even if it means truncating growth and
  development period 
• If what parents can do for offspring enhances
  offspring survival and their reproductive value,
  parents are predicted to go for quality over
  quantity, invest more per child and have fewer
  children
• If parents have no control over the factors that
  affect children, they will go for quantity over
  quality

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Current Situation

• Teen pregnancy and parenthood rates have steadily
  grown since programs first introduced to prevent
  them 
  
• Conference in Albuquerque, organized by state
  agencies, health care providers entitled
  "Children having children"
  
• Keynote speaker states "we know what to do, we
  have the technology" and points to success of
  college campuses and Netherlands in preventing
  early childbearing. Suggests all we need is the
  local support systems available at many colleges
  with the morning after pill, contraceptives,
  abortion counseling, etc. and our teens
  population will stop having children. Sees no
  difference between poor teenagers and college
  girls except lack of access to technology.

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Teenage Childbearing and Neonatal Mortality
Geronimus

• Infants of teens suffer from excessive rates of
  neonatal mortality
  
• when we plot younger and older womens
  pregnancies, we get U-shaped curves for infant
  mortality
  
• What do maternal age variables measure? Do they
  measure a true age effect or is the trend simply
  a result of the disproportionately large number
  of lower-class young mothers that dont have
  access to proper medical care or resources?

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Policy Implications

• Current assumption teenagers are reproductively
  immature and that women in their 20's are mature
  and have not yet incurred ill effects of aging.
  
• These assumptions don't examine whether or not
  the living conditions of the high risk
  populations lead to a rapid deterioration of
  reproductive health with age, STD'S, smoking,
  poor nutrition, drugs, untreated gonorrhea,
  pelvic inflammatory disease, subfecundity and
  ultimately sterility, deleterious effects of
  smoking also increase with age.
• Assumption that if teens could be persuaded to
  postpone into mid twenties that they would be
  healthier and more mature reproductively. But
  the opposite is true. Disadvantages of being in a
  high risk population increase with each year
  health may be very poor by the late 20's. Policy
  curbing teen pregnancy among the poor could fail
  to reduce infant mortality and might even
  increase it.

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Policy Implications (contd)

• Question is if at risk women are asked to
  postpone - will they be healthier?
  
• Infants of first time black mothers aged 24-34
  exhibit equivalent or higher rates of low birth
  weight than infants of teenage first time
  mothers.
• Kass estimates that among low income American
  women, as much as half of the excess low birth
  weight experienced by their infants is related to
  maternal exposure to certain sexually transmitted
  infections such as chlamydia during pregnancy -
  highest rates are in inner cities and isolated
  rural areas. 
• Major improvement in use of contraceptives,
  especially by black females, but teen birth rates
  are up. Can it be that they know about birth
  control, have it available, but don't use it?
• All public health programs are based on the firm
  belief that if "they" had ready access to
  contraception they would use it, because wouldn't
  everyone do better if they waited until their
  mid-twenties to reproduce?

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Major changes in the reproductive behavior of
poor women cf. 25 years ago

• Life history strategy takes into account new,
  changing context of reproduction
  
• They know about and use contraception and
  abortion
  
• They have radically cut down completed family
  size to 2.3 children - recognition by poor In US
  that are native born, this is a tough society,
  very competitive, raising children is very costly
  in money, attention, emotions, high risk, only
  newcomers to US see US as a wide-open bonanza.
  e.g. foreign born Americans from Pacific Rim,
  Caribbean, Central America
• They complete high school
• They enter labor force when their children are in
  school, mid-twenties
  
• They have lowered their rate of marriage
  drastically in relation to the loss of suitable
  male partner

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Brief Overview of What Was Just Covered

• In summary, in the US the populations with high
  rates of teenage childbearing are the same
  populations that are most subject to predisposing
  risk factors for neonatal mortality and they are
  least able to obtain adequate medical service.
  Not surprising that teen mothers should
  experience excessive neonatal mortality,
  infection, malnutrition, stress, smoking and
  inadequate medical services

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Social and Environmental Influences on Teenage
Childbearing

• Common intervention self esteem training and
  self assertion, assuming that pregnant teens have
  low self esteem.
  
• Urban black teens no more likely to engage in
  unhealthy or deviant behaviors than
  nonreproducing peers. Also, pregnant teens who
  keep their child have higher self esteem, better
  relations with their boyfriends and family than
  those who choose to abort.
• Evidence that those teenagers believed by
  families to possess skills necessary to overcome
  chronic barriers to achievement and upward social
  mobility are selected out of peer groups and
  discouraged from bearing children during their
  teens

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Completed Family Size

• Completed family size similar to whites
  -evidence that early fertility is not
  uncontrolled fertility but a motivated
  life-course pattern that is strategically timed.
• Two family planning strategies
• Growth completed - reproduction - education -
  marriage for some
  
• Growth completed - education - marriage
  reproduction
  
• Majority strategy
• Both patterns produce small families
• 1992 mean completed fertility - 2.1 Blacks, 1.82
  whites

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Availability of Quality Males

• Black women outnumber black men by age 20-24.
  Among whites, a comparable excess does not occur
  until ages 55-59, this is just in live bodies,
  remember much more goes into male status on the
  marriage market.

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Staples

• Womans decision to bear children out of wedlock
  is related to the quantity and quality of the
  available pool of marriageable black males which
  have
• high rates of mortality, incarceration,
  interracial mating
  
• unemployment (12.3), military service

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Shortage of Men

• Inability of black males to meet marriageability
  standards is directly related to social and
  economic forces. Changes from a manufacturing to
  a technological work force have decreased numbers
  of available jobs, particularly with inferior
  education.
• Welfare system provides full benefits to young
  mothers only when their mates are absent from the
  home.
  
• All of these factors create a shortage of black
  men relative to black women during the
  marriageable years.

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Adaptation to Child Rearing in a World With a
Shortage of Eligible Males as Partners An
Age-Condensed Family Structure and
Intergenerational Caregiving

• Age condensed families have a greater number of
  people across and within generations who are also
  closer in age than people in the families of
  later child bearers.
• Late child bearers greater distances between
  generations is a trend in direct conflict with
  the caregiving needs of children and dependent
  elderly parents, grandmother of 50 put in a
  position of shouldering the dependency of frail
  elderly parents and young grandchildren needing
  childcare, etc.

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Adaptation to Child Rearing (contd)

• Tradeoff for a short intergeneration span paid by
  the poor is economic stability families that
  delay child bearing are much more likely to have
  viable economic resources than families that do
  not.
• If you cant afford daycare or nannies, best to
  have a young, vigorous grandmother or older
  children who can assist in care of younger
  siblings, young adults who can help older family
  members and young grandmothers who can parent the
  infants of teen mothers.

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Implications for Social Policy

• Changes in social policy should take into
  consideration the social reality of those who
  bear children early. If teen parenthood is an
  adaptive response to a social reality as it is
  experienced by individual women, policies that do
  not attempt to alter that reality are likely to
  fail.
• They might even cost more. Problem of teenage
  pregnancy has been framed collectively that their
  fertility behavior costs the tax payer extra
  dollars for welfare expenditures.
• However, logical extension is that postponement
  of childbearing among the poor could, without
  other changes, lead to increased rates of
  neonatal mortality, childhood morbidity, and
  STDs, as well as to longer periods of single
  parenthood, welfare dependency and greater number
  of years spent in poverty by some children
  because their mothers would not get the help they
  need to complete their education and enter the
  labor market.
• Third world - even greater effects, poor
  nutrition and health slow and compromise growth,
  early deterioration of health means that there is
  an even smaller window of opportunity. Healthy
  reproduction should be as soon as possible after
  fertility established.

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Modern US - Perhaps 2 Life Course Patterns for
Timing of Reproduction with Same Total Fertility

• Growth completed - reproduction - education -
  marriage for some
  
• Growth completed - education - marriage -
  reproduction