Teen Pregnancy

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Perceptions of pregnant/parenting teens: Reframing issues for an integrated approach to pregnancy problems
Author: Rodriquez, Cleo Jr; Moore, Nelwyn B ProQuest document link Abstract (Abstract): Rodriquez and Moore investigated the correlations between personal, family, and

educational background factors and unplanned teen pregnancy. Significant differences among respondents to an anonymous questionnaire were related to family

relationships, race/ethnicity, and sexuality education. Abstract: Indisputably, unplanned teen pregnancies have myriad personal, family, and social consequences, but

answers to questions surrounding this phenomenon are far less obvious. The purpose of this investigation was to determine correlations, if any, between personal,

family, and educational background factors and unplanned teen pregnancy. An anonymous questionnaire was administered to 341 volunteer respondents in 14 Teenage

Pregnancy/Parenting Programs (TAPPS). Significant differences among respondents were related to family relationships, race/ethnicity, and sexuality education. These

findings provide valuable information for family science researchers, family life educators, health personnel, policymakers, and parents who wish to ameliorate the

problems in teen pregnancy/parenting by reframing issues for a more intergrated approach involving both prevention and intervention. Links: Linking Service Full text:

INTRODUCTION Americans take great pride in their leadership among nations. Such a distinction becomes dubious, however, when the title is claimed for the highest rate

of teen pregnancies among industrialized societies. By the mid-1970s, teenage pregnancy in the United States had become an issue of grave concern for policymakers,

educators, clinicians, and parents as well as for teens themselves (Christopher &Roosa, 1990). In spite of the fact that the use of condoms more than doubled during

the 1980s, as of 1990, one-third of sexually active teens were still practicing unprotected sex and 60% of their pregnancies were unplanned (“Sexuality…”, 1990).

This sad social commentary was evidenced by a record 1.16 million babies born to unmarried mothers in 1990, most of whom were teenagers (“Paternity Establishment

Plan…,” 1993). The multiple personal and social implications rooted in teen pregnancies are well documented. Babies born to teen mothers are at increased risk of

developing physical, social, and cognitive problems and deficiencies (Henshaw, Kenney, Somberg, &Van Vort, 1989). Teenage mothers do not acquire as much education as

teens who delay childbearing; therefore, they are less likely to find stable employment and more likely to rely on public assistance, thus perpetuating the cycle of

poverty (Furstenburg, 1991). In fact, one half of teen mothers go on welfare within a year, and 77% within five years (“Face up to Sex Ed,” 1993). In 1989, the

national public cost of all families started by a teen birth was $21.6 billion (“Teenager Pregnancy…”, 1990). At that time, the annual cost of providing first-year

welfare services in the form of Aid to Families with Dependent Children (AFDC), Medicaid, and food stamps to a low-income mother and her child was $9,200.

Paradoxically, the annual cost of family planning services under Title XIX for a sexually active teen was only $64 (“Systems Report MI…”, 1990). The spiraling costs

continue to climb. For example, in one state, the average monthly cost for AFDC benefits rose from $18.2 million in 1991 to $25.5 million in 1992 (“Adolescent

Pregnancy…”, 1993). From any view, a too-early teen pregnancy is costly to both the persons involved and to society. Purpose of Study Because of their complexity,

teen pregnancy issues are usually investigated within singular frameworks such as 18 August 2014 Page 1 of 13 ProQuest

developmental, cognitive, and/or social learning theories. Further, the focus of current programs and practices for teens and their babies is on either intervention or

prevention. The urgency of solving the escalating teen pregnancy problems, however demands that professionals in research, medicine, therapy, and education, adopt a

perspective of integration. A model recently proposed in the family therapy field as a biopsychological framework offers such an integrated alternative (Weiner, 1993).

Accordingly, connections among various factors impacting an issue are holistically explored. This investigation was designed to seek connections among the

developmental, cognitive, social, and emotional variables inherent in teen pregnancy issues by assessing the perceptions of pregnant teens currently enrolled in

school-based pregnancy/parenting programs. Data were sought to determine correlations among personal, family, race/ethnicity, and educational background variables and

unplanned teen pregnancy. Basic assumptions, based on a review of the literature, were that teens who demonstrated a lack of responsible sexual decision making with a

too-early pregnancy would exhibit the following characteristics: (1) membership in one-parent family; (2) a lack of emotional closeness with family members; (3) a

dearth of sex education in their family and educational backgrounds; and (4) race/ ethnicity differences related to marital status of parent(s), attendance at

religious services, and feeling good about self. While the initial purpose was concerned with intervention, that is, obtaining data with which family practitioners can

improve the current programs and practices for pregnant teens and their babies, the ultimate goal is prevention. By furnishing pragmatic, integrative information for

family science professionals and policymakers interested in developing and promoting preventative models of educational strategies, healthier behaviors may be effected

in future generations. Such early intervention has the potential to disrupt the cycle of failure so often experienced by teen mothers and their babies and to stem the

tide of this growing phenomenon. REVIEW OF LITERATURE Conceptual Framework Pregnancy at any age generates developmental change, but in a teenager it can create a

developmental crisis. When the stress of two developmental stages, adolescence and young adulthood are compressed, successful completion of both sets of tasks is

compromised. Failure to accomplish the developmental tasks at hand not only places the teen at risk for further developmental difficulties, but places the children of

teens at biological, social, and psychological risk. For example, infants born to teen mothers are more likely to be born premature and, therefore, in a higher risk

category for problems with respiration, body temperature, and digestion (Zigler &Stevenson-Finn, 1987). When the problems inherent in coping with a premature infant

are added to the normal pressures of the adolescent years, infants of teen parents are also at greater risk of being abused. Parenting is stressful, but teenage

parenting, fraught with developmental issues, is particularly so, often leading to a cyclical inability to cope with further stress (Morrison, 1990). Adolescent

mothers, specifically, lack parenting skills. When compared to older mothers, for example, they communicate less with their children and are less expressive and

responsive, as evidenced in lower levels of play and interaction (Dusek, 1991). As a result, the children of teen mothers do not develop and progress at optimal levels

and they are more likely to be disadvantaged because of their higher risk of growing up in a single-parent home (Morrison, 1990). Evidence suggests that teen mothers

themselves are most likely to have come from homes with a single-parent who had limited control over the adolescent’s behavior. Such mothers potentially model behavior

in dating and sexual relationships that could alter their daughters’ perception of sexuality (Dusek, 1991). Frustration in school, low achievement, and lack of

economic success in later life by children born to adolescent mothers are only a few of the individual consequences of early parenthood with obvious social

implications (Davis, 1989). Teen Developmental Profile What is normal adolescence? The answer to this question appears to be changing according to recent research

examining the connection between puberty changes, cognitive development, and emotional growth (“What is…”, 1993). Acknowledged at the beginning of this century as a

period of transition from childhood to adulthood, adolescence was often characterized as turbulent in both research and public policy (Chilman 1990). Research 18

August 2014 Page 2 of 13 ProQuest

today reveals that the passage to adulthood is far more calm than previously believed. It is now viewed more simply as a time to renegotiate roles. There are, however,

specific developmental characteristics of adolescence that can furnish insight into teen pregnancy issues. Physical development. “Babies having babies,” is a commonly

used phrase to describe adolescent pregnancy. A twelve-year-old girl is faced with a multitude of problems caused by an unplanned pregnancy. While embarking upon the

normal developmental tasks of adolescence, feelings of self-confidence are challenged by rapid increases in height, changes in body proportions, and the realities of

sexual maturity. Time is needed to integrate these changes into a positive self-image, an arduous task even without the added bodily distortions of pregnancy (Conger,

1991). In the study of teen pregnancy, increasing attention has focused on early sexual involvement and its relationship to the escalated physical development in

earlier menarche. The onset of menarche has dropped from a mean of 14 years in the early 1900s to a mean of 12.5 years by the late 19608 (Davis, 1989). This escalated

physical development encourages earlier sexual activity while their cognitive skills for decision making are still unsophisticated. The convergence of myriad factors,

including earlier age of menarche, growing up in a sex-saturated society with less parental supervision and more peer pressure, means that today’s teens may be faced

with making premature sexual decisions. In contrast, former generations did not have to make such decisions until they were developmentally more capable (Zigler

&Stevenson-Finn, 1987). Cognitive development. The teen years, characterized by many changes and adjustments, are recognized as a time when teens have limited

cognitive tools to address such problems as whether to become sexually active or how to deal with the consequences of an unplanned pregnancy. Since developmental and

chronological age levels may differ significantly, many young persons reach the reproductive years with less than adequate decision-making skills to face questions

surrounding a too-early pregnancy (Morrison, 1990). For the young girl whose developmental age limits her achievement of autonomy, the decision to carry to term, to

abort, to place for adoption, or to keep the baby, may be based more on parental values than on her own value system. Developmentalists link unintended pregnancies to

variations in cognitive development. According to Piaget’s Theory of Cognitive Development, operational thinking, essential for planning for the future, is not yet

fully developed in teens. Consequently, they are less likely to perceive the advantage of preventive behavior (Davis, 1989). Also, risk-related behavior is reinforced

by another cognitive characteristic of the adolescent called “magical thinking,” a belief that one is magically protected from dangers that only happen to other people

(Zigler Stevenson-Finn, 1987). Social development. Social learning theorists have speculated that teens form their feelings, thoughts, and actions from observing and

imitating others whom they perceive as appropriate role models, whether they are adults or peers (Dusek, 1991). As young teens approach the middle adolescent years

(ages 11-15), the pressure of peer rejection increases as does the motive to conform. Some research models have implied that early sexual involvement ensures a more

pseudo-sophisticated status for a teenager among her/his peers. This false sense of maturity also increases chances that the teenager will participate in other

nonconforming behavior, such as involvement with a “fast crowd,” increasing susceptibility to related negative consequences (Billy, Landale, Grady, &Zimmerle, 1988).

Specific behaviors correlated with early sexual activity are smoking and school misbehavior requiring disciplinary action (Davis, 1989). Emotional development.

Although some sexually active teens have emotional problems, most who experience an unplanned pregnancy are simply caught up in an immature, emotional, caring

relationship that is expressed by sexual intercourse (Duesk, 1991). In fact, the pregnant adolescent is usually described as outgoing and typical, not rebellious,

maladjusted, or deviant. However, because of the instability of their developmental stages, teenagers may be more prone than others to emotional outbursts, dramatic

mood changes, and acute depression (Zigler &Stevenson-Finn, 1987). Add a baby to this highly charged environment and the risk for child 18 August 2014 Page 3 of 13

ProQuest

abuse escalates. These babies are in the hands of a parent who, in many cases, is very immature and incapable of understanding the developmental needs of self, not to

mention those of a baby. For example, problems often occur when baby decides to test his/her autonomy skills with parents who have not yet satisfied their own need for

power (Wallis, 1985). Teen Pregnancy Programs Because of the concerns about teenage pregnancies, several types of intervention programs have been initiated. The most

common is the school-based Teen-Age Parenting Program, or TAPP (Roosa, 1986). Originally, their primary goals were to provide an academic environment with in-house

medical and social services to reduce pregnancy-related school dropouts and to ensure academic progress during pregnancy (Morrison, 1990). More recently, the focus of

many school-based programs has been not only students who are parents, but their children. Objectives have grown to include preparation for parenting and, at times,

quality child care. One survey of 18 school-age parenting projects revealed that 55% included mother-father-child, 38% mother and child only, and 5% mother only (Moore

&Krals, 1991). Although efforts to reduce the rates of adolescent pregnancy in the United States have spanned two decades, there are few well-evaluated programs, and

even fewer evaluation results that have been published (Carrera, Dempsey, Philliber, &Philliber, 1992; Stahler, DuCette, &McBride, 1989). Nevertheless, teen mothers

enrolled in pregnancy-parenting programs have been found to show a significant increase in their knowledge of human reproduction and child development (Roosa, 1985).

While the immediate effect on teen mothers’ knowledge was small, the TAPPS have had a significant impact in helping mothers who stayed in the program to complete their

education. It is suggested that TAPPS may be serving a small, elite group of fairly well-informed and motivated teens but are having little, if any, impact on the

lives of the majority of teens who need the services. Teen parenting programs that do nothing more than provide the opportunity for teen mothers to continue their

education are, however, viewed as serving a valuable purpose because of the long-term value of education (Roosa &Vaughn, 1983). METHOD Sample The sample was comprised

of 341 pregnant/parenting teens, ages 11-19, who were enrolled in 14 schoolbased pregnant/parenting programs in Texas. Of these participants, 46% were 16 years of age

or younger (see Table 1). The majority of the respondents were Hispanic, never married, reared in a one-parent home, and below 12th grade in school (see Table 1). As

for the education level of the parent(s) of the pregnant/parenting teen, about one half had less than a high school education: mothers 48% and fathers 52% (see Table

1). Procedure An anonymous questionnaire was administered to volunteer respondents enrolled in 14 school-based pregnant/parenting teens programs. The survey

instrument, designed to assess perceptions of pregnant/ parenting teens, consisted of 83 items that addressed personal, family, and educational backgrounds as well as

peer relations, future plans, and prenatal health. The questionnaire was pretested in select school districts in Central Texas. Questionnaire packets, consisting of a

cover letter, survey instrument, optical scan sheet, and return envelope, were distributed to those schools that agreed to participate in the project. Program staff

administered and returned the completed questionnaires. Given the nonrandom manner in which the respondents were obtained and the levels of measurement developed for

the data collection process, the chi-square test was chosen to evaluate any group differences. For the purpose of this study, the significance level was established at

p <.05. It should be noted that the reported p values of .000 were, in fact, zero to three decimal places after rounding the values upward. RESULTS Profile of

Pregnant/Parenting Teens 18 August 2014 Page 4 of 13 ProQuest

Family relationships. While growing up, 58% of the pregnant/parenting teens lived in a one-parent household (see Figure 1). (Figure 1 omitted) Of these households, 66%

had been created either through divorce or separation, but in only 2% of the cases were these father-only homes. In the two-parent households, 62% involved a

remarriage on the part of either the father, mother, or both (see Figure 1). As might be anticipated, the pregnant/parenting teens had a closer relationship with their

mothers than with their fathers. In rating their parental relationship, 70% of the teens rated their relationship with their mother as either “excellent” or “good.” In

contrast, only 45% gave a similar rating to their relationship with their fathers. With regard to independence, 21% believed their parent(s) gave them “too much”

independence, and 32% believed they gave them “too little” independence. Thus, it came as no surprise that when asked if they would consult with their parents about a

problem, evidence of poor communication emerged. Of these teens, only 34% would “always” or “usually” consult with their mothers and only 13% would confer with their

fathers. Nonetheless, 68% indicated that their parents were supportive of their pregnancy. Father of baby. It is of interest to examine the relationship, if any,

between the pregnant/parenting teen and the father of the baby, hereafter referred to as FOB. Since male dating partners tend to be, on the average, three years older

than their female counterparts, it was expected that many FOBs would be older than the pregnant/parenting adolescents. As anticipated, over one third of the FOBs were

age 20 or older (see Figure 2). When asked about their relationship with the FOB, 81% of the adolescents replied they were “in love” with him. In fact, 82% reported an

exclusive relationship with the FOB at the time of conception. Circumstances evidently changed for many respondents after they became pregnant, however, with 21%

reporting “no relationship” with the FOB and 17% indicating being “friends” only (see Figure 2). Despite these findings, 77% of the FOBs gave a “supportive” response

upon learning of the pregnancy. Risk-taking sexual behavior. In assessing sexual risk-taking behavior, it was determined that 35% of these adolescents had initially

experienced sexual intercourse before age 14 and another 60% had their first intercourse between ages 14-16. Other evidence of risk-taking can be found in their

contraceptive practices. Among these respondents, 89% had used no form of contraception prior to becoming pregnant. In fact, 55% indicated that although sexually

active, they thought they never would become pregnant. It should be noted, however, that 31% of these teens reported intentionally becoming pregnant. Perhaps substance

abuse was also a factor because 48% were using alcohol or some other form of drugs at the time of conception (25%–teen herself, 14%–partner, or 9%–both). Parenting

plans. Of these adolescents, 46% plan to rear their child by themselves, while 50% plan to rear it together with the FOB. It is of interest that when comparing their

anticipated degree of strictness in child-rearing practices with those of their own parent(s), 21% of the teens planned to be more strict, 28% less strict, and 22% the

same as their parent(s). The two most important ways that they planned to prepare for child rearing were personal experience (69%) and advice from parent(s) 42%. It is

important to note the areas of family life education about which they wanted to learn more. These were child development and child guidance (65%), financial management

(32%), effective discipline (26%), relationships with others (20%), and personal and home management (19%). Sex education. Of the teens surveyed, only 52% reported

that their parent(s) had ever talked with them about sex, and such information tended to come late. Only 17% indicated that their parents discussed sexuality with them

before age 11. Among topics discussed by parents were premarital pregnancy (69%), contraception (56%), sexually transmitted diseases (51%), pleasurable aspects of

sexual intercourse (35%), and masturbation (8%). Seemingly, these respondents were aware of the deficits in their sexuality education because an encouraging 83%

reported that, as parents, they planned to provide more sex information to their child(ren) than their parents(s) had done. Future education/career plans. In reviewing

the data on school performance, 44% of the respondents reported their usual grades to be in the second quartile (Bs) of their class, and 31% in the third quartile

(Cs). With respect 18 August 2014 Page 5 of 13 ProQuest

to their education plans after having a baby, 77% intended to complete high school. Of those who anticipated graduating from high school, 20% planned to attend

technical college, 23% a two-year college, and 48% a fouryear college/university. Statistically Significant Factors After completion of the statistical analyses, all

assumptions concerning pregnant/parenting teens were substantiated. These adolescents perceived a lack of emotional closeness with their parent(s), indicated a dearth

of sex education, and evidenced race/ethnicity differences on key variables. Family relationship variables. There were four statistically significant variables related

to emotional closeness in the family (see Table 2): teens in two-parent families were more likely to have a positive mother/daughter relationship than those in one-

parent families; teens in two-parent families were more likely to have a positive father/ daughter relationship than those in one-parent families; teens with a

positive mother/daughter relationship were more likely to feel good about themselves than those with a negative mother/daughter relationship; teens with a positive

father/daughter relationship were more likely to feel good about themselves than those with a negative father/ daughter relationship. (Table 2 omitted) Sexuality

education. Concerning sexuality education, there were two significant variables related to the race/ethnicity of the pregnant/parenting teens: black teens were more

likely to have received sex information from their parent(s) while growing up than were Hispanic or white teens (see Table 3); Hispanic teens were more likely than

black or white teens to plan to provide their children with more sex education than they had received from their parent(s) (see Table 3). (Table 3 omitted)

Race/ethnicity variables. Finally, there were four significant differences associated with race/ethnicity and the variables of parent status, religious participation,

and feeling good about self (see Table 3): Hispanic teens were more likely to have grown up in two-parent families than were white or black teens; white teens were

more likely to have divorced parents than were black or Hispanic teens; black teens were likely to attend religious services more frequently than were Hispanic or

white teens; black teens were more likely to feel good about themselves than were Hispanic or white teens. As the findings of this study indicate, 25% of the

respondents were under age 14 when they experienced their first sexual intercourse, and 30% of them had intentionally become pregnant. Therefore, the fact that most

parents waited until at least ages 11-13 to provide sex information, poses a “too little, too late” dilemma. In fact, sexuality education teachers indicated in a

recent survey by the Alan Guttmacher Institute that instruction about sexuality does begin too late. Between 30-50% of teens have their first sex education course

after grade 10 which, for many, is aer they have had sexual intercourse (“Face up to Sex Education,” 1993). Some research questions the relationship between sex

education or knowledge about sexuality and the postponement of sexual intercourse and/or the use of contraceptives among adolescents younger than age 17 (Howard

&McCabe, 1990). One review of two decades of pregnancy prevention efforts, however, concluded that providing both sexuality and contraception education helps

adolescents act more responsibly (“Sex Ed Promotes…” 1992). While a need for further study is acknowledged, it may be that the issues need to be reframed. It is

likely that such findings are related to two facts that surfaced in this study. Parents, as sex educators, most often emphasize only the dangers and risks of sexuality

with little, if any, mention of its pleasurable aspects. Also, parents often believe themselves to be sex educators of their children after having mentioned the

subject only once (Francoeur, 1991). Many young women in this study who reported intentionally becoming pregnant indicated having the “right” amount of free time while

growing up. This finding is consistent with other research that has found pregnant teenagers are least likely to be involved in extracurricular school activities and

more likely to evidence a lack of planned activities and more unsupervised time (Pete &DeSantis, 1990). When, from a teenager’s perspective, there is the “right”

amount of free time, it is likely to be unsupervised time. Perhaps the fact that many of those with more free time did choose to become pregnant reflects a lack of

structure and connectedness to parents, 18 August 2014 Page 6 of 13 ProQuest

variables that reflect low self-esteem. Adolescents with high self-esteem and a belief that they have future options are less likely to experience a pregnancy while

unmarried (Franken &Budlong, 1988). As noted, many pregnant teens in this study reported a lack of closeness to their families. Females who grow up in a family where

they are able to develop and maintain a balance between emotional closeness and individuation are better able to withstand peer pressure to have sexual intercourse

(Barnett, Papini, &Gbur, 1991). Families who do not foster this individuation and closeness place their teens at risk of feeling socially and emotionally isolated.

Such feelings may be compensated for through the establishment of premature sexual relationships. Further, adolescents who perceive that they have little parental

support and who do not communicate well with their parents are also more likely to become sexually active (Casper, 1990). Pregnant adolescents who frequently

experience stressful relationships with their fathers fail to seek health-related services, including contraception (Moss, 1987). The pregnant/parenting teens in the

present study had a positive relationship with both mother and father but a low probability of discussing problems with either parent. This finding agrees with that of

Pete and DeSantis (1990) who found that even young women who have positive relationships with their parents still feel limited in what they can discuss with their

mothers. The correlation of positive father/daughter relationships with feeling good about self, and the more positive relationships with mother and father reported by

those from two-parent families underscores the importance of family relationships in dealing with teen pregnancy issues. Family involvement, regardless of how it is

defined and measured, is positively associated with a large number of outcomes for the female teen and her family (Hanson, 1992). In this era of health reform, “family

centered’ and “family-friendly” are words frequently used to define the ideal health care system (“Principles of Family-Centered…”, 1992). By recognizing parents as

partners with professionals in planning, providing, and evaluating health care, the family system becomes the focus for support and services. The fact that Hispanic

teens in this study were more likely to be from two-parent homes, but less likely to have received sex education, suggests the need to investigate other questions,

including cultural and economic variables. For example, why are Hispanic teen mothers more likely than those of other races and ethnic groups to live with a parent who

is also single (Berger et al., 1991)? A plausible answer may be linked to the finding that Hispanic families more significantly influence decisions made by their

children than do non-Hispanic, white families (Clayton, Gonzalo, Underwood, &McEndree, 1992). Although family background factors were significantly related to too-

early teen pregnancy in this study, some commonly held assumptions about oneparent families were challenged. For example, the findings suggest that divorced

Expound on the topic