Adolescent Repeat Pregnancies: An Evaluation Study of a Comprehensive Service Program for Pregnant and Parenting Black Adolescents

Abstract

To meet the needs of black adolescent childbearing which occurred in 1988 at the rate of 88.9/1000 versus 26.6/1000 for whites 8 comprehensive service programs provided by the nonprofit agency Family Focus/Our Place in the Chicago area were set up and evaluated for their impact on repeat pregnancies. A selected review of evaluative research studies of repeat pregnancies revealed that participation in an program did not affect longterm incidence of repeat pregnancy but was marginally associated with a slight postponement. The 8 programs evaluated consisted of 1 prebirth service 4 comprehensive pre and post birth services and 3 post birth services serving entirely black females since 1979. The sample included 52 single girls referred to the agency between 1981-83 who were between 12 and 19 years and pregnant with their 1st child. 90% had <a high school education 75% lived in extended family households and maintained contact with relatives in the community. Assessment took place 2 years after referral and 4 years after. All subjects were rated on program utilization repeat pregnancy occurrence and time elapses between pregnancies. 3 caveats are noted: that generalizability is limited due to lack of random sampling the power of statistical significance was limited by factors such as small sample size and insufficient background information limits detailed analyses. All came from environments with a high risk for repeat pregnancy. The results were that the probability of a repeat pregnancy was relatively low (13.5% of subjects within 4 years). Level of participation in the program did not predict those with a repeat pregnancy. The combined pre and post services played a positive substantial and significant role in accounting for the variance in the length of time before a 2nd pregnancy (15% of the variance) controlling for subjects background including prior participation in the prebirth programs. The implications are that adolescent mothers can obtain knowledge about motherhood parenthood and build positive self images in a secure environment. Each lecture provided for feedback and a reward system. Interaction involved individual concerns staff support belief in the client and warmth. Sessions were intensive meeting daily and 2 evenings a week for 2 and a half hours. Followup post pregnancy tied clients to a center. Case management systems are recommended as well as expanded utilization rating scales and a support system inventory at entry and exit points in each program. Since 80% of the variance was unexplained research is needed.