Adolescent Childbirth Research Articles

Determinants of Adolescent First Births in Indonesia

Adolescent childbirth remains a central issue for lower-middle-income countries such as Indonesia. The available literature suggests that this is associated with several adverse outcomes, including health and socioeconomic factors. This study aimed to evaluate determinants that correlate with mothers in Indonesia who first gave birth when they were adolescents. This study is a cross-sectional and examined data collected by Indonesia Demographic and Health Survey (IDHS) in 2017. We investigated the variables of educational level, wealth index, residence, and access to media (frequency of reading newspaper or magazine, listening to the radio, watching television, using the internet) and their correlation with a weighted sample of women who had their first live birth when they were younger than 19 years old. We used multivariate logistic regression to adjust for confounding factors and to analyze the determinants of adolescent first birth. Education (AOR=15.39; 95 CI=11.13-21.26), wealth index (AOR=1.22; 95 CI=1.08-1.39), place of residence (AOR=1.23; 95 CI=1.13-1.34), frequency of reading newspaper or magazine (AOR=1.31; 95 CI=1.11-1.55), and frequency of using internet (AOR=1.30; 95 CI=1.02-1.65) were significant determinants of.adolescent first births in Indonesia. This study recommends better access to education for poor and lower educated young women to be prioritized. Policies and programs that support the wellbeing of adolescents to achieve the best outcome of health reproduction are needed. © Advanced Scientific Research. All rights reserved.

Trends and determinants of adolescent childbirth in Uganda- analysis of rural and urban women using six demographic and health surveys, 1988\u20132016

IntroductionUganda has high adolescent pregnancy. The details of adolescent childbirth and urban/rural patterns are scarce. We investigated the levels, time trends and determinants of adolescent childbirth in Uganda separately for urban and rural women.MethodsWe estimated the percentage of women 20–24 years at each of the six Uganda Demographic and Health Surveys (1988/89, 1995, 2000/01, 2006, 2011 and 2016) who reported a live childbirth before age 20 years (“adolescent childbirth”), and examined change over time using t-test. A modified multivariable Poisson regression was used to examine determinants of having adolescent childbirth on the 2016 survey.ResultsAmong these women, 67.5, 66.4, 70.1, 62.3, 57.3 and 54.1% reported an adolescent childbirth in 1988/89, 1995, 2000/01, 2006, 2011 and 2016 surveys, respectively. Between 1988/89 to 2000/01, there was no evidence of change (+ 2.6% point (pp), p = 0.170), unlike between the 2000/01 and 2016 surveys when a significant decline occurred (− 16.0 pp., p < 0.001). First childbirth < 18 years of age declined by − 13.5 pp. (p < 0.001) between 2000/01 and 2016. There was no change over time in the percentage of adolescents 18–19.9 years of age having first childbirth. Among rural residents, childbirth < 18 years declined from 43.8% in 1988/89 to 32.7% in 2016 (− 11.1 pp., p < 0.001), in urban it declined from 28.3 to 18.2% (− 10.1 pp., p = 0.006). There was an increase over time in the percentage of women, both rural and urban, who wanted to delay their first pregnancy. Independent determinants of reporting an adolescent childbirth in both urban and rural residents were: no education/incomplete primary and younger age at first sex. Additional determinants for rural women were residence in Eastern region, Muslim religion, and poor household wealth index.ConclusionIn the 30-year period examined, adolescent childbirth in Uganda declined from highs of 7 in 10 to approximately 5 in 10 women, with more wanting to delay the pregnancy. The decline started after the 2000/01 survey and affected predominantly younger adolescent childbirth < 18 years among both rural and urban residence women. Efforts need to be intensified to sustain the decline in adolescent pregnancies. Targeted and specific strategies for urban and rural areas might be required.

Roma origin as a factor for high level of adolescent fertility and abortion rate in European Union

Abstract Background Adolescence is a vulnerable phase in human development. Adolescent girls from Roma origin, especially younger girls, are particularly vulnerable because they face the risks of premature pregnancy and childbirth. The study aims to evaluate the association between Roma origin of mothers and prevalence of adolescent fertility and abortion rate in EU member states. Methods A correlational study was conducted and data on prevalence of adolescent fertility and abortion among adolescent girls (per 1000 live births) were extracted from European database “Health for all”. The means of variables in different countries were compared and Pearson’s correlation coefficients with share of Roma population were calculated. Data processing was performed by SPSS v.24. Results Increasing trend in premature childbirth has been observed in parallel with the increase of share of Roma population within countries, significantly more expressed in South-East member states. The mean adolescent live birth rate in the countries with highest proportion of Roma population was 5.6 times higher as compared to the mean for those with lowest proportion of Roma population. The highest level of proportion of live births to mothers aged less than 20 years was found in Romania (9.8%) and Bulgaria (9.5%). At the same tame proportion of Roma population in those countries is highest: Bulgaria (4.7%) and Romania (2.5%). The relation of adolescent fertility rate with share of Roma population shows significant positive correlation (r = 0.804, with 2-tailed significance p = 0.000). As far as the correlation of abortion among adolescent girls with the Roma origin is concerned, it is inverse and not significant. Conclusions Our results indicate significant correlation between share of Roma population and adolescent live birth in EU member states. A holistic approach is needed in which socio-economic development and education of Roma girls leads to further reduction of adolescent childbirth and abortions in EU. Key messages Adolescent girls from Roma origin in EU face the risks of premature pregnancy and childbirth more expressed in South-East member states and significant positive correlation for it was found. Bulgaria is the country with highest share of Roma population (4.7%) and in the second place according proportion of live births to mothers aged less than 20 years (9.5%) in the EU in 2015.

Adolescent childbirth, miscarriage, and abortion: associations with changes in alcohol, marijuana, and cigarette use.

Adolescent girls who become pregnant demonstrate greater risk for substance use than same-aged peers. However, it remains unclear how risk relates to normative changes in adolescence. Few studies have examined adolescent substance use changes before, during, and after pregnancy and considered how pregnancy outcomes (childbirth, miscarriage, abortion) differentially influence substance use changes. The present study examined associations between different adolescent pregnancy outcomes and within-person changes in substance use from prepregnancy to postpregnancy. Participants included 2,450 girls (52% Black) oversampled from low-income urban neighborhoods in Pittsburgh, PA. Participants self-reported pregnancy outcomes and substance use frequency (alcohol, cigarette, marijuana) annually from ages 11-20. Fixed effects regressions focused on first births, first miscarriages, and first abortions occurring from ages 12-19 to test the associations between pregnancy outcomes and within-individual changes in substance use from prepregnancy to postpregnancy. By design, models controlled for all potential time-stable confounds,and models included age and subsequent pregnancies as time-varying covariates. Consistent with prior studies, girls who became pregnant (20%) reported greater early risk for substance use problems than never-pregnant adolescents, including earlier age of onset and more regular marijuana and cigarette use. Childbirth predicted a 26%-51% within-individual reduction in alcohol, marijuana, and cigarette use that remained significantly lower than prepregnancy levels after childbirth. Alcohol and marijuana use decreased (32%-47%) after miscarriage. Abortion was not associated with long-term changes in substance use; however, marijuana and cigarette use gradually increased (44%-46%) in the years leading up to the year of and after abortion, respectively, before returning to prepregnancy levels. Findings highlight important differences in adolescent substance use patterns based on pregnancy outcome. For pregnant adolescents with heightened pre-existing risk for substance use, pregnancy may be a window of opportunity for substance use screening and behavioral intervention.

Collaborative Governance Program GenRe Sebagai Upaya Peningkatan Kesadaran Remaja Terhadap Kesehatan Reproduksi di Provinsi DIY

Problems of adolescence such as unwanted pregnancy, early marriage, risky adolescent childbirth have sought attention to urgently resolve. Based on the data from family planning institute (PKBI), as many as 976 of 1.078 childbirth cases happened at age 10-18 years in 2015. This study focuses on finding out the possible collaborative dynamics in GenRe program, which aims at checking adolescence reproduction health. This research uses descriptive method with qualitative approach and case study design. Based on the research, it showed that the highly and interest power have Gubernur DIY, BPPM DIY, Dinas Dikpora DIY, Dinas Sosial DIY, Dinas Kesehatan DIY, Perwakilan BKKBN DIY between stakeholders including with power and interests low have Biro Kesra Setda DIY. Collaboration has been done through principled engagement, share motivation and capasity of join action show FP2KRR forum, but the leadership and management resources are still under expectation.

Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial

BackgroundEarly marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living.MethodsThe study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives.DiscussionWhile the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be considered seriously when evaluating whether such a program can justify the required investments in a setting with scarce resources. The economic evaluations outlined in this paper will generate valuable information that can be used to guide large-scale implementation of programs to address the problem of the high prevalence of adolescent childbirth and school drop-outs in similar settings.Trial registrationClinicalTrials.gov, NCT02709967. Registered on 2 March 2016. ISRCTN, ISRCTN12727868. Registered on 4 March 2016.

A Comparison of Childbirth Costs for Adolescents and Adults From 2001 to 2010

PurposeAlthough teenage birth rates in America have fallen to a historic low of 26.2 births per 1,000 teenagers, the U.S. remains behind the rest of the industrialized world. Adolescent pregnancy is relatively well discussed in today's literature, with ever more detailed estimates constantly emerging to quantify the cost of children born to America's teenagers. This study, however, describes the financial cost of childbirth in the U.S. with a specific focus on understanding the impact of adolescent childbirth in comparison to that of adult women and of annual childbirth as a whole. MethodsThis retrospective cohort study used data from the 2001–2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS), a uniform, multistate database containing information regarding approximately 8 million hospital inpatient stays per year of data. Data were analyzed involving payment type, length of stay, and aggregate cost of all childbirths to adolescent girls (under 18 years of age) and to adult women. ResultsThis study found that Medicaid pays for the majority (70%) of births to adolescent girls, whereas private insurance pays for the majority (53%) of births to adult women. This was in contrast to the Medicaid coverage of 41% of all childbirths within the study time frame. Furthermore, the aggregate cost of childbirths to adolescent girls paid for by Medicaid was $670 million. ConclusionsBeyond their social impact, births to adolescent mothers place a financial burden on the national economy. Stronger efforts must be made to decrease adolescent childbirth.

Comparing the use and content of antenatal care in adolescent and older first-time mothers in 13 countries of west Africa: a cross-sectional analysis of Demographic and Health Surveys

West Africa has the highest proportion of married adolescents, and the highest adolescent childbirth rate and maternal death rate in sub-Saharan Africa. However, few studies have focused on the type and quality of health care accessed by pregnant young women in countries in this subregion. We obtained data from Demographic and Health Surveys done between 2010 and 2014, to compare the use, timing, source, and components of antenatal care between adolescent and older first-time mothers in 13 west African countries. The sample included primiparous women who were aged 15-49 years with a livebirth in the 5-year survey recall period, and women were assigned to one of three groups on the basis of age at the time of childbirth: adolescent (10-19 years), young adults (20-24 years), or adults (25 years or older). We calculated the percentage of women who: attended at least one antenatal care visit, completed at least one visit during the first trimester of pregnancy, attended four or more appointments in antenatal care, and received four components of antenatal care (blood pressure measurement, urine tests, blood tests, and information on complications), as well as the sector where the women received care. We primarily report the comparison between adolescents and young adults. In 2016, we acquired data from the Demographic Health Surveys from 13 west African countries between 2010 and 2014 on primiparous women. The study sample was 19 211 women, of whom 10 025 (52%) were adolescents, 6099 (32%) were young adults, and 3087 (16%) were adults. Overall, 17 386 (91%) of 19 211 first-time mothers made use of antenatal care facilities on at least one occasion. 3597 (41%) of 8741 adolescents compared with 8202 (47%) of all 17 386 women began the use of antenatal care during the first trimester. Across west Africa, 5430 (62%) of 8741 adolescents had four or more antenatal care visits compared with 4067 (71%) of 5717 young adults and 2358 (81%) of 2928 adults. Of those who had four or more visits to antenatal care, 2779 (51%) of 5430 adolescents received all the antenatal care components examined compared with 2488 (61%) of 4067 young adults and 1600 (68%) of 2358 adults. Although most women received antenatal care in the public sector, in nine of the 13 countries, the proportion of women that used the private sector was higher in older mothers. Although a large percentage of west African adolescents use some antenatal care for their first birth, they seek care later, make fewer visits during pregnancy, and receive fewer components of care than older first-time mothers. Governments must ensure the pregnancy care accessed by adolescent mothers is of high quality and tailored to meet their needs. MSD for Mothers.

Predictors of Early Childbirth Among Female Adolescents in Foster Care

PurposePlacement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care. MethodsA longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among girls in foster care after their 10th birthday were generated. Chi-square tests assessed differences and survival models were specified to determine the rate of childbearing across key characteristics. ResultsAmong the 30,339 girls who spent time in foster care as adolescents, 18.3% (5,567) gave birth for the first time before their 20th birthday. At a bivariate level, significant differences (p < .001) in birth rates were observed across demographic characteristics, maltreatment history, and foster care placement experiences. In the fully adjusted survival model, the highest birth rates were observed among girls who entered care between ages 13 and 16 years; had been in care for relatively short periods of time; lived in congregate care at the estimated date of conception; had a history of running away; and were Latina, black, or Native American. ConclusionsThe results suggest that there are identifiable risk factors associated with early childbirth among girls in foster care, which can help determine the timing and location of reproductive health services to minimize unintended pregnancy and maximize adolescent health and well-being.

First Births to Maltreated Adolescent Girls: Differences Associated With Spending Time in Foster Care.

Few studies have examined early parenting among girls receiving child welfare services (CWS) or disentangled the relationship between maltreatment, spending time in foster care, and adolescent childbirth. Using population-based, linked administrative data, this study calculated birth rates among maltreated adolescent girls and assessed differences in birth rates associated with spending time in foster care. Of the 85,766 girls with substantiated allegations of maltreatment during adolescence, nearly 18% subsequently gave birth. Among girls who spent time in foster care, the proportion was higher (19.5%). Significant variations ( p < .001) were observed in the rate of childbirth across demographic characteristics and maltreatment experiences. When accounting for all of the covariates, spending time in foster care was associated with a modestly higher rate of a first birth (Hazard Ratio [HR] = 1.10; 95% confidence interval = [1.06, 1.14]). While age at first substantiated allegation of maltreatment and race/ethnicity were significant predictors of adolescent childbirth, specific maltreatment experiences were associated with minimal or no differences in birth rates. The findings of this study suggest that the experience of spending time in care may not be a meaningful predictor of giving birth as a teen among CWS-involved adolescent girls and highlight subgroups of this population who may be more vulnerable to early childbirth.

Long-Term Effect of Exposure to a Friend's Adolescent Childbirth on Fertility, Education, and Earnings

PurposeTo examine the long-term effect of a female adolescent's exposure to a peer's childbirth on fertility, schooling, and earnings. MethodsEstimating causal peer effects in fertility is challenging because the exposure variable (peer pregnancy and childbirth) is nonrandomly assigned. Miscarriages in early pregnancy occur spontaneously in a significant proportion of pregnancies and, therefore, create a natural experiment within which the causal effect of childbirth can be examined. This exploratory study compared adjusted fertility, educational, and labor market outcomes of female adolescents whose adolescent pregnant friend gave birth to female adolescents whose pregnant friend miscarried. Longitudinal data from the National Longitudinal Study of Adolescent Health were analyzed using logistic, ordinal logistic, linear, and log-linear regressions. ResultsFemales whose adolescent pregnant friends gave birth (instead of miscarried) had decreased adolescent sexual activity, pregnancy, and teen childbearing and increased educational attainment, but there were no significant long-term effects on total fertility or differences in labor market outcomes, relative to females whose pregnant adolescent friend miscarried. ConclusionsAdolescent females appear to learn vicariously from teen childbearing experiences of their friends, resulting in delayed childbearing and higher educational attainment. Interventions that expose adolescents to the reality of teen motherhood may be an effective way of reducing the rates of teen childbearing and improving schooling.

Early maternal age and multiparity are associated to poor physical performance in middle-aged women from Northeast Brazil: a cross-sectional community based study.

BackgroundAdolescent childbirth and elevated parity are relatively common in middle and low-income countries and they may be related to the higher prevalence and earlier onset of physical decline documented in these settings, especially in women. The aim of this paper is to investigate whether reproductive history is associated with physical function in middle-aged women from Northeast Brazil.MethodsThe relationship between poor physical performance (grip strength, gait speed and chair stand), early maternal age at first birth (<18 years old), and multiparity (≥3 children) was evaluated in a community sample of 473 women living in Parnamirim (Northeast Brazil). Linear regression models were used to examine the relationship of interest; in addition, mediation analyses were employed to assess indirect effects of obesity and family income.ResultsWomen who gave birth at less than 18 years of age took approximately 0.50 s longer to complete the chair stand test compared to women who gave birth at 18 years or older. Moreover, women who gave birth to < 3 children completed the chair stand test 0.42 s faster compared to those who had ≥ 3 children. The relation between reproductive history and physical performance was mediated by BMI. Reproductive history was not associated with performance in gait speed.ConclusionsThis study provides evidence that adolescent childbirth and multiparity are related to worse physical performance in middle-aged women from a low income setting. Reproductive history may partially account for earlier physical decline and greater disability in women from lower income settings.

Adolescent Pregnancy: A Webliography

Although rates have declined since the early 1990s, adolescent pregnancy remains a public health concern in the United States. Adolescent pregnancy and childbirth have various adverse health, social, and economic effects on mother, father, and child. Comprehensive sex education including discussions of abstinence and birth control are effective in modifying sexual behaviors and opinions in adolescents. The web sites reviewed in this article are designed for use by the layperson and may be used by adolescents and their parents and educators to promote safe and healthy sexual relationships.

Early maternal age at first birth is associated with chronic diseases and poor physical performance in older age: cross-sectional analysis from the International Mobility in Aging Study

BackgroundEarly maternal age at first birth and elevated parity may have long-term consequences for the health of women as they age. Both are known risk factors for obstetrical complications with lifelong associated morbidities. They may also be related to diabetes and cardiovascular disease development.MethodsWe examine the relationship between early maternal age at first birth, defined as ≤18 years of age, multiparity (>2 births), and poor physical performance (Short Physical Performance Battery ≤8) in community samples of women between 65 and 74 years of age from Canada, Albania, Colombia, and Brazil (N = 1040). Data were collected in 2012 to provide a baseline assessment for a longitudinal cohort called the International Mobility in Aging Study. We used logistic regression and general linear models to analyse the data.ResultsEarly maternal age at first birth is significantly associated with diabetes, chronic lung disease, high blood pressure, and poor physical performance in women at older ages. Parity was not independently associated with chronic conditions and physical performance in older age. After adjustment for study site, age, education, childhood economic adversity and lifetime births, women who gave birth at a young age had 1.75 (95% CI: 1.17 – 2.64) the odds of poor SPPB compared to women who gave birth > 18 years of age. Adjustment for chronic diseases attenuated the association between early first birth and physical performance. Results were weaker in Colombia and Brazil, than Canada and Albania.ConclusionsThis study provides evidence that adolescent childbirth may increase the risk of developing chronic diseases and physical limitations in older age. Results likely reflect both the biological and social consequences of early childbearing and if the observed relationship is causal, it reinforces the importance of providing contraception and sex education to young women, as the consequences of early pregnancy may be life-long.

Construct validity of the childbirth trauma index for adolescents.

The potentially traumatic nature of childbirth for adult mothers has been confirmed in research; however, adolescent childbirth trauma is unexplored. This article presents research on the construct validity of the Childbirth Trauma Index by providing a conceptual analysis of psychological childbirth trauma, factor validity of the Childbirth Trauma Index, and discussion of testing the Childbirth Trauma Index via contrasted-groups approach. Childbirth trauma can result in an acute stress reaction or actual posttraumatic stress disorder. Using subjective reports, the Impact of Event Scale, and the Childbirth Trauma Index, an appraisal of birth trauma, trauma impact, and indicators associated with childbirth trauma were revealed among 112 adolescents. Clinical implications and research recommendations are offered.

Promoting a Positive Childbirth Experience for Adolescents

ABSTRACT Objective: To identify and describe the labor support needs of adolescents that promote a positive childbirth experience. Design: Mixed method Setting: Three tertiary care hospitals. Patient/Participants: A convenience sample of 185 adolescents in the immediate postpartum period. Methods: The quantitative component identified the supportive behaviors using the 26‐item Bryanton Adaptation of the Nursing Support in Labor Questionnaire‐Adolescents. The qualitative component used two open‐ended questions to explore adolescents' needs during childbirth. Results: The most helpful supportive behavior was to provide pain medication. By psychosocial developmental levels, early adolescents perceived the nurse praising them was most helpful whereas middle and late adolescents perceived the provision of pain medication most helpful. Four major themes emerged from written responses: respectful nurse caring, assistance with pain control, nursing support of the adolescent's support person, and childbirth guidance. Conclusions: Adolescents were asked to recall their childbirth experiences to begin to develop a knowledge base specific to adolescent childbirth needs. By understanding the supportive behaviors that adolescents in labor desire and implementing those behaviors in their practice, intrapartum nurses can improve the childbirth experience for the adolescent.

Urban‐Rural Literacy Gaps in Sub‐Saharan Africa: The Roles of Socioeconomic Status and School Quality

Urban‐Rural Literacy Gaps in Sub‐Saharan Africa: The Roles of Socioeconomic Status and School Quality

The Nature and Support of Adolescent Mothers' Life Aspirations

The Nature and Support of Adolescent Mothers' Life Aspirations* Phame M. Camarena,** Kris Minor, Theresa Melmer, and Cheryl Ferrie Semi-structured interviews were conducted with 58 young mothers from a rural region of upper midwest to examine how mothers construct life aspirations in face of new parent roles. The majority of participants reported that parenting demands had resulted in an adjustment of expectations rather than a dramatic change in either level or nature of aspirations. Although all of mothers reported some support for pursuing life goals, this support was generally weak and inconsistent. Access to resources and firm encouragement to pursue aspirations now characterized participants with most resilient stories of adjustment. Although negative consequences of early parenting have been well documented, societal image of teenage parents has become too stereotyped and fails to recognize diversity of adolescent parents' experiences (Chase-Lansdale, Brooks-Gunn, & Paikoff, 1992). One of these stereotypes is belief that early parenting dooms young mothers to a life of unfulfilled dreams and aspirations. The consistent link between adolescent pregnancy and relatively low levels of educational and employment achievement certainly does lend some support to this belief (e.g., Barbour, Richardson, & Bubenzer, 1993; Hayes, 1987). These connections, however, are not necessarily causal in nature since many of factors that predict adolescent childbirth are linked to educational and employment aspirations prior to pregnancy (Melhuish & Phoenix, 198788; Upchurch, 1993). The resultant picture of adolescent mothers' aspirations is, therefore, somewhat difficult to disentangle. What is clear, however, is that life aspirations are an important component of adolescent mothers` adjustment. As suggested by Blinn (1990), aspirations for family. education, and work become highly salient to adolescent mothers as they are to reevaluate their visions of future. Both long and short term choices that most adolescents face now take on a new sense of urgency for adolescent parent as priorities shift to account for future of new child (White & Cummings, 1995). The Significance of Aspirations The importance of aspirations and for adjustment during adolescence generally are manifest conceptually in two different ways. First, they provide a yardstick or standard to help adolescents weigh degree to which different choices will help or hinder their chances of achieving desired goals. Second, as a motivational force they influence degree to which effort is expended on tasks that make achievement of aspirations and possible. For adolescent mothers forced to confront new parenting demands, a clear set of aspirations and may provide an important protection as a guide through difficult choices and serve as a buffer against discouragements and stressors they experience. Evidence for this power of aspirations as a protective factor for populations. generally, and adolescent mothers, specifically, is found in both Kauai and Baltimore longitudinal studies. The Kauai study (Werner & Smith, 1992) was designed to examine factors that protected an at risk sample of individuals born in Hawaii in 1955 from prenatal development into young adulthood. Although Werner and Smith describe a number of different factors that distinguished adolescents and young adults who had overcome their earlier high status, they concluded that greatest differences could be found in goals they had set for their adult lives and their sense of personal competence and determination (pp. 69-70). These same factors were highlighted as being central parts of the paths that led to improvement for adolescent mothers in this sample (p. 95). In a similar vein, Baltimore study followed a sample of primarily African American urban adolescent mothers from birth of child to young adulthood to trace developmental paths of both mother and child (Furstenberg, Brooks-Gunn, & Morgan, 1987; Furstenberg, Brooks-Gunn, & Chase-Lansdale, 1989). …

Adolescent Pregnancy

<h3>To the Editor.</h3> —Adolescent pregnancy is associated with a variety of individual and societal costs, as the study by Ms Spitz and colleagues¹notes, and the phenomenon has become an increasingly important element in policy debate. Conservatives and liberals alike are eager to uncover the root causes of adolescent childbirth. We were surprised, therefore, at the study's concluding statement that "95% of adolescent pregnancies are unintended," implying that adolescent pregnancy is accidental. First, we wonder how this 95% figure was obtained. Surveying teens with children about their intent is problematic. Whatever the teen's prepregnancy state of mind, if she has now been hit by the reality of child rearing, her current feeling will likely be that she did not intend these particular consequences. Citing this 95% figure, without questioning further, obscures deeper issues facing American adolescents. Perhaps adolescent childbirth has less to do with sex and contraception and more to do with

The significance of social context: the case of adolescent childbearing in the African American community.

The incidence of adolescent childbearing is significantly higher among African Americans compared to Whites, whereas the rates of early childbirth have declined more rapidlyforAfricanAmericans over the past two decades. Although traditional measures of socioeconomic status do not account for the difference in adolescent childbirth rates by race, there are important reasons to question the external validity of these conventional variables. After summarizing differences in teen childbearing by race, this article addresses the problems inherent in a comparative approach to understanding race differences. More meaningful measures of socioeconomic status that provide a richer account of the social context of adolescents at risk of early childbearing are outlined. The social context approach might help inform literature on the role of family factors in adolescent childbearing, and some recent exanples of such an approach are provided. The resiliency shown by African American adolescents living within socially disadvantaged communities is also discussed. Finally, a brief excursion into how attention to the social context of teen childbearing might inform public policy is undertaken.