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10/20/93

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TEEN PREGNANCY: ECONOMICS MORE IMPORTANT THAN AGE

STANFORD - Teen-age mothers may be no worse off than their sisters and friends who wait until they are older to have children, says a new book on teen-age pregnancy. In fact, some women may find there are advantages to having a baby at age 17 or 18 compared to 20 or 22.

The problem is less pregnancy than poverty, say scholars from Great Britain and the United States. They dispute conventional American wisdom that teen-age motherhood is emotionally and financially ruinous.

It's true that most teen-age mothers and their children are poor, they say, but delaying childbearing, by itself, does not necessarily help poor women escape poverty.

In other words, says Stanford University Law Professor Deborah Rhode, "some of the negative consequences that have been attributed to teen-age pregnancy in this country appear also to be partial causes."

Recent studies suggest, for example, that "most young mothers leave school before becoming pregnant, rather than the converse, and that mothers who give birth while in school are as likely to graduate as their peers," Rhode said.

"It's quite sobering to realize that the conventional liberal's solution to teen-age pregnancy - encourage women to stay in school and ensure they have a high school education - doesn't necessarily translate into greater self sufficiency later in life," said Rhode, co-editor of the book, The Politics of Pregnancy: Adolescent Sexuality and Public Policy (Yale University Press).

And while conservatives urge teens, particularly females, to "just say no" to sex, Rhode said, "there are cultural norms and pressures in this society that make it hard for teens to just say no, particularly if they lack opportunities to say yes to something else."

Rhode, who began coordinating work for the book in 1989 when she was director of Stanford's Institute for Research on Women and Gender, said she was among those surprised by its conclusions. Many stereotypes people have of teen-age pregnancy, she said, are based on their own personal experience or on a public debate about teen-age sexuality, pregnancy, abortion and childbearing that distorts the facts to serve "symbolic political purposes."

"There is also a common perception in this country that teen- age pregnancy is somehow a problem of minority groups," she said, "but white teen-agers account for 68 percent of all adolescent births in the United States and over half the births to unmarried mothers."

African and Hispanic Americans have higher rates of teen-age childbearing, as well as of poverty associated with it, Rhode said. However, "the statistical trends in both the United States and the United Kingdom indicate that childbearing patterns are converging among low- income communities." Abortion is more frequent among higher social classes.

"The same economic forces that have made marriage less attractive for young black women [since the 1950s] are starting to make it less attractive for whites as well," she said.

"The fact that adolescent pregnancy is not identified as a racial problem at all in Great Britain is also of interest."

"We do not wish to deny that a pregnancy - and its outcome - may well be problematic for many teen-agers. But we want to stress that it may be equally problematic for women of other ages," write British medical sociologists Sally MacIntyre and Sarah Cunningham-Burley. "Having children can be highly disruptive of women's careers and costly (in terms of both direct and opportunity losses) at all ages."

Rhode added that "a growing number of scholars has suggested that early pregnancies are more adaptive for economically and racially subordinate groups than is commonly acknowledged."

For example, "since young black mothers are likely to live in an extended family, they often have better access to kin support and childcare than older mothers," Rhode said studies have found.

One study compared Baltimore adolescent sisters where one became a mother and the other did not. It found that the deferral of parenthood and additional schooling did not significantly increase income or reduce welfare dependency.

For low-income youths, Rhode said, research indicates that "the economic opportunities sacrificed through early parenting did not appear sufficiently great to justify deferring childbirth. Changing that opportunity structure will require fundamental social changes."

Policies limited by political debate

"The central problem in formulating public policies on adolescent pregnancy lies in too narrow a definition of what the problem is," Rhode writes in the book's concluding chapter. Laws such as the federal Adolescent Health, Services and Pregnancy Prevention Act do not serve society's needs adequately, she said, partly because they are political compromises that reflect a "deep cultural ambivalence" about teen-age sexuality.

Most liberals begin with the premise that teen-agers should not have babies, she said, while most conservatives begin with the premise they should not have sex.

"For conservatives, the problem involves primarily moral and fiscal concerns: Premarital sexuality is not only objectionable in itself, it promotes other objectionable practices, such as abortion and the destruction of fetal 'life,' or non-marital childbearing and the erosion of traditional values and financial self-sufficiency," Rhode said.

"For liberals, the problem involves primarily health and socioeconomic status: Single parenthood is linked with disrupted education, reduced employment opportunities and an increased likelihood of poverty for mothers, as well as heightened medical risks and developmental difficulties for their children."

Research indicates, she said, that both sides have "overstated the adverse consequences of adolescent pregnancy and understated the barriers to addressing it."

Rhode and co-editor Annette Lawson, a British sociologist, argue in the book that "too much blame has been placed at the individual level, on teen-agers who 'want too much too soon' in sexual relationships. Inadequate attention has focused on the societal level, on the institutions that offer 'too little too late' - too little birth control and prenatal assistance, too little reason to complete school, and too few opportunities for childcare and meaningful employment."

'Crisis' statistics

Statistics on adolescent sexuality, pregnancy and childbirth show that there is a crisis, although they tend to distort what that crisis is, Rhode said. Here are some of those statistics:

  • An estimated 45 percent of all U.S. female teen-agers have premarital sex. Most are not consistent contraceptive users. As a result, an estimated 40 percent of females become pregnant at least once before age 20, and about four-fifths of these pregnancies are unintended.
  • Twenty percent of female teen-agers in the United States bear a child. These rates of pregnancy and childbirth are the highest among Western industrialized nations.
  • About half of those young women are unmarried, and less than 5 percent give the baby up for adoption. Fewer teens have babies in Great Britain, but an even higher proportion - three-quarters - are not married when they do.
  • In U.S. families headed by 15- to 21-year-old females, more than four-fifths of children are poor compared to one-third of children in households headed by a young male.

In their search for understanding the causes behind the statistics, authors of the book point out these infrequently cited perspectives:

  • Adolescence is a relatively new and ill-defined "stage" of human development. More than two-thirds of female teen-agers bearing children are 18 or 19, which suggests it is a distortion to describe the rising rates as an epidemic of "children having children."

"It is still considered normal for women of that age to have children in many countries," Rhode pointed out, and there is evidence that they and their babies do as well or better physically than older-age mothers and children.

  • The statistical trends for adolescents parallel changes in "adult" society.

"Teen-agers, far from being out of step and alienated from their social worlds, actually follow trends similar to those of their elders," writes Lawson. Fewer adults are giving birth, and a greater proportion of them also are single. About one-quarter of all births in the United Sates and United Kingdom are to single women.

Rhode cautions that prevalence of childbearing, marriage and abortion vary within ethnic, age and other commonly used demographic categories. Prudent policy-makers should not design one-size-fits-all programs, and they should make provisions for community involvement in devising workable strategies, she said.

In general, however, she said most researchers agree that programs and policies will be more successful if they address the "problems and responsibilities" of young men as well as women.

Male teens ignored

"We sometimes behave as if babies come from the stork and that 'the problem' belongs only to the female teen," Rhode said. "Few adolescent pregnancy and parenting initiatives have included men or have focused on the systemic deprivation that young fathers often confront."

Programs to collect financial support from fathers should be undertaken, but that won't change the plight of many poor children because the fathers don't earn enough, she said.

Teen-age fathers are rarely included in studies, partly because they are difficult to identify. One British study, however, found that like the teen-age mothers, young fathers were likely to have had low self- confidence and to have performed poorly in school before the pregnancy. They tended to be "conformist within a narrowly defined subculture of working-class youth," whereas the women who gave birth tended to be "non-conforming and somewhat isolated from social support," wrote psychologist Glynis Breakwell of the University of Surrey in Guildford, England.

"Increasing rates of unemployment among young, unskilled males may largely account for the dramatic increases in the proportion of young women who are single rather than married when they give birth," writes British psychologist Ann Phoenix of Brunel University.

Said Rhode: "American data leave no doubt that recent declines in education and employment opportunities together with increases in violence, drug use, suicide and incarceration among young black males have had some impact on marriage and the capacity for child support."

Unplanned vs. unwanted babies

Until recently, even most research has tended to confuse teen- age pregnancy with "unwanted, unplanned and unwed" pregnancy, she said. The book's authors point to studies that show these as distinct categories. Professors Nancy Adler and Jeanne Tschann of the University of California-San Francisco, for example, conclude that many teen-agers may see pregnancy as desirable at a subconscious level without explicitly intending to get pregnant. A child in this case may be unplanned but not unwanted.

In their study of sexually active female adolescents seen at several Bay Area health clinics, they found that one-third of adolescents who said they did not plan to get pregnant nevertheless related stories about hypothetical teen-agers in which pregnancy was described as desirable.

"Studies of pregnant teen-agers have shown that they may be motivated by hopes of achieving adult status, prestige or autonomy through pregnancy, by a desire to demonstrate love or commitment to a partner, and/or by the wish to replace a real or threatened loss of a significant person," Adler and Tschann write, as well as by the desires of other people, including boyfriends and parents.

Rhode added: "We offer too few alternative sources of self- esteem to young women of lower socioeconomic backgrounds. For many of them, having a child is the best way to find love and support and make a commitment to the future."

Existing policies, services

Programs to address social problems surrounding adolescent sexuality, pregnancy and childbirth fall into three categories, according to Claire Brindis, a professor of pediatrics at U.C.-San Francisco. They attempt to:

  • Convince teen-agers to defer sexual activity and delay childbearing.
  • Facilitate sexually active teen-agers' access to contraceptives.
  • Maximize teen-agers' abilities to make responsible decisions about their sexual activity.

The primary source of public funding has been the Family Planning Services and Population Research Act, which helps support 4,500 family-planning clinics. However, because of "official ambivalence," Brindis writes, federal funds have been earmarked only for "say-no-to- sex" programs.

Locally initiated school-based health services, which offer services pertaining to sexual decision-making and referrals for family planning, are now operating in more than 340 communities, Brindis reports. Most require consent from a students' parent before any treatment or counseling.

"Despite the claims by some critics that school-based clinics encourage or condone sexual activity, findings from . . . clinic programs show that sexual activity does not increase following establishment of a clinic in a school," Brindis writes. "Although it is premature to assess the impact of school-based clinics on the problem of adolescent pregnancy, the range and multiplicity of health services they provide are clear indicators of the serious unmet medical needs of young people."

Rhode said: "We don't have as good data as we should about what programs are most effective in promoting use of contraceptives or responsible sexual behavior, but what evidence we have suggests the most successful interventions are ones that expand the array of what's called 'life-planning options.'

"That is, they build self-confidence, improve school performance, strengthen vocational skills and empower women to act independently on the choices that they make. Improving schools, health care and welfare support are critical. And that's where a lot of people get off the boat, because talk is cheap and welfare programs aren't."

More may be done, she said, because "we now have an administration with a different political mandate and a different level of sensitivity to these issues than the previous one." She pointed to President Clinton's response to the press when he was asked during the 1992 presidential campaign what he would do if his teen-age daughter, Chelsea, became pregnant. In contrast to Dan Quayle's wife who said their 13-year-old daughter would carry the child to term, Clinton said he wouldn't talk to the press about it, Rhode said.

"He shouldn't talk to the press about it," she said. "Studies show that one of the major obstacles to adolescent use of birth-control services is their concern about lack of privacy. Can you imagine how either of the candidates' daughters would feel having their chastity become a discussion topic in their classroom?"

Rhode says she also thinks policy-makers and their constituents have too often made the mistake of devising policies by analyzing only their own family situation. When she was clerking for Supreme Court Justice Thurgood Marshall in 1979, the first of the cases involving parental consent for adolescent abortions came before the court.

"The court was all-male then, and all the justices could think about was the fact that they would want their daughters to come to them with this sort of issue," Rhode said.

The result, she said, was that the court devised a lengthy, intrusive legal process. Although virtually all teen-age women who go through the legal steps can get an abortion without parental consent, many adolescents are deterred from attempting to terminate an unplanned pregnancy.

"Having a wider socioeconomic distribution of judges would have made a difference, I believe, because some would have realized that the groups least able to care for a child would be the ones least able to surmount these legal hurdles," she said.

"There's been very little appreciation for the trauma and the costs that the procedure itself exacts."

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