RESEARCH

Bennett, T., Skatrud, J., Guild, P., Loda, F., & Klerman, L. (1997). Rural adolescent pregnancy: A view from the south. Family Planning Perspectives, 29, 265-260.

    This study, published in the Family Planning Perspectives (29) in 1997, was the first study conducted to examine U.S. rural adolescent pregnancy. The researchers began by saying, "The predominant image of adolescent pregnancy is that of an epidemic in inner-city communities." Nevertheless, nearly 1/4 of the nation_s youth live in rural areas, characterized by high rates of poverty, social isolations, and shortages of medical services-- all risk factors for early childbearing and poor birth outcomes. In fact, rural youth are 22% more likely to be living in poverty, but are 20% less likely to be covered by public assistance.

    This study was done in an effort to determine whether the frequency, determinants, and outcomes of adolescent pregnancy vary by rurality in the Southeast. 1990 census data files gathered from the Region IV Network for Data Management and Utilization (RNDMU) covered eight Southeastern states: Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. The RNDMU provided information on births, abortions, and pregnancies according to women_s residence, age, and race for the eight states. The study population consisted of the region_s 11.9 million female residents aged 10-44 in 1990 (all women of childbearing age). The analyses reported in this article focused on the region_s 1.6 million women aged 15-19. Data for the 5.5 million women aged 20-34 were reported as a comparison. The independent variables were residence, age, and race. 96% of the women in the sample were either black or white; the remaining 4% were Asian American or Native American. Overall, approximately 13% of both white and black residents live in rural areas.

    Results show that the proportion of births to 15-19 year olds was markedly higher in rural areas (20%) than in metropolitan areas (15%). The birthrate was higher among blacks than whites. Abortion rates were higher among metropolitan areas (20 per 1,000 women) versus rural areas (nine per 1,000 women), despite age or race. Pregnancies on the other hand were considerably higher for black women in all age groups, regardless of residence. In rural areas the pregnancy rate was 46 per 1,000 white women and 87 per 1,000. In metropolitan areas, the rates were 46 per 1,000 and 106 per 1,000. **Researchers note that pregnancy rates are underestimated to an unknown degree because they do not include fetal death data. Also, abortion rates sometimes go underreported.

    In conclusion, pregnancy rates for white teenagers are only slightly higher in rural than in metropolitan areas, and some black teenagers have lower pregnancy rates in rural than in metropolitan areas. Researchers add that, "The major difference between rural and metropolitan areas is not in the probability of teenagers_ becoming pregnant, but in the likelihood of their obtaining abortions if they conceive." In other words, whereas pregnancy rates and birthrates are higher for black teenagers than for whites, the likelihood of resolving a pregnancy through abortion is greater for white teenagers. The researchers end by saying that these discrepancies might be attributable to divergent norms, values, and preferences.

    This information from this research study can be very useful to healthcare providers, especially those in rurul areas. If access to clinics is what is lacking in these rural areas, then we as healthcare providers need to be able to provide teenage girls with all of their options, and services and how to obtain these services.

Blinn-Pike, L., Kuschel, D. (1998) The process of mentoring pregnant adolescents: an exploratory study, Family Relation, 47 (2), 119-128.

    This exploratory study examines the process that occurs in relationships between volunteer adult mentors and pregnant adolescent mentees. Case records of 20 mentors were analyzed. Results revealed mentors help mentees access services and resources, discuss interpersonal issues and infant development, and are involved in intimate details of mentees' lives. Previously, studies have not spent enough time on theory building, conceptualization, or evaluations of mentoring programs. The authors of this study believed that empirical data was needed about the mentoring process, so that was their primary goal. The sample was mentees that were all pregnant adolescents, with the mean age of 17.5 years, and were pregnant for an average of 4.8 months. Previous research reveals that having a positive relationship with at least one caring adult is one of the most important elements in protecting youth from risks. Results showed that mentored children were less likely than nonmentored to use alcohol or drugs, or to hit someone, and more likely to have a better attitude towards school. Data was collected by having each mentor keep a written record of each contact with her mentee, using the Resource Mothers Contact Form. The form consists of a series of quantitative descriptive questions and checklists, plus a space for qualitative comments. The study was limited in external validity due to a small sample size; however, internal validity was strong. Further research is needed to compare pregnant and nonpregnant adolescents.

Collins, M.E., Stevens, J.W., & Lane, T.S. (2000). Teenage parents and welfare reform: Findings from a survey of teenagers affected by living requirements. Social Work, 45(4), 327-339.

    This article reports on a survey of 199 teenage female parents who lived in the Teen Living Program. The TLP is an alternative living arrangement for minor teenage parents receiving welfare whom are unable to live with family members. The aim of this research article is to find out at what extent have teenagers attained key outcomes once leaving the facility. Outcomes measured included educational attainment, welfare status employment and homelessness. Races include Latina, black, white and biracial. There was no comparison group used in this study. The research shows that 65 % reported engaging in some type of education or training and 44% reported employment since leaving the TLP. 16% reported having been homeless at some point since leaving the TLP and 71% reported receiving welfare.

    A large percentage of teen mothers are pursuing an education. To support this, previous research conducted by Coley & Chase-Lansdale have found an increase in the educational attainment of teen parents, in part because of the GED programs and schools for pregnant students (1998).Cameron & Heckman found that those entering college with a GED are more likely to drop out than those with a diploma (1993). Less promising outcomes were those related to employment and homelessness. Previous data found that over one-half of all mothers with infants less than one year of age are working and almost two-thirds of mothers of preschoolers are employed (U.S. Bureau of Labor Statistics, cited in Brooks-Gunn, Smith, Berlin, & Lee, 1998). A recent investigation of New England high school students found that 5% to 10% reported homelessness or severe housing distress in a year's period (Vissing % Diament, 1997). A nationally representative survey of youths found that almost 8% had at least one homeless episode in the past 12 months (Ringwalt, Greene, Robertson, & McPheeters, 1998). The current study was a larger percentage than the two previous studies. No previous studies available to compare the welfare statistics mentioned in this study although 71% is a substantially high percentage of welfare dependence.

    The evidence shows that teen parents have received positive and negative outcomes since leaving the TLP. By eliminating welfare dependence all together, teen mothers would not be living at the TLP. Chances are homelessness and unemployment are less likely to occur if a teen is not receiving welfare, rather, employed and making money.

    Based on the information being a secondary source and lack of validity or reliability mentioned, this article is not very well supported.

Daly, K. (1994, March). Adolescent perceptions of adoption. Youth and Society, 25 (3),330-345.

      This study surveyed 300 high school students in a mid-sized city in Southern Ontario, Canada, and their attitudes and perceptions towards adoption and alternatives to unwanted pregnancy. Only 175 (58% participation rate) of those surveyed responded due to the fact that they must be 18 years old, or older, or have a parent consent form signed. The age criteria was to be between 15 and 19 years old, with the mean age being 17. 54% of the sample were female, 70% of the students lived with both biological parents at home, 17% lived in single parent families, and 13% lived in remarriage families. 59% of the sample said they were currently "dating" somebody and 45% said they had never had sexual intercourse. Of the 55% who had experienced sexual intercourse had an average frequency of 2-10 times, over half (57%) of these indicated that they always use birth control, 9% had experienced a pregnancy (either themselves or their partner).

      Results found that 6% indicated they would definitely would make an adoption plan if they (or their partner) became pregnant, 17% said they probably would, 36% were unsure and the remaining 40% said they would not. This suggest that adoption is not a highly favored option for adolescents. When questioned about who they would turn to for support if they were to become pregnant, 28% said their partner, 25% said a friend, and 23% said their parents.

      This information contains some important statistics that may want to be shared with adolescents possibly while they are in school or while they are at a doctors office or clinic discussing birth control options. If they see what others are doing, and hopefully, the mistakes others are making, they can learn from the others instead of having to learn for themselves.

Deal, L.W., & Holt, V.L. (1998), Young maternal age and depressive symptoms: Results from the 1988 national maternal and infant health survey. American Journal of Public Health, 88(2), 266-273.

    The aim of this non-experimental study was to provide population-based estimates of the prevalence of depressive symptoms among primiparous US adolescent mothers. Associations between young maternal age, socio demographic characteristics, and depression were explored in a large, nationally representative sample. The sample population included black and white primiparous adolescent mothers. The comparison group included primiparous women between 25 to 34 years of age. The sample size was 1796 recipients. The instrument is shown to be a reliable and valid instrument across racial and gender categories. Independent variables include maternal education, marital status, current smoking, family income and current receipt of AFDC and WIC. Dependent variables include level of depression and age of mother.

    Results show that teen mothers of both races were more likely than adult mothers to be depressed: 48% of 15-to 17-year old Black teen mothers and 28% of White teens were depressed, as were 37% of Black 18-to 19-year olds and 33% of Whites. Black and White 25-to 34-year olds were 25% and 14%. A similar research study found that the rate of depressive symptomatology among adults was 9% and teen mothers were 67%. In another previous research study, findings indicated a positive correlation between maternal depression and multiparous adolescents. They indicated that they were more depressed than the primiparous teenagers were. Regardless of number of children, studies show that teen mothers are more likely to be depressed compared to adult mothers.

    The presence of depressive symptoms among teen mothers in this study was associated with Black race, unmarried status, low educational attainment, WIC and AFDC, and food stamp recipients. These findings indicate that maternal depression varies by race and socio demographic characteristics and is related to inadequate social support and dependence on public assistance. The findings can be used to educate teenage mothers about ways to prevent depression or overcome depression by graduating high school, working a good paying job and supporting themselves and the baby, and getting married. Age and race are uncontrollable variables with depression once pregnancy has been determined. Because the reliability and validity is mentioned in this article, this article is supported.

Donnelly, B., & Voydanoff, P. (1996, October). Parenting versus placing for adoption. Family Relations, 45 (4),427-435.

      This study examined the consequences of parenting versus placing for adoption and the impact of this decision on the lives of young women. These parents were reviewed over a 24-month period and looked for indications of regret between the parents who chose to place and those who did not. It also looked at the differences in depression, personal efficacy, and the influence of socioeconomic status with the relationship to parenting or choosing adoption.

      Data was collected for a longitudinal study from 181 pregnant or newly postpartum adolescents between 1987 and 1992 aged 12 to 19 years. They were interviewed from health clinics, crisis counseling centers, and private social service agencies all from a mid-sized city in Ohio. All follow up interviews were conducted at 6, 12 and 24 months postpartum. The results are based on 113 (62%) of the beginning adolescents who completed all the surveys for the full 2 years. Non-white teens were more likely to drop out, leaving 33% of the completers non-white. 26 (23%) of the participants had placed for adoption and the remaining 87 (77%) chose to parent.

      The independent variable in this study was the parenting decision and the dependent variables were satisfaction with their decision, mental health status, socioeconomic status, sexual risk taking behaviors. The study found that parents who choose to place for adoption were more likely to show regret on having to decided to place, have a higher socioeconomic class and tend to engage in less sexual risk-taking behaviors over the people who chose not to place over the course of the 24-months. No significant difference in depression or person efficacy were found between the two groups. The adolescents that chose to place tended to be younger and more likely to be attending school. At 2 years postpartum 62% of those who chose to parent would recommend parenting to others in a similar situation.

      This information would be very useful for doctors, nurse practitioners, social workers, counselors, etc. to discuss with pregnant adolescents so they may be able to see their own future ahead of them. This study may help them realize the truth, or give them hope, whichever the case may be. It could be very persuasive information so should be presented in the correct manner.

Felice, M. (1996). The adolescents right to confidential care when considering abortion. Pediatrics, 97, 746-752.

    This study published in Pediatrics (97) in 1996, looks at the American Academy of Pediatrics (AAP) position that the rights of adolescents to confidential care when considering abortion should be protected. Here is a summary of what they found:

    • Legislation mandating parental involvement does no achieve the intended benefit of promoting family communication, but it does increase the risk of harm to the adolescent by delaying access to appropriate medical care.
    • The American Medical Association, the Society for Adolescent Medicine, the American Public Health Association, the American College of OB/GYN, and the AAP have reached a consensus that minors should not be compelled or required to involve their parents in their decisions to obtain abortions, although they should be encouraged to discuss their pregnancies with their parents and other responsible adults.
    • Research confirms that pregnant minors do not make abortion decisions in isolation; they actively involve adults to whom they feel close. Even when not required to, the majority of minors seeking abortions voluntarily involve at least one parent in their decision. A survey of 1,519 unmarried pregnant minors in states where parental involvement is not mandatory found that 61% told one or both parents about their intent to have an abortion. The younger the minor, the more likely she was to do so, 90% of those 14 or younger, 74% of those 16. And among minors who did not involve a parent, most;y all involved at least one responsible adult other than clinic staff.
    • The most frequent reasons minors cite for not telling parents include the belief that the knowledge would damage their relationship, the fear that it would escalate conflict or coercion, and the desire to protect a vulnerable parent from stress and disappointment.
    • No studies show that forced disclosure results in improved parent-child relationships, improved communication, or improved satisfaction with the decision about pregnancy outcome.
    • The age of 18 years is a convenient legal dividing line, but it has no scientific validity as the point at which individuals become competent decision makers. Summaries of well designed research conclude that most minors 14-17 years old are as competent as adults to provide consent to abortion.
    • In other research, pregnant adolescents who chose not to communicate with parents were as satisfied with their decisions as those who did consult with parents and received support for their decision. But adolescents who communicated with non-supportive parents were the ones more likely to express dissatisfaction with pregnancy decisions.
    • The most damaging impact of mandatory parental notification laws is that they can delay and obstruct the access of pregnant adolescents to timely professional advice and medical care. After enactment of such statutes, court proceedings in Massachusetts delayed the termination of pregnancy by as much as 6 weeks; in Minnesota, the average delay was 1-3 weeks.
    • Ultimately, the pregnant patient_s right to decide should be respected regarding who should be involved and what the outcome of the pregnancy will be, which is the approach most consistent with ethical, legal, and health care principles.

    In continuation of the previous article on Parental Involvement, laws mandating that parents be involved in the abortion decisions of minors should not be the basis for what options a pregnant teenage girl has. This research study found that 18 is just a convenient dividing line, and not a clear cut basis on maturity level. Ecah girl should have the right to make her own decision.

Fischer, R.L. (1997). Evaluating the delivery of a teen pregnancy and parenting program across two settings, Research on Social Work Practice, 7 (3), 350-370.

    The intake, service, and outcome data on program participants in the Teenage Pregnancy and Parenting (TAPP) program in Georgia was covered in this study. The program is designed to help teen mothers complete a high school diploma, have a healthy pregnancy and develop parenting skills, and avoid additional pregnancies while in school. The program has moved from a public heath clinic to a school-based program. Studies were performed on participants at the public health clinic and the public school. Before, studies relied on less rigorous designs and not enough emphasis on effectiveness or outcomes. The article discusses data from earlier research on the TAPP program from 1993-1994 examining the 2-year experience in the school-based setting, and to examine the differences between the health care setting and school setting in delivering TAPP services. The study was limited due to not being able to use randomization or any other pre-and posttest data. The data came from case files from the case managers at TAPPs. A summary sheet was used to make a set of uniform data. Due to the inadequate research from previous studies, sample sizes varied and were not reported in the article. The evidence of the study showed that the TAPP program is making some improvements in teen parents' lives, even more so since they have become school-based. The TAPP participants before 1994 were found to have a greater number of abortions and a larger percentage of low birth weight infants.

Flynn, L. (1999). The adolescent parenting program: improving outcomes through Mentorship, Public Health Nursing, 16 (3), 182-189.

    This intervention study was performed on one pretest-posttest group in a program designed to improve infant outcomes by enhancing health practices and parenting skills. The sample consisted of 137 low-income, pregnant and parenting adolescents who live in an urban area and are at risk of child maltreatment. Criteria to be included in the study required that participants be women age 18 or younger; Medicaid eligible; residents of Newark, NJ; not currently clients of the Division of Youth and Family Services; either pregnant with their first child or within 6 weeks postpartum; and who screened to be at risk for potential child maltreatment. The program is based on mentorship and social support, and provides intensive home visitation by a nursing paraprofessional. The study was done over a period of three years. Outcomes revealed that the participation in the program decreased the percentage of low birth weight infants, the incidence of infant mortality (to zero), and the incidence of child neglect/abuse. This study shows that from the outcomes, effective community-based programs are needed to help improve outcomes within the vulnerable group of adolescent pregnant women and single mothers. Limitations in the study included an insufficient number of participants, the length of time the study was performed should have been longer, and the topic of maltreatment was not studied in depth. The study also was limited due to generalizability, since the sample was limited to urban-residing, low-income adolescents. Findings cannot be generalized beyond that population. This same study should be performed on suburban and rural populations in the future. An additional limitation was that neither the mentoring relationship nor social support were directly measured, but should be in future studies. Further research is suggested to include a large, geographically diverse sample, measures of social support and mentorship, and alternate measures of child abuse potential.

Garrett, S.C., & Tidwell, R. (1999). Differences between adolescent mothers and non -mothers: An interview study. Adolescence, 34(133), 91-106.

    In-depth interviews were conducted with nine adolescent females-five African-American, three Mexican-American, and one Anglo-all residing in a licensed institution. Four of them were already mothers, four were not mothers, and one was pregnant. Open-ended questions were asked in an interview format. Some of the questions include: "What is your relationship with your parent's like? What motivated you to become pregnant, or to keep the baby? How did you envision teen motherhood? What is your relationship like with the father of your baby? Do you like school or have plans for future education?"

    The two groups were similar in family histories that led to their current placement. Based on the findings, common backgrounds between mothers and non- mothers included disrupted family structure, abuse, neglect, abandonment, and parental drug addiction. To support these findings, previous research found that disrupted family relationships, foster care, and substance abuse are also elements of the typical adolescent mother (de Anda, 1983; Elkes & Crocitto, 1987; McCullough & Scherman, 1991). Also, Elkes and Crocitto (1987), in a multiple case study of pregnant adolescents discovered several family themes: disrupted family structure, strained relationships with parents, physical and emotional abuse by parents, and parental substance abuse. Finally, teen motherhood has been related to the desire to have someone to love (Crockenberg & Soby, 1989). Several themes about teen mothers were derived from the present study. Adolescent mothers do not see pregnancy as a likely result of unprotected sex; wanting to have a baby "to have someone to love"; and viewing child rearing as fun and easier than it really is.

    Based on this study, abuse, disrupted family relationships and substance abuse are all three related to pregnant teenagers, teenage mothers and non-mothers. Shelters for battered women could be a way to get out of these situations. Teenagers who are not pregnant need to be better educated about the complex responsibility involved when raising a child, such as taking a parenting class. Also, if they want "someone to love", they should perhaps buy a pet or have a family member or friend buy them one. Finally, teenagers need to be better educated on how pregnancy occurs. This would give them the knowledge that pregnancy does occur from unprotected sex. I do not support this article because no information was given about validity or reliability of the instrument used.

Griffin-Carlson, M. , & Schwanenflugel, P. (1998). Adolescent abortion and parental notification: Evidence for the importance of family functioning on the perceived quality of parental involvement in US families. Journal of Child Psychology and Psychiatry 39 (4), 543-553.

    This study was designed to find the levels and trends of teenage pregnancy in developed countries. They took vital statistics reports from different industrialized countries to compare the birth rate, abortion rate, and pregnancy rate. They found that over the past twenty five years there have been varying differences in pregnancy in the industrialized world possible due to increased education importance and goals other than motherhood for young women

Griffin, N.C. (1998). Cultivating self-efficacy in adolescent mothers: a collaborative Approach, Professional School Counseling, 1 (4), 53-59.

    Recent research has shown that school failure, delinquency, substance abuse, and unprotected sex tend to be interrelated. School failure often sets off these events. A relationship has also been found to exist between early childbearing, lower educational attainment, and subsequent employment opportunities. A low self-esteem and perception that failure is inevitable limits the future performance a teen mother is willing to attempt. The article mentions other studies performed that found a large portion of adolescent mothers manage to recover from the "handicaps" of early parenthood, complete high school, find regular employment, and even when they had been on welfare, they eventually managed to escape from public assistance. Programs designed to support and enforce educational goals, improve academic skills, and increase motivation have been proven to enhance the probability of later success. This research laid the ground for the need for programs to aid teen mothers in experiences related to parenting, school, and part-time employment to better prepare them for the transition to adult life roles. The program studied in this article was the Teen Parent Support (TPS) program, which encourages teen mothers to stay in the program until graduation. Program objectives, components, childcare, teen mothers' agreement, classes, counseling, support group, mentor mothers, funding and outcomes are all discussed. Results have shown the success of the program in the past five years, assisting twenty-eight teen mothers and their babies, by the 86% of participants who graduated from high school and 82% who avoided another pregnancy until beyond graduation. All graduated are currently working and/or furthering their education.

Hardy, J.B., Shapiro, S., Astone, N.M., Miller, T.L., Brooks-Gunn, J., & Sterling, C.H. (1997). Adolescent childbearing revisited: The age of inner-city mothers at delivery is a determinant of their children's self-sufficiency at age 27 to 33. Pediatrics, 100(5), 802-809.

    Data from recent interviews with 1798 inner-city children, born between 1960-1965 and followed with their mothers in the Pathways to Adulthood Study to age 27-33 years, were used to address two questions: "Is maternal age, across the reproductive range, a determinant of child's adult outcome? Do covariates of maternal age at delivery reduce or eliminate the effect of maternal age on child's adult outcomes?" An intergenerational life course model of development, the instrument used, identified characteristics of mother and child at birth associated with the child's self-sufficient outcomes in adulthood. Independent variables of the mothers include delay of first birth, education and financial independence.

    For education, the first-born children of the oldest mothers with the highest level of education have the highest probability of successful attainment (72%). For financial independence, 78% came from older mothers. Daughters of teen mothers are 3.6 times more likely to receive public financial support than daughters of older mothers. When the child's ability to delay parenthood to age 20 or older was considered, the age of the mother was significant (79% of mothers were older than 25). 27% of all the female children and 40% of the males reported having no children at the time of interview. These findings support the observation that maternal age and its covariates are predictors of the child's adult outcome. In a previous study composed by Hoffman, he also found that educational attainment and socioeconomic status reflected maternal age at delivery (1997).

    Although teen mothers may cause education attainment, financial dependence and early childbearing for their children, all teenagers, regardless of mother's age should be better educated about the importance of staying in school, going to college, having a stable career and then choosing to have a baby. This would hopefully decrease education attainment, financial dependence and childbearing at an early age. Early intervention is the key to prevention. This article is supported based on reliability and validity of the study.

Hudson, D.B., Elek, S.M., & Campbell-Grossman. (2000). Depression, self- esteem, loneliness, and social support among adolescent mothers participating in the new parents' project. Adolescence, 35(139), 445-466.

    The purpose of this pilot study was to examine levels of depression, self-esteem, loneliness, and social support, and the relationships between these variables, among teen mothers participating in the New Parents Project. The sample consists of 21 teen mothers: 13 Caucasian, 4 Hispanic, 3 African-American, and 1 Native-American. No control group used in this study. A demographic questionnaire, UCLA Loneliness Scale, Rosenberg's Self-Esteem Scale, and Social Support Questionnaire-Short Form were all instruments used in this study.

    53 % of the teens scored within the depression category. In Barnet, Joffe, Duggan, Wilson, and Repke's (1996) sample of 114 teen mothers, 36% had elevated depression scores at two months postpartum; at four months it was 32%. Also, Hall (1990) found that depression was significantly related to maternal age. There was a strong relationship between most of the variables (depression, self-esteem, loneliness, and social support). Depression was associated with increased feelings of loneliness and decreased social support. A correlation between loneliness and depression has been found consistently by previous research studies (Brage et al., 1993). Hurlbut, Culp, Jabunathan, and Butler (1997) reported that adolescent childbearing was associated with lower self-esteem. They noted that teen mothers' self-esteem was significantly related to parenting skill knowledge. Correlations between depression in adolescents and feelings of disconnected from social support have also been documented (Barnet et al., 1996). Colletta (1981) reported that emotional support was significantly related to teen mothers' parental role behavior. In a study of adolescents one month after delivery, Dormire, Strauss, and Clarke (1989) found that participants needed social support to be effective mothers. There was a negative correlation between self-esteem and loneliness, which has also been found in other teen populations (Brage et al., 1993).

    Based on these findings on depression, social support, self-esteem, and loneliness, depression can not always be controlled when a mothers age or postpartum is the case. It is normal for mothers to suffer from postpartum depression a week or two after delivery. On the other hand, depression can be controlled when social support is involved. The teenager's family and society are the two systems that a teen mother needs to be a healthy person and to carry a positive role of a mother. A positive role of a mother leads to better parenting skills which in turn improves a mother's self-esteem. This article is support because validity and reliability of all instruments are mentioned.

Jewell, A., Todd, R., & Brown, R. (2000). An economic analysis of abortion: The effect of travel cost on teenagers. Social Science Journal, 37, 113-118.

    This study published in the Social Science Journal (37) in 2000 examines the effect of travel cost on the decision of teenage women in Texas to seek abortion. Here is a summary of what the authors found:

    • Abortion rates of teenage women 13-17 years old are sensitive to variations in travel cost. Counties in which teenage women must travel longer distances to obtain an abortion have lower abortion rates both per woman, and per pregnancy.
    • Counties with higher travel costs have lower teenage abortion rates: the coefficient sizes imply that a $1.00 increase in travel cost would decrease abortions per woman by 0.86% and per pregnancy by 0.67%.
    • The mean travel cost in a county that currently has abortion providers is $3.61. If a girl has to travel to a county where abortions are performed, the travel costs increases to $15.48. This increase of $11.87 in travel cost would reduce teenage abortion rates by 10.2% per woman, and by 8.0% per pregnancy, translating into approximately 20 fewer abortions per county.
    • Abortion restrictions lead to fewer abortions among teenage women, possibly die to an increase in the monetary or psychic cost ob obtaining an abortion. There can be legal restrictions, such as parental consent laws, or geographical restrictions in the number or location of abortion facilities.
    • Teens who live in states with greater abortion availability are more likely to have an abortion.
    • Higher poverty rates are associated with lower teenage abortion rates.
    • Counties with a higher proportion of high-school educated residents also have higher teenage abortion rates. School enrollment raises the possibility of abortion.
    • Counties with higher percentages of females employed have lower abortion rates. So does counties with higher proportions of married households.
    • Counties with higher proportions of Catholics have lower abortion rates.
    • More urbanized counties and those with higher percentages of white residents have lower abortion rates.
    • Counties with more clinics have higher abortion rates.

      This research also suggests as the others do, that girls will drive for an abortion. Why not provide more access rather than making where you live decide what your choices as a pregnant teen are.

Kalmuss, D. (1992, August). Adoption and black teenagers: the viability of a pregnancy resolution strategy. Journal of Marriage and the Family, 54(3), 1-11.

      This article did research addressing whether adoption is a suitable option and resolution for pregnant black teenagers. The study used 429, 757 participants. Group A was 180, 790 of them were never married, black women under the age of 30 who are not cohabiting, have never had a child, and have completed at least some college. Group B was 248,967 of them are black married couples with impaired fecundity in which both spouses have at least completed high school. 55.6% (100,528) of group A are women who want a child. 21.1% (21,242) of that group who have made adoption contacts. 53.3% (132,783) of group B are women who want a child. 21.0% (27,940) of that group have made adoption contacts.

      The study suggests that for black, pregnant teenagers adoption has been virtually ignored in the research. Their research found that the main reason for the low number of black women putting their baby up for adoption is due to the low demand of black infants. They concluded that adoption is not a "viable alternative for black teenagers".

      This information would be important for anyone who is the support person for a pregnant, black teenager. They could inform them of the facts and make the girl realize that there are many black couples out there who may be wanting to adopt a black child, but can not because of the scarce number of them for adoption.

Lesser, J., Koniak-Griffin, D., & Anderson, N. L. R. (1999). Depressed adolescent mothers' perceptions of their own maternal role, Issues in Mental Health Nursing, 20, 131-149.

    This article points out that although research is continually being done on adolescent pregnancy and parenting, little has been done on these teen mothers' personal experiences. This study used an ethnographic approach with a goal of narrowing existing gaps in knowledge about the affective component of adolescent mothers' role attainment. The sample consisted of fifteen volunteers who reported having experienced depressive symptoms during pregnancy and/or postpartum. Finding of this study suggest that the experience of motherhood may actually help teen mothers improve their previously self-destructive lives. Motherhood has brought these teens an established identity and development of a strong sense of maternal protectiveness. These women are making realistic, future-oriented decisions that have motivated them to leave gang life, finish high school, go to college, and get vocational training. Suggestions for future research on this issue are to identify the individual factors motivating young mothers to make positive behavior changes, explore the experience and subjective meaning of these women's' success, and combine quantitative and qualitative strategies.

Massat, C. R. (1995). Is older better? Adolescent parenthood and maltreatment, Child Welfare, 74 (2), 325-335.

    This study was performed on parents who were subjects of maltreatment reports in Illinois in 1988, consisting of 23, 764 people, and parents in Illinois with children in out-of-home care (8,535 people). The study examined the relationship between the age of the parent and maltreatment by separating the parents into two categories: adolescent parents and adult parents. The hypothesis was that the adolescent status would not increase the likelihood of maltreatment. Earlier research showed that risk of low birth weight infants and infant death was more common with adolescents. However, newer studies indicated that prenatal care can prevent those problems, and poor neonatal outcomes were associated with factors other than age. Other studies have revealed that the negative outcomes for children of adolescent parents are due to social effects, not biological. The findings of this study suggested that adolescents are no more likely to maltreat their children than are older parents, contrary to the myths.

McBride, D., & Gienapp, A. (2000, September/October). Using randomized designs to evaluate client-centered programs. Family Planning Perspectives, 32 (5),227-237.

      This study looked at curriculum-based intervention programs to prevent adolescent pregnancy. Clients were randomly selected to be in either the treatment or control group and were evaluated by the effects of a "client-centered" program, which is an approach to help reduce pregnancy among high risk young adults. This study was conducted in Washington state among seven communities. 1,042 youths aged 9-13 were divided into four groups and 690 teenagers aged 14-17 were divided into three groups.

      Prior to getting any counseling services it was reported that 25% of those aged 15-17 and 16% of those aged 18-19 use no method. Those who did use a method to prevent STDs or pregnancy, incorrect or inconsistent use was reported. These adolescents are said to lack "real" information about sexual activity and its consequences, lack emotional support and positive guidance and lack positive coping skills to manage stress, anger and sadness.

      These groups got a variety of services, including counseling, mentoring and advocacy to help prevent sexual activity leading to adolescent pregnancy. The results found that the youth received 14 hours, the teenagers received 27 hours and the control group only 2-5 hours. The youths were less likely to intent to have intercourse after the sessions than before and the teenagers reported to have a reduce in sexual behavior and an increase in contraceptive use.

      From this information they concluded that clients who are considered high risk need more intervention and intense services than a normal program can provide to help them in their situation.

      This information is very important and should show health care professionals where help is needed. If these adolescents stated that they lack "real" information, they must not be getting it at home, in school, or anywhere else, and evidently, they want it. These teens need to know the facts, they want to know the facts, and this study proved that, so it is our job as the future of kids and as health care professionals, to make sure they are getting this information they want and need.

Medoff, M., & Boulter, S. (1996). An estimate of teenage abortion demand. Journal of Socio-Economics, 28, 175-181.

    This was published in the Journal of Socio-Economics (28) in 1999. This study estimates the demand for abortion by U.S teenagers aged 15-19 for the year 1992. The model used in this paper argues that the pregnancy resolution decision by a woman is based on a comparison of the perceived costs and benefits expected to be imposed by that child. The perceived costs include the earnings, labor market, and social opportunities foregone from having the child and the benefits include the satisfaction from the child. When the perceived costs exceed the benefits, a woman will engage in fertility control. Abortion is a fertility control method which reduces the probability of a birth to zero. The researcher found that forty percent of the one million pregnancies among U.S. teenagers 15-19 years of age end in abortion. The results also showed that teenage demand for abortion is price inelastic, and increases with income. Teenage abortion demand is also found to be positively related to state Medicaid funding, women_s labor force participation and negatively related to Christian Fundamentalism.

    This study shows that when girls are debating what to do with their unintended pregnancy, they look at issues like income, school and benefits versus consequences. This is great evidence for healthcare providers because this shows that girls are at least trying to make a rationale decision, versus going with what others pursuade them to do.

Miller, B.C., & Moore, B.C. (1990, November). Adolescent sexual behavior, pregnancy, and parenting: Research through the 1980's. Journal of Marriage and the Family, 52 (4), 1025-1047.

      This article summarizes research from the 80's within the topics of adolescent sexual activity, conception, abortion, marriage, adoption, and childbearing. Information about the adolescents sexual and contraception behavior is stressed because they are seen as key risk factors in adolescent pregnancy. Moore and Patterson (1989) reported that youth aged 17 or younger stated when they first had sex 1 in 10 whites and 1 in 5 blacks did not think about pregnancy or didn't care whether it occurred.

      This article stated that the incidence of adoption dropped dramatically around the time that it became legal. In 1971 the adoption rate was 18% and fell to 7% in 1976 and 1982. For blacks, this fell from 2% to under 1%. They also found that adolescents who decided to place have less influence on their partners, have a higher education level and tend to be in school more often than unmarried mother who chose to parent.

      A study is still underway at the University of North Carolina by John O. G. Billy who is conducting a longitudinal study of 20,000 students from 200 schools in the eleventh grade. He is interested in the behaviors that puts adolescents at risk for AIDS, other STDs, and pregnancy. When this information comes out it will be very beneficial and useful due to how in-depth it is.

      This article has important information that should be presented to a pregnant adolescent. These teenagers need to see that it can happen to them and they are not immune. This study shows that apparently many teenagers think that they are. It also gives them good information about adoptions and how not any people choose it as one of their options anymore, even though there are more people than ever on waiting lists.

Pan, M. , Gross, D. , Gross, A. , & Bello, D. (1996, Nov-Dec). Prenatal power-education for life. Public Health Reports, 111 (6), 701-706.

    This study was conducted by Tufts University of Medicine at Boston High School. It was conducted during the 1994-1995 school year and 134 students were included in this study. This study was conducted to increase the self-confidence and decision making skills of high-risk teenage mothers. "They are trying to promote continued education and betterment of socioeconomic status, prevent future pregnancies, and improve adolescent outcomes." This study is still being evaluated for both short and long term outcomes. Currently students are accepting and favoring the project.

Peterson, D. , & Alexander, G. (1992, Nov-Dec). Seasonal variation in adolescent conceptions, induced abortions, and late initiation of prenatal care. Public Health Reports, 107, (6), 701-706.

    This was study conducted to see different seasonal patterns on pregnancies, live births, abortion, and initiation of prenatal care. The peak month of adolescent conception was around the end of the school year. This is believed to be because the teenagers attend the prom and because this time of year these young women have more free time. This is also significant because many of these events may be associated with drugs or alcohol. They found that the abortion rate of adolescents that conceived in the month of October was lower. This is believed to be because the time for the abortion falls around December. This time of year is thought of as a religious time that is to be spent with family. There are also less available financial resources. The largest delay in prenatal care was found in the month of April. They believe this is due to the end of the school year when teenager think less counseling and health care services are available. They believe if we educated these teenagers during these social events then may be we can help reduce the risk of pregnancy, abortion, and delayed prenatal care.

Pierson, V. ,(1995). Missouri's parental consent law and teen pregnancy outcomes. Women & Health, 22, (3), 47-57.

    This was a study conducted to evaluated parental involvement following parental notification of a teenager's decision to have an abortion. Past studies found that about half of pregnant teens have abortion without informing their parents. Right now about 61% of minors inform their parents about their abortion. This study was conducted by survey. However each teenage had to have a parent present to be included in the survey. There were three different approaches: the Demographic, the Religious, and the Family Approach. The researchers found that the most important was the Family Approach. Communication, cohesion coping, and adaptability were related to Quality. The researchers did found some flaws in their research. They thought that their sample might have been biased. They needed to do it in states where parental involvement is not a law.

Raab, M. (1998). Birthrates among teenagers are unaffected when states require parental involvement in their abortion decisions. Family Planning Perspectives, 30, 197-207.

    In this research article published in 1998 by Family Planning Perspectives (30), the researcher wanted to see if the birthrate would rise in 3 states who inacted a parental involvement law that required consent of a parent for a minor (under 18) to receive an abortion. The analysis examined the effects of parental consent or notification laws in Minnesota, Missouri, and Indiana, using data from the state health departments and the Census Bureau.

    In Missouri, the birthrate among those women under 18 rose 4%, however the rate for those teenagers over the age of 18 also increased during the same period; the difference between these percentages was statistically significant. In Indiana, there was a 9% decline in minor_s birthrate. And in Minnesota, the birthrate rose 1%. The abortion rate decreased for minors in all 3 states after the parental involvement laws went into effect.

    The researcher points out that it is unclear whether the decrease in abortion rates were actual decreases or attributable to out-of-state travel. The researcher also points out that the decrease in abortion rates could be due to minors delaying their abortion until they did turn 18. These two factors, and several others including the idea that minors may have prevented pregnancies with birth control methods, or abstained from sex altogether when confronted with the law, others may have misrepresented their age or induced their own abortions, and some abortions may not have been reported at all, all combined together may explain why minor_s abortion rates fell following the enforcement of parental involvement laws while birthrates did not increase.

    In conclusion, in all 3 states, data yielded no evidence that parental involvement laws caused an increase in minor_s birthrates.

    This information is useful to state legislators as well as healthcare providers. As state representatives, we should not let laws concerning abortion cause a girl to postpone her pregnancy because she_s waiting to turn 18. We should do our best to promote parental guidance and support, but only at the girl_s discretion.

Rich, L. M., & Kim, S. (1999). Patterns of later life education among teenage mothers, Gender & Society, 13 (6), 798-818.

    This article used data from the National Longitudinal Study of Youth to examine patterns of educational attainment of women through the middle 30s, disaggregated by age at first birth. The authors compared the amount of education received by teen mothers to women who delay giving birth until adulthood. Studies are mentioned that examined later life educational attainment among localized samples of teen mothers. These studies all showed that a significant percentage of women who gave birth as teens had either finished high school or received a general equivalency diploma (GED), with some having gone on to complete postsecondary education. This study surveyed a diverse sample of young men and women who were between the ages of 14-21 years old in 1979. Findings revealed that mothers who gave birth in their teens not only continued to enroll and complete high school through their middle 30s, but that the proportion completing high school continues to increase. Many of these mothers have also gone on to complete one or more years of college by age 36. Evidence also indicates that later life educational attainment by mothers who gave birth before age 18 resulted in narrowing the gap in total years of completed schooling relative to mothers who delayed childbearing.

Roling, P. C., & Burnett, M. F. (1997). The influence of open-mindedness and Knowledge on attitudes toward teen pregnancy among family and consumer science Teachers, Family & Consumer Sciences Research Journal, 26 (2), 141-160.

    This study's purpose was to determine the influence of knowledge about teenage pregnancy/parenting and open-mindedness on family and consumer sciences (FCS) teachers' attitudes toward teenage pregnancy/parenting. The simple random sample was taken from a population of FCS teachers in Louisiana. Data was collected by mailed questionnaires. Variables included open-mindedness, number of pregnant teen taught, number of in-service programs attended, age and marital status. The hypothesis was that teachers with higher knowledge scores and higher levels of open-mindedness would have more positive attitudes. These teachers were studied because they're most likely to deal with pregnant teens in the school environment. Teachers with higher levels in both areas (knowledge and open-mindedness) had more positive attitudes toward pregnant teens, as did those who had attended more in-service programs, were younger, and were not married or widowed. These results showed that the hypothesis was supported; however, there is room for improvement in FCS teachers' level of knowledge about teen pregnancy and parenting, as well as open-mindedness. This was the first study statewide ever to investigate FCS teachers' attitudes as the primary variable. Recommendations were made for all schools to begin programs to meet pregnant teens' needs, and for further research to be conducted to determine the impact of support on these programs. Further recommendations were made to FCS teachers to improve their levels of knowledge and open-mindedness.

White, S. D., & Cummings, M. N. (1995). Goal setting and control orientation of Pregnant/parenting female adolescents in the GRADS program, Family & Consumer Sciences Research Journal, 23 (3), 249-268.

    Previous studies have found that adolescents have vague and tentative life goals and more short-term goals. Adolescents with higher educational and vocational aspirations exhibit behaviors that minimize the risks of unplanned motherhood. This qualitative study was performed on students in the GRADS (Graduation, Reality, and Dual-role Skills) program to determine if they differ from nonpregnant/nonparenting teens on types of goals viewed important, goal orientation, and locus of control. The GRADS program helps at risk pregnant/parenting teens graduate from high school, set life goals, and feel empowered. The sample was 151 females in New Mexico who had either been in the GRADS program for one year or more (Group A=37 participants), GRADS students new to the program (Group B=46 participants), and a group of English class students who were not pregnant or parenting (Group C=68 participants). A modified Q-sort instrument was used to collect data on material, intrapersonal, and interpersonal goals. Reliability was established by using a test-retest format. Data analysis indicated the three groups differed in the types of goals chosen as priorities, but no significant difference was found on goal orientation or locus of control. The three groups were more alike than different.

Russo, N. , Horn, J. , & Tromp, S. (1993). Childspacing intervals and abortions among Blacks and whites: A brief report, Women & Health, 20, (3), 42-50.

    This was a study was conducted to examine women in 1987 who had abortions by both race and age. And of these mothers who had at least one child under two years old. This study was conducted through questionnaires given at 27 nonhospital facilities in all four areas of the US. They believe that the sample from the Midwest may have been too largely represented. Child spacing can have psychological, sociological, and behavioral influences on both child and mother. The researchers found that about one of every four abortions had a child of less than two years of age. Out of the black and white mothers surveyed one out of the two with a child less than two years of age had more than two children. Abortion may be of benefit to women who have closely spaced child because of all the risk factors associated with close child bearing.

Other References:

Anderson, L., Glanze, W., Mosby's Medical, Nursing, and Allied Health Dictionary. 5th Edition (1998). St. Louis: Mosby, Inc.

Coley, R.L., & Chase-Lansdale, P.L. (1998). Adolescent pregnancy and parenthood: Recent evidence and future directions. American Psycologist, 53(2), 152-166.

Lesser, J., & Escot-Lloyd, S. (1999). Health-related problems in a vulnerable population: Pregnant teens and adolescent mothers. Nursing Clinics of North America, 34(2), 289-295.

Lowdermilk, D., Perry, S., & Bobak, I., Maternity and Women's Health Care. 7th Edition (2000). St. Louis: Mosby, Inc.


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