Teenage Pregnancy Social Policy Choices Carole Hanks School of Nursing

Agenda zBurton’s article and her approach to research on a social problem 20 min yDiscuss Burton’s article and it’s thesis -- teenage pregnancy is an alternative life course strategy created in response to socio- environmental constraints. zBackground of facts and attitudes about teenage pregnancy yTeenage pregnancy rates yNeonatal mortality rates yHow did teen age pregnancy = cause of poverty

What are Burton’s conclusions? zwithin low-income black families there is an different timetable for assume various life roles than in higher-income families za separation of reproduction and marriage zage-condensed family structure (matrilineal) zgrand-parental child-rearing along with reciprocal care of grandparents by young adult grandchildren zmarginalization of males

Value of this research? zHer research was with 20 families; she just “talked to them.” Is this generalizable? valid? zThink of Ghana -- when are causes and solutions to poverty the same? zWhat other kinds of research would clarify these issues?

Social Policy zTA Pregnancy -- example of a “social problem” zRelated to what we have studied this semester: identifying and defining social issues; measuring beliefs, dispositions, and behaviors related to those issues (specification); developing and evaluating social policy zIs teenage pregnancy a “problem” or a strategy to deal with poverty and the poor health and deprivation linked to poverty zThe wrong public policy could do more harm than good.

Myths about teenage births: zhigher infant mortality (not biologically prepared to have children) zcauses dropping out of school zprevents completing education and entering workforce zirresponsible act (Is teenage childbearing an individual or a social act?)

Personal Responsibility & Work Opportunity Reconciliation Act zValues & behaviors of the poor---> poverty zTeen age childbearing in particular --> poverty zSo, incentives to decrease TA childbearing ydeny benefits ymoral renaissance

Teenage Births x1920 rate per thousand women aged 15 to x x x x x x x x x x x x1998 ~50 x U.S. BR was 15.2 in 1994

Neonatal Mortality zCross-sectional research conclusions yNNMR of teens is higher than women in 20’s yBut what does maternal age measure? zNon random distribution of maternal age at first birth ysocio-economic status is a confounder ycontrol statistically, sister studies, miscarriage studies

When are poor women healthiest? zPrevalence of smoking, drug use, and drinking increases as poor women age zCumulative risk of infection of reproductive organs --->low fertility zHypertension, diabetes prevalence increase zshortened lifespan overall

NNMR by Age and Race z z z z z z z z z z> z 1512(1.54) z (1.22) z 179.9(1.44) z 188.7(1.67) z 197.4(1.79) z (1.74) z (2.68) z (2.19) z (1.88) z >347.2(1.97)

Summary zteenage pregnancy and birth is not a very useful construct, that is, it is too general - - covering a wide age span and drastically different cultural contexts zwhat is normative in one culture may not be in another zsocial policy must recognize the rationale for deciding to give birth as a teen zsocial policy should address “proximate determinants” of neonatal births such as poor nutrition, STD’s, access to medical services, and poor health status. Other social science issues in the decision to give birth and the sucess or failure for the mother and child include rural isolation, unemployment, low wages, lack of day care. zpostponed childbearing among the poor could lead to increased rates of infant mortality, childhood morbidity, welfare dependency, and more years spent in poverty for children., zWhat do you think

Where to get more information zFamily Planning Perspectives, and other journals. Arlene Geronimus has written numerous articles about this issue. zKristin Luker, Dubious conceptions: The Politics of Teenage Pregnancy zLinda Burton also studies the grandparent generation & the contribution of neighborhood context to children’s health and development