'I have to pretend that I don't care': Stigma management among unmarried young mothers in South-Western Nigeria.

Young mothers often encounter stigma and discrimination, affecting their lives and that of their children. This paper explores stigma management strategies and their effectiveness for young mothers in rural Nigeria. Ten key informants and 24 young mothers were recruited from Ife-East in South-Western Nigeria. Data from semi-structured interviews showed that societal disapproval of pregnant teenagers and young mothers were common experiences. Women used a range of strategies to actively cope with stigma including: belief in predestination, avoidance, concealment, and cohabitation. These strategies could be seen as tools to mitigate negative stereotypes and discrimination. However, they also had the unintended consequences of compounding many young women's difficult circumstances and exposing them to adverse outcomes, including gender-based violence, repeat pregnancies, poor mental health, and low uptake of services. The results show the need for policy frameworks to actively combat stigma by addressing the negative framing of early pregnancy and motherhood and promoting supportive environments for young mothers. Health professionals need to be trained to offer de-stigmatising services to encourage young mothers to seek help and reduce pre-existing inequities in access to services, and policies need to include measures that address the rights of young mothers and protect them from violence and abuse.

Evaluation of a child abuse prevention program for unmarried mothers in South Korea: a single-case experimental design.

PURPOSE: The purpose of this study is to apply and evaluate the effectiveness of a child abuse prevention program based on the Nursing Model of Resilience and Coping Skills Training Model for unmarried mothers during pregnancy and puerperium. METHODS: This study had a prospective single-case, AB design with four repeated self-questionnaire measures and three observational measures. Seven unmarried mothers were provided with 10 sessions child abuse prevention program through individual visits from 32 to 34 weeks of pregnancy to 6 weeks after childbirth. The questionnaire was composed related to resilience, maternal stress, maternal attitude, parent-child interaction, child abuse potential. The observation was measured by video recording (total 16 times) the interaction of parent-child during feeding and analyzing it by three experts. Data were analyzed by Wilcoxon signed-rank test and Friedman's test. RESULTS: Maternal attitude and parent-child interaction were statistically significantly improved after intervention compared to before intervention. However, maternal stress decreased after intervention compared to before intervention, but it was not statistically significant. Also, resilience and child abuse potential were not statistically significant. This program is partially effective in preventing child abuse by promoting parenting attitudes and parent-child interactions. CONCLUSION: This study focused on individual resilience and applied systematic intervention as coping skills training to prevent child abuse. This study is meaningful in that interventions were conducted through individual visits to unmarried mothers at high risk of child abuse, and the program was applied, including pregnancy and postpartum periods, to prevent child abuse early.

The Development of a Health Promotion Program for Unmarried Mothers Living in Residential Facilities Using Urban Forests: An Intervention Mapping Approach Based on the Transtheoretical Model.

Unmarried mothers living in residential facilities (UMLFs) in Korea face complex and challenging physical, psychological, and socioeconomic issues. This study developed a physical and mental health promotion program using urban forests for UMLFs based on the transtheoretical model and evidence. We utilized an intervention mapping approach (IMA) and assessed the needs of UMLFs by analyzing previous quantitative studies. Moreover, we conducted a qualitative hermeneutic phenomenological study involving nine participants. Based on the needs assessment, important and changeable determinants were identified; further, the program performance and change objectives were classified to achieve the program goals and establish the intervention strategy. We found that physical activity using forests, self-reflection using metaphors, five-sense activities, achievement activities using natural objects, building interpersonal relationships in the forest, and designing future plans, are desirable methods for improving the health of UMLFs. The IMA was deemed appropriate for the systematic development of health promotion programs for UMLFs through clear links among change objectives, theoretical methods, and practice strategies. These results should be applied to future intervention studies.

Unmarried Mothers' Postnatal School Enrollment: The Role and Intersection of Demographic and Socioeconomic Characteristics.

Drawing from a theoretical model of educational decisions and intersectionality theory, this study examined demographic, socioeconomic, and public assistance characteristics that influence unmarried mothers' postnatal enrollment. Using the Fragile Families and Child Wellbeing Study (FFCWS), binomial and multinomial regression techniques were used to examine unmarried mothers' enrollment in their child's first nine years. Results showed unmarried mothers' educational commitment coupled with the influence of race and class indicate that they need additional opportunities to optimize their educations and job opportunities. Targeting outreach and enrollment assistance to underrepresented groups can reduce social-origin inequalities. Important directions for future research include understanding unmarried mothers' rationale for school enrollment and considering how race and class work in combination to support or deter enrollment.

The out-of-wedlock pregnancy. Six-years' experience with a university population.

PIP: Illegitimate births are increasing. Associated with this increase are higher rates of prenatal deaths and prematurity, in some studies double that of legitamate births. Marriage after such conception has a higher divorce rate. The present study includes data on every pregnancy diagnosed at the University of California Santa Barbara Student Health Service during 1965-1971. It considers the outcome of those pregnancies and reviews some programs that were instituted with an aim toward prevention. Out-of-wedlock pregnancies decreased after an educational, counseling, and contraception program was instituted. The rate of abortions remained unchanged in spite of liberalized abortion laws; there were no repeaters after the program was instituted. Experience in counseling confirms the contention of several authors that some out-of-wedlock pregnancies stem from subconscious reasons. A multiple disciplinary approach to such pregnancies is advocated.^ieng

Outcome of illegitimate conceptions in a black population.

PIP: Field interviews were conducted to gather data on pregnancy wastage and illegitimacy among 990 urban black women in a North Carolina Standard Metropolitan Statistical Area. The sample range in age from 15-39, was at least gravida 1, and was at the poverty level (based on relationship of family size to income). 90% of births were illegitimate with little influence from economic status or income, but higher educational levels were associated with a greater percentage of conceptions resulting in illegitimate live births. The older the women, the lower was the proportion of illegitimate conceptions resulting in illegitimate births. In groups aged 15-24, and 30-39, there was a positive relationship between education and percentage of illegitimate live births, possibly due to general good health, awareness of health facilities for the more educated, and a reluctance to view abortion as acceptable. In this group aged 25-29, higher education was negatively related to illegitimate births, possibly explained by the relatively better health of this group, regardless of knowledge or availability of health care, and their tendency to view abortion as acceptable. Only 4% saw having children as a handicap to getting married. Only 9.7% of all conceptions which were terminated could have been via abortion, which is indicative of the corresponding attitudinal survey where 77% of the sample were opposed to abortion under any circumstances.^ieng

A nonmedical approach to fertility reduction. An experimental contraceptive service unit.

PIP: A preliminary report if given of results of 3 walk-up Contraceptive Service (CS) Units started in Forsyth County, North Carolina, by the Behavioral Science Center of Bowman Gray School of Medicine that tried through an experimental and nonmedical approach to reduce fertility among young poverty-level females by focusing on young sexually active males. 552 new and 874 returning clients visited the CS units during the first 7 months of the experiment. 90% new and 98% returning clients have been male. The first clinic was opened September 1, 1968, 3 hours each evening except Sunday. In November a second clinic was opened in March. Each was staffed by a nonmedical trained counselor. A choice of condoms, foam, or jelly and instruction in proper technics in using these methods provided at no cost. Male clients have been highly responsive, entering freely into discussion. Objections to mechanical methods were removed by instruction in proper use. Most requested condoms and foam. Location accounts different degrees of success and will be evaluated in a future report. CS effectiveness should be measured in lower venereal disease incidence. Further evaluation will include excess fertility analysis and numerator anaylsis.^ieng

Nutrition services for pregnant adolescents within a public high school.

PIP: The St. Paul Maternal and Infant Care Project (MIC) was begun in 1973 in response to the recognition that pregnant adolescents were medically, nutritionally, and socially at risk. The program provides prenatal care as well as adolescent health care and drug screening. It operates within 3 inner city public high schools and has a strong educational component for parents and for infants and children. Funds come from state-allocated Title V Maternal and Child Health funds, Title XIX EPSDT funds, and grants from the Minnesota Community Health Services Act and the St. Paul-Ramsey Hospital Medical Education and Research Foundation. Title XX monies are used to support the day care component. In-kind contributions from the St. Paul Schools provide physical facilities for the school health clinics and the day care center. Since implementation, the program has secured a 50% reduction in school fertility rates, there have been fewer obstetric complications, and a lower incidence of low-birth-weight infants compared with adolescents served by the MIC Project in non-school clinics. 85% have completed high school. The article then describes the nutritional problems of pregnant adolescents and the measures taken to deal with these.^ieng

Historical overview of fertility and age.

PIP: Since the early 1980s, the number of births to women over age 35 has been increasing in most European countries. Consequently, the period of highest fertility shifted from the 20-25 to the 25-30 age range. During the baby boom after World War II in France, the annual number of births rose from 610,000 in 1938 to 870,000 by the end of the 1940s. In 1964 when the baby boom children reached reproductive age, annual births were close to 850,000. The number of births in mothers over 35 increased from 47,000 in 1980 to 70,000 in 1985. The total fertility ratio was 3 children/woman by the end of the 1940s, then it declined to 1.8 between 1964 and 1976, below the replacement level up to the present time. The proportion of the ratio attributable to women over 35 age declined during the 20th century from 25% to the current 9%. Between 1964 and 1976, all the age-specific birth rates fell. In France in 1978, unwanted births dropped from 21% to 13.5% between the periods 1963 and 1967, and 1973 and 1977, respectively. In 1976, fertility in the 25-39 and the 30-34 age ranges started to increase. The main reason for the increase in fertility beyond age 35 was the decrease in nuptiality at younger ages due to more efficient birth control. Illegitimate fertility rates also rapidly increased along with single women at all ages. In Sweden, the illegitimacy ratio is currently close to 1 out-of wedlock birth in every 2 births. The illegitimacy ratio nearly doubled between 1976 and 1985 to reach 17% in the UK and 20% in France. It is not close to 6% in Switzerland, 8.5% in the Netherlands, and 9% in West Germany. On the one hand, the increase in the number of births at maternal ages over 35 occurred because the baby boom cohorts are not 25-40 year old. New cohorts will marry later and often get divorced, while out-of-wedlock fertility continues to increase. These changes will bring about the decline in fertility before age 25 and an increase between ages 25 and 35. Late fertility after age 35 will probably increase to a much smaller extent than mid-period fertility.^ieng

HIV-related attitudes and risk behavior of young adolescent mothers.

This article reports on the prevalence of HIV-related risk behaviors among young adolescent mothers. To determine the facilitators and barriers to condom use for young adolescent mothers, a survey of HIV-related knowledge, attitudes and behavior and focus groups was conducted. Young mothers (N = 58) have basic knowledge and some personal concern about HIV, but also hold common misconceptions about HIV and people with AIDS. Despite their anxiety about HIV, almost half rarely or never protect themselves against HIV by using a condom. Although 70% of the sample use hormonal contraceptives, more than one third of the sample have had a second child within an average of 18 months after the birth of their first baby. Personal concern about HIV was significantly associated with consistency of condom use. Because of low rates of condom use and substantial rates of multiple sex partners, STDs and second pregnancies, disadvantaged adolescent mothers are at risk of exposure to HIV. Increased personalized concern for HIV may lead to greater motivations for safer behavior for these mothers. In addition to protecting their own safety, the protection of their child may be an important motivator for safe behavior. Cultural taboos against safe sex and the perception of such behavior as "unfeminine" also need to be addressed for these women.

PIP: HIV-related knowledge, attitudes, and risk behaviors were investigated in a study of 58 primarily Latina, low-income adolescent mothers (mean age, 17.5 years) enrolled in the Rhode Island (US) Hospital Teen-Tot Clinic. Respondents expressed fear concerning the threat of AIDS and 9% were worried they had already been exposed to HIV. Their basic knowledge about HIV transmission was adequate. Despite substantial anxiety about HIV infection, 47.4% of teen mothers did not use condoms consistently, 31.7% had 2 or more sex partners in the past year, 14.0% had a history of a sexually transmitted disease, and 22.8% had intentionally cut their body with an instrument such as a razor blade or pen. Although 70% used hormonal contraception, 33% of respondents had a second child within an average of 18 months of the birth of the first. Consistent condom users were significantly more likely than those who almost never or never used condoms to report personalized anxiety and concern about HIV/AIDS, significantly less likely to engage in self-mutilating behaviors, and significantly more likely to express intentions to engage in future HIV prevention behaviors. In focus groups discussions attended by 59 respondents, teen mothers expressed a sense of powerlessness in negotiating condom use with older male sexual partners and cultural taboos against condom use in primary relationships. Latinas viewed assertive sexual decision-making as incompatible with cultural norms regarding the female role. While hormonal methods of contraception were perceived as a medical regimen, barrier methods were associated with a culturally unacceptable premeditated decision to have sex.

Births to unmarried mothers: trends and obstetric outcomes.

PIP: This study examines trends in nonmarital childbearing among women who represent an inner-city urban population that includes high-risk privately insured mothers and a large number of indigent mothers. The study population includes data collected from a computerized database at the MetroHealth Medical Center in Cleveland, Ohio, during 1974-93, on 73,544 births. The subsample for the clinical analysis is based on 29,865 deliveries that occurred during 1987-93. Findings indicate that the proportion of deliveries to unmarried mothers increased by at least 20% over a 19-year period. The proportion of privately insured unmarried mothers increased from 6.7% to 27.3% during 1975-93. The proportion of staff-funded mothers increased from 63.5% to 77.5%. The proportion increased for all races, funding groups, and age groups. In the subsample of births during 1987-93, there were 51% Whites, 38% Blacks, 8% Hispanics, and 3% other. Only 15% had private medical insurance. 34.2% of births were to married mothers. 38% of births were to women who were smokers, 3.2% were alcohol users, and 15.4% were narcotic users. 15.4% were cesarean births. The infant mortality rate was 13/1000 live births. Unmarried mothers tended to be about four years younger than married mothers. Over 30% of unmarried mothers and only 10% of married mothers were teenagers. 48% of White mothers, 14% of Black mothers, 35% of Hispanic mothers, and 70% of mothers of other race were married at the time of delivery. The mean birth weight for unmarried mothers was 100 g less than for married mothers. Significant predictors of mothers' marital status were insurance status, race, age, and their interaction. The odds of unmarried status increased with younger age, delivery later in the study period, race, insurance pay status, and parity, which, when controlled for, showed Black and Hispanic mothers with increased odds of an unmarried status. Significantly more unmarried mothers had infants with thick meconium, premature delivery, and fetal distress among neonates.^ieng

Sexual attitudes and behavior among students in Uganda.

PIP: A study was conducted of sexual attitudes and behavior among students in secondary schools in Uganda. Surveys were undertaken during June-August, 1970 and 1971, in 7 schools near Kampala. These students are exposed to the following nonindigenous factors: Christianity, formal education, urbanism, and Western materialism. The survey indicates that all change has not been in the direction from traditional to modern, although there is a permissive trend among the students that differs from their restrictive cultural background. Traditional attitudes and behaviors regarding the sex act and acceptance of premarital children remain. Acceptance of premarital sex and abortion are departures from traditional views. Premarital parenthood is still preferred to abortion. Males particularly still support traditional sexual practices. In general, females were less liberal in their views than males; differences between the groups tend to disappear as age and educational level rise. Sex education, gynecological counseling, and contraceptive advice are needed among these students.^ieng

Evolution of fertility and mortality.

PIP: Historical and current fertility trends in both Quebec and Canada as a whole are surveyed. While fertility among French Canadians was higher than that in neighboring provinces until the mid-20th century, in 1968 Quebec's crude birthrate was the lowest in Canada, and in 1972 it was 13.8 vs. 15.9 (the national birthrate). This reversal is explained in terms of the demographic transition theory, the declining influence of organized religion, and new opportunities for social mobility for minority groups. The birthrate throughout Canada is also declining. Although recent cohort studies are incomplete because women have not yet finished their reproductive years, it appears that completed family size will be lower than at any time in Canadian history. The period total fertility rate indicates an average family size of 1.8 children in 1976, but it is unclear whether this represents an actual reduction in family size or the postponement of childbearing. The sharpest fertility decline has been among women aged 35-49, but peak fertility rates have shifted from the 20-24 age group to those aged 25-29. Fertility is negatively related to education, and the lowest fertility is found among the intermediate income groups. Since the 1969 lifting of the ban on contraceptive sales and advertising, family planning activities have been stepped up. Also removed was the total ban on abortion. In 1975 there were 14.9 therapeutic abortions per 100 live births, but it has been charged that abortion standards are being applied inequitably from hospital to hospital.^ieng

Adolescent pregnancy and childbearing - growing concerns for Americans.

PIP: The negative impact of the increase in sexual activity among teen-agers and the health and life chances of those involved are examined. The barriers to effective contraception by teen-agers, racial differences, and the U.S. experience in relation to that of other countries are discussed. Some of the major topics discussed are: 1) overall fertility rates among teen-agers, 2) legitimate and illegitimate births, 3) marriage among teen-agers, 4) adoption, 5) abortion as an outlet, 6) sexual activity, 7) patterns in conceptions, and 8) patterns of contraceptive practice. Also discussed are: 1) teen-agers and clinical services, 2) health consequences of adolescent childbearing, 3) teen-agers health and sex, 4) child development, 5) life chances for a t een-age mother, 6) consequences for society, and 7) international comparisons. 6 figures and 11 tables are included.^ieng

A study of out-of-wedlock pregnancies: outcome and utilization of maternal/child health services.

The characteristics of unwed pregnant women, their utilization of maternal and child health services and the infant mortality among these out-of-wedlock births were investigated. During the study period, 5% of all pregnancies (48 of 855) were of this nature. Utilization of antenatal services was poor among unwed pregnant women, compared to those who were married. However, they used the child care services satisfactorily, as observed by the well-baby-clinic visits and acceptance of immunization. The infant mortality was 125 per 1000 live births, more than double the rate among infants born to married women. Either immediately after child birth or within one year after delivery, 50% of the unwed mothers started living with the putative fathers.

PIP: Data from the records of the Jawaharlal Institute Urban Center of Pondicherry, India were used 1) to assess the extent of illegitimate births among the 7065 residents served by the Center's clinic; 2) to determine the degree to which unwed mothers utilized the services of the clinic in comparison to married mothers; and 3) to assess the rate of infant mortality among illegitimate infants; and 4) to identify the characteristics of unwed pregnant women. The clinic maintained records on all 1385 families served by the clinic, and clinic personnel lived in the community and knew the patients on a personal basis. Among the 855 pregnancies recorded for the clinic families during a 5 year period there were 48 out of wedlock pregnancies. Unmarried mothers utilized the prenatal services of the clinic less frequently than married mothers. 51% of the unwed mothers, compared to 22% of the married mothers, failed to visit the clinic even once during their pregnancy. The unwed mothers were also more likely to register their pregnancy at a later date than the married mothers. Only 44% of the unwed mothers, compared to 77% of the married mothers received prenatal tetanus toxoid immunizations. The unwed mothers did take advantage of the postnatal services of the clinic for their infants. All of the children of unwed mothers were vaccinated for small pox. 72% of the mothers brought their infant to the clinic 5 or more times. The infant mortality rate among the infants of unwed mothers was 125.0/1000 live births and 51.8/1000 live births for infants born to married mothers. Illegitimate births in the area were frequently hidden. 56.3% of the unwed mothers were 15-19 years of age and 59.0% were Hindu. 83% were illiterate and 67% were unemployed. About 50% of the unwed mothers moved in with the putative father within a year of delivery and an additional 7% of the fathers moved into the family home of the unwed mother.

Teenage pregnancy in perspective.

In an effort to provide the clinician with suggestions for preventive and remedial approaches to adolescent pregnancy, the nature, medical, social, economic, and psychological aspects of the problem are reviewed and discussed. While the rate of adolescent pregnancy is declining, there are more than 560,000 deliveries to teenagers annually. Medical risks are significantly diminished by early and comprehensive prenatal care. The major complications continue to be social and economic. Lower I.Q.s in offspring of adolescent mothers have been reported. Failure to complete high school significantly increases the risk of unemployment, trapping the premature parent and her offspring in a web of poverty. A lack of a sense of future and viable alternatives may legitimize the option of motherhood in the minds of many adolescent girls. Furthermore, an ignorance and a denial of sexuality combined with the developmental imperatives of experimentation and rebellion place the adolescent at high risk for pregnancy.

PIP: The nature, medical, social, economic and psychological aspects of the problem of adolescent pregnancy are reviewed and discussed in an attempt to provide the clinician with suggestions for preventive and remedial approaches. Despite the fact that the rate of adolescent pregnancy is declining, there are more than 560,000 deliveries to teenagers annually in the United States. Early and comprehensive prenatal care significantly cuts down the medical risks. The major complications continue to be social and economic. A Johns Hopkins Child Development Study, which followed 4600 pregnant women and their offspring over a 12-year period, revealed that those children born to mothers initially 16 years of age or younger had lower intelligence quotient performances than the children of older women. Failure to complete high school has been found to significantly increase the risk of unemployment, trapping the premature parent and her child in a web of poverty. Among the most significant determinants of childhood pregnancy are the number of years the individual has been sexually active and whether or not she has used contraception. An ignorance and a denial of sexuality along with the developmental imperatives of experimentation and rebellion place the adolescent at high risk for pregnancy.

Factors associated with ex-nuptial birth.

The paper examines the background to 210 live exnuptial births studied in the first phase of the Christ-church Child Development Study. The results show: 1. That nearly half of the children had been conceived within cohabiting situations. 2. That nearly one in five ex-nuptial children was the result of a planned pregnancy. 3. Maternal reactions to the birth and pregnancy varied with the mother's situation: cohabiting mothers reported considerably less adverse reaction to the birth than did non-cohabiting mothers. 4. Overall, mothers of ex-nuptial children had a fairly sophisticated appreciation of contraceptive methods. 5. One quarter of unplanned ex-nuptial pregnancies were the result of contraceptive failure and three-quarters were the result of contraceptive non-usage. 6. In common with previous findings for nuptial pregnancies, about 35 percent of unplanned ex-nuptial pregnancies were ascribed to a breakdown in the mother's pattern of usage of the contraceptive pill.

PIP: The background of 210 live ex-nuptial births studied in the 1st phase of the Christchurch Child Development Study were examined. The mothers participated in an hour-long interview during the April 15, 1977-August 5, 1977 period, answering questions regarding various aspects of the birth and the pregnancy. The mothers of ex-nuptial children were classified into 2 groups in terms of the mother's status at the time of conception -- cohabitating with the child's father and not cohabitating with the child's father. Each group was cross-classified by a series of measures of the mother's reaction to the pregnancy. The results reveal the following: 1) almost 1/2 of the children had been conceived within cohabiting situations; 2) nearly 1 in 5 ex-nuptial children were the result of a planned pregnancy; 3) maternal reactions to the birth and pregnancy varied with the mother's situation -- cohabiting mothers reported much less adverse reaction to the birth than did the non-cohabiting mothers; 4) overall, mothers of ex-nuptial children had a fairly sophisticated appreciation of contraceptive methods; 5) 1/4 of the unplanned ex-nuptial pregnancies were the result of contraceptive failure and 3/4 were the result of contraceptive non-usage; and 6) about 35% of the unplanned ex-nuptial pregnancies were ascribed to a breakdown in the mother's pattern of usage of the oral contraceptive.

Exnuptial conception in New Zealand.

PIP: A survey was conducted in Auckland, New Zealand to obtain some information about exnuptial conception. The study subjects came from 2 main sources: antenatal clinics at the teaching obstetric hospital; and a hostel/hospital catering to unmarried mothers only. The clinic group was comprised of all unmarried primagravida attending over a 3 month period--Group 1 (n=92). Toward the end of this 3-month period it was decided to obtain contrast groups by interviewing all married primigravidae under the age of 23. About half of those interviewed in the married group had participated in "shotgun" weddings--Group 3 (n=22). Those who successfully avoided pregnancy before marriage formed Group 4 (n=23). The hostel group--Group 2 (n=22)--was necessarily somewhat different. The authorities allowed only volunteers to be interviewed, and the sample turned out to be ethnically and educationally advantaged over the clinic group. The hostel group was analyzed separately at all times. The data concerning conception was in the main retrospective and is subject to an unknown reminiscence error. Although not statistically significant, the study suggested that females who continue unmarried throughout their pregnancy are younger than those who marry because of the pregnancy (pregnant/married), and this latter group in turn are younger than those who manage to avoid pregnancy until after marriage (married/pregnant). If one excludes the highly selected hostel population, there was little difference across groups except that Catholics in general appear to be least successful in avoiding extranuptial conceptions, particularly those leading to "shotgun" weddings. The 3 clinic groups did not differ markedly in educational attainment or socioeconomic status as judged by the women's father's occupation so that advantaged status did not appear to protect against exnuptial preg nancy. Most had had some sex education, and mother and school were the primary sources of the information. Only 4 women, all in the single group, seemed not to have known clearly that unprotected sexual intercourse is the cause of pregnancy. Although over 1/3 of the women or their partners had used contraceptive methods at some time, mostly oral contraception and the condom, only 15-20% were using a method at the time of conception and unreliable methods dominated with the pill failures being due mostly to failure to take it regularly. At a conscious level at least, the prospect of pregnancy was simply not considered as a risk in the 2 extranuptially confined groups; the 2 married groups had better realization of the possibility of pregnancy.^ieng

Adolescent mothers four years later: narratives of the self and visions of the future.

This study examined patterns, variations, and existential turning points in young mothers' narratives of self and their visions of the future as part of a larger hermeneutic, longitudinal study. The study was philosophically based in the phenomenology of everyday practices as inherently meaningful, situated, and historically derived and drew on dialogical views of the self. The sample consisted of 13 (of the original 16) young mothers and family members who had been interviewed 4 years earlier. For the present study, data consisted of life history accounts of the intervening 4 years, stories of caregiving routines, and recent coping episodes of parenting elicited through in-depth interviews. Findings offer a situated understanding of young mothering and highlight meaningful distinctions in the ways young mothers experience the self and project themselves into the future. The discovery of patterns and variations in the young mother's sense of self and future have implications for guiding clinical practice and are preliminary to designing programs and interventions that are tailored to the practical understanding and situated possibilities of young mothers.

PIP: The prevailing view that an early pregnancy jeopardizes a young woman's emotional development disregards the social nature of the construction of self and others. Although parenting can be a stressful life experience, it also has the potential to create new ways of coping and to contribute to a revised understanding of the self. For many impoverished African-American teens, with few opportunities to establish an identity through education or a career, motherhood provides the route to adulthood. The present study investigated patterns in young mothers' narratives of self and their visions of the future. In-depth interviews were conducted with 13 US adolescent mothers 4 years after the birth of their first child at an average age of 15.6 years. In the majority of cases, mothering was described as a generally positive experience that engendered a sense of responsibility and supplied a social identity consistent with family and cultural meanings of becoming a woman. The mothers' efforts to become a responsible parent tended to transform their sense of identity and provide a sense of future possibility not previously available. Those who lived in conditions of extreme poverty and danger, without social support, were less able to turn motherhood into an opportunity for reconstruction of the self. Instead, mothering diminished the self and exacerbated feelings of powerlessness, frustration, and conflict. These findings suggest that motherhood is adversely affected by the conditions associated with poverty rather than maternal age per se. Needed, to improve the outcomes of adolescent pregnancy, are interventions that focus on ethical and political questions rather than technical issues.

Social and psychological correlates of pregnancy resolution among adolescent women: a review.

A review of the recent literature on pregnancy resolution among unmarried adolescent women suggests that those who seek and go through with an abortion do not comprise a "special" population, but are similar to their age mates in many of their social and psychological characteristics. Previous research does suggest, however, that teenage abortion patients differ from their term counterparts on a number of significant variables.

PIP: The sociodemographic profile of the unmarried adolescent abortion patient appears to be somewhat distinctive from that of her counterpart who carries her pregnancy to term. She is slightly older, of higher social class, better educated, more financially independent, and more likely to be white. These characteristics suggest that the circumstances of the adolescent abortion patient are more favorable than those of her term counterpart, for whom pregnancy inevitably results in social and economic hardships. Some of the psychological correlates of pregnancy are intentions, attitudes, and beliefs, as well as various personality characteristics. In general, reports on adolescent fertility have emphasized the social and economic problems of women who carry their pregnancies to term. Some studies stress the psychological effects of almost certain disruption of schooling and other 'life schedule' events. The social and psychological costs of unmarried adolescent childbearing appear to be great and may effect the mother's psychological well-being, limit her prospects for the future, and restrict life chances of her offspring.