Teenage Precnancy
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By Desirae M. Domenico, Ph.D. and Karen H. Jones, Ed.D.
Volume 30, Number 1, Fall 2007
Adolescent Pregnancy in America: Causes and Responses
Abstract
Adolescent pregnancy has oc curred throughout America’s his tory. Only in recent years has it been deemed an urgent crisis, as more young adolescent mothers give birth outside of marriage. Atrisk circumstances associated with adolescent pregnancy in clude medical and health compli cations, less schooling and higher dropout rates, lower career aspi rations, and a life encircled by poverty. While legislation for ca reer and technical education has focused attention on special needs populations, the definition has been broadened to include single parents. This article en compasses a brief history of ado lescent pregnancy in America, factors influencing adolescent pregnancy, and the conse quences associated with adoles cent pregnancy. The conclusion includes implications for educa tors, researchers, and practitioners.
Introduction
While slightly decreasing in rates in recent years, adolescent pregnancy continues to be prevalent in the United States, with nearly one million teenage females becoming pregnant each year (Meade & Ickovics, 2005; National Campaign to Prevent Teen Pregnancy, 2003; Sarri & Phillips, 2004). The country’s adolescent pregnancy rate re mains the highest among west ern industrialized nations, with 4 of every 10 pregnancies occur ring in women younger than age 20 (Dangal, 2006; Farber, 2003; SmithBattle, 2003; Spear, 2004). Despite a 21% decline in the rate of pregnancy among older ado lescents between ages 15 and 19, nearly 12,000 adolescent fe males under age 15 become pregnant each year (National Campaign to Prevent Teen Preg nancy, 2003; Rothenberg & Weissman, 2002; Sexuality In formation & Education Council of the United States [SIECUS], 2002). Adolescent pregnancy and childbearing are national prob lems that affect the community and society at large (Spear, 2004). Adolescent mothers be come economically dependent due to their decreased educa tional attainment, the decision to keep and raise their children, subsequent high fertility rates, and greater occurrences of single-parent families (Brindis & Philliber, 2003; Farber, 2003). Not only is adolescent pregnancy economically costly, it poses various social consequences for teen mothers. Pregnancy is one of the reasons commonly cited by female secondary students for dropping out of high school (Brindis & Philliber, 2003). Rothenberg and Weissman (2002) found that 7 out of 10 fe males who became adolescent
mothers did not graduate from high school. Less than one-third of adolescent females giving birth before age 18 ever complete high school, and the younger the pregnant adolescents are, the less likely they are to complete high school (Brindis & Philliber, 2003; Koshar, 2001). Nationally, about 25% of adolescent moth ers have a second baby within one year of their first baby, leav ing the prospect of high school graduation improbable. How ever, if a parenting female can delay a second pregnancy, she becomes less at risk for dropping out of school and her chance of finishing high school increases (Kreinin, 1998). Research reveals many ado lescent females become preg nant intentionally because they see no other life goals within their reach (Winter, 1997). Plagued by poor school perfor mance and low self-esteem, they have no realistic expectations about education or occupations; thus, pregnancy is viewed as an alternative path to economic in dependence and adult status (Brown & Barbosa, 2001; Farber, 2003; Rothenberg & Weissman, 2002; Turner, 2004). Usually adolescents who become teen mothers are already expe riencing academic difficulties in school, have low educational expectations, and are not confi dent they will graduate from high school, or are attempting to escape abusive home situa tions (Coles, 2005; Koshar, 2001). Pursuing higher educa tion or a career is not reason ably within their reach, and they may experience feelings of hope lessness or helplessness regard ing their future (Rothenberg & Weissman, 2002). Coupled with a lack of positive role models and impoverished living situations,
The Journal for Vocational Special Needs Education adolescent females decide to be come pregnant or they “drift” into pregnancy, as this decision appears to be their best option (Brindis & Philliber, 2003; Rothenberg & Weissman, 2002; Winter, 1997). It is equally im portant to recognize that adoles cent pregnancy can be a posi tive life choice for females from certain ethnic or social groups (Tripp & Viner, 2005). witnessed a decline in premari tal pregnancies, which was par tially attributed to greater church participation and more emphasis on self-control and self-discipline (Farber, 2003). Even into the mid-twentieth century, one-fourth of all Ameri can women were mothers before age 20. However, almost all ado lescent mothers were married before the arrival of their babies, or they succumbed to the pres sure to drop out of school to con ceal the pregnancy (Hofferth, Reid, & Mott, 2001; Hymowitz, 1997; Luker, 1996). If adolescent pregnancy and childbearing have been so com mon throughout American his tory, why have these issues re ceived such mounting attention and concern in recent years? Adolescent pregnancy and early marriage among teenagers were more accepted in the 1950s be cause the young girl usually married the baby’s father to le gitimize the birth (SmithBattle, 2003; Zero Population Growth, 1997). As long as the end result of a premarital adolescent preg nancy was marriage, the issue remained virtually invisible to soci ety (Farber, 2003; Furstenberg Jr., 1991; Hymowitz, 1997). In fact, it was not until the radical social changes of the 1960s that ado lescent pregnancy became a more prominent and socially dis turbing trend (Cherry, Dillon, & Rugh, 2001). In the 1960s, ado lescents began having sexual intercourse at an earlier age and rejected hasty marriages to le gitimize a birth, opting instead to remain in school (Furstenberg Jr., 1991). The country saw a 50% increase in the birth rate among unwed teenagers from 1960 to 1975, and the number of births to unmarried teenagers between ages 15 to 19 quadrupled from 1960 to 1992 (Furstenberg Jr.; Hogan, Sun, & Cornwell, 2000). Today, while premarital sex is not condoned, nearly 47% of
5 secondary students have re ported being sexually active be fore marriage (Center for Disease Control and Prevention [CDC], 2004; Santelli et al., 2004; Zero Population Growth, 1997). De spite high rates of adolescent pregnancy, the majority of American adults still believe teens should not be sexually active, non-marital childbearing is unacceptable, and unwed adolescent mothers are viewed in a negative manner (Hofferth et al., 2001; National Campaign to Prevent Teen Pregnancy, 2003; Zero Population Growth, 1997). This position is substan tiated by a recent study of ado lescent females who reported having negative views toward teen motherhood (Turner, 2004).
Adolescent Pregnancy in Early America
While many Americans have become increasingly concerned with the problem of teenage pregnancy over the past three decades, the truth is that teen age pregnancy has been a soci etal concern for more than three centuries (Luker, 1996). In pre vious centuries, adolescent pregnancy and the problems surrounding it were not specific to any age group, but instead were treated as part of broader social issues. Only since the 1970s has the issue of unwed motherhood become associated with teenagers (Luker, 1996). Subsequently, teenage preg nancy has gripped the attention of educators, policymakers, and the public, hence, being deemed an urgent crisis not only for the young mother and her child, but for society as well (Farber, 2003; Furstenberg Jr., 1991; Manlove, 1998; Spear, 2004). In the Puritan communities of early North America, it was not unusual for an adolescent female to be a wife and mother because she was considered to be mature. Throughout the co lonial period, the incidence of young motherhood and of outof-wedlock births posed an eco nomic burden on communities. In both the Puritan and colonial times, young mothers were pun ished, hastily married off, and considered immoral by the church (Farber, 2003; Luker, 1996). The nineteenth century
Factors Influencing Adolescent Pregnancy
For years researchers have ex amined risk factors related to adolescent pregnancy. Charac teristics such as family struc ture, age at first intercourse, goals, and child sexual abuse have been associated with ado lescent pregnancy (Farber, 2003; McCullough & Scherman, 1991; Stewart, 2003; Xie, Cairns, & Cairns, 2001).
Family Structure
Family structure is considered a major factor contributing to adolescent pregnancy and moth erhood. Rosen (1997) found a growing number of American adolescent females lived in rela tively unstable family situations and many became sexually inti mate for a short-term sense of comfort. Parental rejection, or a lack of warmth, affection, or love, also led adolescents to seek relationships outside the family to boost their self-esteem (McCullough & Scherman, 1991). However, strong family relation ships and two parent families have been found to lower the incidence of adolescent preg
6 nancy (Weisfeld & Woodward, 2004). Hymowitz (1997) claimed parental influence was the most significant variable in adolescent pregnancy prevention. She con cluded the absence of a father was the primary factor in teen girls becoming pregnant. It was also reported that adolescents whose parents communicated strong disapproval of sexual activity exhibited fewer risk-tak ing behaviors and were likely to delay sex until a later age (Manlove et al., 2002).
Volume 30, Number 1, Fall 2007 culties in school, or they at tempted to escape abusive home situations (Koshar, 2001). Many adolescent mothers viewed postsecondary education as un attainable, and they possessed little awareness of their life op tions and career opportunities. Seeing no future for themselves and coupled with a lack of posi tive role models to follow, ado lescent females chose to become pregnant, as this decision ap peared to be their best alterna tive (Brown & Barbosa, 2001; Rothenberg & Weissman, 2002). Teen mothers viewed childbearing as the one thing they could do that was socially responsible, gave meaning to their lives, and offered hope for their futures (Rosen, 1997). over 65% of adolescent mothers had babies by men who were age 20 or older, implying that a higher number of adolescent preg nancies may result from sexual abuse than previously thought (Klein, 1997; Villarosa, 1997).
Consequences of Adolescent Pregnancy
Adolescent pregnancy and child birth impose difficult long-term outcomes and have adverse ef fects not only on the young mother, but also on her child (Hao & Cherlin, 2004; Meade & Ickovics, 2005). These negative consequences and outcomes have been documented over the years, and society tends to ste reotype all adolescent mothers in an unfavorable manner (Camarena, Minor, Melmer, & Ferrie, 1998). Possessing an understanding of the factors asso ciated with adolescent pregnancy and its consequences is necessary to effectively prevent and ease the costs of adolescent pregnancy.
Age at First Intercourse
Today puberty occurs much ear lier in adolescents, and firsttime sexual encounters are tak ing place at younger ages, re sulting in more sexually experi enced adolescents (Xie et al., 2001). Between 1988 and 1995, the proportion of adolescent fe males who first had sex at 14 years old or younger practically doubled (National Campaign to Prevent Teen Pregnancy, 2003). There is not a direct relationship between the time a girl reaches puberty and the likeliness of her becoming pregnant; however, earlier onset of puberty com bined with more peer pressure and less parental supervision results in today’s adolescents being faced with making prema ture sexual decisions (Farber, 2003; Rodriguez Jr., & Moore, 1995). Adolescents whose moth ers gave birth as teenagers or who have pregnant siblings are also more likely to engage in early sexual intercourse and be come teen parents as well (Manlove et al., 2002; Xie et al., 2001).
Sexual Abuse
Sexual abuse may alter percep tions about sexual behavior, leading an abused adolescent, especially females, to initiate sex at an earlier age and have more partners (Saewyc, Magee, & Pettingell, 2004). McCullough & Scherman (1991) speculated some teen pregnancies possibly resulted from unresolved feel ings and behaviors associated with earlier sexual abuse. Al though the majority of adoles cent females claimed their first sexual experience was volun tary, Farber (2003) found about 40% of girls who first had inter course at age 13 or 14 indicated involuntary or unwanted inter course with an older partner. Herman-Giddens et al. (1998) reported that females who were sexually abused as children were three times more likely to become pregnant during their teen years and usually became pregnant at a younger age. Like wise, about two-thirds of adoles cent mothers were previously sexually abused or raped by a father, stepfather, or other rela tive, and often suffered from low self-esteem and depression (Sarri & Phillips, 2004; Villarosa, 1997). Additional studies found
Career Opportunities
Often pregnant adolescents are unaware of the various types of jobs available in the workforce. Pregnant secondary students have been found to possess lower career aspirations, attain less prestigious occupations, and experience less satisfaction with career progress, feel their future job choices are limited when compared to their non pregnant peers. They were less likely to get a job or attend col lege (Hockaday, Crase, Shelley, & Stockdale, 2000; Nord, Moore, Morrison, Brown, Myers, 1992; School Board News, 1999). As a result, adolescent mothers often experienced a lack of meaning ful and equal career opportuni ties, leading to a high rate of teen unemployment (Merrick, 1995). Childbearing at an early age has also been found to reduce a female’s career opportunities to mostly non-professional occupa
Future Expectations
Often the phenomenon of inten tional pregnancy is limited to atrisk, low-income adolescents because they are more likely to perceive their futures as bleak and motherhood as a better op tion (Davies et al., 2004). Usually adolescents who became moth ers experienced academic diffi
The Journal for Vocational Special Needs Education tions (Bissell, 2000). Additional studies reinforced the notion that adolescent motherhood was associated with unrealistic ca reer aspirations, unequal career opportunities, and high unem ployment rates among adolescent females (Drummond & Hansford, 1992; Merrick, 1995; Nord et al., 1992). Pregnant adolescents rep resent the portion of at-risk youth that commonly fall into occupations for which there is an oversupply of workers (Drummond & Hansford, 1992). Chartrand and Rose (1996) stressed the need for more ca reer development theories that focused on at-risk persons, as these at-risk individuals are at the junction of race, gender, and class, often resulting in limited access to education and career opportunities. As mentioned earlier, the best protection an adolescent female can have against becom ing pregnant is to have life goals (Winter, 1997). Having positive attitudes about education and clear educational goals was as sociated with fewer incidences of adolescent births (Hockaday et al., 2000; Manlove, 1998; Manlove et al., 2002). Stewart (2003) theorized that adolescent females with high career aspi rations may postpone early motherhood to focus on their educational and career goals. O’Connor (1999) found that aca demically-oriented females, meaning those with good grades, high test scores, and high edu cational aspirations, were less likely to give birth while still in high school. Other studies (Rodriguez Jr. & Moore, 1995; Young, Turner, Denny, & Young, 2004) reported adolescents with a high self-esteem and a belief they had future goals were less likely to experience an early pregnancy. mothers face poor life scenarios and bleak impending prospects for educational and economic well-being (Maynard, 1996; Tonelli, 2004). Sarri and Phillips (2004) implied young mothers were at risk for confronting many years of social and eco nomic disadvantages. Adoles cent mothers have often experi enced medical complications and health problems during pregnancy, as many do not seek prenatal care (Sarri & Phillips, 2004). Children of teen mothers are more likely to achieve lower levels of education, suffer from lifelong leaning disabilities, and are at risk for becoming young, unmarried parents themselves (Farber, 2003; Merrick, 1995; Rothenberg & Weissman, 2002). Generally, adolescent females had more children than women who delayed childbearing until their twenties, and this trend continues today (Maynard, 1996; National Campaign to Pre vent Teen Pregnancy, 2002; Zero Population Growth, 1997). Because adolescent mothers often lack work experience, edu cational skills, and job training, their future employment levels and earnings are minimal. Sawhill (2000) observed that adolescent mothers who did work were less competitive in the workforce, and many struggled to survive with low-wage or dead-end jobs. Many men re sponsible for children born to adolescent mothers provide little or no child support; thus a large number of adolescent mothers have remained disproportion ately poor, depending on public assistance to support them eco nomically (National Campaign to Prevent Teen Pregnancy, 2002; Nord et al., 1992; Rothenberg & Weissman, 2002; Sawhill, 2000). These grim statistics are the re alities adolescent mothers must face concerning their futures.
7 cial outcomes of adolescent pregnancy, various economic outcomes are also evident. Ado lescent pregnancy and early childbearing is detrimental, for very often the young female is unable to attain sufficient edu cation needed to compete in the economy (Sawhill, 2000). It is estimated that adolescent child bearing costs the nation roughly seven billion dollars annually (National Campaign to Prevent Teen Pregnancy, 2003; Rothenberg & Weissman, 2002). Adolescent mothers have relied heavily on public assistance and constituted nearly one-half of all welfare recipients (Maynard, 1995; Zero Population Growth, 1997). Such high levels of de pendence on public assistance indicated widespread poverty in families of young adolescent mothers in America (National Center for Research in Voca tional Education, 1992). Many Americans falsely assumed wel fare encouraged people, espe cially adolescent females, to have babies. Given the United States provided less support for single mothers, and the welfare benefits have steadily decreased since 1973, Luker (1996) stated there was likely no correlation between the level of welfare ben efits and the incidence of outof-wedlock births.
Educational Outcomes
Timing of family formation is critical in the amount of educa tion a young girl obtains (Hofferth et al., 2001). Becom ing an adolescent mother has been associated with less formal education, often leading to pov erty (Meade & Ickovics, 2005; Merrick, 1995). Adolescent preg nancy can pose major chal lenges to school attendance and completion, and it is one of the reasons commonly cited by fe male secondary students for dropping out of high school (Drummond & Hansford, 1992; Hao & Cherlin, 2004). Balanc
Adolescent Mothers’ Futures
Many researchers have painted a dismal picture of the future for adolescent mothers. Young
Economic Consequences
In addition to the numerous so
8 ing school, a job, and childcare is often overwhelming for female adolescent parents and consumes time and energy that they could otherwise spend on school (Hofferth et al., 2001; Koshar, 2001). Less than one-third of fe male adolescents who gave birth before age 18 completed high school. Additionally, for adoles cent mothers experiencing a subsequent pregnancy within two years of their first delivery, the prospect of high school graduation is improbable (Kreinin, 1998; Meade & Ickovics, 2005). Hofferth et al. (2001) found that adolescent childbearing was greatly associ ated with reduced chances of completing high school and at tending college, thus leading the researchers to conclude that today’s adolescent mothers who are unable to obtain some form of higher edu cation are at a disadvantage. Koshar (2001) discovered that many adolescent females who became pregnant were al ready experiencing academic dif ficulties in school and therefore were at risk for dropping out. While many adolescent females on the verge of dropping out claimed becoming pregnant gave them the excuse to quit school, other adolescent females first dropped out of school and then became pregnant (Kreinin, 1998; School Board News, 1999). Academic success and a bonding to school have been associated with reduced adolescent pregnancy rates (Yampolskaya, Brown, & Vargo, 2004). Adoles cents who had friends with high educational aspirations were less likely to engage in sex at an early age, thus reducing their chances of adolescent pregnancy and increasing their likelihood of completing high school when com pared to adolescents whose peers did not have these char acteristics (Manlove et al., 2002).
Volume 30, Number 1, Fall 2007 Poverty
Poverty is an additional conse quence of adolescent pregnancy, often leading to poorer outcomes for adolescent mothers (Tripp & Viner, 2005). As many as 80% of unwed adolescent mothers grew up in extreme poverty and the likelihood their children will grow up in poverty is high. Many poverty-stricken adolescents accepted their pregnancy and viewed it as a means of improv ing their lives (Rosen, 1997). Adolescents subjected to disad vantaged circumstances, such as living in poor, racially segre gated, high crime communities, or living in problematic or single parent families, were more at risk of becoming pregnant dur ing their teenage years (Maynard, 1995; Sarri & Phillips, 2004). Manlove et al. (2002) reported adolescents liv ing in poverty stricken neighbor hoods were more apt to engage in sexual intercourse, often lead ing to adolescent pregnancy and childbirth. Maynard (1995) speculated that adolescent preg nancy and childbearing directly resulted in the intergenerational transfer of poverty. tion use (Tonelli, 2004; Zero Population Growth, 1997). The Institute for Educational Lead ership (1997) suggested that schools extend educational op portunities in alternative schools, offer supportive learn ing environments for pregnant and parenting adolescents. School districts that have alter native programs meet the needs of parenting adolescents by scheduling later class times, of fering pregnancy and childbirth classes, allowing students to gain graduation credits, providing access to services such as counsel ing and on-site nursing aides, and arranging quality childcare services (Essortment, 2007). While adolescent pregnancy prevention programs offer countless support services to pregnant and parenting adoles cents, not all support services are consistently available throughout the country and pro grams vary from state to state (Brindis & Philliber, 2003). Pro grams aimed at preventing preg nancy and parenting among adolescents must be long-term and comprehensive, while incor porating important components such as early intervention, sexu ality education, counseling, health services, adolescent do mestic violence, and youth de velopment (Raphael, 2005; Rothenberg & Weissman, 2002; School Board News, 1999). Na tional programs such as the Abstinence Education Program, funded by the welfare reform law and administered by Health and Human Services, offers federal grants to states for abstinence education activities including mentoring and counseling. The Adolescent Family Life Program, also administered by Health and Human Services, affords educa tion and social services to teen fathers to help them realize their roles and responsibilities as a parent. In addition, many teen mothers receive medical assis
Responses to Adolescent Pregnancy
Over the last half of the twenti eth century, schools, communi ties, and government agencies have worked diligently to help combat adolescent pregnancy. There are literally hundreds of adolescent pregnancy preven tion programs available to teens today, yet it is difficult for edu cators and practitioners to know which of these programs serve as “best practices” (Franklin & Corcoran, 2000). Successful programs are characterized as being multifaceted, incorporat ing not only abstinence, but also other topics including delayed sexual activity, life skills train ing, self-esteem, sex education, parenting skills, and contracep
The Journal for Vocational Special Needs Education tance, and family planning and reproductive health services through Medicaid, provided through Title XIX of the Social Security Act (Association of Ma ternal & Child Health Programs, 2006). Adolescent pregnancy is a complex problem, and there is a need for collaboration among various organizations to achieve successful pregnancy preven tion programs, as only marginal success in the fight against ado lescent pregnancy has been achieved to date (Brindis & Philliber, 2003; School Board News, 1999; Tonelli, 2004; Weisfeld & Woodward, 2004). fessionals to assist families of these adolescents in teaching them to become independent, self-sufficient adults. Out reach programs should stress the importance of career as pirations for all pregnant and parenting adolescents, espe cially those with special needs.
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(Sarkees-Wircenski & Scott, 2003). The recent passage of the Carl D. Perkins Career and Technical Improvement Act of 2006 continues the support of single parents, including adoles cent mothers, while preparing them for occupations that lead to self-efficacy (Association for Career and Technical Education, 2006). The federal welfare pro gram, Temporary Assistance for Needy Families (TANF), requires adolescent parents who are mi nors to participate in school or training to receive aid (Center for Law and Social Policy, 2001). Once pregnant and parenting adolescents gain a higher self-efficacy with realis tic outcome expectations, they can begin to establish and work toward the attainment of career goals. According to Young, Mar tin, Young, and Ting (2001), pro grams that connect behaviors with outcomes and programs that promote the importance of higher education afford adoles cent females the skills to develop realistic strategies for meeting life goals. Guidance programs that include career education and exploration opportunities have been found to provide ex posure to postsecondary educa tion and training options (McWhirter, Rasheed, & Crothers, 2000). An implication of this paper is the need for vo cational special needs educators and career and technical edu cators to understand the neces sity for building adolescent selfefficacy and intense education in linking pregnant or parenting adolescent females’ outcome ex pectations with their goals re garding future career aspira tions. Another implication would be to recognize the importance of assisting pregnant and parenting females from special needs populations in determin ing barriers to the workforce in an effort to enable them to reas sess their career options.
Implications for Career and Technical Education
Federal and state governments can contribute in the effort to reduce adolescent pregnancy by providing stable funding for comprehensive educational and support services to pregnant and parenting adolescents (In stitute for Educational Leader ship, 1997). Students with spe cial needs are at further risk for adolescent pregnancy; however, information regarding the num ber of adolescent mothers with special needs and their educa tional needs has not been pre viously recorded (Jones, Domenico, & Valente, 2006; Jones, Woolcock-Henry, & Domenico, 2005; Shapland, 1999; Yampolskaya, Brown, & Greenbaum, 2002). Inclusive vocational training for all stu dents, including special needs students, is mandated and sup ported by a variety of national policy initiatives addressing transition services for students with special needs. These in clude: The Technology-Related Act for Individuals with Disabili ties, Goals 2000- Educate America Act; School-To-Work Opportunities Act, and the Americans with Disabilities Act. Specifically, legislation for career and technical education has fo cused attention on special needs populations as early as the Vo cational Education Act of 1963. The Carl D. Perkins Vocational and Technical Education Act of 1998 broadened the definition of disadvantaged populations to include single parents, which includes adolescent mothers
Recommendations for Practice
1. To increase adolescent fe males’ self-efficacy, schools should incorporate curricu lum that nurtures a sense of self-worth and productivity that can lend itself to the workforce. Beginning in ninth grade, delivery of such cur riculum can be provided through Career and Techni cal Education classroom ex ercises, guidance career ac tivities, and community school-to-work programs. 2. Students from impoverished backgrounds should be af forded opportunities to partici pate in long-term secondary pro grams that will enable them to establish career and educational goals and provide them the tools to achieve these goals. 3. Sex education curriculum prior to high school entry should clearly define the de cision-making process for a sexual relationship, the out comes of a sexual relationship, and the choice to abstain from sex without a sense of guilt. 4. Because families are often a support group for pregnant and parenting adolescents, there is a need for community outreach programs headed by social workers and health pro
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Typically, Americans have been reluctant to deal with is sues regarding sexuality and reproductive health (Zero Popu lation Growth, 1997). However, society must assume the re sponsibility of educating teens about sex, adolescent preg nancy, and the negative effects of early motherhood on young females. The challenge of reduc ing rates of teenage pregnancy remains, and until America’s youth are able to fully under stand the consequences of teen age pregnancy, prevention pro grams, interventions, and coun seling services must be acces sible for all adolescents (McCullough & Scherman, 1991; Tonelli, 2004).
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References
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The Journal for Vocational Special Needs Education disengagement on the risk of schoolage pregnancy. Journal of Research on Adolescence, 8, 187-220. Manlove, J., Terry-Humen, E., Papillo, A. R., Franzetta, K., Wil liams, S., & Ryan, S. (2002). Pre venting teenage pregnancy, child bearing, and sexually transmit ted diseases: What the research shows. Child Trends Research Brief. Maynard, R. (1995). Teenage child bearing and welfare reform: Les sons from a decade of demonstra tion and evaluation research. Children and Youth Services Re view, 17(1-2), 309-332. (ERIC Document Reproduction Service No. EJ508#810) Maynard, R. A. (Ed.). (1996). Kids having kids: A Robin Hood Foun dation Special Report on the costs of adolescent childbearing. New York. McCullough, M. & Scherman, A. (1991). Adolescent pregnancy: Contributing factors and strate gies for prevention. Adolescence, 26, 809-817. McWhirter, E. H., Rasheed, S., & Crothers, M. (2000). The effects of high school career education on social-cognitive variables. Journal of Counseling Psychology, 47, 330-341. Meade, C. S., & Ickovics, J. R. (2005). Systematic review of sexual risk among pregnant and mothering teens in the USA: Preg nancy as an opportunity for in tegrated prevention of STD and repeat pregnancy. Social Science & Medicine, 60, 661-678. Merrick, E. N. (1995). Adolescent childbearing as a career ‘choice’: Perspective from an ecological context. Journal of Counseling & Development, 73, 288-295. National Campaign to Prevent Teen Pregnancy. (2002, February). Not just another single issue: Teen pregnancy prevention’s link to other critical social issues. Re trieved July 15, 2003, from http:/ /www.teenpregnancy.org National Campaign to Prevent Teen Pregnancy. (2003). Fact sheet: Re cent trends in teen pregnancy, sexual activity, & contraceptive use. Retrieved April 23, 2003, from http:/ /www.teenpregnancy.org/re sources/reading/pdf/rectrend.pdf National Center for Research in Vocational Education (1992). Ac cess to and use of vocational edu cation in teen parent programs. University of California, Berkeley: Zellman, G. L., Feifer, C., & Hirsch, A. E. Nord, C., Moore, K., Morrison, D., Brown, B., & Myers, D. (1992). Consequences of teen-age parenting. Journal of School Health, 62, 310-318. O’Connor, M. L. (1999). Academically oriented teenage women have re duced pregnancy risk. Family Plan ning Perspectives, 31, 105-106. Raphael, J. (2005). Teens having babies: The unexplored role of domestic violence. Prevention Re searcher, 12(1), 15-17. Rodriguez, C., Jr., & Moore, N. B. (1995). Perceptions of pregnant/ parenting teens: Reframing issues for an integrated approach to preg nancy. Adolescence, 30, 685-707. Rosen, R. (1997). Poverty is a cause of teenage pregnancy. In S. P. Thompson (Ed.), Teenage preg nancy: Opposing viewpoints (pp. 55-58). San Diego, CA: Greenhaven Press. Rothenberg, A., & Weissman, A. (2002). The development of programs for pregnant and parenting teens. So cial Work in Health Care, 35, 65-83. Saewyc, E. M., Magee, L. L., & Pettingell, S. E. (2004). Teenage pregnancy and associated risk behaviors among sexually abused adolescents. Perspectives on Sexual & Reproductive Health, 36, 98-105. Santelli, J. S., Abma, J., Ventura, S., Lindberg, L., Morrow, B., Anderson, J. E., et al. (2004). Can changes in sexual behaviors among high school students ex plain the decline in teen preg nancy rates in the 1990s? Journal of Adolescent Health, 35(2), 80-90. Sarkees-Wircenski, M., & Scott, J. L. (2003). Special populations in career and technical education. Homewood, IL: American Tech nical Publishers. Sarri, R., & Phillips, A. (2004). Health and social services for pregnant and parenting high risk teens. Children & Youth Services, 26, 537-560. Sawhill, I. V. (2000, Winter). Wel fare reform and reducing teen preg nancy. Public Interest, (138), 40-52. School Board News (1999). Curricular programs to curb teen pregnancy. Education Digest, 64, 38-42. Sexuality Information and Educa
11 tion Council of the United States. (2002). Fact sheet: Teen preg nancy, birth and abortion. Re trieved July 17, 2003, from http:/ /www.siecus.org/pubs/fact/ fact0010.html Shapland, C. (1999). Sexuality is sues for youth with disabilities and chronic health conditions. An oc casional policy brief of the Institute for Child Health Policy, Gainesville, FL. (ISBN 0-9700909-3-5) SmithBattle, L. (2003). Under standing teenage mothering: Conventional and unconven tional wisdom. Prevention Re searcher, 10(3), 1-4. Spear, H. J. (2004). Personal narra tives of adolescent mothers-to-be: Contraception, decision making, and future expectations. Public Health Nursing, 21, 338-346. Stewart, J. (2003). The mommy track: The consequences of gender ideology and aspirations on age at first motherhood. Journal of Sociol ogy and Social Welfare, 30, 3-30. Tonelli, M. (2004). The continuing challenge of teen pregnancy. Journal of Pediatric & Adolescent Gynecology, 17(1), 69-70. Tripp, J., & Viner, R. (2005). Sexual health, contraception, and teen age pregnancy. British Medical Journal, 330, 590-593. Turner, K. M. (2004). Young women’s views on teenage moth erhood: A possible explanation for the relationship between socio economic background and teen age pregnancy outcome. Journal of Youth Studies, 7, 221-238. Villarosa, L. (1997). Adult men are largely responsible for teenage pregnancy. In S. P. Thompson (Ed.), Teenage pregnancy: Oppos ing viewpoints (pp. 77-81). San Diego, CA: Greenhaven Press. Weisfeld, G. E., & Woodward, L. (2004). Current evolutionary per spectives on adolescent roman tic relations and sexuality. Jour nal of the American Academy of Child & Adolescent Psychiatry, 43, 11-19. Winter, M. (1997). Why teenage girls become pregnant. Human Ecology, 25, 14. Xie, H., Cairns, B. D., & Cairns, R. B. (2001). Predicting teen moth erhood and teen fatherhood: In dividual characteristics and peer affiliations. Social Development, 10, 488-511.
12
Yampolskaya, S., Brown, E. C., & Greenbaum, P. E. (2002). Early pregnancy among adolescent females with serious emotional disturbance: Risk factors and outcomes. Journal of Emotional & Behavioral Disorders, 10, 108-116. Yampolskaya, S., Brown, E. C., & Vargo, A. C. (2004). Assessment of teen pregnancy prevention interventions among middle school youth. Child & Adolescent Social Work Journal, 21(1), 69-83. Young, T. M., Martin, S. S., Young, M. E., & Ting, L. (2001). Internal
Volume 30, Number 1, Fall 2007 poverty and teen pregnancy. Adolescence, 36, 289-304. Young, T., Turner, J., Denny, G., & Young, M. (2004). Examining external and internal poverty as antecedents of teen pregnancy. American Journal of Health Behavior, 28, 361-373. Zero Population Growth (1997). Teen pregnancy: A major problem in the U.S. Women’s International Network News, 23, 69-72.
Correspondence about this manuscript may be sent to Desirae M. Domenico, Ph.D., Career Technology Department, Pebblebrook High School, 991 Old Alabama Road, Mableton, GA 30126. Electronic mail may be sent to dmdomenico@ hotmail.com
References: Association for Career and Techni cal Education (2006). Perkins re authorization. Retrieved Septem ber 7, 2006, from http://www. acteonline.org/policy/ legislative_issues/Perkins-new.cfm Association of Maternal and Child Health Programs (2006). State innovations to prevent teen preg nancy. Retrieved July 30, 2007 from www.amchp.org/ aboutamchp/publications/ teenpregnancyreport.pdf Bissell, M. (2000). The socio-eco nomic outcomes of teen preg nancy and parenthood: A review of the literature. Canadian Journal of Human Sexuality, 9, 191-204. Brindis, C., & Philliber, S. (2003). Improving services for pregnant and parenting teens. Prevention Researcher, 10(3), 9-13. Brown, S. G., & Barbosa, G. (2001). Nothing is going to stop me now: Obstacles perceived by low-in come women as they become selfsufficient. Public Health Nursing, 18, 364-372. Camarena, P. M., Minor, K., Melmer, T., & Ferrie, C. (1998). The nature and support of ado lescent mothers’ life aspirations. Family Relations, 47, 129-137. Center for Disease Control and Pre vention. (2004). Youth Risk Be havior Surveillance System Youth online: Comprehensive resultssexual behaviors. Retrieved No The Journal for Vocational Special Needs Education disengagement on the risk of schoolage pregnancy. Journal of Research on Adolescence, 8, 187-220. Manlove, J., Terry-Humen, E., Papillo, A. R., Franzetta, K., Wil liams, S., & Ryan, S. (2002). Pre venting teenage pregnancy, child bearing, and sexually transmit ted diseases: What the research shows. Child Trends Research Brief. Maynard, R. (1995). Teenage child bearing and welfare reform: Les sons from a decade of demonstra tion and evaluation research. Children and Youth Services Re view, 17(1-2), 309-332. (ERIC Document Reproduction Service No. EJ508#810) Maynard, R. A. (Ed.). (1996). Kids having kids: A Robin Hood Foun dation Special Report on the costs of adolescent childbearing. New York. McCullough, M. & Scherman, A. (1991). Adolescent pregnancy: Contributing factors and strate gies for prevention. Adolescence, 26, 809-817. McWhirter, E. H., Rasheed, S., & Crothers, M. (2000). The effects of high school career education on social-cognitive variables. Journal of Counseling Psychology, 47, 330-341. Meade, C. S., & Ickovics, J. R. (2005). Systematic review of sexual risk among pregnant and mothering teens in the USA: Preg nancy as an opportunity for in tegrated prevention of STD and repeat pregnancy. Social Science & Medicine, 60, 661-678. Merrick, E. N. (1995). Adolescent childbearing as a career ‘choice’: Perspective from an ecological context. Journal of Counseling & Development, 73, 288-295. National Campaign to Prevent Teen Pregnancy. (2002, February). Not just another single issue: Teen pregnancy prevention’s link to other critical social issues. Re trieved July 15, 2003, from http:/ /www.teenpregnancy.org National Campaign to Prevent Teen Pregnancy. (2003). Fact sheet: Re cent trends in teen pregnancy, sexual activity, & contraceptive use. Retrieved April 23, 2003, from http:/ /www.teenpregnancy.org/re sources/reading/pdf/rectrend.pdf National Center for Research in Vocational Education (1992). Ac cess to and use of vocational edu cation in teen parent programs. University of California, Berkeley: Zellman, G. L., Feifer, C., & Hirsch, A. E. Nord, C., Moore, K., Morrison, D., Brown, B., & Myers, D. (1992). Consequences of teen-age parenting. Journal of School Health, 62, 310-318. O’Connor, M. L. (1999). Academically oriented teenage women have re duced pregnancy risk. Family Plan ning Perspectives, 31, 105-106. Raphael, J. (2005). Teens having babies: The unexplored role of domestic violence. Prevention Re searcher, 12(1), 15-17. Rodriguez, C., Jr., & Moore, N. B. (1995). Perceptions of pregnant/ parenting teens: Reframing issues for an integrated approach to preg nancy. Adolescence, 30, 685-707. Rosen, R. (1997). Poverty is a cause of teenage pregnancy. In S. P. Thompson (Ed.), Teenage preg nancy: Opposing viewpoints (pp. 55-58). San Diego, CA: Greenhaven Press. Rothenberg, A., & Weissman, A. (2002). The development of programs for pregnant and parenting teens. So cial Work in Health Care, 35, 65-83. Saewyc, E. M., Magee, L. L., & Pettingell, S. E. (2004). Teenage pregnancy and associated risk behaviors among sexually abused adolescents. Perspectives on Sexual & Reproductive Health, 36, 98-105. Santelli, J. S., Abma, J., Ventura, S., Lindberg, L., Morrow, B., Anderson, J. E., et al. (2004). Can changes in sexual behaviors among high school students ex plain the decline in teen preg nancy rates in the 1990s? Journal of Adolescent Health, 35(2), 80-90. Sarkees-Wircenski, M., & Scott, J. L. (2003). Special populations in career and technical education. Homewood, IL: American Tech nical Publishers. Sarri, R., & Phillips, A. (2004). Health and social services for pregnant and parenting high risk teens. Children & Youth Services, 26, 537-560. Sawhill, I. V. (2000, Winter). Wel fare reform and reducing teen preg nancy. Public Interest, (138), 40-52. School Board News (1999). Curricular programs to curb teen pregnancy. Education Digest, 64, 38-42. Sexuality Information and Educa 11 tion Council of the United States. (2002). Fact sheet: Teen preg nancy, birth and abortion. Re trieved July 17, 2003, from http:/ /www.siecus.org/pubs/fact/ fact0010.html Shapland, C. (1999). Sexuality is sues for youth with disabilities and chronic health conditions. An oc casional policy brief of the Institute for Child Health Policy, Gainesville, FL. (ISBN 0-9700909-3-5) SmithBattle, L. (2003). Under standing teenage mothering: Conventional and unconven tional wisdom. Prevention Re searcher, 10(3), 1-4. Spear, H. J. (2004). Personal narra tives of adolescent mothers-to-be: Contraception, decision making, and future expectations. Public Health Nursing, 21, 338-346. Stewart, J. (2003). The mommy track: The consequences of gender ideology and aspirations on age at first motherhood. Journal of Sociol ogy and Social Welfare, 30, 3-30. Tonelli, M. (2004). The continuing challenge of teen pregnancy. Journal of Pediatric & Adolescent Gynecology, 17(1), 69-70. Tripp, J., & Viner, R. (2005). Sexual health, contraception, and teen age pregnancy. British Medical Journal, 330, 590-593. Turner, K. M. (2004). Young women’s views on teenage moth erhood: A possible explanation for the relationship between socio economic background and teen age pregnancy outcome. Journal of Youth Studies, 7, 221-238. Villarosa, L. (1997). Adult men are largely responsible for teenage pregnancy. In S. P. Thompson (Ed.), Teenage pregnancy: Oppos ing viewpoints (pp. 77-81). San Diego, CA: Greenhaven Press. Weisfeld, G. E., & Woodward, L. (2004). Current evolutionary per spectives on adolescent roman tic relations and sexuality. Jour nal of the American Academy of Child & Adolescent Psychiatry, 43, 11-19. Winter, M. (1997). Why teenage girls become pregnant. Human Ecology, 25, 14. Xie, H., Cairns, B. D., & Cairns, R. B. (2001). Predicting teen moth erhood and teen fatherhood: In dividual characteristics and peer affiliations. Social Development, 10, 488-511. 12 Yampolskaya, S., Brown, E. C., & Greenbaum, P. E. (2002). Early pregnancy among adolescent females with serious emotional disturbance: Risk factors and outcomes. Journal of Emotional & Behavioral Disorders, 10, 108-116. Yampolskaya, S., Brown, E. C., & Vargo, A. C. (2004). Assessment of teen pregnancy prevention interventions among middle school youth. Child & Adolescent Social Work Journal, 21(1), 69-83. Young, T. M., Martin, S. S., Young, M. E., & Ting, L. (2001). Internal Volume 30, Number 1, Fall 2007 poverty and teen pregnancy. Adolescence, 36, 289-304. Young, T., Turner, J., Denny, G., & Young, M. (2004). Examining external and internal poverty as antecedents of teen pregnancy. American Journal of Health Behavior, 28, 361-373. Zero Population Growth (1997). Teen pregnancy: A major problem in the U.S. Women’s International Network News, 23, 69-72. Correspondence about this manuscript may be sent to Desirae M. Domenico, Ph.D., Career Technology Department, Pebblebrook High School, 991 Old Alabama Road, Mableton, GA 30126. Electronic mail may be sent to dmdomenico@ hotmail.com
By Desirae M. Domenico, Ph.D. and Karen H. Jones, Ed.D.
Volume 30, Number 1, Fall 2007
Adolescent Pregnancy in America: Causes and Responses
Abstract
Adolescent pregnancy has oc curred throughout America’s his tory. Only in recent years has it been deemed an urgent crisis, as more young adolescent mothers give birth outside of marriage. Atrisk circumstances associated with adolescent pregnancy in clude medical and health compli cations, less schooling and higher dropout rates, lower career aspi rations, and a life encircled by poverty. While legislation for ca reer and technical education has focused attention on special needs populations, the definition has been broadened to include single parents. This article en compasses a brief history of ado lescent pregnancy in America, factors influencing adolescent pregnancy, and the conse quences associated with adoles cent pregnancy. The conclusion includes implications for educa tors, researchers, and practitioners.
Introduction
While slightly decreasing in rates in recent years, adolescent pregnancy continues to be prevalent in the United States, with nearly one million teenage females becoming pregnant each year (Meade & Ickovics, 2005; National Campaign to Prevent Teen Pregnancy, 2003; Sarri & Phillips, 2004). The country’s adolescent pregnancy rate re mains the highest among west ern industrialized nations, with 4 of every 10 pregnancies occur ring in women younger than age 20 (Dangal, 2006; Farber, 2003; SmithBattle, 2003; Spear, 2004). Despite a 21% decline in the rate of pregnancy among older ado lescents between ages 15 and 19, nearly 12,000 adolescent fe males under age 15 become pregnant each year (National Campaign to Prevent Teen Preg nancy, 2003; Rothenberg & Weissman, 2002; Sexuality In formation & Education Council of the United States [SIECUS], 2002). Adolescent pregnancy and childbearing are national prob lems that affect the community and society at large (Spear, 2004). Adolescent mothers be come economically dependent due to their decreased educa tional attainment, the decision to keep and raise their children, subsequent high fertility rates, and greater occurrences of single-parent families (Brindis & Philliber, 2003; Farber, 2003). Not only is adolescent pregnancy economically costly, it poses various social consequences for teen mothers. Pregnancy is one of the reasons commonly cited by female secondary students for dropping out of high school (Brindis & Philliber, 2003). Rothenberg and Weissman (2002) found that 7 out of 10 fe males who became adolescent
mothers did not graduate from high school. Less than one-third of adolescent females giving birth before age 18 ever complete high school, and the younger the pregnant adolescents are, the less likely they are to complete high school (Brindis & Philliber, 2003; Koshar, 2001). Nationally, about 25% of adolescent moth ers have a second baby within one year of their first baby, leav ing the prospect of high school graduation improbable. How ever, if a parenting female can delay a second pregnancy, she becomes less at risk for dropping out of school and her chance of finishing high school increases (Kreinin, 1998). Research reveals many ado lescent females become preg nant intentionally because they see no other life goals within their reach (Winter, 1997). Plagued by poor school perfor mance and low self-esteem, they have no realistic expectations about education or occupations; thus, pregnancy is viewed as an alternative path to economic in dependence and adult status (Brown & Barbosa, 2001; Farber, 2003; Rothenberg & Weissman, 2002; Turner, 2004). Usually adolescents who become teen mothers are already expe riencing academic difficulties in school, have low educational expectations, and are not confi dent they will graduate from high school, or are attempting to escape abusive home situa tions (Coles, 2005; Koshar, 2001). Pursuing higher educa tion or a career is not reason ably within their reach, and they may experience feelings of hope lessness or helplessness regard ing their future (Rothenberg & Weissman, 2002). Coupled with a lack of positive role models and impoverished living situations,
The Journal for Vocational Special Needs Education adolescent females decide to be come pregnant or they “drift” into pregnancy, as this decision appears to be their best option (Brindis & Philliber, 2003; Rothenberg & Weissman, 2002; Winter, 1997). It is equally im portant to recognize that adoles cent pregnancy can be a posi tive life choice for females from certain ethnic or social groups (Tripp & Viner, 2005). witnessed a decline in premari tal pregnancies, which was par tially attributed to greater church participation and more emphasis on self-control and self-discipline (Farber, 2003). Even into the mid-twentieth century, one-fourth of all Ameri can women were mothers before age 20. However, almost all ado lescent mothers were married before the arrival of their babies, or they succumbed to the pres sure to drop out of school to con ceal the pregnancy (Hofferth, Reid, & Mott, 2001; Hymowitz, 1997; Luker, 1996). If adolescent pregnancy and childbearing have been so com mon throughout American his tory, why have these issues re ceived such mounting attention and concern in recent years? Adolescent pregnancy and early marriage among teenagers were more accepted in the 1950s be cause the young girl usually married the baby’s father to le gitimize the birth (SmithBattle, 2003; Zero Population Growth, 1997). As long as the end result of a premarital adolescent preg nancy was marriage, the issue remained virtually invisible to soci ety (Farber, 2003; Furstenberg Jr., 1991; Hymowitz, 1997). In fact, it was not until the radical social changes of the 1960s that ado lescent pregnancy became a more prominent and socially dis turbing trend (Cherry, Dillon, & Rugh, 2001). In the 1960s, ado lescents began having sexual intercourse at an earlier age and rejected hasty marriages to le gitimize a birth, opting instead to remain in school (Furstenberg Jr., 1991). The country saw a 50% increase in the birth rate among unwed teenagers from 1960 to 1975, and the number of births to unmarried teenagers between ages 15 to 19 quadrupled from 1960 to 1992 (Furstenberg Jr.; Hogan, Sun, & Cornwell, 2000). Today, while premarital sex is not condoned, nearly 47% of
5 secondary students have re ported being sexually active be fore marriage (Center for Disease Control and Prevention [CDC], 2004; Santelli et al., 2004; Zero Population Growth, 1997). De spite high rates of adolescent pregnancy, the majority of American adults still believe teens should not be sexually active, non-marital childbearing is unacceptable, and unwed adolescent mothers are viewed in a negative manner (Hofferth et al., 2001; National Campaign to Prevent Teen Pregnancy, 2003; Zero Population Growth, 1997). This position is substan tiated by a recent study of ado lescent females who reported having negative views toward teen motherhood (Turner, 2004).
Adolescent Pregnancy in Early America
While many Americans have become increasingly concerned with the problem of teenage pregnancy over the past three decades, the truth is that teen age pregnancy has been a soci etal concern for more than three centuries (Luker, 1996). In pre vious centuries, adolescent pregnancy and the problems surrounding it were not specific to any age group, but instead were treated as part of broader social issues. Only since the 1970s has the issue of unwed motherhood become associated with teenagers (Luker, 1996). Subsequently, teenage preg nancy has gripped the attention of educators, policymakers, and the public, hence, being deemed an urgent crisis not only for the young mother and her child, but for society as well (Farber, 2003; Furstenberg Jr., 1991; Manlove, 1998; Spear, 2004). In the Puritan communities of early North America, it was not unusual for an adolescent female to be a wife and mother because she was considered to be mature. Throughout the co lonial period, the incidence of young motherhood and of outof-wedlock births posed an eco nomic burden on communities. In both the Puritan and colonial times, young mothers were pun ished, hastily married off, and considered immoral by the church (Farber, 2003; Luker, 1996). The nineteenth century
Factors Influencing Adolescent Pregnancy
For years researchers have ex amined risk factors related to adolescent pregnancy. Charac teristics such as family struc ture, age at first intercourse, goals, and child sexual abuse have been associated with ado lescent pregnancy (Farber, 2003; McCullough & Scherman, 1991; Stewart, 2003; Xie, Cairns, & Cairns, 2001).
Family Structure
Family structure is considered a major factor contributing to adolescent pregnancy and moth erhood. Rosen (1997) found a growing number of American adolescent females lived in rela tively unstable family situations and many became sexually inti mate for a short-term sense of comfort. Parental rejection, or a lack of warmth, affection, or love, also led adolescents to seek relationships outside the family to boost their self-esteem (McCullough & Scherman, 1991). However, strong family relation ships and two parent families have been found to lower the incidence of adolescent preg
6 nancy (Weisfeld & Woodward, 2004). Hymowitz (1997) claimed parental influence was the most significant variable in adolescent pregnancy prevention. She con cluded the absence of a father was the primary factor in teen girls becoming pregnant. It was also reported that adolescents whose parents communicated strong disapproval of sexual activity exhibited fewer risk-tak ing behaviors and were likely to delay sex until a later age (Manlove et al., 2002).
Volume 30, Number 1, Fall 2007 culties in school, or they at tempted to escape abusive home situations (Koshar, 2001). Many adolescent mothers viewed postsecondary education as un attainable, and they possessed little awareness of their life op tions and career opportunities. Seeing no future for themselves and coupled with a lack of posi tive role models to follow, ado lescent females chose to become pregnant, as this decision ap peared to be their best alterna tive (Brown & Barbosa, 2001; Rothenberg & Weissman, 2002). Teen mothers viewed childbearing as the one thing they could do that was socially responsible, gave meaning to their lives, and offered hope for their futures (Rosen, 1997). over 65% of adolescent mothers had babies by men who were age 20 or older, implying that a higher number of adolescent preg nancies may result from sexual abuse than previously thought (Klein, 1997; Villarosa, 1997).
Consequences of Adolescent Pregnancy
Adolescent pregnancy and child birth impose difficult long-term outcomes and have adverse ef fects not only on the young mother, but also on her child (Hao & Cherlin, 2004; Meade & Ickovics, 2005). These negative consequences and outcomes have been documented over the years, and society tends to ste reotype all adolescent mothers in an unfavorable manner (Camarena, Minor, Melmer, & Ferrie, 1998). Possessing an understanding of the factors asso ciated with adolescent pregnancy and its consequences is necessary to effectively prevent and ease the costs of adolescent pregnancy.
Age at First Intercourse
Today puberty occurs much ear lier in adolescents, and firsttime sexual encounters are tak ing place at younger ages, re sulting in more sexually experi enced adolescents (Xie et al., 2001). Between 1988 and 1995, the proportion of adolescent fe males who first had sex at 14 years old or younger practically doubled (National Campaign to Prevent Teen Pregnancy, 2003). There is not a direct relationship between the time a girl reaches puberty and the likeliness of her becoming pregnant; however, earlier onset of puberty com bined with more peer pressure and less parental supervision results in today’s adolescents being faced with making prema ture sexual decisions (Farber, 2003; Rodriguez Jr., & Moore, 1995). Adolescents whose moth ers gave birth as teenagers or who have pregnant siblings are also more likely to engage in early sexual intercourse and be come teen parents as well (Manlove et al., 2002; Xie et al., 2001).
Sexual Abuse
Sexual abuse may alter percep tions about sexual behavior, leading an abused adolescent, especially females, to initiate sex at an earlier age and have more partners (Saewyc, Magee, & Pettingell, 2004). McCullough & Scherman (1991) speculated some teen pregnancies possibly resulted from unresolved feel ings and behaviors associated with earlier sexual abuse. Al though the majority of adoles cent females claimed their first sexual experience was volun tary, Farber (2003) found about 40% of girls who first had inter course at age 13 or 14 indicated involuntary or unwanted inter course with an older partner. Herman-Giddens et al. (1998) reported that females who were sexually abused as children were three times more likely to become pregnant during their teen years and usually became pregnant at a younger age. Like wise, about two-thirds of adoles cent mothers were previously sexually abused or raped by a father, stepfather, or other rela tive, and often suffered from low self-esteem and depression (Sarri & Phillips, 2004; Villarosa, 1997). Additional studies found
Career Opportunities
Often pregnant adolescents are unaware of the various types of jobs available in the workforce. Pregnant secondary students have been found to possess lower career aspirations, attain less prestigious occupations, and experience less satisfaction with career progress, feel their future job choices are limited when compared to their non pregnant peers. They were less likely to get a job or attend col lege (Hockaday, Crase, Shelley, & Stockdale, 2000; Nord, Moore, Morrison, Brown, Myers, 1992; School Board News, 1999). As a result, adolescent mothers often experienced a lack of meaning ful and equal career opportuni ties, leading to a high rate of teen unemployment (Merrick, 1995). Childbearing at an early age has also been found to reduce a female’s career opportunities to mostly non-professional occupa
Future Expectations
Often the phenomenon of inten tional pregnancy is limited to atrisk, low-income adolescents because they are more likely to perceive their futures as bleak and motherhood as a better op tion (Davies et al., 2004). Usually adolescents who became moth ers experienced academic diffi
The Journal for Vocational Special Needs Education tions (Bissell, 2000). Additional studies reinforced the notion that adolescent motherhood was associated with unrealistic ca reer aspirations, unequal career opportunities, and high unem ployment rates among adolescent females (Drummond & Hansford, 1992; Merrick, 1995; Nord et al., 1992). Pregnant adolescents rep resent the portion of at-risk youth that commonly fall into occupations for which there is an oversupply of workers (Drummond & Hansford, 1992). Chartrand and Rose (1996) stressed the need for more ca reer development theories that focused on at-risk persons, as these at-risk individuals are at the junction of race, gender, and class, often resulting in limited access to education and career opportunities. As mentioned earlier, the best protection an adolescent female can have against becom ing pregnant is to have life goals (Winter, 1997). Having positive attitudes about education and clear educational goals was as sociated with fewer incidences of adolescent births (Hockaday et al., 2000; Manlove, 1998; Manlove et al., 2002). Stewart (2003) theorized that adolescent females with high career aspi rations may postpone early motherhood to focus on their educational and career goals. O’Connor (1999) found that aca demically-oriented females, meaning those with good grades, high test scores, and high edu cational aspirations, were less likely to give birth while still in high school. Other studies (Rodriguez Jr. & Moore, 1995; Young, Turner, Denny, & Young, 2004) reported adolescents with a high self-esteem and a belief they had future goals were less likely to experience an early pregnancy. mothers face poor life scenarios and bleak impending prospects for educational and economic well-being (Maynard, 1996; Tonelli, 2004). Sarri and Phillips (2004) implied young mothers were at risk for confronting many years of social and eco nomic disadvantages. Adoles cent mothers have often experi enced medical complications and health problems during pregnancy, as many do not seek prenatal care (Sarri & Phillips, 2004). Children of teen mothers are more likely to achieve lower levels of education, suffer from lifelong leaning disabilities, and are at risk for becoming young, unmarried parents themselves (Farber, 2003; Merrick, 1995; Rothenberg & Weissman, 2002). Generally, adolescent females had more children than women who delayed childbearing until their twenties, and this trend continues today (Maynard, 1996; National Campaign to Pre vent Teen Pregnancy, 2002; Zero Population Growth, 1997). Because adolescent mothers often lack work experience, edu cational skills, and job training, their future employment levels and earnings are minimal. Sawhill (2000) observed that adolescent mothers who did work were less competitive in the workforce, and many struggled to survive with low-wage or dead-end jobs. Many men re sponsible for children born to adolescent mothers provide little or no child support; thus a large number of adolescent mothers have remained disproportion ately poor, depending on public assistance to support them eco nomically (National Campaign to Prevent Teen Pregnancy, 2002; Nord et al., 1992; Rothenberg & Weissman, 2002; Sawhill, 2000). These grim statistics are the re alities adolescent mothers must face concerning their futures.
7 cial outcomes of adolescent pregnancy, various economic outcomes are also evident. Ado lescent pregnancy and early childbearing is detrimental, for very often the young female is unable to attain sufficient edu cation needed to compete in the economy (Sawhill, 2000). It is estimated that adolescent child bearing costs the nation roughly seven billion dollars annually (National Campaign to Prevent Teen Pregnancy, 2003; Rothenberg & Weissman, 2002). Adolescent mothers have relied heavily on public assistance and constituted nearly one-half of all welfare recipients (Maynard, 1995; Zero Population Growth, 1997). Such high levels of de pendence on public assistance indicated widespread poverty in families of young adolescent mothers in America (National Center for Research in Voca tional Education, 1992). Many Americans falsely assumed wel fare encouraged people, espe cially adolescent females, to have babies. Given the United States provided less support for single mothers, and the welfare benefits have steadily decreased since 1973, Luker (1996) stated there was likely no correlation between the level of welfare ben efits and the incidence of outof-wedlock births.
Educational Outcomes
Timing of family formation is critical in the amount of educa tion a young girl obtains (Hofferth et al., 2001). Becom ing an adolescent mother has been associated with less formal education, often leading to pov erty (Meade & Ickovics, 2005; Merrick, 1995). Adolescent preg nancy can pose major chal lenges to school attendance and completion, and it is one of the reasons commonly cited by fe male secondary students for dropping out of high school (Drummond & Hansford, 1992; Hao & Cherlin, 2004). Balanc
Adolescent Mothers’ Futures
Many researchers have painted a dismal picture of the future for adolescent mothers. Young
Economic Consequences
In addition to the numerous so
8 ing school, a job, and childcare is often overwhelming for female adolescent parents and consumes time and energy that they could otherwise spend on school (Hofferth et al., 2001; Koshar, 2001). Less than one-third of fe male adolescents who gave birth before age 18 completed high school. Additionally, for adoles cent mothers experiencing a subsequent pregnancy within two years of their first delivery, the prospect of high school graduation is improbable (Kreinin, 1998; Meade & Ickovics, 2005). Hofferth et al. (2001) found that adolescent childbearing was greatly associ ated with reduced chances of completing high school and at tending college, thus leading the researchers to conclude that today’s adolescent mothers who are unable to obtain some form of higher edu cation are at a disadvantage. Koshar (2001) discovered that many adolescent females who became pregnant were al ready experiencing academic dif ficulties in school and therefore were at risk for dropping out. While many adolescent females on the verge of dropping out claimed becoming pregnant gave them the excuse to quit school, other adolescent females first dropped out of school and then became pregnant (Kreinin, 1998; School Board News, 1999). Academic success and a bonding to school have been associated with reduced adolescent pregnancy rates (Yampolskaya, Brown, & Vargo, 2004). Adoles cents who had friends with high educational aspirations were less likely to engage in sex at an early age, thus reducing their chances of adolescent pregnancy and increasing their likelihood of completing high school when com pared to adolescents whose peers did not have these char acteristics (Manlove et al., 2002).
Volume 30, Number 1, Fall 2007 Poverty
Poverty is an additional conse quence of adolescent pregnancy, often leading to poorer outcomes for adolescent mothers (Tripp & Viner, 2005). As many as 80% of unwed adolescent mothers grew up in extreme poverty and the likelihood their children will grow up in poverty is high. Many poverty-stricken adolescents accepted their pregnancy and viewed it as a means of improv ing their lives (Rosen, 1997). Adolescents subjected to disad vantaged circumstances, such as living in poor, racially segre gated, high crime communities, or living in problematic or single parent families, were more at risk of becoming pregnant dur ing their teenage years (Maynard, 1995; Sarri & Phillips, 2004). Manlove et al. (2002) reported adolescents liv ing in poverty stricken neighbor hoods were more apt to engage in sexual intercourse, often lead ing to adolescent pregnancy and childbirth. Maynard (1995) speculated that adolescent preg nancy and childbearing directly resulted in the intergenerational transfer of poverty. tion use (Tonelli, 2004; Zero Population Growth, 1997). The Institute for Educational Lead ership (1997) suggested that schools extend educational op portunities in alternative schools, offer supportive learn ing environments for pregnant and parenting adolescents. School districts that have alter native programs meet the needs of parenting adolescents by scheduling later class times, of fering pregnancy and childbirth classes, allowing students to gain graduation credits, providing access to services such as counsel ing and on-site nursing aides, and arranging quality childcare services (Essortment, 2007). While adolescent pregnancy prevention programs offer countless support services to pregnant and parenting adoles cents, not all support services are consistently available throughout the country and pro grams vary from state to state (Brindis & Philliber, 2003). Pro grams aimed at preventing preg nancy and parenting among adolescents must be long-term and comprehensive, while incor porating important components such as early intervention, sexu ality education, counseling, health services, adolescent do mestic violence, and youth de velopment (Raphael, 2005; Rothenberg & Weissman, 2002; School Board News, 1999). Na tional programs such as the Abstinence Education Program, funded by the welfare reform law and administered by Health and Human Services, offers federal grants to states for abstinence education activities including mentoring and counseling. The Adolescent Family Life Program, also administered by Health and Human Services, affords educa tion and social services to teen fathers to help them realize their roles and responsibilities as a parent. In addition, many teen mothers receive medical assis
Responses to Adolescent Pregnancy
Over the last half of the twenti eth century, schools, communi ties, and government agencies have worked diligently to help combat adolescent pregnancy. There are literally hundreds of adolescent pregnancy preven tion programs available to teens today, yet it is difficult for edu cators and practitioners to know which of these programs serve as “best practices” (Franklin & Corcoran, 2000). Successful programs are characterized as being multifaceted, incorporat ing not only abstinence, but also other topics including delayed sexual activity, life skills train ing, self-esteem, sex education, parenting skills, and contracep
The Journal for Vocational Special Needs Education tance, and family planning and reproductive health services through Medicaid, provided through Title XIX of the Social Security Act (Association of Ma ternal & Child Health Programs, 2006). Adolescent pregnancy is a complex problem, and there is a need for collaboration among various organizations to achieve successful pregnancy preven tion programs, as only marginal success in the fight against ado lescent pregnancy has been achieved to date (Brindis & Philliber, 2003; School Board News, 1999; Tonelli, 2004; Weisfeld & Woodward, 2004). fessionals to assist families of these adolescents in teaching them to become independent, self-sufficient adults. Out reach programs should stress the importance of career as pirations for all pregnant and parenting adolescents, espe cially those with special needs.
9
(Sarkees-Wircenski & Scott, 2003). The recent passage of the Carl D. Perkins Career and Technical Improvement Act of 2006 continues the support of single parents, including adoles cent mothers, while preparing them for occupations that lead to self-efficacy (Association for Career and Technical Education, 2006). The federal welfare pro gram, Temporary Assistance for Needy Families (TANF), requires adolescent parents who are mi nors to participate in school or training to receive aid (Center for Law and Social Policy, 2001). Once pregnant and parenting adolescents gain a higher self-efficacy with realis tic outcome expectations, they can begin to establish and work toward the attainment of career goals. According to Young, Mar tin, Young, and Ting (2001), pro grams that connect behaviors with outcomes and programs that promote the importance of higher education afford adoles cent females the skills to develop realistic strategies for meeting life goals. Guidance programs that include career education and exploration opportunities have been found to provide ex posure to postsecondary educa tion and training options (McWhirter, Rasheed, & Crothers, 2000). An implication of this paper is the need for vo cational special needs educators and career and technical edu cators to understand the neces sity for building adolescent selfefficacy and intense education in linking pregnant or parenting adolescent females’ outcome ex pectations with their goals re garding future career aspira tions. Another implication would be to recognize the importance of assisting pregnant and parenting females from special needs populations in determin ing barriers to the workforce in an effort to enable them to reas sess their career options.
Implications for Career and Technical Education
Federal and state governments can contribute in the effort to reduce adolescent pregnancy by providing stable funding for comprehensive educational and support services to pregnant and parenting adolescents (In stitute for Educational Leader ship, 1997). Students with spe cial needs are at further risk for adolescent pregnancy; however, information regarding the num ber of adolescent mothers with special needs and their educa tional needs has not been pre viously recorded (Jones, Domenico, & Valente, 2006; Jones, Woolcock-Henry, & Domenico, 2005; Shapland, 1999; Yampolskaya, Brown, & Greenbaum, 2002). Inclusive vocational training for all stu dents, including special needs students, is mandated and sup ported by a variety of national policy initiatives addressing transition services for students with special needs. These in clude: The Technology-Related Act for Individuals with Disabili ties, Goals 2000- Educate America Act; School-To-Work Opportunities Act, and the Americans with Disabilities Act. Specifically, legislation for career and technical education has fo cused attention on special needs populations as early as the Vo cational Education Act of 1963. The Carl D. Perkins Vocational and Technical Education Act of 1998 broadened the definition of disadvantaged populations to include single parents, which includes adolescent mothers
Recommendations for Practice
1. To increase adolescent fe males’ self-efficacy, schools should incorporate curricu lum that nurtures a sense of self-worth and productivity that can lend itself to the workforce. Beginning in ninth grade, delivery of such cur riculum can be provided through Career and Techni cal Education classroom ex ercises, guidance career ac tivities, and community school-to-work programs. 2. Students from impoverished backgrounds should be af forded opportunities to partici pate in long-term secondary pro grams that will enable them to establish career and educational goals and provide them the tools to achieve these goals. 3. Sex education curriculum prior to high school entry should clearly define the de cision-making process for a sexual relationship, the out comes of a sexual relationship, and the choice to abstain from sex without a sense of guilt. 4. Because families are often a support group for pregnant and parenting adolescents, there is a need for community outreach programs headed by social workers and health pro
10
Typically, Americans have been reluctant to deal with is sues regarding sexuality and reproductive health (Zero Popu lation Growth, 1997). However, society must assume the re sponsibility of educating teens about sex, adolescent preg nancy, and the negative effects of early motherhood on young females. The challenge of reduc ing rates of teenage pregnancy remains, and until America’s youth are able to fully under stand the consequences of teen age pregnancy, prevention pro grams, interventions, and coun seling services must be acces sible for all adolescents (McCullough & Scherman, 1991; Tonelli, 2004).
Volume 30, Number 1, Fall 2007 vember 20, 2004 from http:// apps.nccd.cdc.gov/yrbss/ CategoryQuestions.asp?Cat= 4&desc=Sexual%20Behavior Center for Law and Social Policy. (2001, November). TANF and teen parents with disabilities. Wash ington, DC. Author. Chartrand, J. M., & Rose, M. L. (1996). Career interventions for atrisk populations: Incorporating so cial cognitive influences. Career De velopment Quarterly, 44, 341-354. Cherry, A. L., Dillon, M. E., & Rugh, D. (2001). United States. In A. L. Cherry, M. E. Dillon, & D. Rugh (Eds.), Teenage pregnancy: A glo bal view (pp. 183-197). Westport, CT: Greenwood Press. Coles, C. (2005). Teen pregnancy and “internal poverty.” The Futur ist, 38(7), 10. Dangal, G. (2006). An update on teenage pregnancy. Internet Jour nal of Gynecology & Obstetrics, 5(1). Davies, S. L., DiClemente, R. J., Wingwood, G. M., Person, S. D., Crosby, R. A., Harrington, K. F., et al. (2004). Relationship char acteristics and sexual practices of African American adolescent girls who desire pregnancy. Health Education & Behavior, 31, 85S-96S. Drummond, R. J., & Hansford, S. G. (1992). Career aspirations of pregnant teens. Journal of Employ ment Counseling, 29, 166-171. Essortment (2007). Pregnant teen age parents: Alternative pro grams. Retrieved August 14, 2007 from http://wi.essortment.com/ pregnantteenpa_rzym.htm Farber, N. (2003). Adolescent preg nancy: Policy and prevention ser vices. New York: Springer. Franklin, C., & Corcoran, J. (2000). Preventing adolescent pregnancy: A review of programs and prac tices. Social Work, 45, 40-53. Furstenberg, F. F., Jr. (1991). As the pendulum swings: Teenage childbearing and social concern. Family Relations, 40, 127-139. Hao, L., & Cherlin, A. J. (2004). Welfare reform and teenage preg nancy, childbirth, and school dropout. Journal of Marriage & Family, 66, 179-194. Herman-Giddens, M. E., Kotch, J. B., Browne, D. C., Ruina, E., Winsor, J. R., Jung, J., Stewart, P. W. (1998). Childbearing pat terns in a cohort of women sexu ally abused as children. Journal of Interpersonal Violence, 13, 504-513. Hockaday, C., Crase, S. J., Shelley, M. C., II, & Stockdale, D. F. (2000). A prospective study of adolescent pregnancy. Journal of Adolescence, 23, 423-438. Hofferth, S. L., Reid, L., & Mott, F. L. (2001). The effects of early childbearing on schooling over time. Family Planning Perspec tives, 33, 259-267. Hogan, D. P., Sun, R., & Cornwell, G. T. (2000). Sexual and fertility behaviors of American females aged 15-19 years: 1985, 1990, and 1995. American Journal of Public Health, 90, 1421- 1425. Hymowitz, K. S. (1997). Lack of parental influence is a factor in teenage pregnancy. In S. P. Th ompson (Ed.), Teenage preg nancy: Opposing viewpoints (pp. 82-92). San Diego, CA: Greenhaven Press. Institute for Educational Leader ship (1997, November). Schoolbased and school-linked programs for pregnant and parenting teens and their children. Washington, D. C. Retrieved July 15, 2003, from http://www.ed.gov/pubs/ ParentingTeens/ Jones, K. H., Domenico, D. M., & Valente, J. S. (2006). The inci dence of pregnant and parenting teens with disabilities in FCS pro grams. Journal of Family and Consumer Sciences Education, 24(2), 24-35. Jones, K. H., Woolcock-Henry, C. O., & Domenico, D. M. (2005). A wake up call: Pregnant and parenting teens with disabilities. International Journal of Special Education, 20(1), 92-104. Klein, J. (1997). Sexual abuse is a factor in teenage pregnancy. In S. P. Thompson (Ed.), Teenage pregnancy: Opposing viewpoints (pp. 73-76). San Diego, CA: Greenhaven Press. Koshar, J. (2001). Teen pregnancy 2001- Still no easy answers. Pe diatric Nursing, 27, 505-509. Kreinin, T. (1998). Keep kids from making babies. NEA Today, 17, 25. Luker, K. (1996). Dubious concep tions: The politics of teenage preg nancy. Cambridge, MA: Harvard University Press. Manlove, J. (1998). The influence of high school dropout and school
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Yampolskaya, S., Brown, E. C., & Greenbaum, P. E. (2002). Early pregnancy among adolescent females with serious emotional disturbance: Risk factors and outcomes. Journal of Emotional & Behavioral Disorders, 10, 108-116. Yampolskaya, S., Brown, E. C., & Vargo, A. C. (2004). Assessment of teen pregnancy prevention interventions among middle school youth. Child & Adolescent Social Work Journal, 21(1), 69-83. Young, T. M., Martin, S. S., Young, M. E., & Ting, L. (2001). Internal
Volume 30, Number 1, Fall 2007 poverty and teen pregnancy. Adolescence, 36, 289-304. Young, T., Turner, J., Denny, G., & Young, M. (2004). Examining external and internal poverty as antecedents of teen pregnancy. American Journal of Health Behavior, 28, 361-373. Zero Population Growth (1997). Teen pregnancy: A major problem in the U.S. Women’s International Network News, 23, 69-72.
Correspondence about this manuscript may be sent to Desirae M. Domenico, Ph.D., Career Technology Department, Pebblebrook High School, 991 Old Alabama Road, Mableton, GA 30126. Electronic mail may be sent to dmdomenico@ hotmail.com
References: Association for Career and Techni cal Education (2006). Perkins re authorization. Retrieved Septem ber 7, 2006, from http://www. acteonline.org/policy/ legislative_issues/Perkins-new.cfm Association of Maternal and Child Health Programs (2006). State innovations to prevent teen preg nancy. Retrieved July 30, 2007 from www.amchp.org/ aboutamchp/publications/ teenpregnancyreport.pdf Bissell, M. (2000). The socio-eco nomic outcomes of teen preg nancy and parenthood: A review of the literature. Canadian Journal of Human Sexuality, 9, 191-204. Brindis, C., & Philliber, S. (2003). Improving services for pregnant and parenting teens. Prevention Researcher, 10(3), 9-13. Brown, S. G., & Barbosa, G. (2001). Nothing is going to stop me now: Obstacles perceived by low-in come women as they become selfsufficient. Public Health Nursing, 18, 364-372. Camarena, P. M., Minor, K., Melmer, T., & Ferrie, C. (1998). The nature and support of ado lescent mothers’ life aspirations. Family Relations, 47, 129-137. Center for Disease Control and Pre vention. (2004). Youth Risk Be havior Surveillance System Youth online: Comprehensive resultssexual behaviors. Retrieved No The Journal for Vocational Special Needs Education disengagement on the risk of schoolage pregnancy. Journal of Research on Adolescence, 8, 187-220. Manlove, J., Terry-Humen, E., Papillo, A. R., Franzetta, K., Wil liams, S., & Ryan, S. (2002). Pre venting teenage pregnancy, child bearing, and sexually transmit ted diseases: What the research shows. Child Trends Research Brief. Maynard, R. (1995). Teenage child bearing and welfare reform: Les sons from a decade of demonstra tion and evaluation research. Children and Youth Services Re view, 17(1-2), 309-332. (ERIC Document Reproduction Service No. EJ508#810) Maynard, R. A. (Ed.). (1996). Kids having kids: A Robin Hood Foun dation Special Report on the costs of adolescent childbearing. New York. McCullough, M. & Scherman, A. (1991). Adolescent pregnancy: Contributing factors and strate gies for prevention. Adolescence, 26, 809-817. McWhirter, E. H., Rasheed, S., & Crothers, M. (2000). The effects of high school career education on social-cognitive variables. Journal of Counseling Psychology, 47, 330-341. Meade, C. S., & Ickovics, J. R. (2005). Systematic review of sexual risk among pregnant and mothering teens in the USA: Preg nancy as an opportunity for in tegrated prevention of STD and repeat pregnancy. Social Science & Medicine, 60, 661-678. Merrick, E. N. (1995). Adolescent childbearing as a career ‘choice’: Perspective from an ecological context. Journal of Counseling & Development, 73, 288-295. National Campaign to Prevent Teen Pregnancy. (2002, February). Not just another single issue: Teen pregnancy prevention’s link to other critical social issues. Re trieved July 15, 2003, from http:/ /www.teenpregnancy.org National Campaign to Prevent Teen Pregnancy. (2003). 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