1. SmithBattle, Lee DNSc, RN

Article Content

Rarely does a teenage girl intend to become pregnant, but those who do often have done little to prevent it-especially those without the resources and options afforded the middle class, who are more likely to experience mothering as a common right of passage to adulthood.


Although many studies report associations between young maternal age and negative educational, economic, and parenting outcomes, it doesn't necessarily follow that disadvantaged teens' lives would be greatly improved if they waited to have a child. When studies control for disadvantaged social conditions and the multiple and cumulative risks associated with growing up in poverty, the negative childhood experiences and disadvantages that precede many teen births are shown to account for some-if not most-of the negative outcomes of teen mothering. While researchers continue to debate the magnitude of this effect, there is growing consensus that postponing motherhood would not substantially enhance teen mothers' lives as long as the experiences associated with being disadvantaged before pregnancy are not addressed.


These newer findings seem counterintuitive-until we appreciate that not all children in the United States grow up in the same social world. Middle-class children learn that college awaits them from the many educational and social opportunities provided by their families, schools, and communities. Because having a baby would jeopardize their plans for college and careers, they are more likely to use birth control effectively and abort in the event of pregnancy.


In contrast, poor children navigate a world that conspires against educational success and occupational opportunities. Many poor children go to school hungry and are exposed to lead, violence, and other dangers of substandard housing and poor neighborhoods with high unemployment rates. Inferior schools not only breed alienation, they reinforce the reality that even with a high-school diploma, the chances of attending college or finding a job with decent wages and health benefits are slim.

FIGURE. No caption a... - Click to enlarge in new windowFIGURE. No caption available.

In this absence of a promising future, motherhood can provide a pathway to adulthood. And although teens may later wish they had waited to have children because of the challenges of raising a child, many studies have shown that motherhood becomes a catalyst for growth and encourages many teens to return to school or to become better students.


This doesn't mean that I am advocating pregnancy for teens who grow up in grim circumstances. That would be foolhardy. I am suggesting, however, that we must all reconsider our assumptions about teen mothers and reevaluate the nation's priorities and policies regarding sex education, public education, and social welfare, and their combined influence on the future of our children.


In spite of recent declines in the rates of births to teenagers in the United States, this country has the highest among Western countries. Our dismal track record in preventing teen pregnancy will continue as long as politicians restrict federal and state funding to abstinence-only sex education programs. These programs proliferate, despite evidence that an abstinence-only approach has few short-term benefits and no lasting, positive effect on rates of pregnancy or sexually transmitted infections, and that the majority of teachers, parents, and students favor comprehensive sex education. While all teens deserve effective sex education, it alone is unlikely to deter the most disadvantaged girls from becoming pregnant as long as they lack the opportunities and resources that middle-class teens take for granted. Marian Wright Edelman of the Children's Defense Fund grasped this when she argued that a promising future is the best deterrent to becoming a teen mother.


As trusted health professionals, we must also be advocates of effective sex education programs and join with our fellow citizens to challenge the social conditions and policies that predispose teens to becoming mothers in the first place.