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Foreword Adolescent pregnancy and childbearing are matters of substantial na- tiona] concern. Even the analysis and description of these phenomena, much less prescriptions for altering present trends, are highly controver- sial. And it is a]} too easy to avoid or to deal only obliquely with issues that arouse so many dee~seated emotions and convictions. There is, nonethe- less, broad agreement that the personal and public costs resulting from unintended pregnancies and untimely birth are far tOO high to counte- nance an indifferent response. Discontinued educations, reduced employ- ment opportunities, unstable mamages (if they occur at alI), low incomes, and heightened health and developmental risks to the children of adoles- cent mothers are a few of the most obvious and immediate personal costs. Sustained poverty, frustration, and hopelessness are all too often the long- term outcomes. Furthermore, the welfare, Medicaid, and Food Stamp program COStS in 198i for families begun by a birth tO a teenager reached $16.65 billion. Programs and services to prevent pregnancy and improve the life chances of teenage parents and their children have appeared in increasing number since the mid-1970s, frequently stirnug up powered or vocal advocates and opponents. An ever more impassioned debate has drawn public, private, voluntary, and philanthropic organizations into a continu- ing pursuit for `' solutions" tO the perceived problems. Yet, after more than a decade of experience, there seemed to many observers an imbalance in emphasis between what people believed and what policy makers, professionals, and society in general knew about the impacts and COSt- effectiveness of alternative prevention and amelioration strategies in light . . Vt!
. v''' FOREWORD of better scientific knowledge aboue early sexual and fertility behavior. There seemed to be distressingly little discussion about how venous interventions work, for whom, under what circumstances, and untie what intended and unintended effects. And what were the most prorrus- ing directions for fixture policy and program development? In 1983, at the urging of several of its members, the Committee on Child Development Research and Public Policy within the National Research Council proposers the establishment of a study pane} to conduct a broad and dispassionate renew of relevant research and program expen- ence and to recommend approaches for policy formulation, program design, research, and evaluation. In 1984, Rich generous support from five foundations the Rockefeller Foundation, the Ford Foundation, the William and Flora Hewlett Founciation, the Robert Wood Johnson Foundation, and the Charles Stewart Mott Foundation the Pane} on Adolescent Pregnanq and Childbeanug began its study. Over a two-year period, this broadly interdisaplina~r iS-person pane] and its staff and consultants undertook three major tasks. (~) to assemble, integrate, and assess data on erencis in teenage sexual ant! fertility behavior; (2) to rewew anti synthesize research on the antecedents and consequences of early pregnancy anc] childbeanng; ant! (3) to review alternative preventive and ameliorative policies and programs. In meeting its charge, the pane} developed two volumes. Volume ~ presents the panel's findings, conclusions, anc} recommendations. De- ta~led background] renews of ex3 sting research on factors affecting the · · · · · · · ~ mtlatlon ot sexual Intercourse, contraceptive use, pregnancy ant I preg- nancy resolution, and the consequences of teenage pregnancy, childbear- ing, and parenting for young mothers, fathers, and their children, as well as the costs and effects of poliaes and programs, constitute Volume Il. Also included In Volume I! is a comprehensive statistical appendix present- ing data from a Ninety of sources on trends in teenage sexual and fertility behavior. Throughout Volume ~ the pane] refers to the papers and the statistical appendix In Volume I! to Support its deliberations. The pane} based its study on both existing information and new analyses of existing data. These sources were supplemented by workshops and individual discussions uneh many federal, seate, and local policy makers, program designers, sernce providers, "d evaluators, as wed as site visits to a variety of programs across the nation. In accordance with institutional policy, this report has been extensively and thoroughly renewed by indi- vi`duals other than members of the study panel.
FOREWORD ix In recent years, many other individuals and groups representing an array of moral, philosophical, and politick perspectives have addressed the complex and controversial issues surrounding adolescent pregnancy. Many have developed recommendations and guidelines for policy makers, service providers, parents, and adolescents themselves. This report is one step in a continuing process of inquiry, review, and synthesis. As a scientific body, the Pane] on Adolescent Pregnancy and Childbeanng sought to cianf~r the issues, sharpen awareness of crucial decision points, and define the limits of existing knowledge. Although science cannot resolve issues that are inextncably bound to differences in human values, it can illuminate the trade-offs among different political and ideological positions, and we believe this report will inform the continuing public debate. On behalf of the members of the parent Committee on Child Develop- ment Research and Public Policy, ~ would like to acknowledge the special contribution of Daniel D. Federman, who served as pane} chair. His commitment of time, energy, and intellectual resources over the past two years has been extraordinary. In large part, the success of this study is due to his exquisite leadership. Acknowledgment is also due tO the other members of the Pane} on Adolescent Pregnancy and Childbeanng. All gave generously of their time and knowledge throughout the study. As a diverse group of individuals, they are to be commended for producing a unanimous report on a topic that inevitably raises public controversy and stirs persona convictions. The members of the pane! join the committee in extending our great appreciation tO the staffof the study. Cheryl D. Hayes, the study director for the pane] as well as the parent committee, once again demonstrated the enormous energy, outstanding thoroughness, and great skill for which she is well known tO many of us. Special thanks go also tO Celia Shapiro, staff assistant to the committee and the panel, for her tireless attention tO administrative detail throughout the study and for her patience and persis- tence In assembling the references for the two volumes. We gratefully acknowledge the significant contribution of Sandra L. Hofferth of the ~ - O - O ~ National lnst~tute ot Child Health and Human Development, who au- thored many of the research reviews that informed the panel's delibera- tions and coedited Volume I! of the report. The efforts of Dee Ann Wenk of the University of Kentucky, who served as statistical consultant and worked with members of the pane! and the staffin compiling the data and preparing the numerous tables and figures that appear in the report and the
x FOREWORD statistical appendix, are also gratefully acknowledged. Margaret A. Ens- minger and Donna M. Strobino, both of Johns Hopk~ns University, served as consultants an] authored thoughtful background papers that are included In Volume Il. FmaDy, Chnseme L. McShane, editor for the Commission on Behavioral and Social Sciences and Education, edifier! the report with a aincal eye and managed the final production of the volumes. The pane] has also benefited from the contributions of several ~ndind- uals who prepared special tabulations of existing data to help it address a number of difficult issues that remain unresolved ~ the available research. Special thanks are due Frank Mott of the Center for Human Resource Research at Ohio State University, William Pratt, Magone Hom, Chns- tine Bachrach, and Stephanie Ventura of the National Center for Health Statistics, and Stanley Henshaw of the Alan Gut smacker Institute. Many other individuals played an important role in the panel's fdeliberations by providing information, critical analysis, advice, and reviews of the draft report and the draft background papers. Their thoughtful comrnenes and insights are reflected in the final manuscnpts. Finally, this study would not have been possible without the generous support of our foundation sponsors. On behalf of the Committee on Child Development Research and Public Policy, ~ would like to extend special thanks to Mary Kritz of the Rockefeller Foundation, Prudence Brown of the Ford Foundation, Anne Fireh Murray of the William and Flora Hewlett Foundation, Paul Jellinek of the Robert Wood Johnson Foundation, and Manlyn Steele of the Charles Stewart Moor Foundation. They encouragement and advice greatly enhanced the study at every stage. W~LIAM A. MORRILL, Chair Comrnieeee on Child Development Research and Public Policy
