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Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing (1987)

Chapter: 5 Consequences of Adolescent Childbearing

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Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Page 124
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 125
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 126
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 127
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 128
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 129
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 130
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 131
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 132
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 133
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 134
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 135
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 136
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 137
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 138
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
×
Page 139
Suggested Citation:"5 Consequences of Adolescent Childbearing." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Page 140

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5 Consequences of Aclolescent Child~g Scientific knowledge about the risks and consequences of adolescent childbeanng has grown in the past 15 years. A substantialbody of research now exists indicating that becoming a parent as a teenager leads to lower social and economic attainment for young mothers and their families and that it entails considerable health and developmental nsks. As many researchers note, In~in~ua] differences such as family background, race, and socioeconomic status Influence the attainment of young women and their families. Nevertheless, early childbearing appears to have indepen- ~ent negative effects beyond the impact of somal, economic, and cultural factors (Moore and Burt, 1982~. In some cases the mother's age directly affects outcomes; in other cases the mother's age influences other relevant factors that in turn affect her social, econorn~c, and physical weD-be~g and that of her child. This chapter discusses the consequences of adolescent pregnancy and childbearing in terms of health risks and outcomes, educational atta~n- ment, family structure and size, work status and income, financial depen- dence and poverty, and somoemotional and cognitive outcomes for the children of teenage mothers. HEALTH RISKS AND OUTCOMES Research on the health risks and outcomes of adolescent pregnancy and childbearing shows that pregnant teenagers, espec~aDy those under age 15, have higher rates of complications, maternal morbidity and mortality, and premature and/or low birthweight babies (Strobino, Vol. Il:Ch. 51. 123

124 ADOLESCENT SEXUALITY PREGNANCY AND CHILDBEARING Miscamages and stillbirths are more frequent among teenagers than among adult women (Menken, 1980; Mednick and Baker, 1980~. In addition, children born to teenage mothers are more likely to be injured and to be hospitalized by age five (Taylor et al., 19831. However, despite some evidence that the health risks to teenage mothers and their babies cannot be entirely eliminated, in general the medical problems associated with adolescent pregnancy can be greatly reduced with appropriate health care, especially prenatal care and good nutrition (Strobino, Vol. Il:Ch. 5; Institute of Medicine, 1985; Baldwin and Cain, 1980; Gnf6ths, 1977; Hardy and Flagle, 1980; McAnamey et hi., 1978~. Many researchers and health care professionals believe that the greatest difficulty in this regard is the behavior patterns of teenagers themselves. It is not unusual for them to neglect their physics health, regardless of pregnancy (Mar~no and King, 1980~. In addition, poor eating habits are relatively common among this age group. Among Tow-income teenagers, for whom the financial impediments to good health care and nutrition are greater, poor health and poor health habits are even more prevalent. Often they enter pregnancy with poor health habits; they fad! to make the necessary adjustments in their life-styTe to promote a healthy pregnancy; an] they often do not seek regular prenatal care until late in the pregnancy, if at all (Alan Guttmacher Institute, 1981; Children's Defense Fund, 1985~. As a consequence, teenage mothers from low-income families are at especially high risk of pregnancy complications, and their babies are at greater risk of long-te~ health and developmental problems. Recent research ~ the United States has concluded that many adverse health consequences found to be associated with teenage pregnancy and child- bearing in pre-1970 studies may be due to socioeconomic factors that were not adequately controlled rather than to young age per se (Mak3mson, 1985; Menken, 1980; Hollingswonh et al., 1982~. Despite the fact that many of the health problems associated with early pregnancy and childbearing can be dramatically reduced with early, regu- lar, and nsk-appropnate (i.e., appropriate to the defied level of nsk) prenatal care, the youngest mothers (those under age 15) arid their infants face greater risks than older teenagers and adult women and their children. These very young mothers have high rates of pregnancy complications including toxern~a, anemia, prolonged labor, and premature labor (Stro- b~o, Vol. Il:Ch. 5; Bonham and Placek, 1978; Menken, 1980~. Mothers under age 15, for example, experience a rate of maternal death that is 2.5 times that for mothers ages 2~24 (Alan Gut~macher Institute, 19811.

CONSEQUENCES OF ADOLESCENT CHILDBEARING 12: Similarly, mothers under 15 are twice as likely to have infants that are premature or low birthweight (less than 5.5 pounds) (Alan Guttmacher Institute, 1981; Bonham and Placek, 1978; Jekel et al., 1975; Menken, 1980; Nye, 1976) As Moore and Burt (1982) point out, poor and black teenagers suffer proportionately more of these health difficulties than middle-class and white teenagers, and differences in rates by age (though relatively small) remain after race and income factors have been controlled. Approximately 40 percent of all adolescent pregnancies are terminated by induced abortion. Complications following induced abortion are gen- erally lower among adolescents than among older women, regardless of the gestation at which the abortion is per foe or the method used (Strobino, Vol. Il:Ch. 5; Cates et al., 1983~. Two exceptions are cervical injury (Tyler, 1983; Hogue et al., 1982) and death-to-case rates from sepsis (Gnmes et al., 1981), which are more frequent among teenagers. However, within gestation, teenagers have been shown to have the lowest overall death rates from legally induced abortion among all age groups (Cates et al., 1983~. Strobino further concludes Dom her renew of the research (Vol. IT:Ch. 5) that if there is an increased risk of unfavorable outcomes (including spontaneous abortion) in pregnancies following an induced abortion, the risk is small and appears to be more significantly associated with diffenng characteristics of the women-for example, race, poverty status, poor health and health habits-than with abortion history (Hogue et al., 1982; Daling and Emanuel, 1977; Madore et al., 1981; Schoenbaum et al., 1980; Kline et al., 1978~. Among adult women the odds of a second-trimester spontaneous abortion increased somewhat as the number of prior induced abortions am creased (Lev~n et al., 1980), which suggests the need for additional research on the delayed effects of Educed abortion on teenagers. However, Cates et al. (1983) concluded that, like any surgical procedure, induced abortion is not without Asks. In general, though, these risks are not greater for teenagers than for adult women, and, In some cases, they are Tower. EDUCATIONAL ATTAINMENT Throughout the past two decades, educational attainment has become more significant In determining a young person's life chances. One's education substantially affects one's income and occupational opport~n~- ties (HoFerth et al., 1978; McClendon, 1976~. It also affects one's chances for employment (Furstenberg, 1976~.

126 ADOLESCENT SEXUALITY; PREGNANCY; AND CHILDBEARING Ilofferth (Vol. Il:Ch 6) highlights a number of studies that strongly support the conclusion that young women who give birth while they are in.,un~or high school or high school complete on average fewer years of school, are less likely to earn a high school diploma, and are less likely to go on to college and graduate study than those who delay childbeanng until their twenties (Most and Marsiglio, 1985; Card and Wise, 1978; Fursten- berg, 1976; Presser, 1976a; TrusseE, 1976; Waite and Moore, 1978; Haggstrom et al., 1983~. Later research that has controlled for socioeco- nomic background, academic ability, and motivational factors has also found that early childbearers are more likely to have reduced educational attainment than later childbearers (Card and Wise, 1978; Haggstrom et al., 1983; Moore and Hofferth, 1980; Hofferth and Moore, 1979; Moore et al., 1978; Waite and Moore, 1978~. The younger the mother at the time of birth, the greater the educational decrement, although this effect is somewhat less significant for blacks than for whites (Wa~te and Moore, 19781. Teenage fathers are also negatively affected, but not to the same degree that teenage mothers are (Card and Wise, 1978~. As several researchers have found, the causal relationship between educational completion and age at first birth runs in both directions, particularly among older childbearers. That is, the older a young woman at first both, the more education she is likely to receive (Rindfuss et at., 1980; HoRerth and Moore, 1979~; the more years of schooling that a young woman has completed, the more likely she is to delay childbearing (Ho~enh and Moore, 1979; Manni, 1984~. As Hofferth (Vol. Il:Ch. 6) reports, recent research on the relationship between educational attainment and early childbearing has focused on the complex effects of dropping Out of school. The clear conclusion of these studies is that young women who have a first birth while they are Sti] under 18 are more likely to drop out of school than those who do not (Moore et al., 1978; Marini, 1984~. While many young women drop out at the dime they give birth, it appears that many others drop Out during the year before the birth of their child. Although some are ur~doubtedly pregnant at the time, it also seems likely that many young women who drop out become pregnant within several months after leaving school (Moore et al., 1978~. Ironically, those who give birth at ages 16, 17, and 18 are at greater risk of not finishing high school than those who give birth at younger ages. Hofferth (Vol. Il:Ch. 6) reports that teens who have a first birth at younger ages are more likely to stay In their parental home and therefore

CONSEQUENCES OF ADOLESCENT CHILDBEARING 127 to stay in school or return to school (Furstenberg and Crawford, 1978~. In contrast, those who give birth at ages 16 to 18 are likely to make other adjust transitions at the same time-for example, establishing independent living arrangements, getting ajob, or getting married all of which make it more difficult for a young woman to continue her education. In particu- lar, teenagers who marry are at higher risk of dropping out of school, and those who both marry and bear a child have the highest probability of dropping out of school (Moore et al., 1978~. Do high school dropouts catch up? Hofferth (Vol. Il:Ch. 6) suggests that the answer is generally no. Although many make progress, especially In they late twenties, teenage mothers typically do not catch up com- pletely. However, the effects seem less pronounced for young black women than for their white counterparts. In large part, this probably reflects the fact that in black families and the black community in general, the necessary support mechanisms are better developed to help young unmarried women cope with early childbearing (Hill, 1977; Williams, 1977, as cited ~ Moore et al., 1986; Mider, 19831. Differences In educational attainment between teenagers who give birth and those who do not are Sect ~ the list severe yews following the both of their child, but there is ewdence that they 33iIunish somewhat over time. Furstenberg and Brooks-Gunn (1985a) found in their 17-year foDow-up of a sample of teenage mothers ~ Baltimore (mostly black) that of aD educational att~'n...ent following the birth of a first child, more than half took place six or more years after that birth. More than half of the young women in this study reported at least one year of additional schooling after five years of motherhood, while a significant propomon went on to earn a high school diploma or equivalent, and many went on to postsecondary education. Although the results do not suggest that these adolescent mothers completely caught up with their classmates who did not give birth, they do point Out that many teenage mothers who interrupt schooling to have a child do resume their educa- nonal careers later ~ life (Furstenberg and 13rooks-Gunn, 1985a). Short- term (] to 5 years foDow~g a first birth) and Tong-term (6 tO 15 years foLov~g a first birth) educational outcomes may be very different for some proportion of early chil~earers. In addition, it seems likely that for more recent cohorts of adolescents, the difference In educational attainment between those who give birch while Sty of school age =d those who do not has lessened (Most and Maxwell, 1981~. Until the m~-197Os, young pregnant women were

128 ADOLESCENT SEXUALITY; PREGNANCY AND CHILDBEARING frequently prohibited from staying in school. Title SEX of the Education Amendments of 1972 (implemented in 1975) prohibits publicly supported educational programs from discriminating on the basis of pregnancy status. As a result, school systems make a variety of arrangements for helping expectant mothers continue their education, either in regular classes or in alternative programs. However, as McCarthy and Radish (1982) point out, young women who do not give birth early also get more schooling. As a result, it seems unlikely that the gap will be diminished. FAMILY STRUCTURE AND FAMILY SIZE Early marriage is strongly associated with early childbeanng. One-third of brides age 17 and younger are pregnant at mamage (Bureau of the Census, 1984a). Although the rate of nomnantal childbeanng has in- creased significantly over the past two decades, approximately half of all adolescent mothers are warned at the time they give birth (O'Connell and Rogers, 1984~. Marriage to legitimate a birth is more common among whites than among blacks, and it is far more common among older teenagers (18- and 19-year-olds) than among younger ones (O'Connell and Rogers, 1984; McCarthy and Menken, 19791. More recent cohorts of teenagers are less likely tO marry tO legitunate a pregnancy than past cohorts were. Unfortunately, the majority of adolescent marriages are highly unstable (Bumpass and Sweet, 1972; Card and Wise, 1978; Furstenberg, 1976; Glick and Norton, 1979~. Furstenberg (1976) found among his Baltimore sample that more than half the marriages had dissolved by the time of the 5-year follow-up and, among those women who were still married, a substantial proportion reported severe mantal problems. Those who were divorced or never married were generally disinclined tO enter or reenter marriage (Furstenberg, 1976). At the 17-year foLow-up, Furstenberg and Brooks-G~nn (1985a) found that, despite their initial intentions, less than on~quarter of their sample (then in their Early thirties) had never married, and less than 10 percent had neither married nor entered a cohabitationai arrangement. However, the relationships of the women who married or cohabited were not permanent. Approximately two-thirds of all Erst marriages were dissolved, as were many second marriages, and the dissolu- iion of cohabitaiional arrangements was even greater (Furstenberg and Brooks-Gunn, 1985a). Thus, while early childbearing appears to acceler- ate the pace of marriage for some, it also appears to accelerate the pace of

CONSEQUENCES OF ADOLESCENT CHILDBEARING 129 separation and divorce. After 17 years, the early childbearers in the Baln- more study were less likely to be married than peers who delayed chiid- bearing, and they were significantly less likely to have remained in their first marriage (Furstenberg and Brooks-Gunn, 198Sa). Other researchers have found that remarriage is generally far less likely following marital disruption among blacks than among whites (Ross and Sawhill, 1975~. Adolescent parenthood, especially among low-~ncome blacks, has serious negative unplicanons for long-ter~ mantal stability and ultunately for the economic well-being of a young mother and her children. Nevertheiess, teenage mothers who marry before the birth of their child rather than afterward appear less likely to separate from their husbands in later years (McLaughlin et al., 1986~. Among the small proportion of early child- bearers who do enter stable mantal relationships, economic outcomes are far more favorable than for those who do not marry and become single heads of household (Furstenberg an] Brooks-Gunn, 1985a). In addition, infants born to teenage mothers who are marned at the tune of birth have more favorable outcomes (i.e., less likely to have low birthweight, more likely to breast-feed) than those of unmarried mothers. Teenage childbearing is also strongly associated with higher levels of completed fertility, closer spacing of births, more nonmarital births, and higher proportions of unintended births (Trussed and Menken, 1978; Moore and Hofferth, 1978; Card and Wise, 1978~. Moore aDd Roberto (1978) found that women ages 35-52 who had their first child at age 15 or younger had three more children on average than women who delayed their first birth to age 24, after controlling for race, religion, education, and other ferocity determinants. Similarly, Card and Wise (1978) found that, by age 29, women whose first both occurred at age 18 or younger had 3.! children on average, compared with 2.2 children for a matched sample of women who began childbearing in their early twenties. Among recent cohorts, however, these effects seem to have diminished somewhat, particularly among blacks (Trussed and Menken, 1978; Mi0- man and Hendershot, 1980~. Furstenberg and Brooks-Gurln's (1985a) 17- year fohow-up of their sample of early childbearers revealed that most women had fewer children than they had ongmally indicated they eventu- a~y wanted an] fewer than they had medicated that they expected to eventually have when reinterviewed at the 5-year follow-up. Among this group of mainly ~nner-c~ty black women, approximately 20 percent had one child, 40 percent had two chidden, 30 percent had three children, and about 8 percent had four or more chidden. More than 60 percent of Al

130 ADOLESCENT SEXUALITY; PREGNANCY; AND CHILDBEARING additional births among these women occurred within five years after the first birth. Rather than rely on venous methods of contraception, sterili- zation was the chosen means of fertility control for more than half (57 percent) of the women in the study (Furstenberg and Brooks-Gunn, 1985a). This follows the current U.S. pattern in which sterilization is the contraceptive method of more than half of couples with two or more children. Approximately half of women currently obtaining tubal sterili- zation are under 30 and 20 percent are under 25 (Centers for Disease Control, 19831. Although the differences in levels of completed fertility between early and later childbearers is declining, women who have their first child as teenagers still tend to have larger families, by about one child on average. This difference has important implications for their economic well-be~g and that of their children, as weD as for their prospects of welfare depen- dence. WORK SIATUS AND INCOME In part because of their educational deficits and larger family size, adolescent mothers are less likely tO 6~3 stable =d remunerative employ- ment than their peers who delay childbearing. Several researchers have found a significant difference ~ work status and income between early and late childbearers, which appears to be at least In part attributable to the aiming of parenthood tCard and Wise, 1978; Hofferth and Moore, 1979; Trussel1 and Abowd, 1979~. While differences in socioeconomic back- gTo~d and ability have some eEect, they do not fully explain the differ- ences in patterns of labor force pari~cipatio~s and levels of earnings between early and later childbearers. Hofferth et al. (1978) conclude that, since early childbearing affects educational attainment and family size, it Indirectly affects work status and mcome. Because teenage mothers ten] to have more children at closer intervals, they accumulate less work experience and have Tower hourly wages, net of other factors. In addition, because they generally complete less schooling and consequently have lower-status occupations, they earn lower wages. Taken together, these facts suggest that an early birth has negative indirect effects on the labor market position of young mothers =d contributes to their lack of satisfaction with their jobs (Card and Wise, 1978; Haggstrom and Momson, 1979~. However, these effects appear to be more sig=fi~t for whites than for blacks, for two reasons. First, young black mothers do accumulate somewhat more work experi

CONSEQUENCES OF ADOLESCENT CHILDBEARING 131 ence than their white counterparts, and, second, the difference in work experience between early and late childbearers is less significant for blacks than for whites (Koo and Biisborrow, 1979~. The differences in work status between early and later childbearers vary over the family life cycle. Card and Wise (1978) report that although teenage mothers are less likely to be working ~ year and 5 years after high school, ~ years later (when they are in their twenties) they are morelikely than later childbearers to be employed. These Endings are supported by Furstenberg and Brooks-Gunn's (1985a) study as well. Although the employment dispanties between the adolescent mothers in the Baltimore study sample and their classmates who had not given birth were great at the 5-year follow-up, the differences had diminished somewhat by the 17- year foLow-up. Fire years after birth, less than half the young mothers heidjobs and were partially or wholly self-supporting, compared with 70 percent of their peers who delayed childbearing. Moreover, the jobs held by classmates were more skilled and better paid. Twelve years later, however, 67 percent of the teenage mothers were working-a figure that is roughly comparable to that of their peers, many of whom were then taking time out to raise children (Furstenberg and Brooks-Gunn, 1985a). Thus it appears that differences in work status between early and later childbearers decline over time. In fact, because of economic need, early childbearers may be more likely to be employed over the long terser; however, there is evidence that differences In the types of jobs they hold are not diminished over time (Hofferth, Vol. Il:Ch. 61. Income differences also decline. In this regard, Trussell and Abowd (1979) found that delay of childbearing raises the "reservation wage," the wage that is sufficient to attract one into the labor force, particularly among white women. Many later childbearers, a greater proportion of whom are married, are likely to leave the labor force when they give birth, unless their jobs provide an income (and presumably a level of job satisfaction) that outweighs the attractions of fur-time motherhood, espec~aDy if their husbands' employment promdes a satisfactory ieve! of economic security. In addition, Koo and Bilsborrow (1979) found that many later childbearers who continue to work or return to work are em- ployed less than fi~-tune. As a result, the differences in Income earned by the women themselves, as wed as the work status differences between early and later childbearers, are less significant in their late twenties and early thirties than they were in their early twenties, when other soc~o- economic, ability, and motivational factors are taken into account. Overall, the effects of an early birth on work status and income are

132 ADOLESCENT SEXUALITY PREGNANCY AND CHILDBEARI.~G much greater for whites than for blacks. Hofferth (Vol. Il:Ch. 6) offers several possible explanations. First, because teenage childbearing is more common in the black community, social institutions have devised mech- anisms to help young women cope with the event. Second, social and economic opportunities for young black women have not developed over the past two decades to the extent that they have for young white women. As a result, the opportunity costs of early childbeanng are not as great for blacks as for whites. Third, because the reservation wage is lower for blacks than for whites, they are attracted into paid employ- ment by lower wages than are white mothers. Finally, because blacks ten] to begin and end childbeanng earlier, they are more likely to devote themselves to employment in their late twenties and thirties than many whites who delay childbearing. While the popular image of severe and life-Ion" social and economic disadvantage for adolescent mothers is exaggerated, women who begin childbearing as teenagers are nevertheless at greater disadvantage than those who delay childbearing. Because they are likely to complete less schooling and to have more children, their ability to obtain positions with higher wages is reduced, and their earnings usually must support a larger family. In addition, because those who begin childbearing at a younger age have fewer prospects of achieving a stable mantal relation- ship, many more of these women are the only or the major source of economic support for their families. Although research has not ad- dressed whether adolescent mothers are less likely to receive child sum port from absent fathers, few mothers receive a majority of their income Tom this source (Bureau of the Census, 1985c). Despite the fact that differences ~ work status and income between early and later child- bea.ers diminish somewhat over tune, women who enter parenthood as teenagers are at greater risk of living in poverty, both in the short and long term. POVERTY AND FINANCIAL DEPENDENCE Teenagers who become mothers are disproportionately poor and de- pendent on public assistance for their economic support (Moore and Burt, 1982; Furstenberg, 1976; Presser, 1975~. Estimates of welfare expenditures to adolescent mothers in 1975 suggest that approximately 5~56 percent of the Aid to Families With Dependent Children (AFDC) budget in that year was directed to households in which the mother was

CONSEQUENCES OF ADOLESCENT CHILDBEARING 133 a teenager at the time her first child was born. These households ac- counted for approximately $; billion in AFDC expenditures; when food stamp benefits were also considered, the total approached $6.5 billion (Moore, 1978; Moore et al., 19814. In addition, because AFDC rec~pi- ents are also eligible for Medicaid benefits, the total rises by another $2. ~ billion ($934 million for Medicaid services to the children of teenage mothers and $~.2 billion for adolescent mothers themseIves) when health care costs are added. In all, Moore et al. (1981) estimated that more than $8.6 billion in public assistance through these three programs was pronded to households in which the mother was an adolescent parent in 1975. A more recent estimate of 1985 outlays suggests that total welfare-related expenditures attributable to teenage childbearing has nearly doubled in the past 10 years, to $16.6 billion: $8 3 billion for AFDC, $3.4 billion for food stamps, and $4.9 billion for Medicaid (Burt, 1986~. As with the earlier estimate, the 1985 figure is conserva- tive, since it includes only sums expended in the three major programs. Other researchers have found that not only are teenage mothers more likely than older childbearers to be receiving AFDC, but also the amounts of their grants are larger, primarily because of their larger average family size (Block and Dubin, 1981; Scheirer, 1981~. In part, teenage mothers are dependent on welfare because welfare use is more prevalent among those for whom the difficulties and expenses associated with arranging child care may seriously affect their ability and motivation to be self-supporting. Particularly among young mothers, blacks, unmamed mothers, and high school dropouts, child care con- straints frequently interfere with employment (Presser, 19801. Women with little education and low incomes also face greater difficulties in Dying jobs that pay well and that offer fringe benefits important to workers with children, for example, comprehensive health care coverage (Moore and Burt, 19821. Despite the fact that teenage mothers are disproportionately repre- sensed in welfare programs, it appears that public assistance is not their preferred means of support (Furstenberg, 1976~. Nor is welfare depen- dence continuous for the majority of yoking mothers. Furstenberg and Brooks-Gunn (1985a) found that among the women In their Baltunore sample, the probability of becoming a welfare recipient rose rapidly during the five years following the birth of a first child. After five years, however, very few teenage mothers went on welfare for the first time, and the probability of their going off welfare increased sharply. Al

134 ADOLESCENT SEXUALITY; PREGNANCY; AND CHILDBEARING though some women ultimately received public assistance again during the 17-year study, most who went back on welfare went off again when circumstances permitted. Moreover, during the 5 years preceding the 17-year follow-up, two-thirds of the women in the sample did not receive any welfare assistance. Furstenberg and Brooks-Gunn (1985a) conclude that, although a small minority of women were consistently dependent on public support, chronic or near-chron~c welfare depen- dence was the exception rather than the rule among the teenage mothers they studied. These Endings are supported by other researchers who found that teenagers who bear children enter the welfare system earlier in the family life cycle and leave it sooner than do women from similar socioeconomic backgrounds who delay childbearing until their twenties (Block and Dubin, 1981~. In addition, however, early childbearers tend to enter and exit the welfare system earlier in the family life cycle because they rely on public support to complete their education and then enter the job mar- ket. McAnarney et al. (1985) conclude that short-term public support for many teenage mothers may be cutical tO their eventual financial independence and success and that of their children. Nevertheless, this dependence imposes a considerable COSt on taxpayers. OUTCOMES FOR CHILDREN OF TEENAGE MOTHERS In addition tO the numerous health risks that the children of teenage mothers face, they are also at greater risk of Tower intellectual and academic achievement, social behavior problems, and problems of self- controT (Hofferth, Vol. Il:Ch. 8~. In addition, data suggest that they maybe more likely tO become adolescent parents themselves than are the children of older mothers. Research on the relationship between early parenting and child devel- opment is relatively sparse. Yet the limited evidence medicates that the age of the mother at the birth of her child does affect the child's intelligence as measured on standardized tests (Broman, 1981; Maracek, 1979; Pur- stenberg, 1976; Belmont et al., 1981; Cohen et al., 1980; Kevin, 1983; Moore, 1986; Davis and Grossbard-Schechtman, 19801. It also affects academic achievement, retention in grade, and other parental and teacher evaluations of school performance (Kinard and Remherz, 1984; Moore, 1986; Vincenzi and Brewer, 1982; Maracek, 1979; Furster~berg and Brooks-Gunn, 198;a, 1985b; Card, 19781. Small but consistent

CONSEQUENCES OF ADOLESCENT CHILDBEARING 135 differences in cognitive functioning appear in the preschool years and continue into elementary school and beyond. These effects are consistent for both blacks and whites and for both boys and girls (although in some cases the effects on boys are greater) (Hofferth, Vol. Il:Ch. 8~. As Hofferth points out, however, the direct effects are small, while the indirect effects seem to be larger. The salient question is what factors account for these differences between the children of early and later chil`]bearers. Teenage mothers, as we have seen, tend to be poor and less well- educated, and their children are likely to grow up in disadvantaged neighborhoods, to attend low-quality schools, and experience high rates of family instability. Indirect effects on the cognitive development and performance of the children of adolescent mothers appear to operate through family structure (i.e., single parenthood), maternal education (i.e., mother's limited schooling), and larger family size. Among these, mother's education has been shown to be most significant. Children of adolescent mothers score consistently lower on A tests and on vocabu- lary and block design tests (Cohen et al., 1980; Kevin, 1983; Dams and Grossbard-Scheclitman, 1980~. According to Daws and Grossbard- Schechtman, children's {Q scores decline by approximately one point for every year of schooling that their mother does not complete. Similarly, Kinard and Reinherz (1984) found that mother's education was the major factor affecting children's achievement scores, with substantial and consistent differences or almost every measure favoring children of more educated mothers. Moore (1986) reports that children born to mothers who had fallen behind or dropped out of school before their first pregnancy had considerably poorer cognitive performance than children born to mothers who were in school or on grade when they became pregnant or who continued school after their first child was born. Furstenberg (1976) found that the children of the women in the Baltimore sample generally had average scores on an achievement and aptitude test when they were evaluated as four- and five-year-olds, and those who saw their fathers regularly and those living in two-parent families scored somewhat higher. However, by the time these children had reached adolescence (15 to 17 years old), the school achievement of those who were still in school (some had already dropped out) was "dismal." Half had repeated at least one grade, and a quarter had been retained at grade level more than one year (Furstenberg and Brooks- Gunn, 1980a). These findings were supported by Maracek (1979), who

136 ADOLESCENT SEXUALITY PREGNANCY AND CHILDBEARING also found that among the children of a~oiescerit mothers, every addi- tiona] year of mother's education reduced the likelihood that the child would be retained in grade by almost 50 percent. Similarly, Moore (1986) reports that the children of adolescent parents are more likely to be behind grade, more likely to be assessed as needing remedial help, and less likely to be doing advanced academic work. As Hofferth (Vol. Il:Ch. 8) points out, however, we know very little about how a mother's level of educational attainment improves the cognitive ability and performance of her child. Is it a reflection of ability, motivation, discipline, encouragement, and support, or all of these factors? Parents with limited education and more children are probably less capable of helping their children to stay in school. They may be less wiring or able to reinforce their educational aims, arid they may also have less ability to provide emotional and material support to help their children establish and Farther their educational goals (Furstenberg and Brooks-Gunn, 1985a). Yet the question of how parental education oper- ates remains largely unanswered. Effects of having a teenage parent on children's socioemotional devel- opment are sometimes present but generally less significant than those on cognitive development. Several studies show that the children of young mothers are at greater risk of social impairment (e.g., poor control of anger, feelings of inferiority, fearfulness, etch and mildbehav- ior disorders (e.g., rebelliousness, aggressiveness, unpuisiveness, etc.) (Maracek, 1979; Mednick and Baker, 1980; Furstenberg and Brooks- Gunn, 1985a). Moore (1986) reports that the sons of teenage mothers are more likely to be rated as impulsive and overactive. Furstenberg and Brooks-Gunn (1985a) found a relatively high incidence of school behav- ior problems (e.g., school suspension, running away, being stopped by the police, and having inflicted a serious injury on someone else) among the adolescent children of the teenage mothers in their study, although they did not control for relevant background factors such as socioeco- nomic status and family structure. In addition, they found that substance abuse (e.g., smoking, Snaking, and drug use) as well as early sexual experience were prevalent among these children. One-quarter of the adolescent daughters in the sample had already had a pregnancy at the time of the 17-year follow-up. As with cognitive outcomes, Hofferth (Vol. II:Ch. 8) concludes from her renew of the available research that most of the effect of having a teenage parent on children's socioemo- tional development is indirect and operates through unstable family

CONSEQUENCES OF ADOLESCENT CHILDBEARING 137 structure. Especially for teenage children, the lack of parental support that often results from marital instability may have some negative effects on socioemotional development. Additional research that controls for relevant background and mediating factors is needed. Although the study of adolescent mothering styles and skills has been largely neglected until the past rEve years, recent work supports the conclusion that the effects of maternal age In this area are also largely indirect and operate through a young woman's education, family struc- ture, support system, knowledge of childreanng, and childrearing expe- rience (McAnarney et al., 1984~. McAnarney et al. (198~) conclude that the prevailing assumption that teenage mothers are poor parents is 200 simplistic and is not supported by the research. Few differences have been found between adolescent and older mothers with the exception of vocalization, which may be linked tO lower cognitive scores during preschool for the children of younger mothers (Field, 1981; Sandier et al., 1981~. Educators and social workers expect a higher incidence of learning disabilities, delinquency, and abuse among the children of teen- age mothers, but the existing record is incomplete and unclear. Thus, for example, when socioeconomic factors and family structure are con- troDed, young mothers do not appear more likely tO abuse or neglect their children than other mothers (Saltier, 1980; Kinard and Klerman, 19801. Kinard and Kle~n~an conclude that both adolescent births and reported cases of child abuse are more common among families with low socioeconomic status, and it is possible that poverty strongly affects both early pregnancy and child abuse. These issues require further study. The available research suggests that having a teenage mother nega- tive~y affects a child's development, and the eRects do not decrease over time. Also apparently significant is the risk of the children of adolescent parents' becoming adolescent parents themselves. In this regard, Moore (1986) reports that the children of white adolescent mothers are more likely than those of black adolescent mothers to accept early childbearing as a possibility for themselves and somewhat more likely to have started dating at a younger age. Studies show that the effects of having a teenage parent on children's development are mediated through a variety of other factors, including mother's education, family structure, family size, and poverty, the very factors that most strongly predict early sexual activity, ineffective contraceptive use, and early nonmantal childbear- ing. However, the assumption that economic dependence and early non

138 Al)OLESCENT SEXUALITY PREGNANCY AND CHILDBEARING mantal childbeanng are perpetuated over generations is not supported by the available research. Indeed, one of the most striking results of the Furstenberg and Brooks-Gunn (1985a) 17-year follow-up of the Balti- more women and their children is the wide diversity of outcomes among both generations. Many of the teenage mothers appear to have found routes to social and economic recovery, and some of their adolescent children appear to be on the track toward productive adult lives. Never- theless, a substantial proportion of the children of mothers in the study sample were not doing well at the 17-year foDow-up. Moore (1986) reports similar heterogeneity among adolescent mothers whose children had reached their teenage years. Yet she also finds that the families of origin of adolescent parents were significantly more likely to have low incomes and to live in neighborhoods that they themselves describe as undesirable for their children. The cycle of school failure, frustration, and disinterest among the children of adolescent mothers is of greatest concern in this context, because we know that it is strongly associated with early sexual activity and pregnancy ire girls and with antisocial behavior in boys. For both sexes it bodes ill for fixture educational atta~nmer~t, marital stability, employment and income, and later soc~o- economic well-being. CONCLUSION The conclusion one must draw from the existing research on the consequences of early childbearing is that women who become parents as teenagers are at greater risk of social and economic disadvantage throughout their lives than those who delay childbeanug until their twenties. They are less likely tO complete their education, to be em- ployed, to earn high wages, and to be happily married; and they are more likely to have larger families and to receive welfare. Despite their poor prospects, though, many young mothers do adapt to their circumstances over the long term and find routes to social and economic recovery. Although adolescent mothers overall do not do as well in I.ter life as women who postpone parenthood, many manage to overcome the handicap of baring a child in their teens (Furstenberg and Brooks-Gunn, 198Sa). The undifferentiated stereotype of the ignorant teenage mother with hordes of children fit g on welfare not only underestimates a young woman's chances of recovery, but may also inhibit her opportuni- ties. Researchers have learned a great deal in recent years about which

CONSEQUENCES OF ADOLESCENT CHIlDBEARING 139 young mothers are at greatest risk of long-term disadvantage and why, and which can be assisted through various types of intervention. While questions remain to be answered, existing knowledge can be used to identify the strategies that are most likely to help young women in different social, economic, and cultural circumstances overcome the detnmental effects of an early first birth and to clarify when in the life span these approaches.are most likely to be effective. In this regard, it seems important to keep in mind that not all young mothers follow the same recovery route, nor do they achieve educational, financial, and personal success on the same schedule, if at all. It is not only teenage mothers who are at risk. Their children are more vulnerable to a number of health risks, including disease, physical dis- ability, and infant death. Children of young mothers also face risks of cognitive deficits and soc~oemotional problems. Few of these problems are the direct result of their mother's age at first birth, however. Instead, available endence suggests that they are mediated to some extent by the social, economic, and cultural conditions of the children's lives. Of special importance is their mother's education, family stability, and, perhaps to a lesser extent, farn~iy size. Knowledge about how these factors operate is incomplete, yet we do know they are strongly associ- ated with the same circumstances, attitudes, and behaviors that fre- quent~y predict school failure, early sexual expenence, ineffective con- traceptive use, and thus adolescent pregnancy. Available evidence suggests that the children of teenage parents are especially prone tO hanng children early in life themselves. The significant danger signals warrant farther investigation and suggest directions for fixture interven- non.

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More than 1 million teenage girls in the United States become pregnant each year; nearly half give birth. Why do these young people, who are hardly more than children themselves, become parents? This volume reviews in detail the trends in and consequences of teenage sexual behavior and offers thoughtful insights on the issues of sexual initiation, contraception, pregnancy, abortion, adoption, and the well-being of adolescent families. It provides a systematic assessment of the impact of various programmatic approaches, both preventive and ameliorative, in light of the growing scientific understanding of the topic.

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