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Re/Assembling the Pregnant and Parenting Teenager

Narratives from the Field(s)

Edited By Annelies Kamp and Majella McSharry

In 2003, Wendy Luttrell posed an important question: what might result if we were able to turn questions of judgement about pregnant and parenting teenagers into questions of interest about their sense of self and identity-making? This book takes up the challenge, offering a re/assemblage of what is, can be and perhaps should be known about teenage pregnancy and parenting in the context of the twenty-first century. The collection presents original contributions from leading commentators in four key contexts: the United States of America, the United Kingdom, Aotearoa New Zealand and the Republic of Ireland, all sites of elevated incidence of and/or concern around what is commonly articulated as the «problem» of teenage pregnancy and parenting. In offering a multi-disciplinary reading of the narratives of young men and women, this volume engages with the ambiguity shared by all of us in confronting the life transition that is pregnancy and parenting.

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4: Teen Mothering in the United States: Fertile Ground for Shifting the Paradigm (Lee SmithBattle)

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LEE SMITHBATTLE

4 Teen Mothering in the United States: Fertile Ground for Shifting the Paradigm

ABSTRACT

Teen mothering was identified as a social and public health problem in the United States (US) beginning in the late 1970s, as advocacy groups, policymakers and researchers responded with alarm to the rise in ‘unwed’ teen pregnancies and births. Alarm intensified as study after study suggested that an early birth stunts or derails the future of mother and child. Although this characterization was problematic from the start, an alarmist paradigm remains entrenched in professional and policy discourse. The cumulative evidence from third generation studies and qualitative research calls for a paradigm shift that recognizes teen mothers’ strengths and resilience and ties their vulnerabilities to childhood adversities and longstanding disadvantage.

Introducing teen mothering as a problem in the United States

Teen mothering became a contentious issue in the US in the late 1970s. Female sexuality, single parenting, poverty and race converged to produce a combustible mix in a country distinguished by its wealth and power, and the highest teen birth rate in the developed world (Sedgh, Finer, Bankole, Eilers & Singh 2015; Ventura, Hamilton & Matthews 2014; Vinson 2012). With close to 250,000 teen births in 2014 (Hamilton, Martin, Osterman, Curtin & Mathews 2015), the US contribution to global numbers is substantial (Sedgh et al. 2015). High rates and numbers encouraged advocacy groups, policymakers and researchers to characterize teen mothering as the beginning of a downward spiral that derails the lives of mother and child. Although this characterization was problematic from the start (Furstenberg 2007), it continues to be accepted as ‘gospel’ despite solid evidence to the ← 75 | 76 → contrary. Unfortunately, the (mis)characterization of teen mothering in the United States exerts worldwide influence (Béhague, Gonçalves, Gigante & Kirkwood 2012).

The purpose of this chapter is to review and critique how teen mothering in the US has been assembled from the late 1970s and why an alarmist paradigm remains so pervasive in social and health policy. After presenting US teen birth rates from a historical perspective, I briefly describe how scientific research on teen mothers has evolved over the last half-century. Growing evidence argues for shifting from an alarmist paradigm that emphasizes teen mothers’ deviance and poor outcomes to greater recognition of their strengths, resilience and vulnerabilities in the context of social inequities and health disparities. Because different terms have been in vogue over the last half-century, I use the term ‘teen mother’ to refer to those who give birth before age twenty. The ‘discovery’ of teen fathering is a more recent development and is not addressed in this chapter.

An alarmist paradigm emerges

Teen birth rates have been tracked in the US since the 1940s. The rate peaked in 1957 at 96.3 per thousand women aged fifteen to nineteen (Ventura et al. 2014), and gradually declined to 24.2 per thousand females aged fifteen to nineteen in 2014 (Hamilton et al. 2015). While the decline in teen births has occurred across all racial/ethnic groups, rates remain substantially higher among African American, Latina and Native American teens (Hamilton et al. 2015). States with larger populations of racial/ethnic groups, higher rates of poverty and wider income inequality have the highest rates of teen births (Kearney & Levine 2012; Ventura et al. 2014). Despite the downward trend in teen births, the US rate remains the highest in the post-industrial world. To put the US rate into an international perspective, fourteen of thirty-one developed countries have rates less than ten per thousand, and only seven of thirty-one countries have rates of twenty or more per thousand (Ventura et al. 2014). ← 76 | 77 →

Teen mothering was identified as a social and public health problem in the US beginning in the late 1970s as advocacy groups, policymakers and researchers responded with alarm to the rise in ‘unwed’ teen pregnancies and births. Paradoxically, high teen birth rates of the 1950s and 1960s did not raise public concern or generate scientific interest, since these births typically occurred in the context of marriage, concealing the sexual activity of young couples who were dating or engaged to marry (Furstenberg 2007). As ‘shotgun’ marriages declined, pregnant white teens resorted to illegal abortions or were sent to maternity homes where they relinquished their babies for adoption and returned home with an unsullied reputation (Solinger 2000). Because black pregnant teens were often excluded from maternity homes due to race-based admission criteria or the families’ lack of financial resources, they gave birth and typically raised their babies with the help of their families (Ladner 1971; Stack 1974). Their growing numbers defined single mothering as a black urban problem of ‘tangled pathologies’ (Furstenberg 2009). The initial surge in births to single black teens was soon mirrored by white teens, with pictures of their protruding bellies appearing in media reports (Arney & Bergen 1984).

The decline in teen marriage and the rise in single mothering signalled a new social landscape. The close ties between sex and marriage were unravelling as the sexual revolution and new family structures challenged traditional norms regarding sex, gender roles and family life. Broad upheavals in the social and economic lives of families began to alter the pathway into young adulthood for teens of different class backgrounds, with more affluent youth facing a lengthy adolescence (Furstenberg 2008). As middle-class girls gained access to family planning, legal abortion, college education and careers, their life-course options expanded. Knowing that a baby would derail college education and careers, these girls were highly motivated to contracept or abort in the event of an unintended pregnancy (Smith, Skinner & Fenwick 2012; Ventura et al. 2014). Options were more limited for girls growing up in low-income communities. With college and careers mostly out of reach, these girls often had few reasons to avoid or terminate a pregnancy (Bell, Glover & Alexander 2014; Driscoll, Sugland, Manlove & Papillo 2005; Smith et al. 2012). In fact, sex and pregnancy were typically viewed by the girls as inevitable (Gabriel & McAnarney 1983; Gubrium, ← 77 | 78 → Barcelona, Buchanan & Gubrium 2013; Jones, Frohwirth & Blades 2016) and something to get over with (Secor-Turner, Sieving & Garwick 2011).

Compared with their more affluent peers, low-income girls continue to have lower expectations for a long life (Chipman & Morrison 2015); are less hopeful about their futures (Fedorowicz, Hellerstedt, Schreiner & Bolland 2014); are more likely to be positive or pleased about pregnancy (Cavazos-Rehg, Krauss, Spitznagel, Schootman, Cottler and Bierut 2013; Lau, Lin & Flores 2014); and are more likely to find identity in family life than in the job market (Edin & Kefalas 2005). The limited opportunities for low-income girls have continued to erode as blue collar jobs have moved overseas; low-income wages have stagnated; labour unions have lost power and influence; and high incarceration rates among men of colour reduce the pool of marriageable partners and increase the economic plight of families. With less faith in a promising future, disadvantaged teens ‘drift’ into pregnancy as part of an accelerated life course (Burton 1990). While such pregnancies are rarely ‘planned’, they are an accepted route for becoming an adult woman (Sisson 2012).

The science of teen mothering

Even though teen birth rates steadily declined from 1957 (Ventura et al. 2014), an influential report from the Alan Guttmacher Institute (1976) declared an epidemic of teen pregnancies. The so-called epidemic fuelled public concerns and generated scientific interest in the causes and consequences of teen mothering. Alarm intensified as study after study suggested that giving birth as a teen ‘stunts’ or derails the future of mother and child and burdens taxpayers (Hayes 1987; Hoffman 2006). Results from this early research were consistent and compelling: teen mothers fared poorly on multiple outcomes. Compared with later childbearers, teen mothers were more likely to drop out of school, rely on welfare and become impoverished. They also tended to be single and have unstable relationships with partners. They were less competent parents, and more neglectful and harsh ← 78 | 79 → with their children (Hofferth 1987b; Westman 2009). Their children also fared worse than the offspring of older mothers (Hofferth 1987a; Ventura et al. 2014; Westman 2009). These early findings implied that poor outcomes, including poverty, welfare dependence and poor parenting, were caused by young maternal age. Following this logic, poor outcomes were avoidable if teens would postpone having children.

Drawing on Fletcher and Wolfe (2009), Weed, Nicholson and Farris (2015) provided a succinct overview of how the research on teen mothering evolved after teen mothering was ‘discovered’. First generation studies, as described above, contributed to an alarmist paradigm by attributing unfavourable maternal-child outcomes to young maternal age (Hayes 1987; Weed et al. 2015). If a comparison group had been used at all in early studies, teens were compared with older mothers without controlling for important differences between them. Although some researchers recognized the limitations of their studies, the limitations were often downplayed or disregarded by policymakers, advocacy groups and the media (Furstenberg 2007; Luker 1996).

The limitations of first generation studies were clearly identified in early critiques and included inadequate comparison groups, unmeasured background factors, the preponderance of cross-sectional studies and the use of theories and instruments consistent with middle-class norms (Geronimus 1991; Luker 1996; Phoenix 1991). These factors exaggerated the negative effects of young maternal age by obscuring the differences between young mothers and later childbearers. Hotz, McElroy and Sanders (2008) explain why these background differences matter:

The assertion that adolescent childbearing causes the poor socioeconomic outcomes […] implies that a teen mother was on the same upwardly mobile life course as her counterpart who did not have a child as a teenager but, by having her first birth as a teenager, altered the remainder of her life detrimentally. For these two groups of women to be comparable, teen mothers and the women with whom they are being compared would have to have virtually identical socioeconomic and background characteristics before the age at which teen mothers had their first child. In fact, this is not the case. (2008: 59, emphasis in original)

Second generation studies used simple regression analyses to statistically control for other influences on the outcomes; these studies found that ← 79 | 80 → poor outcomes were reduced relative to findings from first generation studies (Weed et al. 2015). Third generation studies represented a significant advance, since they used experimental designs and statistical methods to address the following important question: how much of the effect of teen mothering is due to differences that precede the pregnancy and how much to young maternal age? Studies in this vein used innovative comparison groups to more effectively control for unmeasured background factors. In one approach, teen mothers were compared with teens who miscarried or had an abortion (Fletcher & Wolfe 2009; Hotz, McElroy & Sanders 2005; Patel & Sen 2012). These teens were considered similar to teen mothers, since they would have had a baby if they hadn’t miscarried or had an abortion. In another approach, teen mothers were compared with their sisters or cousins who shared family and community characteristics but avoided a teen birth, thereby controlling for subtle and unmeasured differences (Corcoran & Kunz 1997; Coyne, Fontaine, Långström, Lichtenstein & D’Onofrio 2013; Geronimus & Korenman 1992; Webbink, Martin & Visscher 2011). A third approach, referred to as propensity score matching, matched teen mothers to teens who avoided early childbearing but had a statistical probability of becoming teen mothers (Assini-Meytin & Green 2015; Levine & Painter 2003). These three approaches allowed researchers to examine whether differences in outcomes were due to the timing of the birth or to mothers’ pre-existing characteristics.

These approaches have consistently reduced, and in a few cases eliminated, the poor outcomes attributed to young maternal age, suggesting that pre-existing differences account for most of the adverse effects of teen mothering (Weed et al. 2015). As Hotz, McElroy and Sanders (2008) explained above, the life-course trajectories of teen mothers diverge markedly from those of their more affluent peers, beginning in childhood, and these childhood differences are primarily responsible for poor outcomes (Amato & Kane 2011; Levine & Painter 2003). As Luker (1996) asserted two decades ago, young maternal age is not the primary factor leading to poverty and other poor outcomes; rather, poverty threatens child and family health and development in insidious ways that predispose disadvantaged youth to engage in unprotected sex. Young maternal age may worsen disadvantaged girls’ future prospects slightly, but their prospects ← 80 | 81 → are seriously eroded well before conceiving a pregnancy. Based on this evidence, deferring parenthood would not greatly improve the life course of disadvantaged girls.

Early third generation studies sparked a lively debate in the US literature (Furstenberg 1991, 1992; Geronimus 1991, 1992). Two camps emerged around the interpretation of the newer findings. The ‘revisionist’ camp was led by Geronimus, whose groundbreaking research paired teen mothers with their sisters or cousins (Geronimus & Korenman 1993; Geronimus, Korenman & Hillemeier 1994). Because the timing of the birth had little effect on outcomes for the disadvantaged African Americans studied by Geronimus, she argued that teen mothering was best conceptualized as an adaptive response to perverse social conditions, which contribute to chronic illness, premature aging and early death (Geronimus 2003; Geronimus, Hicken, Keene & Bound 2006; Geronimus, Pearson, Linnenbringer, Schulz, Reyes, Epel & Blackburn 2015). Furstenberg was not convinced by her argument or research design. His initial scepticism subsided as additional third generation studies documented a sizable reduction in the magnitude of the effect of teen mothering on poor maternal-child outcomes (Furstenberg 2007).

More recent quantitative studies have taken advantage of the advances made by third generation researchers to determine if the choice of comparison group or statistical approach makes a difference in outcomes. For example, Webbink et al. (2011) compared teen mothers with sibling sisters and twin sisters with an Australian sample and reported about a half year reduction in education for teen mothers when matched to sibling sisters. This gap, however, was eliminated when matching was based on identical twin sisters. Another example is provided by Patel and Sen (2012), who compared teen mothers with two groups on long-term physical and mental health outcomes. One comparison group included women who became pregnant as teens but had a miscarriage, abortion or stillbirth (teen pregnancy only), and the other group consisted of women who reported having unprotected sex as teens but did not become pregnant (teen unprotected sex only). Consistent with prior research, poor physical health among the teen mothers was reduced but not eliminated when background characteristics were adjusted statistically. These differences were eliminated when teen ← 81 | 82 → mothers were compared with both groups. As for mental health, the teen pregnancy only group and the teen mothering group had similarly negative outcomes, suggesting that unmeasured factors leading to pregnancy contribute to poor outcomes regardless of how the pregnancy ended (in miscarriage, stillbirth, abortion or a live birth).

Kane, Morgan, Harris and Guilkey (2013) also demonstrated that the choice of statistical approach makes a difference in the magnitude of reduction on teen mothers’ educational attainment. When no adjustments were made, teen mothers had two to three fewer years of education compared with later childbearers. When four statistical approaches were compared, the educational gap between teen mothers and later childbearers was further reduced (from 0.70 to 1.9 fewer years). In evaluating the strengths and limitations of the four approaches, the researchers preferred the approach based on semi-parametric maximum likelihood estimation, which yielded the estimate of about three-quarters of a year less schooling for teen mothers. Based on their results, Kane et al. suggested that ‘the wide-ranging estimates in past research are related more to the choice of statistical strategy than to the use of different data sets (focused on different cohorts)’ (2013: 2145).

Although we can have much stronger confidence in the findings of third generation studies, they also have limitations. While comparing teen mothers with their sisters or cousins who avoid early parenting adjusts for many pre-existing family and community characteristics, this approach does not adjust for differences between teen mothers and their sisters or cousins. These differences may include cognitive ability, school performance or childhood adversities, to name a few. To my knowledge, no known studies have adjusted for these differences, perhaps because obtaining an adequate sample of sister or cousin pairs is difficult, even with a national data base.

The science is clear: teen mothers differ in important and substantial ways from mothers who defer parenting. Equally important, teen mothers are a more diverse group than our stereotypes and media images suggest. Not all teen mothers are black or brown or grow up in disadvantaged families (Taylor 2009; Williams, Sassler, Addo & Frech 2015). In the event of pregnancy, some white middle-class girls reject abortion and become mothers (SmithBattle 2010). Many teen mothers are alienated from school ← 82 | 83 → as children and drop out prior to pregnancy (Levine & Painter 2003; Pillow 2004), but others have strong academic records before and after giving birth (SmithBattle 2006b, 2007a). Researchers have taken advantage of this naturally occurring heterogeneity among teen mothers to examine variations in outcomes (Borkowski, Farris, Whitman, Carothers, Weed and Keogh 2007; Hillis, Anda, Dube, Felitti, Marchbanks and Marks 2004; Kennedy & Adams 2016). An elegant example of this type of study is provided by Diaz and Fiel (2016). Using data from the National Longitudinal Survey of Youth (NLSY), they examined the long-term consequences of teen fertility on earnings and educational attainment for pregnant teens who differed based on their level of disadvantage. Poor educational attainment (as measured by high school completion and college completion) and reductions in long-term earnings were more clear-cut among the more affluent teens and less pronounced among the more disadvantaged teens. Diaz and Fiel concluded that girls who grow up in disadvantaged families and communities are not substantially harmed by a teen birth, while teens with better prospects for advancing their education and income are harmed the most. Other variations in teen mothers’ backgrounds have also been shown to affect short and long-term outcomes. For example, teen mothers who are exposed to more childhood adversities (Hillis et al. 2004) and violence (Kennedy & Adams 2016) face greater difficulties and worse health and educational outcomes than teen mothers with less exposure to traumatizing experiences. Teen mothers who were white or who remained single reported better self-reported health at mid-life than their African American or married counterparts (Williams, Sassler, Addo & Frech 2015). The authors conjecture that young single mothers, who are disproportionately low income, may have avoided the stress associated with marriages to partners whose economic prospects are limited.

Social scientists and health researchers have also explored outcomes for teen mothers’ children. Early studies portrayed teens as inept parents who jeopardized their children’s development. This depiction is increasingly challenged by studies that mirror the trajectory of research on teen mothers; that is, early studies exaggerated children’s adverse outcomes (for example, in schooling, behavioural problems, delinquency/incarceration, early parenting and earnings/employment). Consistent with the research ← 83 | 84 → on teen mothers, unfavourable child outcomes are largely reduced when researchers control for mothers’ pre-existing characteristics. The reader is referred to recent reviews of this research (Coyne & D’Onofrio 2012; Weed et al. 2015).

While teen mothering has always been a marker of social disadvantage, several birth cohort studies suggest that disadvantage is rising among recent cohorts of teen mothers relative to earlier cohorts in the United States (Driscoll 2014; Woodward, Friesen, Raudino, Fergusson & Horwood 2013); the United Kingdom (McCall, Bhattacharya, Okpo & Macfarlane 2015); New Zealand (Donelan-McCall, Eckenrode & Olds 2009); Finland (Väisänen & Murphy 2014); and Sweden (Coyne et al. 2013). In the Swedish study, there was no difference in criminal convictions between teen and adult mothers in an early cohort, but differences emerged in later cohorts as disadvantage became more pronounced among teen mothers. The growing disadvantage of teen mothers is worrisome, but not unexpected given the growing income inequality in the US and elsewhere (Marmot 2015) and the collapse of the welfare system in the United States (Edin & Shaefer 2015). It remains to be seen if contemporary teen mothers, who face greater levels of disadvantage (Driscoll 2014; Mollborn & Jacobs 2012), will ‘catch up’ over time like their predecessors (Furstenberg 2007).

In summary, the first generation of quantitative research exaggerated the poor outcomes associated with young maternal age. Unfavourable outcomes were used to shine a national spotlight on teen pregnancy and births to advance socio-political agendas, even though rates were declining (Furstenberg 2007; Luker 1996). Early critiques identified the limitations of these studies (Geronimus 1991; Luker 1996; Phoenix 1991). With stronger research designs, studies confirmed that teen mothers’ pre-existing characteristics (which ‘select’ or predispose youth into parenting) are largely responsible for poor outcomes. These selection factors are substantial, since teen mothers are disproportionately of colour and tend to grow up in low-income families and segregated neighbourhoods where they are exposed during childhood to many social and environmental threats (Coyne & D’Onofrio 2012; Driscoll 2014; Farber 2014). The broad conclusion from third generation studies is strikingly at odds with the prevailing paradigm: waiting to have a child does not greatly improve the lives of teens who are ← 84 | 85 → already disadvantaged. Another unexpected finding also challenges conventional wisdom; the anticipation of mothering motivates some teens to improve their lives and reduce drug use, binge drinking or illegal activity (Amato & Kane 2011; Fletcher 2011; Walker & Holtfreter 2016). A tsunami of qualitative research corroborates and extends these findings.

Qualitative studies of teen mothering

Teen mothers’ perspectives on their lives were excluded in the early scientific literature (SmithBattle 1995). As qualitative methods gained acceptance in the academy, social scientists and health researchers began filling this void with studies that exemplify the strengths and rigour of qualitative scholarship. Rather than bracketing out human meanings and reasserting the cultural biases, concepts and methodological screens of the prevailing paradigm, qualitative researchers interrogate participants’ narratives with openness and humility to recover the world as lived. Detailed descriptions of experiences are collected, analysed and presented to provide the contextual backdrop for participants’ meanings, concerns and actions. When the study is done well, the reader is led by the researcher’s interpretation to go beyond his or her vantage point as an outsider to grasp what participants take as self-evident and ‘natural’. As described below, findings bring visibility to mothers’ experiential understanding of their realities, demonstrating how their possibilities and constraints for being and acting as a mother are tied to family and cultural worlds (SmithBattle 2010).

Qualitative findings challenge the alarmist paradigm by showing that teen mothering is an intelligible response to life-worlds and cultural and sub-cultural traditions (Connolly, Heifetz & Bohr 2012; Smith et al. 2012; SmithBattle 2009b). According to teen mothers, mothering may not represent misfortune but provides a pathway into adulthood in the context of adverse childhood experiences, violent neighbourhoods, inferior schools and limited opportunities (Burton 1990; Cherry, Chumbler, Bute & Huff 2015; Dalton 2015). In spite of significant hardships, mothering is often ← 85 | 86 → experienced as a transformative experience that fosters maturity, responsibility and the development of new priorities (Brand, Morrison & Down 2015; Seamark & Lings 2004; Smith et al. 2012), such as leaving harmful relationships (Lesser, Oscos-Sanchez & Davis 2010), reinvesting in school (Anwar & Stanistreet 2014; Rolfe 2008; SmithBattle 2007a), and curbing drug use (Dalton 2015; Quinlivan 2004). The new purpose and meaning that arises from being a mother may lead to narrative repair, a more positive identity, a new horizon for how one should live or an enlarged future (Anwar & Stanistreet 2014; Dornig, Koniak-Griffin, Lesser, Gonzales-Figueroa, Luna, Anderson & Corea-London 2009; Romagnoli & Wall 2012). The demands of mothering may also exacerbate distress and interpersonal conflicts (Mollborn & Jacobs 2012; SmithBattle 1996), and lead some teens to regret the timing of the pregnancy (Warnes & Daiches 2011). Qualitative researchers further suggest that material hardships, social isolation and stigma can overwhelm the best of intentions (Kennedy, Agbenyiga, Kasiborski & Gladden 2010; Mollborn & Jacobs 2012).

The full range of qualitative methods (for example, ethnography, grounded theory, phenomenology, content analysis, qualitative description) is represented in the above research. In the vast majority of studies, data collection is limited to a one-time, face-to-face interview during the teen’s pregnancy or within the first two postpartum years. Samples are often restricted to low-income teens. Longitudinal studies are rare, with two exceptions. Dalla and colleagues (Dalla, Bailey, Cunningham, Green & Vyhlidal 2013; Dalla & Gamble 2000; Dalla & Kennedy 2015) interviewed teen mothers on a Navaho reservation twice over twelve to fifteen years. Mothering remained their central identity at the second wave of the study (with two exceptions); their concerns as mothers had motivated them to improve their education and employment, and in some cases, to leave abusive relationships. Nearly half of the participants had earned a college degree or higher by Time 2, and 76 per cent were married or in a committed relationship. Many of these intimate relationships had ended or were strained by infidelity, alcohol abuse, years of unemployment and interpersonal violence, all of which were common on the reservation. The vulnerability of these mothers was apparent in high levels of interpersonal violence and negative life events and moderate levels of distress and depression scores. ← 86 | 87 →

I have followed teen mothers and family members over six waves and twenty-one years (SmithBattle 2010). The seventh wave is under way. The original study was inspired by my public health nursing practice in the late 1970s and early 1980s, where I had the great fortune to visit teen and older low-income women in their homes during pregnancy and early mothering. The teen mothers on my caseload did not describe their lives as restricted or derailed; their perspectives therefore diverged considerably from the alarmist paradigm that was emerging in the clinical and scientific literature. In contrast with the scientific paradigm that pathologized teen mothers, I entered the field with the broad purpose of understanding the everyday worlds of teen mothers from a non-pathologic lens. This purpose necessarily involved articulating teen mothers’ practical understanding of their lives, including their priorities, struggles, aspirations and contradictions, as organized by family and cultural worlds.

Teen mothers’ partners, parents (referred to as grandparents) and children (beginning at age twelve) continue to be interviewed at each wave. The sample is diverse in terms of family income, education and race/ethnicity, with the African American families tending to be of lower income than the Caucasian participants (SmithBattle 1995). This diversity has proved invaluable in describing how mothers and families negotiate transitions and setbacks, and how these are often shaped by social disadvantage (or advantage), stigma, racism and flawed social policies.

In the first wave of the study, the majority of teen mother participants – sixteen in number – described the transformative potential of mothering; the few teens who were not transformed described their aspirations to be good parents but lacked the agency and resources to act in accord with the mother they wanted to be (SmithBattle 1993, 1995). Their childhoods were marked by traumatic experiences and adversarial family relationships. Patterns of grandparent caregiving played a crucial role in undermining (or promoting) the teen’s care of her child (SmithBattle 1996). Subsequent waves have elaborated on how early patterns of grandparent caregiving shaped long-term outcomes and how teen mothers revised or rejected family caregiving legacies over two decades (SmithBattle 2006a, 2008; SmithBattle & Leonard 2014). The multigenerational data made it possible to describe how individual lives unfold within family legacies, ← 87 | 88 → neighbourhood contexts and larger social structures. Findings highlight the cumulative impact of social disadvantage (or advantage) on the lives of teen mothers and their children and the reciprocity of teen mothers’ and children’s lives (SmithBattle 2007b; SmithBattle & Leonard 2012). For example, the few women who had little maternal agency in the first postpartum year continued to drift into their thirties. Their ‘rudderlessness’ reflected a precarious world that set their first-born children adrift as teenagers and young adults (SmithBattle & Leonard 2012). In contrast, the children of mothers who were transformed by mothering in the first wave experienced a smoother transition into adulthood as they drew on positive family legacies and the emotional and material resources of their families and communities (SmithBattle 2006a, 2008). Like other qualitative research, findings from this longitudinal study problematized the assumptions and stereotypes of teen mothers that are associated with the alarmist paradigm.

In summary, qualitative research has enriched our understanding of teen mothers by adding their experiential realities to the literature. Findings from cross-sectional and longitudinal research corroborate that early childbearing is an intelligible response to family and cultural worlds that are largely invisible to middle-class professionals. For teens who inherit a shabby future at birth, teen mothering is not a tragedy per se or the beginning of a downward spiral. When a future is foreclosed during childhood, mothering cultivates meaning, responsibility and new aspirations. These aspirations may be strengthened (or undermined) as mothers face the demands and challenges of parenting with (or without) the help and support of partners, families and institutions (such as schools; reproductive health and health care agencies; and childcare, justice and welfare systems (Mollborn & Jacobs 2012; Silver 2015; SmithBattle & Leonard 2014). These nuanced findings complement third generation quantitative studies by documenting the situated nature of teen mothers’ lives and the legacy of childhood disadvantage in shaping the life-course and parenting. ← 88 | 89 →

Intervention research

The early findings of poor outcomes and high costs related to early childbearing stimulated the development of programmes that aimed to reverse teen mothers’ downward trajectory (Chrisler & Moore 2012; Ruedinger & Cox 2012; Seitz & Apfel 1999). Many programmes that were developed for teen mothers embraced a scientific–clinical gaze and practices of surveillance to monitor, motivate and educate teen mothers to bring them in line with middle-class norms of the life course and parenting (Horowitz 1995; Kelly 1998; SmithBattle 2009a). In this research, an alarmist paradigm is often implied, and citations of third generation studies and qualitative research are rare. As government and private funders have mandated rigorous evaluations to determine programme effectiveness, experimental and quasi-experimental designs and fidelity to protocols have been emphasized.

Since this large body of research has been summarized in narrative and systematic reviews (Hofferth 1987b; Hoyer 1998; Ruedinger & Cox 2012), only a cursory description of these programmes is provided here. First, programmes are remarkably diverse in their objectives and approaches. Because programmes target a wide array of maternal-child outcomes (for example improved birth outcomes, mental health, parenting behaviour, reduction of repeat births, educational attainment, child health and development), they vary considerably in terms of when services are provided (during pregnancy or postpartum); where they are sited (schools, health settings, homes, community agencies); their length and intensity (one session versus many sessions provided over months or years); staffing patterns (staffed by volunteers, para-professionals or professionals); and programme components (for example, case management, parent support and training, access to services, health education, life-skills training). Although a few interventions produced worse outcomes relative to controls, the majority yielded minimal to small effects (Hofferth 1987b; Hoyer 1998; Lachance, Burrus & Scott 2012; Ruedinger & Cox 2012). A number of issues limit intervention effectiveness, including poor study design, small sample sizes, high attrition and heterogeneity of the sample, to name a few. ← 89 | 90 →

As experimental and quasi-experimental studies have proliferated, meta-analytic techniques have been used to calculate effect sizes for interventions that examine similar outcomes. An umbrella review of twenty-one meta-analyses of these interventions reported that most effect sizes were negligible to small (SmithBattle, Loman, Schneider & Chantamit-o-pas, in review). These results are hardly surprising, since behavioural interventions are too weak to undo the structural inequalities and childhood adversities that contribute to poor outcomes for teen mothers. Because programmes privilege the normative assumptions of the life-course and parenting, and train staff to follow highly structured protocols, staff have little room (or training) for cultivating teen mothers’ strengths and resilience and the transformative potential of mothering. Childhood adversities and the experiences of discrimination also appear to receive little attention, even though these experiences are known to shape long-term outcomes (Hillis et al. 2004) and may undermine teen mothers’ engagement in programmes (O’Brien, Moritz, Luckey, McClatchey, Ingoldsby & Olds 2012).

Paradigm shift or retrenchment?

The construction of adolescence, the timing of childbearing and the meaning of mothering are historically and culturally situated. Before adolescence emerged historically as a distinct phase in the life cycle, childbearing typically occurred in the late teens. Social and economic upheavals of the last half-century have extended adolescence into the late twenties; this lengthened time period prepares (middle-class) youth to participate in a highly competitive, globalized economy (Furstenberg 2015; Geronimus 2003). The alarmist paradigm suggests that teen mothers violate this normative pathway at their peril, as exemplified by the recent remarks of Retta Ward, the Secretary of Health for the State of New Mexico (quoted in Krisberg 2016): ‘Teen births are a primary driver of generational poverty, and reducing teen births will improve high school graduation rates and lead to a better trained workforce, which will ultimately help our economy and improve ← 90 | 91 → our health status’. Similar assertions are routinely made without qualification by epidemiologists (Ventura et al. 2014), advocacy organizations (see <http://thenationalcampaign.org/>) and professionals (Westman 2009). Why does an alarmist paradigm persist?

Thomas Kuhn (1970), in his landmark book, The Structure of Scientific Revolutions, described how researchers resist paradigm shifts until sufficient anomalies perturb the biases embedded in ‘normal science’. In the science on teen mothering, scientific practices and normative theories of parenting and the life course reflect neoliberal assumptions that pervade US political culture. After studying teen mothers for three decades, Furstenberg (2007: 3) came to appreciate these hidden assumptions: ‘The causes and consequences of early childbearing […] have been misunderstood, distorted, and exaggerated because they are refracted through a peculiarly American lens tinted by our distinctive political culture’. This peculiar American lens attributes social problems to the character flaws and deviance of individuals, ignoring the larger social inequities that are woven into educational, economic and justice systems. This distortion has been exacerbated by the illusion that scientific procedures control for theoretical, methodological and cultural biases.

Science, like all human endeavours, is conditioned by historical and cultural forces, and can therefore never be completely purged of prejudice. Claiming otherwise reflects the ultimate scientific bias (Guignon 1983). Crossley (2001: 93) asserts this very point when he writes: ‘all agents, including social scientists, must see the world from “somewhere”. Nobody enjoys a God’s eye view or epistemological privilege’. Kuhn (1970) effectively discredits a God’s eye view of science by describing how researchers absorb hidden assumptions and biases during their training and reinforce them over their careers. The very questions that scientists learn to ask reflect disciplinary assumptions about acceptable and fundable topics and appropriate ways of framing them based on available methods. Early research on teen mothering was primed by neoliberal assumptions and theories of deviance (and more recently by problem behaviour theory (Coyne and D’Onofrio 2012)) to reject teen mothers’ perspectives and to identify objectively defined outcomes (Furstenberg 2007; SmithBattle 1994). By comparing teen mothers with older childbearers, dire outcomes were readily ← 91 | 92 → identified while the assumptions grounding the research remained hidden. Adverse outcomes prodded other researchers to pursue similar questions, and stakeholders (funders, journal editors, policymakers, academic departments) to fund and publish similar studies. By judging and studying teen mothers’ lives and parenting only in terms of their differences from cultural norms, early studies painted an incoherent and stigmatizing picture of teen mothers (SmithBattle 1994, 2013). It would have been heretical for early researchers to pose questions related to teen mothers’ strengths or resilience, to examine how discriminatory educational policies contributed to unfavourable outcomes, or to ask how young mothering coheres with lived experience. Since qualitative research was deemed ‘unscientific’, teen mothers’ perspectives were ignored as a legitimate source of knowledge. Even if a researcher had considered questions that went beyond the ‘normal’ science of the time, it is unlikely that such studies would have been funded or published (Weed et al. 2015). As a case in point, I’m aware of an instance where a case study of a teen mother who was doing well in her late twenties was rejected by a journal editor in the 1980s because positive outcomes were considered anomalous and therefore unworthy of publication. Stakeholders have also exaggerated the negative outcomes of early childbearing for their own purposes. For example, a representative of a US advocacy group informed me that the exaggeration of poor outcomes helped the organization to secure funding. Politicians and policymakers likewise selectively attend to findings that are consistent with their biases and purposes (Furstenberg 2007).

According to Kuhn (1970), science enters a ‘revolutionary’ period when a sufficient number of anomalous findings accumulate to challenge established assumptions and procedures. As researchers have taken advantage of additional computing power, sophisticated software packages, innovative research designs and national data sets, and have recognized the value of qualitative methods, new insights and lines of inquiry have emerged to reveal our cultural and scientific blind spots. Evidence from qualitative and third generation quantitative studies illuminates life-worlds that tend to differ from our own. For the low-income teen mother who is most often studied, becoming a mother can be a tacit recognition of the limited educational and vocational possibilities available to disadvantaged, discouraged ← 92 | 93 → girls (Luker 1996; Sisson 2012; SmithBattle 2000). The alarmist paradigm disregards how the life-worlds of teen mothers are largely discrepant with the middle-class pathway into adulthood and parenting. When teen mothers’ experiences are distorted by cultural biases and scientific theories, we fail to appreciate how girls’ experiences and actions are holistic and pragmatic expressions of the life-worlds they inhabit. The social inequities and childhood adversities that course through the majority of teen mothers’ lives create unrelenting challenges and perverse hardships, but no matter how fraught parenting is on the economic margins, many teen mothers gain purpose and meaning (Clemmens 2003; SmithBattle 2009b). Middle-class teen mothers may also gain purpose and meaning from mothering, even though they may experience worse educational outcomes relative to their peers (Diaz & Fiel 2016).

The view that teen mothering begins a downward spiral leads to misunderstanding and marginalization of young families via punitive social policies and behavioural interventions of surveillance (Sisson 2012; SmithBattle 2012). Reframing programmes and policies so they address teen mothers’ concerns and challenges and capitalize on their aspirations and strengths would be an important step in the right direction (Brand, Morrison, Down & WestBrook 2014; SmithBattle 1994, 2006b; SmithBattle, Lorenz & Leander 2013), but this step should co-occur with US policies that reduce social inequities and restore a safety net for vulnerable families. Reducing social inequities upstream is crucial in light of the grim reality that inequalities in income, wealth and opportunity grow ever wider in the US (Marmot 2015); disadvantage is rising among recent cohorts of teen mothers (Driscoll 2014; Farber 2014); the welfare system has collapsed (Edin & Shaefer 2015; Mollborn & Jacobs 2012); and low-income youth are sequestered into low-paying positions with little assistance for advancing their education or gaining a toe-hold in an increasingly competitive globalized economy (Furstenberg 2008, 2015). ← 93 | 94 →

Reimagining the journeys of pregnant and parenting teens

Teenagers gave birth to babies long before teen mothering was discovered by social scientists and health researchers. The discovery of teen mothering as a social problem focused a national spotlight on young maternal age as a problem of high risk, deviant girls who were partly responsible for family breakdown, crime and welfare dependence. Early findings supported an alarmist paradigm with little regard for the contexts and upstream conditions that contributed to high but declining teen birth rates. The characterization that teens’ lives are derailed by having a child remains pervasive in spite of solid evidence suggesting that the negative effects of teen mothering are negligible-to-small for disadvantaged teens but perhaps greater for teens with more family and community resources. While understanding the magnitude of the effect of teen mothering will remain an important question, there is little question that teen mothers’ vulnerability over the life course is not tied to young maternal age per se but to an unlevel playing field that is saturated with health and social disparities. Precisely because a promising future is derailed for disadvantaged girls (Sisson 2012), mothering offers a ‘lifeline’ into adulthood (Smith et al. 2012) that is imbued with meaning (SmithBattle 2007a, 2009c). Teen mothers’ perspectives invite us to reflect on the ways that power and privilege lead us to misunderstand teen mothers as deviant and irrational actors rather than as youth whose perceptions, skills and resilience are shaped by a world marked by the ‘inequitable institutionalization of life-cycle transitions’ (Béhague et al. 2012: 434). Making this shift calls for bringing into sharp relief the childhood adversities and disadvantage that often precede teen pregnancy, and the structures of power and privilege that conspire against more inclusive policies (Sisson 2012). Given the scientific evidence, a paradigm shift is well overdue. ← 94 | 95 →

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