Abstract - prepared for the 4th European Forum on Adolescent Health.=

Prepared for the 4th European Forum on Adolescent Health.

“The Adolescent = and the family in a changing society”

Title -

“Young Families - Family influences on ea= rly childbearing; what sort of families do schoolage mothers create?”

Author - &n= bsp; Dr Diana= Birch, = ; <= /span>

= ; <= /span>Director Youth Support =

= ; <= /span>

“Young Families= - Family influences on early childbearing; what sort of families do schoolage mothers create?”

Abstract

Most behaviour, including early childbearing is measured as problem= atic in terms of how it measures up to the norms and values of a particular soci= ety or group. For some girls pregnancy represents a solution to a sea of proble= ms albeit the reasoning might be flawed and the solution a ‘false’ one. We need to acknowledge however that for a great many young mothers pregnancy is desirable and very much the norm of their family culture. Continuing this argument, there ar= e also many cultures where early marriage and pregnancy is very much desired and o= ne should separate the ‘problems’ raised by cultural expectations = and lack of societal support from the personal and individual conflicts and str= esses which might be caused by early pregnancy.

Central to this argument is the nature and structure of the family - both in terms of the influence of the family of origin and the eventual structure of the family which the young parent creates. <= /p>

We present findings f= rom a fifteen year longditudinal study of 200 young families in which the mother = gave birth under the age of 16 years. The study has illustrated how the presence= of a supportive family leads to an improved prognosis for young mothers and th= eir children and gives insights into postive and negative predictive factors. We also discuss some unexpected outcomes and their possible aetiology.

Families

“As my children get older I can really say that adolescence i= s a pain. I hope my daughter doesn’t get pregnant and will wait until aft= er l8 at least. Parenting is a big responsibility and as a teenager it is so difficult to keep up with the pressures of life. I found keeping up with the bills as a young parent was a nightmare.&n= bsp;

But it is good to have a young family.”

* * * * *

“I got pregnant when I was fourteen and had my baby just afte= r my fifteenth birthday. I was lucky because I had a lot of support from my fami= ly. I got out of a bad relationship and managed my life better after that.

I still live with my Mum and Dad. It has been good having the company of children and I don’t think I really missed out on anything. I had my childhood while the children grew and had support from my Mum so if I wanted time for myself to go out I could.”

* * * * *

There are many different family structures. Our society in general has moved a= way from the single idea of the nuclear family - mother, father and two childre= n - as being the only acceptable pattern. Single parent families are much more = the ‘norm’ than when this study commenced in the early eighties. It has also become more acceptable= for couples to live together without a marriage to cement their union. - not th= at the unions were necessarily any more stable - the cement often cracked.

To paraphrase an excerpt from a&nb= sp; recent presentation at a conference - “There is no unitary structu= re which can be called a family = - it is not the structure which is important, but the function of the family - individuals are the building block= s, not families .... and individuals<= span style=3D'mso-spacerun:yes'> need support to function at their best”.<= span style=3D'mso-spacerun:yes'> {Leach 96} In no context is this statement more true than in the case of our young families.<= /p>

To recap a little on the family of origin of the teenage mothers. T= hey generally came from large single parent families with an average of five children. Two thirds of their natural fathers were absent from the household and the ‘fath= er figure’ was usually a man who moved in and out of the ‘family’ fathering more children and then going on his way. Nei= ther fathers nor stepfathers figured significantly in most girls lives.

Just under half the girls (45%) got on with their mothers but in ha= lf the of these cases - a fifth of the whole (21%) - the relationship was described as ‘over close’ and suffocating and this was consider= ed a significant influence. <= /o:p>

Hence the families fell into the main groups of -= good relationships with both parents ; absent or weak father and dominant or poor relati= onship with mother; both parents absent or ineffectual.

A fifth of the girls came from what could be described as a ‘goodR= 17; family background - Dad was a= round and so was Mum and they got on reasonably well. Generally these girls have d= one well themselves.

Why did they get pregnant in the first place? For some it was an ‘accident’ For some an ‘out of character’ relations= hip with the ‘wrong’ boy and perhaps they are now well settled with= a stable second relationship. For some the pregnancy was wanted and ‘right’. Some - approximately a quarter of this group - were following a family pattern of early motherhood.

There was no single reason nor even a predominant reason why girls = from ‘good’ families got pregnant - however it does seem that having= a good supportive family behind you does help you to make the most of your situation and build a happy family yourself.

Of course all of us have unhappiness and the odd disasters in our l= ives and it is important not to let the ‘hazards’ of everyday living cloud our perceptions. Unfortunate things happen to ‘ordinary’ people. There is not always a researchable ‘reason’ behind why things turn out the way they do and there will always be exceptions to the ‘rule’. Thus allowing for everything in the garden not being wonderfully rosy, nevertheless there is no concrete example in this study o= f a girl from a stable loving home who as not done reasonably well in recreating her ‘family’ scene.

Our family of origin is a very powerful influence on our emotional development, on our future lives and very much sets the scene or the ‘mould’ for our fu= ture lifestyle. Like it or not, we do tend to recreate our ‘family’ throughout the shifting patterns of our lives one way or another.

Looking thus at family patterns it is interesting to note that in t= he original sample forty percent of their mothers had also been young teenage mothers. In other words sixty percent had not. For si= xty percent this was not a family pattern and there were other influences which steered them in the direction of being schoolgirl mothers.

A twenty year follow up study in Baltimore found a similar situation - “Nearly two thirds of= the daughters of adolescent mothers delayed their first birth until 19 or later, but those who had teenage births may be more vulnerable than their mothers = to economic dependence and less able to escape poverty” (Furstenberg et.= al. 90).

There were also just over a third of sisters (35%) who were teen mothers which is not surprising in view of= the shared family histories, the ‘peer’ influence and perhaps the higher acceptability of early child bearing in these families. This has been suggested as an influence on younger sisters of teenage mothers in reports from the <= span lang=3DEN-GB style=3D'font-size:14.0pt;mso-bidi-font-size:10.0pt'>USA. (East a= nd Felice 92)

Some sisters stubbornly refused to follow their older siblings exam= ple however and stated quite clearly that they had other goals in mind. The vision of not so ‘perfect’ mothering before them seemed to put them off. It seems moreover that siblings do= have their own lives disrupted by = their sisters early child bearing. (Hoffman, Foster, Furstenberg 93).<= /span>

* * * * *

“She’s always looking at me and saying .. ‘what’s wrong with you? Look at you, nearly thirty and not had = any kids yet’

Just because she’s got her seven and my other sister had five= ... they seem to think I’m abnormal.

Then my mum starts ... ‘when are you going to et married?’ There’s plenty of time!

I’ve got other things in my life, I’ve got a job and I = like to have my own time. I love p= laying with their kids when I visit - but I wouldn’t like them around me all= the time.

* * * * *

“I never wanted= to get pregnant - it was a complete mistake for me and I would have planned an abortion if I had been old enough. I was scared to get my boyfriend in trou= ble so I waited till my birthday and then it was too late. .... Anyway I had a = miscarriage .. it was a complete relief although I was really upset at the time.

If I had the baby I would have got on with being a mother and I was starting to get attached to the idea of having a baby. But it was for the b= est ... I never did get pregnant again and that’s right for me. I’ve got a good job, a nice flat. My sister has got children and she is happy to= o - we just lead different lives, that’s all..”

* * * * *

Looking overall at the family history for different groups of girls= it is also somewhat of a surprise to note that there is no difference in prevalence of family history of teenage pregnancy in the groups who have been in care or have not been in care. Perhaps this should not really com= e as a surprise .. maybe the ‘care experience’ and the effect of going into care has such a profound influence that it far supercedes and masks any effect of ‘family pattern’. In other words, the vital point is = not whether your mother had you when she was young - but whether or not that mo= ther could cope with you at a young age and whether or not she gave you up - willingly or not - to the care s= ystem.

The family history of teenage pregnancy does not seem to have any significant impact on repeat patterns of pregnancy either - with the one exception of the ‘late repeater’.

The girl who has only one child until late on and then enters into a second ‘adult phase’ of child-bearing is marginally less likely= to have a family history. This is not unexpected really since one would expect girls whose family pattern encouraged early childbearing to regard teen childbearing as a ‘norm’ rather than entering an ‘adult norm’ at a later date.

childbearing patterns -

Fertility and Repeat pregnancies

Those who have been pregnant as schoolgirls are generally speaking a highly fertile population. They begin their childbearing career at an early= age and are likely to remain fertile during a large segment of their life span.=

Even in the early stages of this survey it was clear that a signifi= cant percentage of the girls would go on to have a large number of pregnancies. = At the stage of the six month follow up 16% of the girls were pregnant again a= nd this had risen to 25% by the time the first child was one year old. The mean interval between pregnancies in the first two year period of follow up was = only 9.8 months. The girls were extremely poor users of contraception; contracep= tive use prior to the first birth was negligible (less than 7% ) and after the first birth the rate was also extremely low (41%). By the two year stage nearly 30% of the girls had been pregna= nt twice and 6% had been pregnant three times or more.

By the time the first child was five years old nearly half of their young mothers (46%) had been pregnant twice and a fifth (22%) three times or more. Going forward another five years to the ten year stage - over a third (37%) had been pregnant three times or more and b= y the 15 year stage this applied to over half of our girls (55%).

	REPEAT	&nb= sp; PREGN	ANCIES
	number	of times	pregnant	%
	1yr	2yr	5yr	10yr	15yr
1	80	65	32	18	12
2	17	29	46	45	33
3	2	4	17	21	36
4	0	1	4	12	12
5	1	1	0	2	4
6			1	1	0
7				1	2
8					1

Looking at the statistics from another direction - on average at 5 = year follow up each girl had been through nearly two pregnancies each (1.9), rising to approximately two and a = half (2.4) at ten years and just under three each (2.7) at the fifteen year foll= ow up. In terms of the number of children this represented, this was slightly lower - the discrepancy being accounted for by miscarriages and some terminations. This resulted in the average number of children per girl at t= he five year follow up being 1.7, rising to 2.2 at ten years and 2.6 at three years.

With regard to the timing of pregnancies, the rate of repeat pregnancies continued to be high throughout the years. Each follow up showed a high number of girls had beco= me pregnant again since the last interview. In fact, we have said that by one = year a quarter (25%) were pregnant again but between the one and two year stages 19% had another pregnancy. By= the time we reached the five year follow up stage 42% of the girls had been pregnant once more between the two and five year stage. <= /p>

Interviews at the ten year stage showed just over 50% had become pregnant again in that five year p= eriod and even at 15 years the rate of pregnancy in the previous five years remai= ned high at over 40% .

There do seem to be three sub-populations with regard to pregnancy = patterns :-

1) &nb= sp; Single pregnancies - girls who ha= ve one pregnancy only and continue like this throughout.

2) Constant repeaters - a group who maintain a high level of repeat pregnancy throughout

3) Late repeaters - girls w= ho have one pregnancy as a schoolgirl then do not have repeat pregnancy until = they enter a second later stage of childbearing (adult childbearing stage)<= /o:p>

The child bearing patterns of the three subgroups are illustrated in the pie chart - 12% have one pregnancy only, 20% had a later pregnancy (late repeat= ers) and 68% fall into the group of constant repeater.=

As we have seen in the discussion of child bearing patterns - some young mothers remain on their own with their one and only child. Usually by the time their children are teenagers they are living in their own h= omes but in the early years the grandparents figured quite strongly in their grandchildren’s lives.

Babyfathers=

The graph shows the gradual decrease in the numbers of baby fathers still in touch with their children. However, this fall off slows down as the years pass and it is possible that the 20% still in touch at l5 years will remain a relatively stable figure.

The biggest drop off is in the first year. At the time of the baby’s birth a quarter = (25%) of their natural fathers had already departed the scene and by the time the child was one year old this had risen to half (50%). From then on the drop = off is slower with each follow up, losing only 5% between 1 and 2 years, 10% between 2 and 5 years and another 10% between 5 and 10 years. By 10 years of age only a quarter (25%) of the children are still in touch with their natu= ral fathers.

The drop off during the first year of life belies the true position since the boys who drop off so early on in their child’s life have established no real bond either with them or with their girlfriends. A proportion of these will be the abusers, one night stands, boys who never intended to form a relationship. Their continuous presence in the life of t= heir offspring would more likely have been detrimental than providing any positi= ve input into the situation. So far as the children are concerned, they would hardly have known that these boys existed let alone that they were their fathers.

* * * * *

Patterns of Relationships.

Naturally enough, discussion of relationships is inextricably bound with discussion of pregnancy rates. In most cases the same factors operate = in determining whether a girl will have single or multiple partners and single= or multiple pregnancies.

There are of course a number of&nb= sp; girls who have several children by the same man, but on the whole those who stay together have = less need to have many extra children and have the stability of their relationsh= ip with each other to keep them emotionally fulfilled.

Staying Together - Sin= gle Partners.

The myth of the promiscuous schoolgirl mother has been exploded alr= eady when it was noted that at the time of conception, over two thirds of the couples had been together for more than six months and similarly for over t= wo thirds of the girls this was their first sexual relationship.

Also, contrary to popular opinion, not all teenage girls are preoccupied with sex. ....

* * * * *

“I got pregnant by accident. I didn’t know what I was d= oing , I never thought about getting pregnant ... I didn’t really want to = have sex anyway .. I did it for him but I didn’t really think I was ready = for it.

He was away during most of the time I was pregnant and he missed the birth .. I don’t think I would have wanted him there anyway .. but he= did see the baby afterwards ... he was inside you see.

We went out together on and off for a few years. I never wanted any= one else but I was not that bothe= red about sex. One boyfriend is enough for me !...”

* * * * *

Those of us still thinking in the ‘promiscuity’ mode wi= ll be surprised to hear that in fact fifteen years later over a third of the g= irls (39%) have only ever had one boyfriend. For a further 12% the ‘rescuing’ boy who entered their lives at an early stage during pregnancy or during the first few months of the first baby’s life and became an ‘early replacement father’ (vide infra) was the only other man on the scene .... so a staggering 50% of the girls only had one significant relationship in their lives.

Multiple Partners.

Moira was first pregnant at 13 at which time she was living with her parents and not doing too badly at school. Despite problems with guilt and anger the parents supported Moira through the pregnancy and in continuing c= are for her child. She mana= ged to attend home tuition and almost got to statutory school leaving age before h= er second pregnancy - her pattern has been to have one child more or less every three years.

Now on her fifth child and fifth unsupportive man - she is happy wi= th her lot and a good caring mother to her children - regarding men she says - “Well, ... I just can&#= 8217;t pick them can I?”

The general pattern of family types are illustrated in the graphs - with an indication of their relative frequency. For the sake of simplicity , the presence of grandparents= and the family of origin has not been considered in these graphs nor are the children who have been taken = into care (see above for numbers in that category).

It is important to consider on a multitude of levels the contributi= on of the grandparents to the family structure and the effect of teenage paren= ting on the wider family group.

To begin with - taking a purely mathematical and ‘simulated’ view of the family the spacing of generations varies in families with ‘average= 217; child-bearing pattern s- i.e. the next generation become parents in their twenties (control group in following graphs) ; from that in families with a recurring history of school age pregnancy (FH) and those families where there is no family history and = teen childbearing is a sporadic occurrence (no FH).

We see here that in both the control group and the family history g= roup the generations are evenly spaced with&nbs= p; teen motherhood creating a narrowing of the generation gap and thus = the potential for the presence of an extra generation of great grand parents who would be that bit younger and more likely to still be living at a time when their younger family members = are born.

The teen parenting wi= thout a family history creates an extra generation but with uneven spacing - (note the differing slope and crossing of the lines). Hence the generation gap is only narrowed in terms of the current generation - not higher up the line.<= o:p>

You may say - this is all very well, but so what?=

The ‘so what‘ comes into play when we consider the basi= s of the phrase “Are you my sister, Mummy?” - in other words what happens when a teenage mother= hands over child care to her own Mum?

In the graph below family structure of controls, Family history (FH) and no family history with absent teenage Mum - mother dropping out (FH-M) = are compared.

At fifteen years ‘mother’ will be thirty and in a recur= rent pattern grandmother may be forty five - not an unreasonable age for a substitute mother. But in a non recurring pattern grandmother may well be fifty-five or much older. Quite a gap for child care.

This is further illustrated in the area graph of family composition and generation = pattern at 15 years when mother drops out.

It is also interesting to look at the family structure at 15 years = for the differing child bearing patterns - single children, constant repeaters = and late repeaters compared with controls.&nbs= p;

The constant repeaters have family members at every age group and t= here are still tiny babies around when the first children are teenagers. The sin= gle children families are small families with two individuals representing the = two generations close together - child 15, mother 30. ate repeaters are similar= but have a baby after a large gap - the siblings are very far apart.=

Grandmothers often have a very hard time coping with their children= and grandchildren. It is also extremely difficult for a child brought up by grandparents who may be too old to do some of the ‘parental’ ta= sk or have fun. Children are also immensely bereaved when grandparents who have been their prime carers eventually die.

Let us look at some examples of these grandparents -

* * * * *

Sandra and her mother lived together with Sandra’s young son. Mum never really approved of the pregnancy but she supported her daughter while she went back to school and then to work. =

The boy knew who his Mum was, but gran did the day to day caring, she gave up= her job to stay at home with him, she took him and collected him from school and she was always there when he needed a cuddle.

When he was ten, grandma died suddenly and the bottom fell out of h= is world.

* * * * *

Wendy was not able to= cope on her own. She had never been particularly bright, never learned to read and write and should have been a= t a special school. However she ran away, got pregnant and lived with Mum after= her boyfriend dumped her. She was= good with the baby but she needed Mum around for support.

She subsequently left her little five year old boy, Ian at mum’s house when she = found another man to take care of her.

He did not prove to b= e very good either to her or to her subsequent children and they eventually split up. He never wanted Ian to jo= in them , but that did not really matter because Ian was happy with gran - unt= il she died.

Wendy had nobody to g= o home to .... Ian had lost his home too. Two generations of children were left orphaned and lost. Wendy has b= een very ill, her housing is awful, her sisters physically abuse her and call her stupid. She has no respite now th= at Mum is not there to protect her. The only person who is there - is her son.=

At our reunion Wendy was just content to sit , in peace, in the gar= den. She loved the physical and mental ‘space’ it was a luxury to he= r.

The children delighted in being children and Ian acted like a five = year old - being ‘let out to play’.

We found that with many of the children at our ‘reunion’ days. They loved being free, being able to genuinely ‘play’. Th= ey related well to the animals in our mini-farm and our ‘animal therapy really came into it’s own in a big way.

* * * * *

The children were all intensely competitive for attention but at the same time joined in with each other and families interacted well. It really= was as if we were ‘all in it together’. No pretension necessary.

Although Vicky had no hesitation in taking on the role of mother to her grand-daughter when her own daughter died - she regretted= the loss of her position as gran&#= 8217;.

“... but I̵= 7;m too old to be a mother ... I want to be a grandmother.”

This feeling was echoed by many of the mums who were left holding t= he baby as their very young daughters dumped the ba= by on them and ran.

* * * * *

This happened to Lynn= e who had looked after her granddaughter when her own daughter gave birth at thir= teen and then ran off with an older man and she had to do it again when in turn granddaughter did the same to her when she was thirteen. Ho= w many generations would she have to mother?

This was one lady who was very nervous when I visited for follow up= s - don’t tell me she’s pregnant again .. she’s not is she? Fortuna= tely she wasn’t. She did go back to school and finished her exams. At the moment things are quiet on that front...

* * * * *

Monique was not so lucky - her daughter got pregnant on a one night stand and soon after the birth disappeared from town. Rumour has it she was involved in prostitution. She never came home but her daughter has grown up beautifully and gives her grandparents great pleasure.

* * * * *