Book Review

Early Parenthood and Coming of Age in the 1990s

N Engl J Med 1994; 330:513-514February 17, 1994

Article

Early Parenthood and Coming of Age in the 1990s
Edited by Margaret K. Rosenheim and Mark F. Testa. 264 pp. New Brunswick, N.J., Rutgers University Press, 1992. $40 (cloth); $15 (paper). ISBN: 0-8135-1815-6 (cloth)

Adolescent pregnancy continues to be an issue of concern to the American public and to professionals in the fields of health, education, and social welfare. The public's need for knowledge is met primarily by newspaper and magazine articles and television specials, many of which oversimplify the problem. The needs of professionals are met by journal articles and books -- both in great profusion. Journal articles, especially those based on well-designed research studies, have added much to our knowledge. (Examples are the work of Brooks-Gunn, Furstenberg, Geronimus, Moore, and others).

Several thoughtful analysts of the problem, who needed more space to expand their theories about adolescents, have chosen to prepare book-length monographs. Examples include Constance A. Nathanson's Dangerous Passage: The Social Control of Sexuality in Women's Adolescence (Philadelphia: Temple University Press, 1991), which deals with public, professional, and organizational responses to the problem and how they have contributed to its definition, and Judith S. Musick's Young, Poor, and Pregnant: The Psychology of Teenage Motherhood (New Haven, Conn.: Yale University Press, 1993), which examines how female sexual maturation, family pressures, and social conditions interact to produce adolescent pregnancies. But professionals with only a peripheral interest in the field often do not have time to locate and study the most relevant journal articles or to read the monographs. They usually pick up one of the edited books on adolescent pregnancy and read the more promising chapters.

Fortunately for them, several recent books allow for such quick studies. One example is The Politics of Pregnancy: Adolescent Sexuality and Public Policy, edited by Annette Lawson and Deborah L. Rhode (New Haven, Conn.: Yale University Press, 1993), reviewed in the November 18 issue of the Journal. Early Parenthood and Coming of Age in the 1990s covers similar terrain. These and other recent books have in common a debunking attitude toward conventional wisdom about adolescent pregnancy. Several authors note that there is no epidemic of adolescent sexuality and, in fact, that the overall trend in births is downward, with minor deviations. They suggest that the adverse consequences usually associated with adolescent pregnancy are probably largely, though not exclusively, due to poverty and the adverse conditions associated with it, in which many young women become pregnant, rather than to age at pregnancy as such. They believe that a substantial reduction in the number of adolescent pregnancies may not be possible through programs of education, provision of contraceptives, and accessible abortion alone but, rather, that such a reduction may depend on changing the circumstances of poor male and female adolescents' lives.

The book edited by Rosenheim and Testa is a good choice for those who want an overview of the field. The essential background data on trends over time in sexual activity, pregnancy, marital status, dependence on welfare, and related issues are presented succinctly in several chapters. Hamburg and Dixon elaborate on the concept of adolescent motherhood as an alternative life course. They and others suggest that completing childbearing while still an adolescent may have adaptive value for women living in poverty. The involvement of the kinship network appears to make it possible for young, usually black women to complete school while baby-sitting assistance is still available and at an age when employment is very difficult to obtain and then to enter the labor market in their 20s with childbearing and early child-rearing tasks completed. Petersen and Crockett provide an interesting assessment of factors that may influence adolescent sexuality, pregnancy, and parenting: biologic influences, sexual abuse, deviant or problem behavior, and normative expectations.

In his chapter on adolescent mothers on welfare, Testa reports the results of his testing of hypotheses about adolescent dependence on welfare: the alternative life course just described, the somewhat discredited culture of poverty, and the social-isolation theory associated with Wilson. Although there was considerable variation among black, non-Hispanic white, and Hispanic groups, in general his findings support the alternative-life-course hypothesis -- that adolescent mothers who live with their parents, stay in school, and delay marriage remain dependent on welfare longer than those who leave home, drop out of school, and marry. These findings suggest that if the completion of education is seen as having long-term benefits for young mothers, society may need to tolerate an initial spell of dependency on welfare.

Furstenberg, Hughes, and Brooks-Gunn explore the effect on children of being born to adolescent mothers, using the same theoretical formulations. In their work they used two indicators of positive transition to adulthood: not having a child before the age of 18 and a combined measure of educational and occupational attainment. They found that young women's early childbearing patterns and educational and occupational attainment were influenced by their mothers' marital status and experiences with welfare. These two indicators, but particularly the measure of attainment, were related to signs of economic success among the adolescent women, such as having a bank account or a driver's license, and to their degree of contentment with various features of their lives.

In Hoem's chapter on the formation of families in Sweden, she notes that “childbearing among women under eighteen has almost disappeared” in that country. She suggests that this may be due to women's expectation that they will participate in the labor force and their need to complete their education and begin working before bearing children. The chapter on teenage pregnancy and parenting in the black community by Gibbs and the historical perspective provided by Vinovskis are particularly interesting. Rosenheim concludes the book with an overview of the problem and of policy and programmatic approaches to its amelioration. She suggests that less attention be paid to pregnancy and parenthood among 18- and 19-year-olds, who have usually completed high school and are adults by most definitions, and that programs focus instead on those under 18 years of age.

This and other recent books differ in important ways from those published in the 1980s and earlier. They are more theory-driven and, possibly as a consequence, more understanding of the magnitude of the problem of “off-time” births. Their authors devote less attention to the adverse consequences of behavior and show greater concern about the forces that generate behavior. And their belief in targeted interventions is balanced by a concern for entrenched social problems. Most of the authors of this book believe that the opportunity costs of adolescent parenthood are not high enough to prevent it in economically deprived groups. As Testa notes, “The critical policy issue for the 1990s is the extent to which American society will seek to raise the level of compliance [with the lengthened social timetable to adulthood] by evening out young people's stakes in delaying their transition to parenthood.”

Lorraine V. Klerman, Dr.P.H.
University of Alabama at Birmingham, Birmingham, AL 35294