Susan Gustavus Philliber

The impact of age of mother on mother-child interaction patterns.

Examines the impact of age of mother on patterns of caretaking separations of mother and child emotional and verbal responsivity of the mother to her child opportunities for daily stimulation of the child and patterns of discipline. In a sample of Black and Hispanic women there was no independent effect of the age of mother on these dimensions of interaction. Rather the factor found most consistently related to these measures was the number of months the mother had been on welfare since her child was born. (Authors)

Sexually active but not pregnant: A comparison of teens who risk and teens who plan

In a departure from the more traditional interest in pregnant adolescents, this research describes the characteristics of a clinic sample of adolescent and mostly minority women who have been sexually active for at least one year and have never been pregnant. Within this group, only 36% were consistent contraceptive users while the others had only sporadically or never used contraception. More importantly, rather than being quite different from one another, these young women had the same stated motivations for avoiding pregnancy. We suggest that adolescents may lack cognitive consistency on this subject and that clinic counselors must not rely on the stated motivations of adolescents to avoid pregnancy.

Pregnancy Risk Taking among Adolescents

This research tests the utility of Kristin Lukers cost-benefit theory for adding to explanations of pregnancy risk taking among teenagers. The data come from interviews with 425 teen women in New York. The findings offer support for the Luker model since in an equation also including background variables and level of ego development, four of the six Luker variables (the subjective probabilities of pregnancy and abortion and the disadvantages of pregnancy and birth control) were significantly related to pregnancy risk taking. The most parsimonious model to explain risk taking includes five Luker variables, as well as welfare history, a measure of previous risk taking, and level of ego development.

The effectiveness of contraceptive programs for teenagers

This paper critically reviews the effectiveness of adolescent family planning programs in the United States. Various models for evaluating family planning programs and the findings from empirical studies of adolescent programs are reviewed. During the past decade there have been major increases in the availability and utilization of contraceptive services by adolescents. Most of those who are sexually active are now aware that these services exist. Program continuation rates among adolescents are not high, in part, because of the sporadic nature of adolescent sexual activity. Data on contraceptive continuation and pregnancy rates in these programs are limited, since few studies follow up clinic noncontinuers. Among clinic continuers pregnancy rates are relatively low, suggesting that at least some programs are effective in reducing pregnancy and/or fertility rates (number of children born) in their target populations. Ecological analyses seem to indicate that programs have had an impact on adolescent marital fertility.

The Effect of Maternal Age on the Well-Being of Children.

The purpose of this study was to examine the effects of maternal age on the well-being of children while limiting the variation in scioeconomic status and ethnicity. Data were gathered from hospital records and from home interviews with a sample of 282 black and Hispanic mothers and their 1st-born children 2 1/2-4 years after delivery. Information on neonatal outcomes child health and development mother-child interaction and nutritious foods in the home was obtained. These findings do not support the hypothesis that adolescent maternity per se leads to negative effects on the well-being of children or to low levels of mother-child interaction. The prevalent popular assumption persists that the children of teenage parents fare worse overall. Studies that have controlled socioeconomic status and/or ethnicity show that these latter variables are far better predictors of childrens status than is maternal age. Even without such controls no systematic disadvantage to the children of teenage mothers in a generally low-income sample was found. The appearance of so few significant bivariate relationships between the mothers age and child outcomes was a surprising finding. Age at 1st birth remains an important screening variable because of its negative association with other factors that are positively related to child health and development. It is important to recognize the source of this disadvantage in order to render suuport where it is needed rather than focusing on assumed deficits in maturity.

Follow-up of adolescent family planning clinic users.

This project instituted a vigorous follow-up system for adolescents attending a hospital-based contraceptive clinic in New York City and to document the utility of such a system in improving the delivery of contraceptive services to young people. The Washington Heights community surrounding the Columbia Presbyterian Medical Center in New York City is similar to many urban centers across the country having an increasingly young low income population of diverse ethnic and racial backgrounds. The neighborhood has particularly large numbers of Hispanic residents mostly immigrants from the Dominican Republic. Although Washington Heights accounts for only 16% of the total population of Manhattan in 1980 27% of all live births reported in Manhattan occurred in this area. The number of live births increased by 33% between 1972 and 1980; 39% were out of wedlock; 49% occurred among mothers eligible for Medicaid. Many poor single teenage mothers do not obtain prenatal care making the need for preventive services for this age groups particularly acute. During its first 4 years of operation almost 20000 patients visited the clinic but many did not return for a 2nd visit. In 1977 the Medical Center expanded the provision of contraceptive services to people aged 21 and younger by opening a Young Adult Clinic. Although many young patients are extremely sensitive to issues of confidentiality and may be highly mobile clinic efforts seem to demonstrate the feasibility of a vigorous follow up system for contacting those who have missed a contraceptive appointment. The highest proportion of patients who could not be contacted were those who only could be reached was by mail. The success of follow-up is partially dependent upon the skills of counselors in eliciting information; 2/3 of the young women missing a scheduled visit were reached. Clinics in neighborhoods with less geographic mobility may experience more success in their follow-up attempts. Even in highly mobile communities this method is likely to increase follow-up over time as counselors improve at eliciting contact information. Since patients who were reached did not differ significantly from those who were not the study findings do not offer any help in predicting what type of patient will be located.

A perspective on adolescent fertility in developing countries.

While the best data at present indicate that adolescent fertility is declining in the developing world, it is still very high relative to the developed world. Access by teenage women to family planning information does not seem to be restricted (except in the cases of abortion and sterilization), if only because much of adolescent fertility takes place in marriages or other sanctioned unions, nor is there much evidence that they are proportionally underrepresented as family planning acceptors. However, services are rarely designed to meet the special needs of young clients. The health and social consequences of adolescent childbearing are a major cause of concern. High maternal, neonatal, and infant mortality have been documented, and U.S. studies show that teenage mothers suffer education and income deficits. Future trends toward urbanization seem likely to exacerbate these problems, and the large number of people entering adolescence in the developing world could have a major demographic effect. In the U.S., recognition of the need for special services to teenagers only became a high priority when teenage fertility had reached 20% of total births. It appears that reassessment of the low priority now being given to adolescent fertility in the developing countries is in order.

Evaluation of a Program for Parenting

The Plainfield Teen Parenting Program, a component of Plainfield High School School-Based Youth Service in Plainfield, New Jersey, provides a comprehensive in-school program to adolescent mothers and their children. The program stresses continued achievement in school, economic self-sufficiency, and positive parenting. Data from 31 mothers who participated in the program and a comparison group indicate that participation was related to improved self-esteem, high school graduation, and postgraduation employment or continued education. The data further suggest that program participation may reduce the frequency of additional births.

Adolescents' Use of a Hospital-Based Contraceptive Program

Reports on a recent study of a 3-year experience with a hospital based adolescent contraceptive program, focuses on the characteristics, contraceptive practices, patterns of clinic attendance and pregnancy rates of the patients served. The program under consideration offers family planning services via a regular day clinic, and also through an evening Young Adult Clinic. Analysis of usage patterns over the period has provided insight into several important factors related to the provision of contraceptive services to adolescents. The potential impact of a hospital based program to attract young people in need of services has also been demonstrated. Despite these achievements in engaging youth in responsible reproductive behavior, certain patterns deserving of further attention are evident. For example, it was found that more than 1/2 of the young women attending the program have had at least 1 pregnancy before coming for care. Moreover, the median interval from the onset of sexual activity to the time of the 1st clinic visit was found to be 9 months. Another problem has been the failure of approximately 4 out of every 10 initial visitors to return for a 2nd appointment. At the 2nd or later visit only 9% of those attending the program were found to be pregnant, but of those the majority were not using a contraceptive method at the time of the conception. These and other shortcomings in adolescent family planning behavior suggest the need for further research into the patterns of contraceptive use and nonuse.

Beliefs about contraceptive sterilization among low-income urban women.

Among a group of low-income clinic patients planning to be sterilized, the vast majority--95 percent--reported believing that sterilization is the surest way to avoid getting pregnant and that it is safer than other contraceptive methods. Among a comparison group who also wanted no more children but did not plan to be sterilized, the majority also held these beliefs, but the proportion was lower (76-80 percent). In both groups, however, only between 64 and 70 percent knew that sterilization makes it impossible to have children in the future. Between 63 and 68 percent of the women in the sterilization group believed that having the operation would improve their family relationships, emotional state and other aspects of their lives, but only 35-58 percent of the comparison group held these beliefs. On the other hand, women in the comparison group were more likely than those in the sterilization group to believe that sterilization has negative health and psychological effects--for example, changes in menses (more bleeding or cramping) or defeminization. The beliefs held by both groups suggest that it is a conviction regarding the advantages of sterilization, rather than a relative unawareness of the disadvantages, that distinguishes women who plan to be sterilized from those who, although they want no more children, do not have similar plans. The study results have implications for family planning professionals: Counselors need to be aware that some women seeking sterilization may not understand its permanency or may have an unrealistic appraisal of its potential effect on their lives.(ABSTRACT TRUNCATED AT 250 WORDS)