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OCR for page 1
Summary
Adolescent pregnancy is widely recognized in our society as a complex
and serious problem. Regardless of one's political philosophy or moral
perspective, the basic facts are disturbing: more than ~ million teenage
girls in the United States become pregnant each year, just over 400,000
teenagers obtain abortions, and nearly 470,000 give birth. The majonty of
these births are to umnarried mothers, nearly half of whom have not yet
reached their eighteenth birthday.
For teenage parents and their children, prospects for a healthy arid
independent life are significantly reduced. Young mothers, in the absence
of adequate nutntion and appropriate prenatal care, are at a heightened
risk of pregnancy complications and poor birth outcomes; they are also
more lil~ely to experience a subsequent pregnancy while still in their teens.
The infants of teenage mothers also face greater health and developmental
nsks.
Despite declining birth rates since 1970, adolescent pregnancy, abor-
tion, and childbearing have remained considerably higher in the United
States then ~ the majority of other developed countries of ache world, even
though the age of miilation and rates of early sexual activity are compara-
ble. The most striking contrast is among the youngest teenagers: U.S.
girls uncles age IS are at least five times more likely to give birth than
young adolescents in any other developed country for which data are
available.
Teenage families with children are disproportionately fatherless, and
most are poor. Teenage marnages, when they occur, are charactenzed by a
high degree of instability. In addition, teenage parents, both male aIld
OCR for page 2
2 ADOLESCENT SEXUALITY PREGNANCY AND CHILDBEARING
female, suffer the negative impact that untimely parenting has on their
education and the related limitation of career oppornmines. Teenage
parents are more likely that} those who delay childbearing to experience
clonic unemployment and Inadequate income. Because these young
people often fare poorly in the workplace, they and they children are
highly likely to become dependent on public assistance md to remain
dependent longer than those who delay childbearing until their twenties.
Society's economic burden in sustaining these families is substantial.
Why do young people who are hardly more than children themselves
become parents? Is it primarily due to a lack of individual responsibility,
maturity, knowledge, and values? Or does it result Tom the penasive
problems associated with poverty, ~CiU3iDg limited education and em-
pioyment opport~iies and the likelihood of growing up in a fatherless
family, so common among high-nsk youth? The answer to both of these
questions seems to be yes. Yet there is widespread disagreement a~nollg
politick, educational, and religious leaders, as we] as parents, about the
problems of adolescent pregnancy and what to do about them. Indeed,
many people fee} that the primary emphasis of U.S. social policy should be
on eliminating poverty, streIlgthemng family ties, and enhancing young
people's perceptions of they Fiches. The pane] joms those who believe
that the primary goal should be to ameliorate these conditions, and
perhaps ~ doing so also solve the problems of adolescent pregnancy and
childbearing In Amenca. Unfommately, however, smeni~sts, policy
makers, =d concemed citizens have so far been Cable to And easy and
effective solutions to these greater social and economic problems. As a
result, during *le past two decades, there has been Ilo coherent U.S.
policy toward adolescent progeny and childbearing, despite explicit
recognii~on on the part of many that government involvement Is needed
and appropriate.
In pan we lack a coherent approach toward policy because adolescents
are not a monolithic group, and adolescent pregnancy is not a unitary
problem. For yoga people of different aces, living in different social,
~ ~ _ ~ ~ ~ _ . .
. t ~ t · ~ · ~ t ~ -
economic' and cultural circumstances' the mug of early sexual aci~v-
ity, pregnancy, and childbearing is IlOt the same. In Addison seaman
relationships and family formation have m~ino~y been regarded as
personal matters in our society. As increasing utlmbers of young people
have become involved ~ these behaviors outside marriage, however,
rr any people have expressed concern about the appropnatejurisdiciion of
parents, the state, and teenagers the...celves ~ these matters. At what age
should adolescents, rather tin their parents, have the authority to make
OCR for page 3
SUMMARY 3
decisions? Under what circumstances should the state mtenrene? These
issues have not been resolved.
The past decade and a half have u~tnessed a dramatic burgeoning of
policies and programs to help delay teenage pregnancies and to reduce the
adverse consequences of early childbearing. Some of these have been
promoted and supported by the federal government; others have been
Ligated by states and local communities; and still others have developed
from significant investments by pirate foundations and philanthropic
groups. Many have been the result of productive public-pn~rate partner-
ships. Some have focused on 3DdinduA teenagers as the unit of treatment;
others have focused on families. Some have provided speared sernces;
others have been comprehensive In their approach. Programs have been
organized in schools, churches, community centers, social service agen-
cies, clinics, aIld hospitals. Some have been single-site programs, while
others have been replicated at several sites within a City or across Me
nation. Despite the magnitude of human and monetary resources that
have been directed at tackling the problems of adolescent pregnancy,
however, there has been no systematic attempt to assess the effects and
effectiveness of alternative approaches In light of growing scientific under-
stand~g of early pregnancy and parenting.
With support fiom a consoriimn of pn~rate fotmdations, the Panel on
Adolescent Pregnancy and ChildbeaIing undertook a comprehensive ex-
~mma~aon of issues associated With teenage sexual and ferocity behavior
and reviewed what is known about the costs and benefits of alternative
policies and programs to address these issues.
On the basis of two years of review, analysis, and debate, the panel has
reached six general conclusions:
I. Prevention of adolescent pregnancy should have the highest pnonty.
both human and monetary terms, it is less costly to prevent pregnancy
than to cope with its consequences; and it IS less expensive to prevent a
repeat pregnancy than to treat the compounded problems.
2. S=ually active teenagers, both boys and girls, need the ability to
avoid pregnancy and the motivation to 60 So. Early, reg - , "d eEe~ve
contraceptive use resets in fewer pregnancies. Debug the ~tianoD of
sow activity wiD also reduce the madence of pregnancy, but we cur-
rendy know very linIe about how to e~ece~vely discourage unmarried
teenagers Mom initiating intercourse. Most young people do become
squally active during their teenage years. Therefore, making contrace~
rive methods available and accessible to those who are sexually active add
OCR for page 4
4 ADOLESCENT SEXUALITY PREGNANCY AND CHILDBEARING
encouraging them to diligently use these methods is the surest strategy for
pregnancy prevention.
3. Society must avoid Cueing adolescent sexuality as a problem pecul-
iar to teenage gels. Our concept of the high-nsk population must include
boys. Their attitudes, motivations, and behavior are as central to the
problems as those of they female parmers, and they must also be central to
the solutions.
4. There is no single approach or quick fix to solving all the problems
of early unintended pregnancy and childbearing. We wig continue to need
a comprehensive array of policies and programs targeted to the special
charactensucs of communities an] to the circumstances of teenagers Tom
different somal, cultural, and economic backgrounds and of different ages.
Because adolescents are not a monolithic group, they do not ad experience
sexual acnvity, pregnancy, md childbearing in the same way. Our broad
goal is the same for all young people: that they develop the necessary
capabilities to make and carry out responsible decisions about their sexual
and fertility behavior. The strategies for achieving these gods and the
specific Interventions to can; them out, however, should be sensitive to
differences in values, attitudes, aIld expenences among individuals and
groups.
5. If trade-offs are to be made in addressing the special needs of one
group over another, priority should be given to those for whom the
consequences of an early ',nintended pregnancy and birth are likely to be
most severe: young adolescents and those Dom the most society and
economically disadvantaged backgrounds. In many ways those at highest
risk are hastiest to serve, yet they are also the groups that have been shown
to benefit most.
6. Responsibility for addressing the problems of adolescent pregnancy
and ~il~beanng should be shared among m~induals, families, voluntary
organizations, communines, and governments. In the United States, we
place a high priority on ensuring the rights of indi~riduals to hold different
values and the rights of families to raise their children according to (hm
own beliefs. Therefore, public policies should alarm the role and responsi-
!oili~r of families to teach Herman values. Federal and state governments
and commLmity institutions should supplement rather than detract Tom
that role.
These general conclusions underlie all of our specific conclusions and
recommendanons for policies, programs, and research.
OCR for page 5
SUMMARY 3
The pane] presents its conclusions and recomunendations Froth an
mtense awareness of the fits of scientific knowledge in dealing with
the problems of adolescent pregnancy and childbeanng. The issues in-
volved are not only sclentirSc; they also reflect widely diffenng values.
We also recognize the importance of families ~ establishing attitudes,
behavior patterns, and traditional values ~ developing children, and we
encourage efforts to involve families as an essential component ~ the
solution of the problems associated with adolescent sexuality. As scien-
tists, however, our role is to contribute to the base of knowledge about
the problems ir~volved, and our goal is to inform the policy debate by
cianf ring the sc~entiEc issues.
PRIORITIES FOR POLICIES AND PROGRAMS
The panel's specific conclusions and recommendations cover a range
of activities that include research, planning, policy development, service
delivery, and monitonng. When existing knowledge supports new or
revised policies and programs or highlights the effectiveness of ongoing
. · . · . -. , , · ~
tlatl~res, we propose specs: 1C new or continuer programs or specl tic
research and development. When existing knowledge provides insights
but is incomplete, we advise further demonstration and evaluation to
enhance understanding of the relative CoStS, effects, and electiveness of
proms approaches. When innovative policies have been initiated but
there are as yet no scientifically measurable outcomes, we urge carefid
observation and mon~tonng. Many of our recommendations build on
policies, programs, and research that are already under way, and many
reinforce the phonics of other m~induals and groups that are address-
~ng the complex and controversial issue of adolescent pregnancy.
The panel has identified three overarching policy goals, presented in
order of pnonty, that provide a Framework for our specific conclusions
and recommendations:
/
I. Reduce the rate and incidence of unintended pregnancy among
adolescents, especially among school-age teenagers.
2. Pronde alternatives to adolescent childbearing and parenting.
3. Promote positive social, economic, health, and developmental out-
comes for adolescent parents add their children.
I:or most young people in the United States, realizing fulfilling adult
work and family roles depends on completing ~ education and entenng
OCR for page 6
6 ADOLESCENT SEXUALITY PREGNANCY AND CHILDBEARING
the labor force before becoming a parent. Accordingly, our highest
priority should be to help teenagers, regardless of the timing of sexual
initiation, to develop the ability and the motivation to avoid becoming
parents before they are socially, emotionally, and economically prepared.
Despite the amount of energy and resources devoted to prevention
strategies, however, some teenagers will experience unintended and
untimely pregnancies. For those who choose to keep an] raise then
children, supports and services to promote healthy development, e~uca-
tional attainment, and economic self-sufEc~ency should be available.
Given the potentially adverse consequences of early parenthood for the
life chances of young people, however, there should be alternatives to
childbearing and childrearing. Abortion is a legal option for all women,
including adolescents. We acknowledge that voluntary termination of
pregnancy is controversial, and for many in our society it is morally
reprehensible. Although the panel strongly prefers prevention of preg-
nan~y to avoid parenthood, abortion is an alternative for teenagers for
whom prevention fails. Adoption should also be available to those
teenagers who choose to continue they pregnancies yet are unable or
unwilling to assume the responsibilities of parenting.
Goal 1: Reduce the Rate and Incidence of Unintended Pregnancy Among
Adolescents, Especially Among Sckool-Age Teenagers
The pane! is unequivocal ~ its con~ci~on that the primary goal of
policy makers, professionals, parents, and teenagers themselves should
be a reduction ~ the rate and incidence of Contended pregnancies
among adolescents, espec~aDy school-age teenagers. Several strategies
can assist in achieving this goal: enhance the life options of disadvantaged
teenagers, delay the initiation of sexual activity, and encourage contra-
ceptive use for teenagers who are sexually active. Unfortunately, very
little scientific evidence is available on the electiveness of pro grams
associated with the first two strategies, and so we can only endorse the
development, implementation, and evaluation of such programs. For
the third strategy, the scientific base is much ~eater, and promos can
be based on the demonstrated effeci;veness of contraceptive use.
Enhance Life Options Poverty and hopelessness, which exacerbate
many social problems, play an especially important role in the problems
associated with adolescent pregnancy. Sexual aciinty and pregnancy
OCR for page 7
SUMMARY 7
among teenagers are not confined by race and income, yet the correlation
between poverty and adolescent fertility is well documented. For too
many high-nsk teenagers, there are too few disincentives to early child-
beanug. Inadequate basic skids, poor employment prospects, and the
lack of successful role models for overcoming the overwhelmingly nega-
i~ve odds of intergenerational poverty have stifled the motivation of
many to delay ~mme~ate gratification and avoid pregnancy. Young
people need a reason to believe that parenthood is ~nappropnate at this
powt in their lives and that their opportunities for personal and occupa-
tional success will be enhanced by postponement. Several possible inter-
ventions are aimed at Indirectly reducing adolescent fertility by nurtur-
ing the motivation to prevent untimely and unplanned parenthood,
inClUdiIlg life planning courses, programs to improve school perfor-
mance, employment programs, and programs to provide role models for
high-risk youth. Program research clearly demonstrating the e~ective-
ness of these interventions is not cuITent~y available. Nevertheless, the
pane] endorses the development, implementation, and evaluation of
such programs as a basis for future policy and program development.
Delay Sexual Initiation A second strategy for reducing the rate of
teenage pregnancy is to help teenagers, both male and female, develop
ways to postpone sexual initiation until they are capable of making wise
and responsible decisions concerning their personal lives and family
formats on. Several interventions are anned at helping young people
delay sexual initiation, ~nclud~g sex and family life education, asseri~ve-
ness and decision-making training, programs to provide role models to
yo',ng adolescents, and efforts to influence the media treannent of
sexuality. Although there is little available evidence to document their
effectiveness, the pane! endorses the development and evaluation of such
programs as a basis for future policy and program decisions. In addition,
Interventions to enhance the life options of teenagers may also encourage
young people to delay the initiation of sexual acidity.
Encourage Contraception Because there is so little evidence of the
effectiveness of the other strategies for prevention, the pane} believes
that the major strategy for reducing early unintended pregnancy must be
the encouragement of diligent contraceptive use by aD sexually active
teenagers. Male contraception, as wed as male support for female contra-
cept~on, is essential. In light of the demonstrated effecnveness of contra
OCR for page 8
8 ADOLESCENT SEXUALITY; PREGNANCY; AND CHILDBEARING
ceptive use, especially use of the contraceptive pill and the condom, in
achieving this goal
The panel concludes that use of the contraceptive pill is the safest and most
effective means of birth controlforsexually active adolescents. Aggressive public
education is needle] to lisper myths about the health risks of pill use by girls in this
ad egroup, and co n traceptive service programs should explore nonmedicaI mod ells
for distnbution of the pill.
The panel concludes that, to make this strategy effective, there must be
continue~publicsupportfor contraceptive cervices to adolescents, such as has been
suppliedipnmanly through Title X of theFamilyPlanning Services and[Popuia
~ tion Research Act, Medicaid, and other federal and state maternal and chill
health programs. Such programs should minimize the potential barriers of cost,
convenience, and confidentiality.
The panel urges that sex education programs include information or methods
of contraception, how to use them, and how to obtain them.
The panel urges continued support for a variety of contraceptive service
models including private physicians to reach adolescents. Contraceptive serv-
ices should be available to all teenagers at low or no cost. Clinic service providers,
whether based in hospitals' public health departments, private clinics, orcommu-
nity service organizations, should make efforts to improve the effectiveness of
their programs by (1J enhancing their outreach efforts to encourage earlier use of
contraceptive methods; 627 exploring more effective couttseling approaches to
encourage compliance; andit3) enhancing theirfolZow-up of clinic patients to track
their contraceptive use.
The panel concludes that school systems, in cooperation with various health
care and youth-sen~ing agencies, shouldfurther develop arty refine comprehensive
school-haled clinic models for implementation in schools with large, high-nsk
populations.
The panel recommends the development, implementation, and: evaluation of
condom ~istri~udon programs.
The panel concludes that efforts should be undertaken to develop and test the
effects on contraceptive use and unintended pregnancy of paid promotional
messages for contraceptives that are directed at sexually active adolescents.
OCR for page 9
SUMMARY 9
Goal 2: Provide Alternatives to Adolescent Childbearing and Parenting
The panel believes that prevention of pregnancy through abstinence
or contraception is far preferable to unintended pregnancy among teen-
agers. Regardless of one's personal convictions, decisions concerning
pregnancy resolution whether to become a parent, to testate a
pregnancy, or to relinquish a child for adoption are difficult, often
painful choices. Nevertheless, when prevention fails, early parenthood is
not the only available course. For young people who are unwilling to
give birth or unable or unwilling to assume the responsibilities of parent-
hood, two alternatives exist-abortion and adoption.
Abortion In 1973 the Supreme Court made abortion a legal option
for pregnancy resolution for all women, yet its use by teenagers, espe-
chilly young teenagers, remains a special issue. There is no evidence
coIlcerniIlg either the cognitive capacity of adolescents to make decisions
about pregnancy termination or the psychological consequences of abor-
tion that would support or refute the imposition of age restnctions
governing access to abortion services. There is, however, growing en-
dence that parental consent statutes cause teenagers to delay their abor-
tions, if for no other reason than that those teenagers unwilling or
unable to consult they parents must undergo the de facto waiting period
associated with Owing a lawyer and gaining access to the courts ~ order
to obtain a judicial bypass. Such delays may increase the health risks
associated with abortion if they result ~ postponing it U=ti] the second
tumester of pregnancy. In general, the health risks associated with an
early, legal abortion are no greater for adolescents than for adult women,
and in most cases they are lower. They are also lower than the risks
associated with pregnancy and childbirth.
The panel urges that at each step along the path from sexual initiation to
parenting-regardless of whether one might wish that that step had not been
reached the girl or woman should be treated with the same dignity, confidential-
ity, kindness, and excellence of health care that are due any patient.
The panel concludes that there is no scientific basisfor restricting the availabiZ-
ity of abortion to adolescents. Evidence shows that to require minor teenagers to
seek parental consent often causes them to delay abortions, with attendant health
risks. On this basis, the panel concludes that minor adolescents should be encour
OCR for page 10
10 ADOLESCENT SEXUALITY PREGNANCY AND CHILDBEARING
aged, but nor required, to involve the~rparer~tsarz~partners in the decision-
making process.
The panel believes there should be no compromise ire the medical andpersona
supportive carefor the 400~000 adolescents who have an abortion each year. For
those adolescents who choose to terminate their pregnancy, abortion services
should include both decision counseling and contraceptive counseling.
Adoption For pregnant adolescents who choose to continue their
pregnancies but are unable or unwilling to assume the role and responsi-
bilities of parenthood, adoption should be a viable option.
The panel recommends that relevant public agencies, in cooperation with the
private sector, explore ways of strengthening adoption services, including ifs
improved decision counseling for pregnant teenagers and (2) development of
effective models for providing comprehensive care to pregnant girls who choose
adoption as an alternative to parenthood.
Goal 3: Promote Positive Social, Economic, Health, and Developmental
Outcomes for Adolescent Parents and Their Children
Regardless of pregnancy prevention strategies or available alternatives
to parenthood, some teenagers experience unpla$lued pregnancies and
become parents. Many of those who do are at serious risk of health and
nutntional deficiencies, dropping out of school, unemployment, single
parenthood, poverty, and long-tenn welfare dependence. Their children
have a higher probability of physical, social, and cognitive problems and
defiaenaes. Although unmarred teenage parents represent a small pro-
portion of the overall adolescent population, their problems and needs
entail high public costs. Accordingly, a thud important goal is to pro-
mote positive outcomes for adolescent parents and their children. Several
. · . . . .
strategies can assist In ac llenOg t 11S goa ..
Promote Healthy Birth Outcomes and Support the Physical Health of Young
Mothers and Their Babies Young expectant mothers who receive early
and regular prenatal care and nutrition are significantly more likely to
have healthy birth outcomes than those who do not. Similarly, young
children who receive regular health care as wed as appropriate emer-
gency care are likely to be in better physical health than those who do
not.
OCR for page 11
SUMMARY 11
The panel recommends continued support for the provision of appropriate
health and nutrition services, ir~cZuling prenatal, labor, and delivery care for
pregnant adolescents and reguZaranl emergency pediatric carefor the children of
teenage mothers, through Medicaid; the Early and Pen olic Screening, Diagnosis
and Treatment Program; and otherfederal and state maternal arz1 child health
programs. Bureaucratic barriers that prevent teenagers from receiving early,
regular, and appropriate care for themselves and their children shout: be mini-
mizel.
Prevent Subsequent Untimely and Unintended Births A second untimely
and unintended birth is likely to compound the already complex and
overwhelming problems faced by many adolescent parents. Prevention
of subsequent pregnancies and births is thus an important strategy for
promoting positive outcomes for teenage parents and their children.
The pane, concludes that contraceptive services should be available and accessi-
bZe to adolescent parents at low or no cost. Because of the special needs of this high-
risk population, service providers should strengthen their programs by (1J enhanc-
ing their outreach efforts to encourage early use of contraceptive methods; (29
leveZoping intensive ir'dividuaZizel counseling and care techniques to encourage
compliance; and (3) en Lancing theirfoZZow-up procedures to track contraceptive
use.
Ensure the Economic Well-being of the Teenage Family Parents, includ-
ing fathers, are obligated to pronde support until their children reach
age 18. But many fathers, especially teenage fathers, who may not have
completed school and who are unemployed or employed only part-time,
are unlikely to be able to make a significant contribution to the support
of their children. For this reason, young fathers have often not been
pursued by child support enforcement authorities. There has been re-
newed interest, however, In enforcing child support by fathers of chil-
dren born to teenage mothers, both to provide additional financial
assistance to young mothers and their children and to increase young
men's sense of parental responsibility. There is little emsung research or
program expenence to guide new policies in this area. Nevertheless, the
pane! urges efforts to educate young men about their cold support
obligations and to enforce those obligations over time. Expenmental
efforts to link chilc! support enforcement to work requirements, mclud-
~ng part-i~me and summer jobs for fathers who are enrobed in school,
should be Ligated and tested.
OCR for page 12
12 ADOLESCENT SEXUALITY, PREGNANCY AND CHILDBEARING
The parents of adolescent parents should also be encouraged to assume
responsibility for the support and obligations of their minor (under age
i8) chi~ciren an] the children of these minors. Again, research and
program experience in this area is liniite]. Recent state legislation estab-
lish3=g grandparent liability should be carefully monitored to dete~ine
its elects.
Enhance Life Options for Adolescent Parents Teenage parents must be
encourage] to invest in their own futures. Both the motivation and the
means to overcome the likely adverse consequences of early childbeanng
are essential. Therefore, another important strategy for improving so-
c~al, economic, and health outcomes is to enhance the life opportunities
of adolescent parents.
Thepanel urges that a broad array of special education programs and cervices
for pregnant and parenting teenagers be developed and implemented to assist
these young people in completing their education.
Thepane2 concludes that efforts should be continued to strengthen and expand
age-appropruz~e employment programs for pregnant girls and teenage parents,
both male andiemale.
The panel recommends that support be providelfor the development, imple-
mentation, and evaluation of model child care programs that are targeted! to the
needs of teenage parents. Schools and other community organizations should
place high priority or' establishing and maintaining these senJicesfor the children
of adolescents.
The panel urges that public and voluntary community agencies explore ways
of developing and evaluating case management capabilities to help adolescent
parents obtain the necessary supports and services.
Promote the Social, Emotional, andlntellectualDevelopment ofthe Children
of Adolescent Parents The children of adolescent parents are especially
vulnerable to health, social, and cognitive problems. Special supports
and services are needed by many adolescent parents to prevent or over-
come these difficuli~es and to promote their chil~en's healthy develop
meet.
The panel urges thatparenting education for teenage parents, especially those
from severely disadvantaged backgrounds, receive specialattention and emphasis.
OCR for page 13
SUMMARY 13
Schools arid other community organtzatiorts should place high pnonty on the
development, implementation, arid evaluation of these programs.
RECOMMENDATIONS FOR DATA COLLECTION
AND RESEARCH
Over the past several years, researchers have made significant advances
in knowledge of teenage sexuality, pregnancy, and parenting. Yet many
questions remain unanswered, and they suggest priorities for future data
collection and research.
Program Evaluation Research
Despite the enormous commitment of public and private monetary
resources and human effort toward designing and implementing preven-
tive and ameliorative interventions, evidence of program COStS, effects,
and effectiveness is frequently unavailable or of poor quality. Although
there are significant methodological, ethical, and practical problems
associated with evaluations of these programs, they can be evaluated.
Evaluation research methods have become quite sophisticated, yet they
are fi:equeIltly not used ir studying the effects of adolescent pregnancy
programs. Reliable data are needed as a basis for policy and program
development.
The pane] recommends that evaluation lo measure the costs, effects, and
effectiveness of service programs be an essential component of intervention:
strategies. Federal and state-leve!funding agencies should be urged to set aside
adequate supportfor evaluation research, and the research community should be
urged to take a more active role in designing and implementing these studies.
Data Collection
Data on teenage sexual acidity, contraceptive use, pregnancy, abor-
tion, childbearing, and other fer~ity-related behaviors have been vital to
Me panel's deliberations and are equally essential for figure research and
analysis. Relevant information is available from several different sources,
including large-scale surveys, federal and state administrative reporting
systems, and service providers. Individual data systems vary in their
underlying purposes and special emphases as wed as they specific charac
OCR for page 14
14 ADOLESCENT SEXUALITY; PREGNANCY; AND CHILDBEARING
ter~stics (e.g., reeditions, sample size, data collection integrals). For
these reasons, and because information on sensitive issues requires ~ralida-
tion Mom more than one source, a muiti~imensionai strategy for data
collection is needed.
The panel recommends that data systems that monitorfertility anlfertility-
retatedbehaviorsshould be maintained and strengthened. Such data are essential
for understanding bends anlcorrelates of adolescent sexualactivity, contraceptive
use, pregnancy, abortion, and childbearing and as a basisforpolicy Deprogram
development. Fiscal cutbacks that affect ongoing Eta collection programs could
seriously damage the quality and availability ofthese Eta systems.
Research on Adolescent Sexual and Fertility Behavior
Research on adolescent sexuality and fertility has increased substan-
tia~y over the past decade, and this knowledge has pronded an essential
basis for the panel's deliberations. Nevertheless, there are several signifi-
cant gaps. In some cases, the gaps reflect issues that have not been
adequately studied because of methodological problems; in others, new
issues have emerged from the accumulation of past findings. Future
research should reflect the domains of causes and consequences of teen-
age pregnancy end childbearing: indim~uals, families, communities, and
society.
The parle! recommends the continue] support of a broad-based researchpro-
gram on adolescent se~cuality antifertility to enhance understanding ofthe causes
and consequences of these behaviors and to inform poll anlprogram levelop-
ment
E:cpenmentation
Although promising program models require further monitoring and
evaluation, emsiingprogr~m development efforts should be expended to
Include arpenmentaiIon with innovative models for and novel ap-
proaches to pregnancy prevention and for the support an] care of preg-
~t an] parenting teenagers and their chidden.
Iltepanelrecommends thatiederalfunding agencies, privatefoundations, and
researchers cooperate in designing, implementing, and evaluating experimental
approaches for pregnancy prevention among hith-nsk a doZescents anclfor im-
proving the well-being of teenage parents and their children.
Representative terms from entire chapter:
adolescent parents
