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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Suggested Citation:"Index." National Research Council. 1987. Risking the Future: Adolescent Sexuality, Pregnancy, and Childbearing. Washington, DC: The National Academies Press. doi: 10.17226/948.
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Index A Abortion access to services, 86, 114,193,276 age restnaions, 9, 192 attitudes about, 17-18, 86, 113, 191 complications of, 9, 125, 277-278 and contraception, 112-113, 16; conmcepnve use following, 113, 193-194 dday in obtaining, 9, 114, 190195, 277 delayed effects of, 12; detcrsninants, 112-113 eEects on birth rates and sexual and fertility behavior, 19~194 effects on male partner, 196 faalines for performing, 191 federal funding of, 85 fees for, 192-193 judicial bypass of parental consent for, 7, 192, 194-195,276-277 health risks associated with, 125,277 legalization of, 9, 17, 58,61,80, 92, 190,193,248,276 Medicaid reimbursement for, 85, 191, 193, 194 mortality rates, 125 numbers and rates of, 1, 1:, S0~5, 58, 60,74, 8;.112, 113,261, 276 parental consent for, 9, 17, 114,192, 194-19S, 249, 276-277 parental influenec on, 113 paynacnt sources for, 193 psychological effects of, 195-196 32j race differences in, :8, 60, 85, 113, 117 recommendations regarding, 6, 9, 26S, 27~279, 285 religiousness/religious affiliation and, 113 repeat, 112 research pnonties on, 244, 249, 27~277 eele~rssion presentation of, 91 underreporting of, 52, 69, 7~71, 113, 239-240 Abortion sennces contraceptive seances offered by provenders, 191, 279 pregnancy testing and counseling by providers, 174, 191-192, 27&-279 Absent fatherhood socioeconomic factors assomaecd with, 82 trends in, 7~77 Abstinence, see Initiation of sexual activity Academic achievement/aspirations abomon decisions based on, 112 contraceptive use and, 101, 120 nonmantal childbeanog and, ITS, 120 sexual activity and, 10~101, 120 see also Educational at~amment Acquired immune deficiency nines, . . . condoms tO prc~rcnt transmission, 166 Adolescent development, 7~93, 110 Adolescent Family Life Act, Title XX, 22-23, 25, 248 Adolescent Family Life Comprehensive Care Prodders, 223

326 INDEX Adolescent Family Life Program, 23, 227 Adolescent Health Sernces and Pregnancy Prevention and Care Act of 1978, 2l, 222 Adolescent Media Project, 1~2-1~3 Adolescent Pregnancy Childwatch Program, 182 Adolescent Pregnancy Prevention and Care Program, 22 Adolescent Pregnancy Projects, 223 Adolescents number in United States, 3030 socioeconomic trends on, 81 transition behaviors of, 93, 102, 24~244; see also Alcohol use, sexual attitudes and behavior associated with; Delinquency, sexual attitudes and behavior associated with; Drug use Adoption data sources and needs on, 71, 116, 239, 245 determinants of, 11: rates, 61, 74, 227, 276 recommendations regarding, 6, 9-10, 23, 26S, 279-280 residential programs, 228 services, 221-228, 281 underreporting of, 61, 69-70 Aid to Families With Dependent Children (AFDC) assistance in obtaining, 190 cost savings of avoiding, 184 eligibility for, 198, 20S, 287 expenditures to adolescent mothers, 132-133, 205-206, 266 incentive to early childbearing, llS, 119, 206, 287 recommendations regarding, 287 socioeconomic factors associated with, 206 state supplementation of, 24 use of payments tO finish school, 258 Alan Guttmacher Institute, 16, 22, o2, 70, 8085, 91, 109, 113, 114, 124, 125, 144, 153, 157, 174, 193, 208, 239, 240 Alcohol use, sexual attitudes and behavior associated until, 93, 102 Alliance for Young Families, 210 Alternative schools, 210, 216-218, 230 American Civil Liberties Union, 23 American College of Obstetricians and Gynecologists recommendations for prenatal care, 197, 283 American Public Welfare System data collection by, 71, 239 see also Aid tO Families With Dependent Children; Public assistance; Welfare Antecedents of adolescent pregnancy and parenting, 31, 244 24; Attitudes abortion, 17-18, 86, 113, 191 alternative schools, 218 cohabitation, 84 conservatism and new morality, 86-87 contraception, 109,110,148, 166-167 family planning, 86 importance in sexual behavior and decision making, 12~121 marriage, 77, 83, 98 nonmantal childbearing, 77, 83, 86, 98, 99, 117-118 perception of opportunities, 82-83, 89, 118, 120 programs to influence, 146; see also Preventive intenrentions; Programs that enhance life options self-perception, 109, 12~121 about sex education, 14~144 about sexual activity, 69, 83. 84, 98 and soQocultural developments, 7~93 B Bank Street College youth employment demonstration project, 181, 214 Bayley Infant Scales, 212 Benign breast disease, 162 Big Brothers and Big Sisters, 178 Birth control pills, see Contraceptive pills Birthnght, 174 Births to adolescents numbers and rates of, 1, 1;, 53, 54~;5, 58~0, 6;-67, 72, 261, 276 see also L'ginmation; Nonmarital childbeanog 13ndge Over Troubled Waters, 182 Bureau of Maternal and Child Health Services, 21 C Canada, rates of adolescent pregnancy, 16

INDEX 327 Cancers, uterine and endomemal, 162 Cardiovascular problems from oral contraceptives, 162 Catholicism / Catholics abomons among, 113 as art indicator of sexual activity, 100 Center for Population Options, 24, 90, 151-1~2, 168, 170, 176-177, 272 Centers for Disease Control, 7~71, 130, 239 Child abuse by adolescent parents, 137 Child care for firstborns of unmarred mothers, 61, 64 inadequacies in, 209 positive effects of, 229 programs, 209-211 recommendations regarding, 12, 289-290 Child Health Act of 1967, Title U 21 Child support adolescent mothers receiving, 132 enforcement, 11, 206 209, 249, 259, 28~2%6 Ether's liability for, 206 207 Child Support Enforcement Program, 207 Chil~eanug by adolescents, see Births to adolescents; Legitimation; Nonmarital childbearing; Pregnancy and childbearing Children of adolescent mothers developmental problems of, see Developmental effects on children of teenage mothers developmental prograsns for, 12, 208~21;, 291-292 Realm risks tO, 124, 261-262 Children's Defense Fund, 124, 182-183. 271 Cleveland Program for Sexual Learning, Sardine, 175 Clinics, see Family planning clinics; School-based clinics Cohabitation, 84 Community of Caring, 216 Comprelensi~c care programs brokerage modd, 224 case management by, 223 commun~ty-b~ced prevention, 181-182 corcser~nces, 200 201, 210216 costs, 225 duration of effects from, 200, 204 goals of, 203, 222-223 outcome evaluations of, 203, 220227, 230 recommendations regarding, 29~291 repeat pregnancy rates, 20~204 Condoms attitudes about, 166-167 distribution programs, 166-168 efficacy, 161, 271-272 intcrfaencc with sexual pleasure, 167, 272 and prevention of sexually transmitted disease, 166, 275 rates of use, 46, 163, 167 research needs on, 258 sources, 154 Contraceptive foam, 46, 161; see also Spermicides Contraceptive pills age factor in use, 106 COStS, 159 effects on liberalization of sexual practices, 165, 271 efficacy of, 161, 271-272 estrogen doses, 162 health benefits of, 162 health complications of 162 . mortality risk, 161 perceptions of health risks, 272 prevalence of use, 46, 48, 107, 113, 154, 162-163 recommcudanons regarding, 7, 272 research needs on, 258 sources, 154,158, 162 Conmcepave service providers clinics, 1501~9, 162-163, 273; see also Family planning clinics; School-based clinics community seance organizations, 8, 155 funnily planning senders, 153-154 health departments, 8,155 hospitals, 8, lSS pmratc physicians, 150157, 159, 162-163 recommendations regarding, 8, 274 school-based clinics, 8, 168-173, 270275 Conmccptivc sconces access to, 86 attitudes about, 86 availability of, 11, 22, 203, 274, 284 285

328 INDEX condom distribution programs, 8, Costs 16~168, 27: costs ofproviding, 159-160 counseling, 191 data needs on, 239 effectiveness, 18~187, 229 funding for, 160 Medicaid reimbursement for, 8, 161, 272 monitoring needs, 239 negative aspects, 165 parental consent and notification requirements, 15~-157, 159, 249 recommendations regarding, 8, 11, 28028: scope of, 8, 153, 155, 157-158 teenagers' first source, 154 Contraceptive use abortion as a substitute for, 112-113 age of first intercourse and, 4809, 74, 10~107, 165 data collection on, 71 following abortions, 113, 19~194 gender roles and, 83 mortality risk of, 161-162 pregnancy probability and, 3, 49 rates of, 46 48, on, 72 recommendations on, 7-8, 271-276 reliance on male methods, 49, 106, 27~; see also Condoms; Withdrawal as contraceptive method television reference to, 91 Contraceptive use detersninants academic achievement/aspirations, 107, 120 acceptance of own sexuality, 109 attitudes, 109-110,148, 16~167 commitment in relationship, 107 development charactenstics, 110 levels of sexual knowledge, 108, 110, 147, 148, 172 mother-daughter communication, 1~0 parental support and controls, 11~111 parents' coeducation, 107,111 self-esteem, 110 Contraceptives continuation of, 164, 170 failure rates of, 49, 52-~3, 56, 74, 111, 161, 272 television advertising of, 8, 91, 153, 275-276 traits of poor users of, 110 see also specific contraccptilJes adolescent pregnancy and parenting, 31, 74, 184-180, 205-206 child care, 210 comprehensive care programs, 22o contraceptive services, 159-160 data collection on fertility, 70 pediatric care, 203 prenatal care and delivery, 197-198 Project Redirection, 225 school-based clinics, 170 sex and family life education programs, 147-148 WIC nutrition program, 201 D Data on fertility availability, 34, 41, 52, 58, 61, 67-71 categories of race and ethnic differences, 233, 238 costs of collecting, 70 inconsistencies in, 68, 232-233 of males, 52 overreporting, 69 priorities for collection, 13, 232-240 recommendations regarding, 232-240 from service provenders, 71, 238-240 sources, 33-34, 6~-71, 170, 232-240 underrepornug, o2, 69-71 verification of, 69-70 from vital statistics, 3~34, SO, o3, 7~71, 237-23S, 240 see also Surveys Dating and scum behavior, 101, 102 Deficit Reduction Act of 1984, 287 Delay of sexual initiation, see Initiation of . . sexua activity Delinquency, sexual attitudes and behavior associated with, 93, 243 Dada Sigma Theta, program to enhance life opnons, 178 Demonstration projects, see Abortion services; Children of adolescent mothers; Economic support; Expersmcntal research; Prenatal care and delivery; Pre~rennve inrenrennons; Programs that enhance life options; ~pecsfsc names Developmental effects on children of teenage mothers intelligence and achievement scores, 134 135,212

INDEX 329 learning disabilities, 137, 211-212 mediation of, 137, 139, 208-214 research needs on, 246-247 childbearing, 119 retention in grade, 134 programs for enhancing, 179-181 school behavioral problems, 136 218-220, 230 socioemotional, 136-13/ trends in, 39, 82 substance abuse, 136 Employment, maternal Diaphragms prevalence of use, 46, 1~4 sources for, 154, 158, 162 Divorce early childbearing associated with, 129 ... . . . .. ear y lnltlatlon or sexual activity associated with, 104 trends in rates of, 76 see also Marital disruption The Door, 182 Douche as contraceptive method, 48 Drug use sexual altitudes and behavior correlated with. 93, 102, 243 E Early and Periodic Screening, Diagnosis and Treatment Program, 10. 198, 282, 284 Economic support programs, 205-206; see also Aid to Families With Dependent Children; Child support; Medicaid recommendations regarding, 11, 28~-287 Education .. . . . . . . . a~scrunmanon associated with pregnancy, 127-128, 217 remedial, 179 see also Mother's education; Parenting education; Parents' education Education Amendments of 1972, Title IX. 128,217,248 Educational attainment early childbe~nng and, 125-128, 217, 262 postsecondary, 127 of teenage fathers, 126 see also Academic achievement/aspirations Educational counseling, 179, 181 Emergency services for pregnant and parceling adolescents, 21~215 Employability, programs for enhancing, 179-181, 219 Employment, adolescent as determinant of nonmarital factors conmbuting tO increases in, 78-79 of heads of household, 78 implications for adolescent development, 79 median family income correlated with, 80 Employment, women's, 7~79 Ethnographic studies, unavailability of data for,34,41,52,58,61, 68,241 Europe child support enforcement in, 208 contraceptive advertising in, 153 Evaluation research see Outcome evaluations; Process evaluations Experimental research priorities for, 14, 257-259 Families, female-headed initiation of sexual intercourse by girls in, 104 maternal employment in, 78 nonmantal childbearing by adolescents in, 119 public assistance tO, 81, 119 research priorities on, 245 socioeconomic status, 8~81, 89 trends in, 76. 80, 82 Family care programs, 22~221 Family communications programs, 149-1~0; 187 Family Focus dro~in centers, 216 Family income changing patterns of. 79-80 median, 80, 266 race differences in, 80, 131-132 Family life education, content and focus of, ', 146, 269-270 Family planning clinics acceptance of Medicaid reimbursement, 159 attendance, 163-16~. 169. 172-173, 273

330 INDEX charactenstics of patients of, 163 fees, 159 parental consent and notification requirements of, 15~156 prevalence in United States, l'=l;S rate of adolescent use of, 157-158 services provided by, 8, 155, 174, 191 see also School-based clinics Family planning services, see Contraceptive sennces Family Planning Services and Population Research Act, Title X. 8, 21-24 Family size of early childbearers, 129 Family structure changes in, 76-77, 82 of early childbearers, 129-130 influence on adolescent sexual activity, 104 race differences in, 7~77, 117 spacing of births, 129 see also Families, female-headed Fatherhood marital status and, 77-78 programs, 213-214 see also Absent fatherhood Fecundity, data on, 40, 96 Fertility completed age at firs: birth, 129, 130 male, need for data on, 52 rates in schools with clinics, 110 see also Data on fertility Food Stamp program, 133, 20o G Gall bladder disease from oral contraceptives, 162 Gender roles changes in, 83-87 influence of working women on attitudes about, 79 Genital }herpes, condoms to prevent, 166 H Health care programs, 196-20~; see also Comprehensive care programs; Contraceptive services; Nutntion; Pediatric care; Postpartum care by nurs~midwives; Prenatal care and delivery; Sex and family life education recommendations regarding, 10. 282 Health Insurance Association of America, 198 Health risks of abortion, 120, 177 of adolescent pregnancy and childbearing, 1,12~12o, 139,196 of contraceptives, 161-162, 271 Health Services and Centers Amendments Act, Title VI, 21 High-Scope Project, 211 Hispanics unavailability of data on, 34, 41, :2, 58. 61,68 see Race and ethnic differences Hormone levels, influence on girls' sexual behavior, 96 Hospitalization, contraceptive side effects requiring, 162 Hot lines, operations and services, 170175 Hypertension from oral contraceptives, 162 I Improved Pregnancy Outcome Project, 199 Income early childbearing effects on levels of, 13~132 see also Family income Infant Stimulation/Mother Training Project, 212 ... . , .. runatlon or sexua . aCt2Vlty age trends in, 4204, 96, 98-99 by girls in female-headed families, 104 contraceptive use and, 48 49, 74, 100107, 165 delay of, 3, 7, 172, 258, 269-271 marital disruption associated with, 104 mother's educational attainment and, 44 peer group influence on, 105-106 race differences in, 98 socioeconomic status and, 44 Intelligence of children of teenage mothas, 13013:, 212 sexual activity correlated with, 100 101 Intergenerational effects of early childbearing, 6, 136-139 Intrautenne devices (IUDs) health risks of, 162 pregnancy rate with, 52, :3, 161 prevalence of use, 46, 107, 113, 154 sources, 154, 1~8, 162

INDEX 331 J Job Corps, 180 lob opportunities for adolescents, 82, 262 Job training for adolescent fathers, 18~181 Johns Hopkins School of Mediane Adolescent Pregnancy Program, 171-172, 202, 223 school-based clinic model, 171-173, 202, 204 Junior League Teen Outreach Program, 176, 187 K Kappa Alpha Psi program tO enhance life options, 178 L Labor force participation by early childbearers, 13~132 by parents of adolescents, 78-79 program tO improve adolescent, 181 rates of adolescent, 39, 13~132 I~egitimanon determinants, 61, 115 educanonal attainment following, 127 raial/ethnic patterns of, 78, 115, 128 rates of, 60 63, 74, 77-78, 114, 128 Life options, see Programs that chance life options Life Planning Project, 176 Life planning, programs tO improve, 17~117, 21~216, 267, 288 Life Skills Counseling program, 148 Life skills training, 11-12, 21~217, 288 Liver tumors from oral contraceptives, 162 Low b~hweight infants costs of care, 203 prenatal care interventions, 196, 201 M Marital disruption association with initiation of adolescent sexual activity, 104 factors contributing to, 85 Marital stabilizer, adolescent parenthood implications for, 1-2, 18, 129, 262 Marriage attitudes about, 77, 83, 98 changing patterns of, 77-78, 85 to legitimate a birth, see Legitimation prevalence among teenagers, 35-36, 72 Maternal and Child Health block grant services funded by, 22, 160, 19~199 Maternal-In~nt Care Program, 170, 223 Media approaches to preventive interventions, 150, ljl-1~3, 270~271 research priorities regarding, 249 treatment of sexuality, 7, 19, 91-92, 1~1-152, 249 see also Radio, public service announcements on pregnancy and childbearing; Television Medicaid eligibility, 10, 198, 202, 282, 284, 287 expenditures for adolescent mothers and their children, 133, 205 recommendations regarding, 8, 10, 273, 282 as a source of fertility data, 71 Medicaid reimbursement for abortions, 83, 191, 193, 194 for contraceptive services, 159, 161 for prenatal care and delivery, 10, 198 Miscarriages numbers and rates of, 54-50, 74, 123 124 reporting of, 70 Mortality risk of abortion, 125 of contraceptive use, 161-162 of pregnancy and childbearing, 124 Mother's education child de~rdopment effects associated with, 135-136 ininanon of sexual activity correlated with, 44 see also Academic achic~remcnt/aspiranons; Educational attainment Motha-daughter relationship association of sexual activity with, 102 contraceptive use end, 110, lS0 see also Parent-child relationship N National Association of State Boards of Education, 144 National Center for Health Statistics,. 15-16, 112, 116, 235, 239

332 INDEX National Institute of Child Health and Human Development, 24 National Institures of Health, 24 National Urban League, 178, 182-183, 271 Native Amencans, need for data on, 68, 234, 241 Natural family planning, see Rhythm method of contraception Neighborhood, sexual activity correlated with, 97 Nonmantal childbeanog attitudes toward, 77, 83, 86, 98, 99, 117-118 determinants, 6,118-120, 266 family structural hanges arising from, 76, 85 family support role, 246 race differences in, 6~67, 86, 98, 116-117 rate among adolescents, 1, 61, 6~-67, 74, 128 television portrayal of, 91 Nonmantal pregnancy, risk of, o~S1, 108; see also Pregnancy resolution Nurse-midwives, prenatal and postpartum care by, 199 Nutntion eating habits of adolescents, 124, 283 services to improve, 20~20l, 229, 283 o Obstesncian-gynecologists abomon services provided by, 191 .. . . . propulsion or contraceptives to minors, 156 Of lice of Adolescent Pregnancy Programs (OAPP), 22, 25, 149, 223, 22S, 228 Omnibus Budget Reconciliation Act, 22 Oral conmcepnves, see Con~racepnve pills Outcome evaluations of adolescent fatherhood programs, 214 of comprehensive care programs, 22 - Z7, 230 control groups in, Z~Z6, 2025: of educational improvement: programs, 179 of funnily co::lmunication programs, 149-150 impediments to performing, 142-14;, 186 of life phoning programs, 177 of Project Choice, 176 of school-based clinics, 170-171, 187, 203 of sex education programs, 146-147, 187 Outcome measures, 252-2~3 Outreach programs to promote condom use, 167-168 Ovarian retention cysts, oral contraceptives to prevent, 162 p Parent-child communication community programs to improve, 14~146, 149-150 nonmarital childbearing associated with, 118 research needs on, 245-246 sexual activity associated with, 102-10 see also Mother-daughter relationship Parental supervision nonmantak hildbearing associated with, 118 sexual activity associated with, 10~104 Parental support and controls effect on adolescent sexual behavior, 102-104 effect on contracepnve use, 11~111 Parenting adolescents, characteristics, 116 Parennog education, 12, 181, 211-214, 229, 291-292 Parents' education abortion decisions ant, 112 adolescent sexual activity and, 10~101 contraccptiveusc end, 107, 111 see also Mother's education Pediamc care for congenital problems, 203 costs, 203 effectiveness, 229 model programs, 202 parenting education with, 212 providers, 201-202, 283-284 recommendanons regarding, 10, 28~284 Pediatricians, provision of contraceptives to minors, 156 Peer counselors, interventions using, 14~146, 149, 270 Peer groups, influence on early sexual activity, 105-106 Peer pressure, 97, 105 Pelvic exams, availability at clinics, 155, 169, 272

INDEX 333 Pelvic inflammatory disease from IUDs. 162 Physical maturity initiation of sexual activity and, 96 race differences in, 97 Planned Parenthood clinics, 155,164; see also Family planning clinics; School-based clinics Policy goals and recommendations alternatives to childbeanog and parenting, 5,8-10, 276 abortion, 9, 276-279 adoption, 9-10, 279-280 pregnancy rate reduction, 3, 5-6, 265-266 contraception, 7-8, 271-276 delay inination of sexual activity, 7, 269-271 enhance life options, 6-7, 266-269 promotion of positive outcomes for parents and children, 10-12, 281 development of children, 291-292 economic support, 11, 285-287 health, 10,281-284 life options, 11-12, 287-291 prevent subsequent untimely births, 10-11,284-285 Postpartum care by nurse-midwives, 199 Postponing Sexual Involvement program, 148-149,177 Postwar baby boom, 76,87 poverty nomnantal childbearing correlated with, 6,118-119,266 prog~n,81 proportion of children in, 81 sexual attitudes and behavior associated with, 6,97,266 see alto Socioeconomic status Pregnancy adolescent, number and rate of, To, 51-~2, 05o, 12, 261 contraceptive availability associated with, 165, 271 cctopic, 162 educational discn~ninaiion on basis of, 127-128, 217 medical complications of al, 120125, 196 repeat, 1, 1~11, 20~204, 280285 underreporting of, 113 Pregnancy and childbearing approach to soling, 18-21 nature of the problem, 1~18 public policies toward, 21-2; Pregnancy intention, o2, 56, 112 Pregnancy probability, factors affecting, 33, 49-50 Pregnancy resolution trends in, 33, 51~7 see also Abortion; Adoption; Legitimation; Nonmantal childbearing Pregnancy fessing and counseling, 173-17;, 191-~92,199, 278-279 Premanurity, 124-125, 196 Prenatal care and delivery costs, 197-198 delayin obtaining, 198-lg9 funding needs, 197 importance of, 124, 196-197, 229 Medicaid reimbursement for, 198 nutrition services, 200'201, 229, 283 provides, 197,199-200 recommendations regarding, 10, 28~-283 trends in use of services, 197 Prenatal/Early lacy Project, 202,223 Preventive interventions access to contraception, 15~175 assertiveness and decision-making training, 7, 14~149, 187, 210 break-even analysis of, 185, 188 by coalitions and interest groups, 182-183 condom Retribution programs, 16~168 cost-bc~cfit analyses of, 180186, 188, 256 cost c~cCtivencss of, l~ evaluation of collectiveness, 142-143, 149-150, 151, 152-153, 17~171, 116,177, 119, 187-188 Emily communication r)ro~rams 149-150, 187 funding for, 143 hot lines, 174 175 media approaches to, 150, 151-153, 27~271; see also Radio, public serges announcemcots OF preo~lCy and childbeanog; Derision pregnancy testing and counseling, 173-175, 191-192, 199, 27~279 programs that impart knowledge/ influence attitudes, 14~153 public service announcements, 152 ~O ,

334 INDEX recommcodarsons regarding, 8-10, 276~280 role model and mentonug programs, 177-178, 221-222, 268-270 successful programs, 187-188 teenage thcatre projects, 15~151 types and aims, 141-142 see also Cont:raceprive services; Family life cducarson, content and focus of; Programs thee enhance liEc options; School-based clinics; Sex education Private physicians abortion services by, 191 contraceptive services by, 154 1;7, 159, 162-163 Pro-life organizations, pregnancy testing and counseling, 174 Process evaluanons, 152-153, 251-252 Program c~raluanon research, 13, 25~257; see also Outcome evaluanons; Process c~aluanons Programs that enhance life options alternative schools, 216-218, 267-268, 288 Choices workbook, 177 communsty-based comprehensive, 181-182 educational, 12, 17~179, 267-268, 288-289 ernploymcn:, 12, 179-181, 218-220, 268, 289 [asnily care, 220~221 lifcpl"~g, 175-177, 215-216, 267, 288 fife skills "raining, 11-12, 21~217, 288 recomsnendanons regarding, ~7, 266-269, 287, 291 Project Choice, 116 Project Redirection community women component of, 178, 221-222 effemi~cness, 219, 225 employability dc~relopment, 219 lift plying through, 216 operating COStS, 225 repeat pregnancy rate, 204 support for, 223 Protes~t ~ndamcutalism, effect on adolescent sexual belabor, 90, 100 Psychological consequences of abortions, 19~196 Pubery, assomanon With initiation of sexual activity, 96 Public assistance factor in legitimation decisions, 115 to female-}2eaded families, 81, 119 minority dependence on, 82 sources of, 81 see also Aid to Families With Dependent Children; Welfare; Welfare dependence Public Health Services Act of 1970 Title X, 21, 160, 272-273 Title XX, 227 Public policies influencing sexual and fertility behavior, 21-25, 248-249 Public/Pnvate Ventures Summer Training and Education Program, 18~181 R Race and ethnic differences abortion rates, 58, 60, So, 113, 117 absent fatherhood, 77 adolescents who keep and raise their children, 61 approach tO women's movement, 86 attitudes, 98 births tO adolescents, 53, 58-59 contracepnve use, 117 di~icultics in detemiisiing, 68 familyincome, 80, 131-1S2 family structure, ~76-77, 117 initiation of sexual intercourse, 98 labor force participation, 13~132 marriage patterns, 36, 77-78, 110, 12% nonmantal childbearing, 65 67, 86, 98, 11~117 peer pressures, 97 physical maturity, 97 poverty status, 8~82 pubertal correlation tenth sexual behavior, 96 research necks on, 247-248 school enrollment patterns, 3~38, 181 sexual activity of teenagers, 41 46, 50, 247 Radio, public sconce announcements on adolescent pregnancy and childbearing, 152-153 Reagan adminis~anon, 22, 183 Rebelliousness, nonmarital chilcDoearing correlated untie, 118 Recession, eject on youth movement, 88 Religiousness contraccpti~rc use and, 111

INDEX 335 influence in abortion decision, 113 sexual activity and, 90, 99-100 Remarriage by early childbearers, 129 Research pnonties abortion, 244, 249, 276 adolescent males, 242-243 adoption, 244 community factors affecting sexual decision making, 247-248 ethnographic studies, 241 family factors affecting sexual decision making, 245 paren:-child communication, 245-246 · psychological antecedents and consequences of sexual decision making, 244 245 public policies, 24~249 race differences, 247-248 school dropout, 243 transition behaviors, 93, 102, 243-244 very young teenagers, 242 see also Program evaluation research Reservation wage, effect of early childbearing on, 131-132 Rhythm method of contraception, 48, 161 Rochester Adolescent Maternity Project, 212, 223 Role models older siblings, 104 programs using, 177-178, 221-222, 26~270 working women as, 79 The Rubber Tree, 167 S School, dropping Out of after pregnancy, 12~127 effects on early childbeanog, 126 rates among teenagers, 36, 38, 170 research needs on, 243 sexual activity correlated with, 14 16 School-based clinics accessibility of parent records, 170 child care services, 210 costs and support, 170, 210 cffecn~rencss, 17~171, 187, 203 family planning services of, 169 goals and sentences of, 16~169, 174 limitations, 171 prenatal care through, 199, 283 recommendations regarding, 274-270 Schools enrollment trends by age and race, 36-38 racial composition correlated with sexual activity, 98-99 Segregation, sexual activity correlated with, 8/, 97-99 Select Committee on Children, Youth and Families, 170 Self-esteem contraceptive use and, 110 program for improving, 176 sexual activity and, 101 Self-percepsion, association with sexual behavior and decision making, 12~121 Sex education assertiveness and decision making training with, 148 attitudes about, 143-144 community-based, 14: content and comprehensiveness of, 8, 144 145, 272 effectiveness of programs, 146~147, 187 parental role in, 7, 103, 143 policy recommendations, 7-8, 269-270, 272, 273 relationship between adolescent sexual behavior and, 109, 146 school-based, 14~14 traditional values, insm~ciion in, 145 see also Family life education, content and focus of Sexual acii`,ity age at initiation, 4102, 9097 attitudes about, 69, 83, 84, 98 child support enforcement as a deterrent to, 208 frequency of intercourse, 42,44, 97, 101 nature of the problem, 1~17 o~rcrreporting of, 69 racial/ethnic variation in, 40 42, 45, 50, 247 rates among unmamed teenagers, 15, 40, 45, 50, 72, 84, 96-97 transition behaviors associated with, 93, 102, 24~244 underreporting of, 46 S=cual activity determinants academic aspirationslachievanent, 100 101, 120 age, 9~97 contraception availability, 16' family stn~cn~re, 104

336 INDEX IQ, 100 101 mothes's age at marriage, 104 mother's sexual and fertility experience, 104 parent-child communication, 102-103 parental support and controls, 102-104 parents' educationala:rainment,44 lo, 10~101 peer groups, 10~106 pubertal development, 96 racial composition of schools, 9~99 religiousness, 99-100 school dropout rate, 4406 selffftcern, 101 socioeconomic status, 97 Sexual decision making age factor in, 101 attinldeimportancein, 12~121 faultily roles in, 245 psychosocial antecedents and consequences, 244 245 Sexual intercourse, see Initiation of sexual intercourse; Sexual activity Sexual knowledge, adolescent levels of, 108 Sexual partners abortion effects on, 196 initial, age of, 97 stability of relationship, 107 Sexually transmitted disease condoms to prevent, 166, 27: exposure to, 6 screening for, 169 Sickle cell anemia' screening in school-based clinics, 169 Single parenthood economic outcomes of, 129 see also Families, femal~headed Smoking, early sacual activity conciated with, 102 Soap operas "General High School," 1~151 portrayal of sexual relationships in, 91 Social Seventy Am Title IV-D, 207 Title XIX, 193 Title XX, 210 Social services block grant funding for family piercing services, 161 Sociocultural developments and sexual attitudes and behavior, 75~93 ~ . . oaceconom~c status abortions according to, 113 absent fatherhood and, 82 age of initiation of sexual activity and, 44 associated with pregnancy complications, 12~12: of femal~headed families, 8~81, 89 Legitimation end, 115 sexual activity and, 97 trends in, 81 Spermicides rates ofuse, 163 sources, 154 Stenlization as contraceptive method, 8~84, 130, 1~3 SnIIbirths, 124 Student revolts, 83, 87-88 Supplemental Food Program for Women, Infants and Children, 200 201, 283 Surgeon General recommendations for prenatal care, 197 Surreys Current Population Surrey, 50, 230235 enhancement of data collection through, 23~237 general population, 50, 230235 health and fertility, 23~-237 Health and Nutrition Examination Survey, 23~237 High School and Beyond Surrey, 237 household, 68 69 Kantner-Zelnik, 49, 5~51, 52 National Health and Nurntion ~aminaiior~ Survey, 40 National Longitudinal Surrey of Youth, 43~o, 76, 96, 237, 240 National Natality Sunrey, 23~236 National Survey of Children, 98 National Survey of F=nily Growth, 41, 44,48,50,96,23S, 240 National Survey of Young Women, 42, 98, 1~8, 166 Nielsen Company, 90 problems with, 69-70 youth, 237 Youth Attitude Surrey, 84 Teen Fathers Collaboration Project, 181, 214, 216 Teen Outreach Project, 176, 181 Teen Parent Family Support Project, 210 Teenage theatre, "General High School" soap opera, 15~151

INDEX 337 Television adolescent viewing time, 9~91 sexual programming, 7, 19, 91-92, 151-1~2, 249, 27~271 video cassette recorders, 92 _ . . . . . elenslor1 a vertlsmg of contraceptives, 8, 91, 153, 275-276 to improve parent-child communication, 150 sexual message tO adolescents, 91 Thromboembolic disorders from oral contraceptives, 162 Too Early Childbearing Network, 178, 183, 204, 216, 223 Traditional values . . , instruction as part or sex education/family life education, 145, 146, 148 youth rejection of, 16, 87-90 U Underreporting of abortions, 52, 69, 7~71, 113, 239-240 of adoptions, S1, 69-70 of pregnanaes, 113 of sexual activity, 46 Unemployment adolescent rates by race, sex, and age, 39 black family instability and, 82, 85 nonmaritalchildbearing end, 119 women's changing patterns of, 78-19 Urban lastitute evaluation of comprehensive care program, 144 Uzgiris-Hunt Infant Ordinal Scales, 212 V Vietnam War, effect on youth attitudes, 87, 88, 92 Voluntary Cooperative Information System data collection on adoption, 71, 239 W Watergate effect on youth attitudes, 89 Welfare benefit levels, 115, 119 expenditures to adolescent mothers, 132-133 see also Aid tO Families With Dependent Children Welfare dependence of early childbearers, 2, 130, 132-134, 138, 205 factors associated with, 206, 262 influence on adolescent pregnancy resolution decisions, 110, 119, 206, 287 Withdrawal as contracepnve method, 46, 48, 161 Women's movement contributions to sexual freedom, 8086 influence on adolescents, 86, 92 influence on gender roles, 8~84 y Young Mothers Program, 200, 204, 223 Youth employment programs, 179-181, 218-220, 230, 288 Youth Incentive Entitlement Pilot Projects, 180 Yout~movemcnt, 87-90

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More than 1 million teenage girls in the United States become pregnant each year; nearly half give birth. Why do these young people, who are hardly more than children themselves, become parents? This volume reviews in detail the trends in and consequences of teenage sexual behavior and offers thoughtful insights on the issues of sexual initiation, contraception, pregnancy, abortion, adoption, and the well-being of adolescent families. It provides a systematic assessment of the impact of various programmatic approaches, both preventive and ameliorative, in light of the growing scientific understanding of the topic.

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