Public Health, Spring 1995 - Women's and Children's Center

Repeat births to adolescent mothers are on the rise in Georgia, and faculty in the Women's and Children's Center want to do something about it.
Te
enaged and Pregnant, Again

Late on a weekday afternoon at a county h ealth department in the Atlanta area, seven grandmothers sat talking with a group moderator. Their daughters, all teenagers, were either pregnant or had just given birth. The moderator wanted to learn how the women felt about that.

"My youngest daught er is a nightmare," one woman said frankly. "It seems as if an alien has entered her body." Another said: "I cried for three days straight when I found out she was pregnant." But others in the group seemed more proud than dismayed. One participant admitte d that, during her daughter's pregnancy, "that's the only time we've been on good terms." "I just wanted to be on her side," said one of the mothers, "be in her shoes, be supportive."

While the rate of teenage pregnancy in Georgia has dipped 4% from 1 980 to 1991, the increase in repeat births to teen mothers has risen dramatically - by 37%. Also adolescents in Georgia are becoming pregnant at younger ages, increasing their chances for repeat pregnancies. Sheana Bull, MPH, a faculty associate in the Wo men's and Children's Center, believes these numbers indicate that interventions to discourage pregnancy among teens are having some effect. However, she points out, most interventions do not target adolescents who have already given birth. If this populat ion is ignored, the health costs of teenage pregnancy will continue to rise.

To remedy the oversight, Carol Hogue, the Jules and Deen Terry Professor of Maternal and Child Health, has directed a qualitative study of the context that motivates adolesce nt mothers to continue to bear children. Sponsored by the Georgia Department of Human Resources, Dr. Hogue and a team of researchers recruited adolescent mothers, their partners, and mothers of teen mothers through the Women, Infant, and Children Suppleme ntal Nutrition Clinics in three urban and two rural settings in Georgia. From ten focus groups, they assessed the social and cultural context for the girls' motivations.

The teenagers, like the older generation, divided themselves into two categories, with some feeling proud of their actions and others feeling they had made a mistake. "I'm proud and I enjoy being a mother," said one teen. "If I had to do it all over again, I would." But another felt differently: "You normally take life hard now. Lord, having a baby is hard."

Based on the data collected from the focus groups, the researchers made five recommendations to the state. They advised integrating services for teens, their parents, and partners and redirecting some sex education to include adolescents who are already mothers. They also recommended addressing adolescent pregnancy at multiple service sites with an emphasis on correct and consistent use of contraception. And finally, they suggested involving communities in reducing the accepta bility or inevitability of teenage pregnancy.

The qualitative findings are the first step in a conceived five-year project, says Dr. Hogue. "Next we will embark on demonstration projects to gather the scientific knowledge to validate the effectiveness of our recommendations. If they work, then we will expand the effort to the entire state."

The adolescent repeat pregnancy study fits in well with the goals of the Women's and Children's Center. Founded in 1992, the Center seeks to empower women to i mprove health. "In many such programs, women are considered only in the context of how they can bear babies, not in the context of what they need for good health," Dr. Hogue says. "However, if you think about it, women spend most of their reproductive lif e trying not to be pregnant. Many of their health problems are not associated with child-bearing."

One of the Center's research priorities is to understand why African-American women and children suffer disproportionate health problems. In an effort s ponsored by the Centers for Disease Control and Prevention, Dr. Hogue and her staff are collaborating with social scientists at Spelman College to develop a survey that measures stress among African-American women. "We want to discover what impact being b lack in America has on health," Dr. Hogue says.

In the international arena, the Center wants to involve more men in developing countries in family planning. But while faculty research includes components of men's influence on women's health issues, th e focal point remains on women and children. "What we don't want," says Dr. Hogue, "is to cloud our focus on empowering women."




Through five Women, Infant, and Children Supplemental Nutrition Clinics in Georgia, such as the one pictured above, faculty gathered data abo ut the motivations of pregnant teens from the teens themselves, their partners, and mothers of adolescent mothers.



Empowering women to achieve good health is the focus of staff members of the Women's and Children's Center - (r to l) Tracy Woods, Director Carol Hogue, and Sheana Bull - who listen here to a presentation by Monica Manns, project director of Positive Generations.


Spring 1995 Issue | Amazing Grace | 1518 Clifton Road | Economics of the Heart | Back on the Farm
Gunning Down Youth Violence | A Shot in the Arm | Tackling the Sexuality of Teens
Teenaged and Pregnant, Again | Ending Hidden Hunger | Cancer: It All Adds Up
Building Bridges for Reform | Class Notes
WHSC | RSPH

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Web version by Jaime Henriquez.