Pregnancy and motherhood among Mexican American adolescents

Preventing Teen Pregnancy: A Qualitative Study of the Perspectives of Parenting and Expecting Latino Adolescents

STUDY OBJECTIVE

Latino youths in the United States experience disproportionately high rates of teen pregnancy. The aim of this study was to obtain expecting and parenting Latino adolescents' perspectives regarding factors contributing to teen pregnancy and pregnancy prevention.

METHODS

Expecting/parenting Latino adolescents were recruited from high schools with high proportions of Latino youths and teen pregnancy. Participants completed a questionnaire on sociodemographic and background characteristics. Focus groups were stratified by age and gender and audio recorded. Grounded theory was used to identify themes from the transcribed audio recordings.

RESULTS

Thirty-two expecting/parenting Latino adolescents (20 females, 12 males) 14-19 years old participated in four focus groups. Quantitative results revealed that two-thirds of participants at birth had adolescent mothers. Over three-quarters of participants reported that their pregnancies had occurred too soon. Qualitative themes for factors contributing to teen pregnancy included lack of contraceptive knowledge/access, belief of invincibility, influence within relationships, male decisions on contraceptive use, desire to belong among peers, lack of parental support for contraceptive use, lack of parental attention, rebellion, normalization of adolescent parenthood in Latino culture, and media. Themes for pregnancy prevention included time alone with physicians, parenting teens as mentors, reproductive health education, and community pregnancy-prevention programs.

CONCLUSION

Multiple factors contribute to teen pregnancy in Latino youth, including influences from Latino culture, family, peers, partners, and social determinants of health. Pregnancy prevention should incorporate interventions to address these aspects, including disseminating culturally sensitive education materials, providing parenting teens as peer mentors, encouraging time alone with health care providers, and addressing various social determinants of health.

A Critical Examination of Acculturation: The Impact of Health Behaviors, Social Support and Economic Resources on Birth Weight among Women of Mexican Descent

Although recent theoretical work points to the multidimensional character of acculturation, empirical studies often fail to operationalize the concept in ways that capture the complexity. This study uses data from in-depth interviews with 58 pregnant and recently postpartum women of Mexican descent to demonstrate that prior studies examining acculturation and low birth weight have focused too much on negative health behaviors and too little on social support and access to resources. The analysis also demonstrates the importance of examining social change in sending and receiving communities by addressing the starting point for acculturation and the forces for acculturation in immigrants' lives.

Sexuality, Pregnancy, and Motherhood among Mexican-American Adolescents

The perspectives of 32 Mexican-American and 17 White adolescent females are presented regarding: (a) their romantic and sexual relation ships; (b) sex education and birth control; and (c) reactions to their pregnancy and motherhood. Mexican-American adolescents indicated notably less sexual experience than their White counterparts with the father of the baby generally being their only sexual partner. The relation ship with the father of the baby most often continued for the Mexican American adolescents, but rarely for the White adolescents. Pregnancy was unanticipated by both groups, despite their failure to use contracep tive methods. Emic data are presented both in summary form and in the adolescents' own words.

Cultural Factors Affecting the Negotiation of First Sexual Intercourse among Latina Adolescent Mothers

In 1995, the Latina adolescent birth rate surpassed that of African Americans for the first time. This article investigates cultural and social factors affecting the initiation of sexual intercourse among Latina adolescent mothers in Los Angeles. The data are from life history interviews with forty young mothers and their partners conducted in 1994 to 1997. Results suggest that sexual intercourse is initiated within the context of the couple's developing relationship, and that the course of relationships is highly scripted. Men pressure for sex and women resist. Women should be ignorant about sex, but control access to intercourse. Sex is never discussed. Thus, it is unexpected, and contraception other than withdrawal is not used. This script places young Latinas at enormous risk for pregnancy and STDs.

Coping Behaviors of Adolescent Mothers

Coping behaviors were examined in a sample of pregnantt and parenting adolescent females (N = 133), currenthl enirolled in school-based programs for adolescent parents in Colorado, and comparisons were made between Mexican-American and Anglo partic ipants. Two themes emerged regarding the most frequently used coping behaviors: a tetndency for these adolescentts to use avoidant or passive types of behaviors, and the importance of close friends as slupport. Significant differences were found on only 7 of the 49 coping behaviors, su4ggesting more similarity than differences between the two groups. The differences reflected a greater religiolus orientation of Mexican-American adolescents. Some cultural and family characteristics influencing adolescent coping behav-ior are discussed, and implications for adolescent parent programs and future research are suggested.

Anglo-American and Mexican American Adolescent Mothers: Caregiving, Approval, and Family Functioning

This study tested the Adolescent Family Assessment Model using a descriptive correlational design. The model describes the relationships between caregiving behaviors, peer and family approval, and the outcome variables of caregiving knowledge and family functioning. Social exchange theory and social learning theory guided the study. Modelbuilding procedures involved replicated testing with data from 64 Mexican American and 50 Anglo-American adolescent mothers, 19 years of age or younger Four instruments were used: the Infant Caregiving Inventory (alpha = .93); Smilkstein's Family APGAR (alpha = .90); the Peer Approval Instrument (alpha = .73); and the Family Approval Instrument (alpha = .83). Results forAnglo mothers indicated that caregiving 2 behavior was explained by single marital status (R = .22). Family functioning was explained by age of the first child (R2 = .11). Model results for the Mexican American mothers differed from the resultant Anglo model. Caregiving knowledge was explained 2 by past experience with child care (R = .14), whereas familyfunctioning was explained by caregiving behavior (R = .10).

Pregnant and Parenting Adolescents

This study comlpared pregnant adolescents intending to relinquish their infants, pregnant adolescents intending to parent, and parenting adolescents on measures of coping and psychosocial adjustment. Comparisons were also made either to a group ofnonpregnant adolescents or to norms. Pregnant adolescents intending to relinquish their infants showed better overall levels of self-image than pregnant adolescents intending to parent, and parenting adolescents. Parenting adolescents showed significantly more disruption in specific areas of psychosocial adjustment than pregnant adolescents intending to parent. These differences were discussed as target areas for intervention. The parenting experience also affected the types of coping strategies used by adolescents. Both groups, pregnant adolescents and nonpregnant adolescents, were more likely to use less active coping strategies than parenting adolescents. A negative relationship found between these less active forms of coping and psychosocial adjustment underscored the importance of targeting individual differences in adolescents' responses to the stressors of pregnancy and parenthood.

“You Have to Give Her That Confidence”

The considerable risk of negative consequences of unprotected intercourse underscores a need to better understand how Latina adolescent girls acquire the skills to manage the risks associated with sexuality. The authors used in-depth qualitative interviews with mothers and their daughters to examine communication related to sexuality with the goal of understanding the sociocultural and family context of Latina adolescents’ sexual behavior and reproductive health care seeking. Mothers and daughters agree that sexual activity threatens girls’ health and future and that open communication about sexuality is highly valued but difficult to achieve. Communication content tends to focus on the threats of sexual activity, but process is important. Strategies of effective communicators include deliberate creation of an atmosphere of approachability and a flow of information from daughter to mother.

Susceptibility to Antisocial Peer Pressure and Its Relation to Acculturation in Mexican-American Adolescents

Antisocial hypothetical situations modeled after those developed by Thomas Berndt and an abridged version of an acculturation questionnaire by Susan Keefe and Amado Padilla were used to examine the relation between susceptibility to antisocial peer pressure and acculturation among a sample of low socioeconomic status (SES) and working-class Mexican-American adolescents (Grades 9 through 12). Multiple regression was used to predict susceptibility to antisocial peer pressure from gender, grade, generational status, and acculturation. Amongfirst-generation immigrants, more acculturated adolescents within each grade were more susceptible to antisocial peerpressure. Generally, susceptibility decreased with advances in grade. Further, boys were more susceptible than were girls. Unexpectedly, there was no main effect for generational status. The findings mirror the gender and grade trends reported in the literature for Anglo adolescents. The findings for acculturation are discussed in terms of cultural differences in the relative influence of parents and peers.

Peer Relationships as a Source of Support for Adolescent Mothers

Little has been written about the role of the peer group in the lives of adolescent mothers. There has been speculation that an adolescent mother's peer relationships change as a result of pregnancy andparenthood. The literature indicates that peers become less able to provide a support system. Little empirical evidence has been provided to support this speculation. This study assessed a sample of 46 adolescent mothers on the amounts and types of supportprovided byfriends as compared to relatives and examined peer support in relation to parenting stress. The Inventory of Social Contacts measured levels of perceived child-rearing, emotional, and material support and interference from family and friends. The Parenting Stress Index assessed self-reported parenting stress arising from child and parent characteristics. Results of repeated-measures ANOVAs and Pearson correlations indicated that, as compared to family, friends provide more emotional support and less interference. Parenting stress is buffered more effectively by the support that is provided by friends.

Initial Validation of a Scale Measuring Self-Efficacy of Breast Self-Examination among Low-Income Mexican American Women

This paper presents the initial validation of a bilingual (English/Spanish) scale designed to assess intensity of perceived self-efficacy for breast self-examination (BSE) among low-income Mexican American women. The validation and reliability analysis included the use of Cronbach's alpha, factor analysis, and correlations of the measure with knowledge of correct BSE procedure, current level of breast self-examination, and English language proficiency. Cronbach 's alpha coefficient demonstrated the reliability (internal consistency) of the scale. Results of the factor analysis supported the construct validity of the perceived self-efficacy measure, and statistically significant correlations with knowledge of correct breast self-examination, frequency of breast self-examination, and English language proficiency substantiate the concurrent validity of the measure. Further testing of the scale is proposed to strengthen the validity of the concept of self-efficacy and its measure.

Acculturation, Gender Role Orientation, and Reproductive Risk-Taking Behavior among Latina Adolescent Family Planning Clients

This article explores the influence of demographic, sociocultural, and risk proneness indicators on age at first intercourse, number of lifetime sexual partners, and number of pregnancies in a sample of 670 Latina adolescents age 14-19 recruited from two publicly funded familyplanning clinics. Acculturation accounted for a small but statisticallysignificant amount of the variation explained for all three reproductive behaviors. Being less acculturated was associated with older age at initiation of sexual intercourse, fewer lifetime sexual partners, and fewer pregnancies. Substance experimentation was associated with earlier sexual debut and more sexual partners but with fewer pregnancies. Gender role orientation was significant onlyfor age at first intercourse. More traditional young women were older at sexual debut. These results suggest that gender role orientation is important for delaying first intercourse, but once sexually active, acculturation and substance experimentation become more important influences on sexual risk taking among Latina adolescents.

Contemporary Research on Hispanic Women:A Selected Bibliography of the Social Science Literature

One of the difficulties in developing a new area of research in any field is the lag time between the interest in the area on the part of researchers and the interest in publishing on the part of editors. Initial work may appear in books or publications outside the disciplinary mainstream and be overlooked in literature searches that focus on established journals. Further, work appearing in mainstream journals may be constrained by traditional paradigms and reflect Anglocentric and sexist biases of traditional research. This has been true for work on Hispanic women, which has been hallmarked by Anglocentric and sexist bias (Senour, 1977).

This 134-item bibliography addresses the difficulty of identifying the diverse work on Hispanic women in the U.S. and Puerto Rico by bringing a large part of it together in one place. We have three goals. The first is to facilitate the integration of material on Hispanic women into the curriculum of psychology. The second is to promote and disseminate research on the psychology of Hispanic women. The third is to recognize contributions of early researchers who have pioneered in developing and articulating knowledge about this neglected group.

We want to emphasize that this bibliography is not comprehensive. The focus is on scholarly work in the English language that advances understanding of Hispanic women's uniqueness and diversity as a group. Studies that included Hispanic women in their sample but did not specifically focus on Hispanic women or did not conduct gender or gender/ethnicity analyses were not included.

Toward a dynamic conceptualization of social ties and context: implications for understanding immigrant and Latino health

Researchers have posited that social ties and social support may contribute to better-than-expected health outcomes among Mexican immigrants vis-à-vis their US-born counterparts. However, in our review of studies examining social ties and health by immigration-related variables among this group, we found little support for this hypothesis. To better understand the social factors that contribute to the health of Mexicans in the United States, we conducted a qualitative analysis of social relationships and social context among first- and second-generation Mexican women. Our results highlight the interplay between immigration processes and social ties, draw attention to the importance of identity support and transnational social relationships, and suggest ways to reconceptualize the relationship between social contexts, social ties, and immigrant and Latino health.

PROMISES THEY CAN KEEP: LOW-INCOME WOMEN'S ATTITUDES TOWARD MOTHERHOOD, MARRIAGE, AND DIVORCE

Using survey data on low-income mothers in Boston, Chicago, and San Antonio (n = 1,722) supplemented with ethnographic data, we test 3 propositions regarding mothers' attitudes toward childbearing, marriage, and divorce. These are drawn from Edin & Kefalas (2005) but have also arisen in other recent studies. We find strong support for the proposition that childbearing outside of marriage carries little stigma, limited support for the proposition that women prefer to have children well before marrying, and almost no support for the proposition that women hesitate to marry because they fear divorce. We suggest that mothers' attitudes and preferences in these 3 domains do not support the long delay between childbearing and marriage that has been noted in the literature. Throughout, we are able to study attitudes among several Hispanic groups as well as among African Americans and non-Hispanic Whites.

The Best of Both Worlds

The relations among language acculturation, biculturality, and psychological adjustment were studied in a sample of 54 young mainland Puerto Rican mothers. Participants were interviewed in the language of their choice concerning their level of symptomatology (i.e., depression, anxiety, somatization, hostility, interpersonal sensitivity), language acculturation, monocultural involvement (assessed by separate adherence to American and Puerto Rican cultural values), and dual cultural involvement (assessed by a combination of cultural values). Results indicated that biculturality significantly predicted adjustment above and beyond monocultural involvement. In addition, although biculturality and bilingualism were both significantly related to psychological adjustment, linguistic balance showed a stronger association with adjustment than biculturality. Findings are discussed in light of the family, cultural, and developmental context in which young mainland Puerto Rican mothers are embedded.

How Latino American and European American adolescents discuss conflicts, sexuality, and AIDS with their mothers

The authors examined how the structure of mother-adolescent conversations differs by ethnic group, age, and dyadic and individual factors. Mother-adolescent dyads of European or Latino descent participated in conversations and reported on their relationship and AIDS knowledge. Latina American mothers dominated conversations more than European American mothers, independent of socioeconomic status. Mothers dominated conversations about sexuality and AIDS more than conversations about conflicts. Mothers of older adolescents reacted more negatively, and older adolescents reported less satisfaction, less openness, and more sexual discussions with persons other than their mothers. Latino American adolescents whose mothers dominated conversations more reported fewer sexual discussions. Latina American mothers who dominated conversations more reported more openness and satisfaction. When mothers dominated conversations more, adolescents had lower AIDS knowledge.

Acculturation, perceived social support, and self-esteem in primigravida Puerto Rican teenagers

The purpose of this study was to explore acculturation, perceived social support, and self-esteem in 63 primigravida adolescents of Puerto Rican background living in the mainland United States. Although more teenagers of Puerto Rican background become pregnant than do those of all other Hispanic mainland groups, few studies have viewed pregnancy within this subculture. Mainland acculturation was not related to either perceived social support or self-esteem among the study sample. The study elucidates the importance of recognizing the dual cultural influence on mainland-dwelling adolescents of Puerto Rican background. The study findings suggest that exploration be continued beyond acculturation, as measured in this study, to understand the differences in adolescent pregnancy rates among the specific cultures of the Hispanic megaculture of the United States.

Contraceptive methods: do Hispanic adolescents and their family planning care providers think about contraceptive methods the same way?

This article describes how a family planning clinic-based program to prevent repeat pregnancy among Hispanic adolescents in Los Angeles used qualitative research to understand client contraceptive behavior. Background information on Hispanic adolescent reproductive patterns and an overview of paths to motherhood among teen clients are provided to contextualize the results. Participants sorted contraceptive methods on perceived similarities and ranked them on effectiveness, safety, and use-preference. Multidimensional scaling was used to identify and compare conceptual models. Both providers and teens grouped methods by effectiveness and mode of action, but acceptability and ease of method use were also important for teens. Providers found participation a worthwhile educational experience that facilitated self-reflection about their own biases and better understanding of their clients' needs. This method could be applied in many clinical settings where education and counseling are important in treatment and where patients and providers are likely to have different conceptual models regarding therapy.

Gender Differences in the Sexual Behavior of Latino Adolescents: An Exploratory Study in a Public High School in the San Francisco Bay Area

Purpose:

The purpose of this study was to examine factors associated with sexual behavior among urban, first-generation Latino adolescents.

Methods:

Data were collected with self-administered questionnaires on 176 (98 girls and 78 boys) Latino high school students between the ages of Fifteen and nineteen years, of whom 76 percent were born in Latin America and 34 percent had lived in the United States for two years or less. The outcome variables measured three levels of sexual activity, defined as: sexual abstinence, “making out” (kissing passionately, or kissing “using one's tongue”), and sexual intercourse. The key predictors were gender and acculturation. Other variables included information on socio-demographics, self and body-image, college aspirations, and family structure/relationships. Stratified analysis was conducted for each gender.

Results:

Twenty percent of boys and 27 percent of girls were abstainers. Whereas girls were more likely than boys to “make out” only (47% vs. 26%), boys were more likely to engage in sexual intercourse (54% vs. 26%). For girls, there was a negative association between making out and maternal punishment, feeling close to both parents and paternal love. Sexual intercourse was inversely associated with having educational goals beyond high school and presence of parental love, and positively correlated with age and maternal communication about sex. In boys, the predictors of “making out” were feeling close to both parents and Spanish language spoken with friends, and for sexual intercourse the significant predictors were feeling close to both parents, presence of an older sister, and body-image.

Conclusions:

The results indicate that family structure and relationships, personal characteristics, and acculturation play important but different roles in the sexual development of Latino adolescent girls and boys. Sex education curricula should take these gender and family influences into account.

Sexual, assaultive, and suicidal behaviors among urban minority junior high school students

OBJECTIVE

A greater understanding of minority adolescents' involvement in sex and violence is an essential precursor to the development of effective prevention programs targeted at inner-city youths.

METHOD

To estimate the prevalence of involvement in sexual, assaultive, and suicidal behaviors and to quantify the relative importance of demographic, psychosocial, and behavioral risk factors for those behaviors, a survey was administered in the spring of 1992 to a sample of 3,738 predominantly Hispanic and African-American students attending four junior high schools in an economically disadvantaged, medically underserved New York City school district. The mean age of participants was 13.5 years; 73.7% were Dominican, 6.9% were other Hispanic, and 10.4% were black.

RESULTS

Thirty-one percent of males and 7% of females reported involvement in sexual intercourse, 27% of males and 8% of females reported involvement in assaultive behavior and 10% of males and 19% of females reported suicide intentions/attempts. The primary risk factor for sexual intercourse was a belief that involvement in intercourse was common and acceptable among peers. The primary risk factor for assaultive behavior was adverse social circumstances. The primary risk factor for suicide intentions/attempts was symptoms of depression. The risk for involvement in each of the three investigated risk behaviors was substantially increased by involvement in the other two behaviors.

CONCLUSIONS

These findings underscore the urgent need for comprehensive sex and violence prevention programs targeted at urban minority junior high school students and suggest factors that may identify students at highest risk.

Adolescent mothers: caregiving, approval, and family functioning

OBJECTIVE

This study tested the Adolescent Family Assessment Model, which describes the relationships between caregiving behaviors, caregiving knowledge, peer and family approval, and family functioning.

DESIGN

A descriptive correlational design was used along with causal modeling procedures to test the model.

SETTING

Subjects were recruited from teen parent programs and an obstetrician's office.

SUBJECTS

A convenience sample of 134 adolescent mothers participated in the study. Each subject had not completed her high school education and was living in the same household as her child.

MAIN OUTCOME MEASURES

Subjects completed a demographic questionnaire, the Infant Caregiving Inventory (caregiving knowledge), the Peer and Family Approval Instruments (social approval), and Smilkstein's Family APGAR (family functioning). Instruments were completed twice by each subject, with a 2-week period between administration.

RESULTS

Fifteen percent of the variance of caregiving behaviors was explained by ethnicity (beta = -.30) and age of the first child (beta = -.26). Ten percent of the variance of family functioning was explained by age of the first child (beta = -.24) and ethnicity (beta = -.20).

CONCLUSIONS

It appears that family functioning declines for the first 2 years after the birth of the adolescent's child.

U.S.- and Mexico-born Hispanic teen mothers: a descriptive study of factors that relate to postpartum compliance

This study examinedfactors that related to postpartum compliance in a group of U.S.-and Mexico-born Hispanic teens who delivered at a county hospital in Houston, Texas. Only 50 (17.3%) of the combined group returnedfor their scheduled postpartum visit. Returning teens across groups were more likely to have no prenatal care, have a preterm or expired infant, report no educational plan, but have a support system. When controlling for marital status, Mexico-born married teens were the most likely to return for postpartum visits. Medical services need to focus on cultural norms andfamily support systems to increase use of health services. These factors appear to be consistent across both groups of Hispanic teens although married teens from Mexico appear to be more compliant to health care.

Hispanic adolescent conception and contraception profiles. A comparison

Marital status, contraception, desire for pregnancy, and social support relationships were analyzed by ethnicity for a group of pregnant and postpartum adolescents. Although no significant differences were found among ethnic groups for birth control information and use, the desire for pregnancy, grouped by marital status at conception, was significantly different for Hispanics. Positive evaluations of the life changes associated with pregnancy were found more frequently among Hispanic mothers. Hispanic teen mothers, however, were least likely to understand the menstrual cycle. The role of ethnic background in adolescent fertility behaviour is discussed, and potential clinical applications for more effectively serving sexually active Hispanic adolescents are presented.