Wednesday, October 20, 2006
Researchers from the University of Maryland School of Medicine found that a home-based mentoring program for low-income, African-American adolescent first time mothers in Baltimore was effective at delaying a second birth by at least two years after the first baby’s arrival. These results are published in the October issue of the journal Pediatrics.
“The United States has the highest rate of teen pregnancies among industrialized nations with approximately 10 percent of adolescent girls becoming pregnant annually,” says Maureen Black, Ph.D., a professor of pediatrics and medicine at the University of Maryland School of Medicine. “Although rates of adolescent childbearing have declined in recent years across all racial and ethnic groups, the most recent birth rates for black adolescents are more than double the rates for non-Hispanic white teens. Within this age and ethnic group, the national rate of repeat childbirth within two years of initial delivery is as high as 30 to 50 percent. Having a baby during adolescence is a huge risk factor for the mother and for the baby, who is now living with a parent who hasn’t completed her education, may not have employment and may not have developed proper parenting skills.”
Mentoring programs, which connect adolescents with adults for support and advice, have long been viewed as an effective strategy to reduce risk behaviors among adolescents. “Teenagers from high-risk backgrounds who have a mentor are less likely to participate in high-risk behaviors such as substance use, carrying a weapon and having sex with multiple partners. These programs have been beneficial at helping teens experience academic success, career activities, and feelings of self-worth and optimism,” says Dr. Black.
For the study, Dr. Black and her colleagues recruited 181 adolescent mothers under the age of 18 who had just given birth at one of three Baltimore hospitals. Because national policies require that adolescent mothers must live with a guardian to receive public assistance, the participants were required to be living with their mothers at the beginning of the study. The adolescent mothers were randomly assigned either to the intervention group or a control group.
Those in the intervention group received bi-weekly home visits for one year from college-educated black women in their 20s who were single mothers and living on their own. “The mentors presented themselves as ‘big sisters’ who had been through the experience of raising a child,” says Dr. Black. “They worked to build trusting relationships with the intervention group mothers and took on a supportive role instead of an authoritarian role.”
The curriculum was designed to help the mothers with their own adolescent development, which included staying in school and delaying a subsequent birth, and parenting skills. During the home visits, the intervention group mothers learned what to expect during their infant’s first year of life, how to interpret their baby’s cries and how to provide developmentally enriching activities. The mentors also focused on personal values and decision-making regarding subsequent pregnancies, access to birth control and goal setting, instead of overtly advising participants to avoid a second birth.
Independent evaluators followed up with participants in both the intervention and control groups when the infants were six, 13 and 24 months of age. Eighty-two percent of participants stayed with the study for its two-year duration.
The researchers found that the mentoring program was effective in preventing second births among mothers in the intervention group. Only 11 percent of the mothers in that group had a second child within two years of their first delivery compared to 24 percent in the control group. Mothers in both groups who had a second baby reported relatively high rates of self-esteem, parenting satisfaction and support from the infant’s grandmother, but they were no more likely to be married, to use contraceptives, or to engage in high-risk behavior such as substance use or fighting than mothers who did not have a second baby.
“Teen mothers tend to be on a faster family track than their peers who haven’t had a child,” says Dr. Black. “Paradoxically, some of the young mothers wanted to have another baby because they were eager to continue the formation of their family. Our study showed that a relatively brief mentoring program focused on adolescent development and interpersonal skills was effective at encouraging mothers to delay a subsequent birth for at least two years after their first child was born. Those additional two years provide time to mature and prepare for the tasks of parenting and adulthood.”