Adolescent Parenthood PDF
Preview Adolescent Parenthood
ADOLESCENT PARENTHOOD adolescent parenthCDd Edited by Max Sugar, M.D. Clinical Professor of Psychiatry Louisiana State University Medical Center New Orleans, Louisiana MTaUMITED International Medical Publishers Published in the UK and Europe by MTP Press Limited Falcon House Lancaster, England Published in the US by SPECTRUM PUBLICATIONS, INC. 175-20 Wexford Terrace J amaica, NY 1 1432 Copyright © 1984 by Spectrum Publications, Inc. Softcover reprint ofthe hardcover 1st edition 1984 All rights reserved. No part of this book may be reproduced in any form, by photostat, microfilm, retrieval system, or any other means without prior written permission of the copyright holder or his licensee. ISBN-13: 978-94-011-5926-5 e-ISBN-13: 978-94-011-5924-1 DOI: 10.1007/978-94-011-5924-1 Contributors Nicholas Anastasiow, Ph.D .• Professor, Department of Special Education, Hunter College, New York, New York Jo Ann B. Fineman, M.D .• University of Arizona Health Sciences Center, Tucson, Arizona Susan M. Fisher, M.D .• Lecturer and Consultant, Department of Psychiatry, University of Chicago Pritzker School of Medicine, Chicago, lllinois James M. Herzog, M.D .• Assistant Professor of Psychiatry, Harvard University Medical School; Faculty Child and Adult Psychoanalysis, Boston Psychoanalytic Institute, Boston, Massachusetts Theodora Ooms, M.S.W .• Director, Family Impact Seminar, National Center for Farnily Studies, Catholic University of America, Washington, D.C. Carlos Salguero, M.D., M.P.H .• Hili Health Center, New Haven, Connecticut; Assistant Professor, Department of Psychiatry, Yale University, New Haven, Connecticut Kathleen Rudd Scharf, Ph.D .• Tucson, Arizona Nancy Schlesinger, M.P.H .• Assistant Analyst and Educator, Management Infor mation Services, Norwalk Hospital, Norwalk, Connecticut Moisy Shopper, M.D .• Clinical Professor of Child Psychiatry, St. Louis Uni versity School of Medicine; Training and Supervising Analyst, St. Louis Psycho analytic Institute, St. Louis, Missouri vi Contributors Marguerite A. Smith, Ph.D .• Retired from Department of Child Psychiatry, Boston University, Boston, Massachusetts Peggy B. Smith, Ph.D .• Assistant Professor, Department of Obstetrics/Gyne cology, Baylor College of Medicine, Texas Medical Center, Houston, Texas Patricia Meyer Spacks, Ph.D .• Professor of Literature, Department of English, Yale University, New Haven, Connecticut Max Sugar, M.D .• Clinical Professor of Psychiatry, Louisiana State University Medical Center, New Orleans, Louisiana Edilma Yearwood, R.N., M.A .• Staff Nurse, Inpatient Child Psychiatry Unit, North Carolina Memorial Hospital, Chapel Hill, North Carolina Foreword The definition of the risks of adolescent childbearing has received considerable investigative attention during the last decade. We have gradually moved away from simplistically studying young maternal age as the sole determinant of biologie and psychosocial outcome, even though we recognize it is one of several factors which warrant consideration. We now recognize that if adolescents receive adequate and consistent pre natal care, they and their infants should do nearly as weIl as adult women and their infants of similar backgrounds. Thus, the major morbidities for adolescent mothers, adolescent fathers, and their infants are psychosocial: lack of educational and voca tional futures, failed marriages, and dependence on government aid for support. The adequacy of the parenting of adolescent mothers and fathers and the long-term developmental and physical outcomes of their children are largely unstudied. This book, edited by Dr. Max Sugar, a recognized authority on adolescence, focuses on the important topic of adolescent parenthood. The authors of this timely contribution approach the topic of adolescent parenthood in a unique fashion, utilizing a combination of several approaches: consideration of fictional characters in history , astute and carefully conceptual ized clinical observations, reviews of the literature, and their own investigation. lt will be through the use of such a creative approach that we shall define the important quest ions which should be addressed about adolescents as parents and the outcome for their children. The uniqueness of studying three developing beings-the adolescent mother, the adolescent father, and their infant-and their interactions with each other should provide future investigators special and exciting challenges. We are indebted to this book's authors for initiating the consideration of adolescents as parents. ELlZABETH R. McANARNEY, M.D. George Washington Gofer Associate Professor of Pediatrics The University of Rochester Medicaf Center Rochester. New York 'relace It is our view that the adolescent parent does not live in isolation but is part of a continued and involved extended family, and social and cultural group. Some of the participants in this larger tableau may or may not be wiHing to be identified or openly involved. But they certainly are affected by, and affect, the young adolescent females and males who become mothers and fathers. These include the infants, bilateral maternal and paternal grandparents, aunts, and uncles, as weH as siblings of the adolescent parents. From these are derived a host in the environment who are members of the helping professions aiming to shepherd the youngster through the pregnancy and early motherhood. These include people who provide funding for her, as weH as pediatric, social, medical, dental, obstetric, nutritional, educational, and other services. The book takes all of these into the purview of the adolescent parents and their children. It is divided into four sections that deal with the adolescent and extended family, the infant and its developmental risks, some current programs for adolescent parents, and the implications for programs. The opening chapter provides a review of cultural contributions to con siderations about adolescent pregnancy, types of motivation involved, and views of men and women. Although adolescent pregnancy is not a psychiatric diag nosis, at times it has almost routinely been inferred in our scientific twentieth century, while in the nineteenth century it was seen as immorality requiring punishment. Two chapters deal with different aspects of the problem of decision making related to the adolescent becoming sexually active or using contracep tives. These areas have been looked at in various ways without providing a suitable response to the fact that most adolescents currently know about contra ceptive use and yet ignore it. The dynamic aspects of the adolescent girl becoming pregnant and being mother are examined. Another chapter focuses on adolescent males and their x Preface line of development toward fatherhood. A chapter differentiates young black and Hispanic mothers on the basis of ethnic factors. Risk factors are described for the young mothers and their infants. The chapters on programs cover some different theoretical and practical aspects. The legislative history of fun ding for adolescent pregnancy and motherhood, which is not quite an illustrious reflection on our society, makes interesting reading about govemmental management of its funds for these young people. The chapter on the extended families of the young parents reflects some begin ning understanding, involvement, and support of the youngster's family through their adolescence and becoming a suitable parent. Although the cures for its slow development, as weIl as for improved legislative funding, are yet to be found, the authors of this section make some very thought-provoking points. Hopefully, the book will inform physicians in aB specialties involved with adolescents and their infants: obstetricians, pediatricians, neonatologists, psychi atrists, along with nutritionists, dentists, social workers, educators, legislators, demographers, anthropologists, sociologists, and those in the helping professions who may be dealing with the grandparents. This area has only recently become of interest to psychiatrists, primarily as a result of the risk features for the infants of adolescent parents for proper physical and emotional development. From this we have learned of the difficulties of these adolescents' emotional development, especiaBy the young adolescent mother who is further burdened by having to look after an infant when she is herself still a child with her own unfulfiBed developmental needs. While this book may provide some answers and clues, it raises issues which may promote a broader and more appropriate view of the situation of the adolescent parents, their baby, and their extended family, including the helping professions and governmental apparatus. HopefuBy, these will lead to improved programs that may be applied in a thoughtful and constructive fashion to deal with the growth and developmental needs of these adolescents and their infants'; this may avoid arrests in development for these infants and their youthful parents. Acknowlcdlclllcnts I wish to express my gratitude to the many who were instrumental, encouraging and supportive in this project: my wife, Barbara, for her editorial help and for bearance; my children for their support and tolerance for time away from them; my secretary, Marion Stafford, M.S., for her sprightly good humor and consistent efforts; Carol A. Leal, M.D., Taghi Modarressi, M.D., and John B. Reinhart, M.D., who were sources of stimulation and enthusiasm. Contents Contributors v Foreword vii Elizabeth R. McAnarney Preface ix Acknowledgements xi ADOLESCENTS AND THE EXTENDED F AMIL Y 1. The Wages of Sin: Adolescent Mothers in Nineteenth-Century Fiction 3 Patricia Meyer Spacks 2. Adolescent Decision-Making Toward Motherhood 21 Max Sugar 3. From .(Re) Discovery to Ownership of the Vagina A Contribution to the Explanation of Nonuse of Contraceptives in the Female Adolescent 35 Moisy Shopper 4. The Psychodynamics of Teenage Pregnancy and Motherhood 55 Susan M. Fisher
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