Bibliography
Gravel, Roy A., Joe T. R. Clarke, Michael M. Kaback, Don Mahu-
ran, Conrad Sandhoff, and Kinuko Suzuki. ‘‘The GM 2
Gangliosidoses.’’ In Charles R. Scriver, Arthur L. Beaudet,
William S. Sly, and David Vale eds., The Metabolic and Molecu-
lar Basis of Inherited Disease, 7th edition. New York: McGraw-
Hill, 1995.
MacQueen, Glenda M., Patricia I. Rosebush, and Michael F. Ma-
zurek. ‘‘Neuropsychiatric Aspects of the Adult Variant of Tay-
Sachs Disease.’’ The Journal of Neuropsychiatry and Clinical
Neurosciences 10 (1998):10–19.
Patricia I. Rosebush
TEENAGE PREGNANCY
Teenage pregnancy has long been a topic of concern
and controversy in the United States. On one hand it
has been characterized as an ‘‘epidemic,’’ and Presi-
dent Clinton referred to teen pregnancy as ‘‘our most
serious social problem’’ in his 1995 State of the Union
Address. Conversely, some research evidence sug-
gests that young maternal age may not be the cause
of all adverse consequences commonly associated
with teen pregnancy. This article discusses the inci-
dence of teenage pregnancy and trends in birth rates,
research on the consequences of teen childbearing for
mothers and their children, and the implications of
these findings for current policy and intervention
strategies.
Incidence of Teenage Pregnancy
Teenage pregnancy rates include those pregnan-
cies that result in live births as well as those ending
in induced abortions or other fetal losses. The Na-
tional Center for Health Statistics estimates that in
1996 the pregnancy rate was 98.7 per 1,000 women
aged fifteen through nineteen years, for a total of ap-
proximately 893,000 pregnancies. In that year, just
over half (55%) of these pregnancies resulted in a live
birth, with 30 percent ending in induced abortion,
and 15 percent in fetal loss.
Pregnancy and birth rates among teenagers have
varied considerably over time. Figure 1 depicts rates
of birth among women aged fifteen through nineteen
years from 1940 to 1999. Teen birth rates were at
their highest from the late 1940s through the early
1960s, mirroring the elevated rates seen among all
women of childbearing age during this time period,
commonly referred to as the ‘‘baby boom.’’ More re-
cently, birth rates showed a relatively modest increase
in the late 1980s and early 1990s, and declined steadi-
ly thereafter. Data for 1999 indicated that the teenage
birth rate in that year fell to a record low of 49.6 births
per 1,000.
Teen births tend to be concentrated in later ado-
lescence, with two-thirds of the total births in 1999 oc-
curring to women eighteen or nineteen years of age.
Birth rates also vary among teens by race and ethnici-
ty. Non-Hispanic white teenagers have historically
had much lower birth rates than other groups. Afri-
can-American teenagers ranked highest of any group
until 1994, after which marked declines led their rates
to track somewhat below those of Hispanic teens.Teenage Pregnancy and Later Outcomes
Becoming a mother as a teenager is associated
with higher risk for a number of poor outcomes. Teen
mothers are less likely to finish high school, less suc-
cessful in the job market, less likely to marry, and
more likely to rely on public assistance than women
who have children after their teen years. In addition,
children of teen mothers generally do not fare as well
as other children. They tend to score less optimally on
assessments of cognitive development and academic
achievement, and also tend to exhibit more problem
behaviors than other children.Although teen pregnancy is associated with this
myriad of unfavorable outcomes, it has become widely
acknowledged that such outcomes should not simply
be interpreted as being caused by early childbearing
itself. This is because teen births do not occur ran-
domly among women in the population, but rather
are experienced by women who themselves are much
more likely to have come from disadvantaged back-
grounds. Teenage mothers are up to twice as likely as
other women, for example, to have grown up in
single-parent families. Many teen mothers have spent
much of their own childhood in poverty, often living
in impoverished neighborhoods characterized by
poor schools, inferior public services, and limited ca-
reer options. Since people who come from disadvan-
taged backgrounds are generally at higher risk for
poorer outcomes, it is very difficult to sort out wheth-
er the long-term difficulties experienced by teen
mothers and their children are due to early childbear-
ing, or are the result of the mothers’ preexisting eco-
nomic and social disadvantages.
During the 1990s, researchers used innovative
methods to try to better understand the actual conse-
quences of teen childbearing. Arline Geronimus and
her colleagues studied pairs of sisters in their late
twenties and thirties in which one of the pair had a
birth while a teenager and the other did not. Since
both sisters were raised in the same conditions, this
strategy provided a way to control for many aspects
of background disadvantage when examining ways
that outcomes differed for the teen and nonteen
mothers. Using data from several nationally repre-402 TEENAGE PREGNANCY