Historic Trends in the Delivery of Services to Teenage Parents

This paper will examine the political, social, and economic factors which underlie the transition in services from unwed mothers to teenage parents over the past 15 years. The experience of agencies in the Boston area serves as the basis for this case study. Data have been collected from open-ended interviews with key service providers who have developed and implemented policy related to adolescent parents. The findings indicate that, prior to 1960, agencies were responding to what was perceived as individual problems or circumstances. Illegitimacy was thought to be an unconscious attempt by white middle class women to fulfill psychological needs. The rediscovery of poverty resulting in the expansion of human services, and the declining utilization of maternity homes due to changing social attitudes relative to abortion and childbearing led to the creation of comprehensive service programs for adolescent parents. Unlike their predecesors, these programs were designed to serve a younger, black population that planned to keep its infants. The reorganization of the service system, however, still failed to address the problem of white working class adolescents who comprise the greatest number of teenage parents. The last 15 years have witnessed the creation of a vast array of specialized services for pregnant adolescents. Prior to the development of such programs, little help was available to this group. Some youthful pregnant girls found assistance in the maternity homes that worked cooperatively with child welfare agencies. These programs were, however, designed to provide shelter for a group of largely white, middle class, past-adolescent women who had become pregnant out-of-wedlock. Casework services at these homes sought to encourage the mothers to release their infants for adoption so they could be raised in a more advantageous environment and the mothers could resume their "normal life course" following delivery. Since most of the residents were over 18, there was no need for educational services. In addition, most pregnancies and deliveries were normal, so they required only conventional medical care. In marked contrast, the 1960's and 1970's saw the development of comprehensive service programs specifically designed for pregnant girls who were still of school age and who in most cases planned to keep their children. School age mothers had been found to be at greater risk than women who bore their children later in life (Klerman and Jekel, 1973; Furstenburg, 1976; Presser, 1978). These young women and their children suffered worse medical outcomes. They typically dropped out of school, and they were faced with the problems of completing their own adolescence while raising a young child. As a result, the comprehensive service programs offered a combination of medical, educational and social services throughout the prenatal period to help alleviate the consequences of adolescent childbearing. In order to explain this shift in service delivery it is necessary to consider what happened during the sixties that resulted in the redefinition of three aspects of the service delivery system: (1) of the problem, from illegitimacy to adolescent parenthood; (2) of the service population from white middle class young women who planned to place their infants for adoption to low income, primarily minority, adolescents who plan to raise their own children; and (3) of the service needs, from intensive casework around the issues of loss and fulfillment to a comprehensive approach including medical, educational, and social services. Certainly one factor which led to these changes was the rapid increase in the number of pregnancies and deliveries to school age women (Baldwin, 1976). Much of the current literature on teenage pregnancy has placed the main issues of the field in the context of changing demographic trends. It is common for articles to begin with a statistical description of patterns of adolescent sexuality and reproduction. A publication of the Allan Guttmacher Institute (1976) goes so far as to speak of adolescent pregnancy as an "epidemic". While such studies adequately document the extent of need, they do not explain the shape services take at a particular time. If one is to understand both the development of new models of services to school-age parents and the problems for which solutions still must be found, it is necessary to look beyond demographic changes and to examine the impact of social movements. It is the contention of this paper that the black protests in the sixties and the women's movement both shaped the response to the rapid increase in the number of adolescents bearing children. Black protests greatly influenced the redefinition both of the problem and of the population which was to receive the newly defined comprehensive services; further, the women's movement helped to create new options for those women who had previously gone to maternity homes to conceal an out-ofwedlock pregnancy. A review of the situation also demonstrates that one group is still not receiving comprehensive services. These are white, working class adolescents whose births far outnumber those of blacks. Similarly, their exclusion from the service sector must be analyzed in terms of these two social movements.