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Self-Esteem and Teenage Pregnancy
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Self-Esteem and Teenage Pregnancy

Susan B. Crockenberg and Barbara A. Soby


I knew I could get pregnant, but I didn't think about it much. I was too embarrassed to go to a clinic and tell a bunch of strangers that I was having sex. I couldn't talk to my boyfriend about birth control, either—he would have made fun of me. My mother would have grounded me permanently if she ever found out I was taking the pill. Anyway, I thought that maybe getting pregnant wouldn't be so bad—what else did I have to do?
—Fictitious pregnant teenager

This vignette illustrates why adolescents with low self-esteem may be more likely to become pregnant than their peers with higher self-esteem. In this chapter, we suggest that adolescents perform—perhaps without realizing it—a cost/benefit analysis in their decisions to engage in sexual intercourse and to forego contraception. Self-esteem is important because it may influence how those costs and benefits are perceived. This intriguing possibility has implications for reducing the number of adolescent pregnancies.

The results of research studies tell a story that is much less straight-forward than the one suggested in the vignette above, however. We begin by considering the birth rate among adolescents in the 1980s.

The birth rate among teenagers has declined in the past twenty years (U.S. Congress, House Select Committee on Children, Youth, and Families 1986), as it has among the general population. In California in 1985,

The authors gratefully acknowledge the assistance of Sandra walker in the preparation of this chapter.


there were 52.5 births per 1,000 girls aged fifteen to nineteen, down from 68.9 births per 1,000 in 1970 (Brindis and Jeremy 1988). This decline has been greater for blacks than for whites, declining 35 percent and 24 percent, respectively, at the national level.[*] Judging from these statistics, we might expect the concern with teen pregnancy to have diminished correspondingly. Instead, it has increased dramatically, as seen in the number of studies funded, articles published, and congressional hearings convened that have focused on teenage pregnancy and parenting.

Three changes in the nature of teenage pregnancies may account for this concern. First, although the overall birth rate among teenagers has decreased significantly, it has increased among the youngest teens. In California, the birth rate among girls ten to fourteen years old rose between 1970 and 1985, from 0.8 to 1.0 births per 1,000 girls in that age group. One percent of all births to whites occurred in this age group, whereas 3 percent of births to Hispanics and 6 percent of births to blacks were to these young teens (Brindis and Jeremy 1988). Thus, the teenagers whose lives may be most adversely affected by a birth and who are presumably least able to care for a child are somewhat more likely to bear children today than they were twenty years ago.

This trend in the birth rate for young teenagers is apparent despite the availability and use of abortion, suggesting that the pregnancy rate would reveal an even steeper increase over time. It is estimated that in 1981 more than half of the pregnant teenagers in California (Brindis and Jeremy 1988) and more than 40 percent of pregnant teens in the United States (Hayes 1987b) terminated their pregnancies through induced abortions. Despite comparable rates of sexual activity, the United States has the highest pregnancy, abortion, and birth rates among adolescents of any developed country, especially among females under the age of fifteen. The birth rate among American adolescents in this age group is five times higher than it is among such young girls in any other developed country (Hayes 1987b).

The second change concerns the circumstances surrounding births to teenagers. In the past, the majority of births occurred in the context of marriage, albeit a hastily arranged one; today, the mother is more likely to remain single. In 1984, for girls between the ages of fifteen and nineteen, 34 percent of births to non-Hispanic whites, 45 percent of births to Hispanics, and 87 percent of births to blacks occurred outside of


marriage (Hayes 1987b). In contrast, in 1950 only 12.6 percent of all births to teens, 5.1 percent of births to white teenagers, and 68.5 percent of births to nonwhite teenagers were out of wedlock (Campbell 1980).

Not only are more babies born outside of marriage, but also the adolescent mothers today are more likely to keep their children and less likely to give them up for adoption than they were in the past (Vinovskis 1981). This is a third reason for concern, because it indicates that unwed adolescents, some of them quite young, will be raising the babies they bring into the world.

A major concern about teenage childbearing is the impact of a birth on the unmarried teen mother, whose subsequent life is viewed as both predictable and constricted. It is feared she will drop out of school, be unable to support herself and her child, and either marry someone she would not have chosen otherwise and then divorce or else enter the ranks of those on welfare. In fact, despite recent evidence of variability in the outcomes of adolescent childbearing (Furstenberg, Brooks-Gunn, and Morgan 1987), there is considerable evidence that these concerns are well founded (Hofferth 1987b). Virtually every study that has controlled for initial differences between adolescent and older childbearers has reported that early births carry an additional impact. In the Furstenberg, Brooks-Gunn, and Morgan (1987) study, for example, significant differences remained seventeen years later between the women who had waited until after age twenty to bear children and the teenage mothers. Fewer of the early childbearers had completed high school or obtained a GED, fewer were employed, and those who were employed were more likely to be in low-paying positions. More early childbearers were on welfare, more were poor, and more had divorced or separated from spouses.

Evidence that women who bear children as adolescents utilize public services more than other women do focuses attention on the economic costs to society of the increase in unmarried teenage mothers. These costs are considerable, as indicated by information collected by the National Research Council on Adolescent Sexuality, Pregnancy, and Childbearing and reported by Hofferth (1987b). In 1975, half of the budget for Aid to Families with Dependent Children (AFDC)—roughly $ 5 billion—went to households in which the mother was a teenager at first birth. When food stamps and Medicaid benefits are added to the bill, it rises to $ 8.55 billion. A 1985 estimate indicated that total welfarerelated expenditures associated with teenage childbearing had nearly


doubled in the preceding ten years, to $ 16.6 billion. In California, taxpayers spend an additional $ 1.24 billion each year on the direct and administrative costs of AFDC, Medi-Cal, and food stamps for families that were started when the mother was a teenager (Brindis and Jeremy 1988).

From this perspective, pregnancy (and therefore parenthood) among unmarried teens cannot be viewed simply as a violation of tradition or of certain moral standards, nor can it be viewed solely as a limiting individual choice. To the extent that social costs are associated with it, single parenthood among teenagers is a problem that society has an investment in solving.

The review that follows is consistent with this perspective. Unlike most other efforts to understand the factors contributing to adolescent pregnancy, however, we will focus primarily on the link between self-esteem and teenage pregnancy. We begin with a brief introduction to self-esteem as a psychological construct, followed by an analysis of low self-esteem as a possible contributor to teen pregnancy. We then describe and evaluate research that has tested whether low self-esteem increases the risk of a teen pregnancy. In the final section, we consider the implications of this research for social policy.


Self-esteem plays a central role in a number of psychological theories, each of which offers its own definition of the term (Wells and Marwell 1976). In nearly all these definitions, self-esteem refers to feelings and attitudes toward the self. These are described and measured along continuums that range from high to low or positive to negative. We have adopted this sparse definition of self-esteem here because it makes the fewest assumptions about the structure of personality, allowing for a more comprehensive review of studies that have considered the association between self-esteem and adolescent pregnancy. Other terms cited (self-attitude, self-regard, self-acceptance—or its opposite, self-derogation) also share the core meaning of feelings toward the self.

In their review of the literature, Wells and Marwell (1976) identify two components of self-esteem: an evaluative component and an affective component. The evaluative component addresses the issue of competence—how competent or successful an individual thinks he or she is. The affective component addresses the issue of acceptance—subjectively, how individuals feel about themselves. These different, though related, aspects of self-esteem are thought to result from differ-


ent forms of experience. The evaluation of competence is associated with success at a task. If students do well in school or in some other activity that they consider important, they will presumably judge themselves as competent. Feelings of acceptance are associated with affiliative experiences, the ways in which significant others respond to an individual. If those responses are positive—that is, if one feels loved and accepted, despite imperfections—then the individual's internalized feelings about himself or herself should reflect this.

Although it is possible to distinguish these aspects of self-esteem, the two often are integrated, as in the definitions and descriptions of self-esteem provided by Rosenberg (1965), Coopersmith (1967), and Kaplan (1975) and in the measures designed by these psychologists to reflect these definitions (see Appendix). Rosenberg emphasizes the affective aspect and refers to self-esteem as "a positive or negative attitude toward a particular object, namely, the self" (1965, 30); but he acknowledges that these feelings derive from the individual's evaluation of self in relation to criteria of excellence, derived in turn from what is valued by the society. Coopersmith's definition—"the extent to which the person believes himself to be capable, significant, successful, and worthy"—emphasizes the evaluative component of self-esteem, but touches on the affective by including the notion of worthiness. Kaplan defines self-esteem as self-attitudes or feelings that "refer to the emotional experiences of the subject upon perceiving and evaluating his own attributes and behaviors" (1975, 10–11).

In general—and this oversimplifies the association considerably—high self-esteem is expected to reflect and predict good adjustment and behaviors valued by the society. In contrast, we expect low self-esteem to be associated with deviant behavior. Again, different theorists explain the dynamics of this association in various ways. Kaplan (1975) presents one of the clearest, yet most complex, descriptions of the association between self-esteem and behavior; his analysis will therefore form part of our theoretical framework for reviewing the research on self-esteem and adolescent pregnancy.

According to Kaplan, individuals attempt to develop, maintain, and improve positive self-attitudes. If they have not yet adopted deviant behaviors, we may assume that their positive self-attitudes are derived from culturally sanctioned (normative) experiences—acceptance and love at home, achievement at school. Because these experiences are associated with emotionally gratifying self-attitudes, they are expected to become gratifying in their own right and to encourage behavior that fosters other such experiences. Individuals who have developed positive


self-esteem in this manner thus would continue to engage in behaviors valued by the culture.

We may also assume that negative self-attitudes derive from normative experiences. In these cases, however, such experiences have been unpleasant, threatening, or devaluing. Because these experiences are associated with emotionally distressing (negative) self-attitudes, they become highly distressing in their own right. Therefore, individuals with normatively derived negative self-attitudes not only are likely to avoid the distress-producing experiences, but also are "motivated to deviate from normative patterns by virtue of their intrinsically distressing nature." In Kaplan's view, "deviant patterns would offer the only remaining promise for satisfying the self-esteem motive" (1975, 54).

Using this analysis, one would predict correlations between high self-esteem and low frequencies of deviant behavior and between low self-esteem and high frequencies of deviant behavior only when positive self-attitude derives from so-called normative experiences (being loved by parents, accepted by friends, appreciated by teachers). If an individual has engaged in deviant acts, however, positive self-attitude may have derived from these acts, rather than from normative experiences. In that case, we would expect to find little empirical association between self-esteem and deviant behavior. Knowing the origins of self-esteem is therefore critical for evaluating the causal link between self-esteem and teen pregnancy, as we will discuss.

Linking Self-Esteem and Teen Pregnancy

Several analyses of the determinants of pregnancy or of deviant behavior would lead us to expect a higher incidence of pregnancy among adolescents with low self-esteem. The first is Kaplan's (1975), linking self-esteem and deviant behavior. A second is Luker's (1975) cost/benefit analysis of contraception and pregnancy, and a third is a variant of Luker's thesis that emphasizes the biological basis of adolescent pregnancy.

Becoming pregnant as an unmarried adolescent is deviant because only a small minority of adolescents do so and because it is not approved by the society at large. Thus, an individual who is motivated to deviate from normative patterns because of their negative connotation may become pregnant as a way of bolstering self-esteem. The adolescent may expect motherhood to improve her status: as a mother, she will have an important task to perform. She may also expect the baby to love


her and the baby's father to feel bound to her. Alternatively, pregnancy could be simply an unconsidered outcome of sexual intercourse, which may be viewed as self-enhancing because it signals a movement away from childhood, because it is associated with the feeling of being loved, and because it may validate the adolescent as an attractive person. In either case, we would anticipate that adolescents with low self-esteem would be more likely to become pregnant.

An alternative view is that adolescent pregnancy becomes more common when the costs of pregnancy are low, especially if the costs of contraception are high (Luker 1975). An adolescent with low self-esteem may be unconcerned about avoiding pregnancy, simply because there is little to lose if she becomes pregnant. If she is not doing well in school and does not expect to get a job that is either interesting or lucrative, early pregnancy and parenthood will not interfere with any important individual goals and will carry little personal "cost." We would predict that this individual is more likely to become pregnant than an adolescent with high self-esteem. In addition, as Luker points out, just as there are costs to a pregnancy, there are costs to prevention, which requires either sexual abstinence or effective contraception. The higher the potential cost of these actions, the greater the cost associated with pregnancy will have to be to ensure that the adolescent successfully avoids becoming pregnant. If this perspective is accurate, it may be essential to include the cost of prevention in our model of self-esteem and teen pregnancy.

Still another view is that early sexuality should be viewed as "expected behavior," because sexual activity has always closely followed sexual maturity, not only in other animal species but also in most human societies prior to the twentieth century (Lancaster 1986). If we assume that the biological changes accompanying sexual maturity prime the individual to engage in sexual behavior, it is the inhibition of this behavior rather than its expression that needs to be accounted for. One plausible explanation is that inhibition will occur to the extent that engaging in early sexual intercourse has negative consequences for the individual. In American society, many of those consequences have diminished in the past thirty years. It is possible not only to prevent conception but also to abort an unwanted pregnancy after conception. Nor does an adolescent pregnancy carry the same stigma as in the past, although this clearly varies among social groups. Pregnant adolescents were once sent away to "homes for unwed mothers"; now they remain at home and attend special school programs. Consequently, teenage


pregnancy and parenthood today, much more so than in the past, are individual decisions affected by perceived costs to the individual. If those costs are few, then pregnancy and parenthood will be more likely than if the costs are many and high.

Each of these perspectives would lead to similar predictions concerning self-esteem and pregnancy. Low self-esteem, we believe, would be associated with a greater risk of adolescent pregnancy.

Confounding Factors and Research Design

Factors other than self-esteem affect the teen pregnancy rate, and these factors vary across studies, making it difficult to evaluate the association between self-esteem and adolescent pregnancy. One such factor is race or ethnicity; others are social class, age, cohort (referring to the historical period during which the adolescent reached childbearing age), and availability of contraceptives.


Racial or ethnic background may be seen as a composite variable that encompasses differences in economic status, the value placed on motherhood, the disapproval associated with pregnancy, educational success and failure, and possibly self-esteem as well. Any of these factors, and therefore race or ethnicity, could affect the pregnancy rate directly, could interact with other predictors to affect the rate, or could confound or mask the association between self-esteem and pregnancy. Thus, in a subcultural group that highly values the maternal role, for example, pregnancy and motherhood may be especially attractive to adolescents and may also be associated with less social disapproval than would be the case in the dominant culture. In such a group, individual differences in self-esteem may play little role in predicting teen pregnancy.

Alternatively, low self-esteem may be associated with a high incidence of teen pregnancy only under certain, culturally linked, conditions. Thus, where there is an extremely high degree of parental or religious control over sexual behavior, low self-esteem may show less association with pregnancy than in a cultural context where the social constraints are weaker. This argument illustrates the difficulty of drawing clear inferences about what psychosocial factors might contribute to teen pregnancy. The possibility of racial or ethnic differences in predictors of teen pregnancy also has implications for attempts to reduce the


pregnancy rate during the teenage years, for if the conditions that lead to pregnancy differ across ethnic groups, attempts to alter the pregnancy rate also must differ.

Social Class

Like race and ethnicity, social class is a composite variable that includes differences in income, occupational status, and education. Any of these factors could be expected to influence the probability of an adolescent pregnancy, through association with the various costs and benefits of pregnancy or its prevention. An adolescent whose parents have relatively little education and hold low-status jobs may not see an early pregnancy in terms of an interrupted education, lost career opportunities, or other such costs.

In addition, self-esteem may be influenced by experiences of success and failure in school, which are likely to be class-related. Thus, social class may be associated with the risk of pregnancy during adolescence as an effect of class-related expectations or as an effect of class-related experiences that contribute to differences in self-esteem. It follows that differences in social class may confound—that is, account for—any observed association between self-esteem and adolescent pregnancy.


The adolescent's age or, more accurately, the age-linked probability that the adolescent has engaged in deviant behavior may influence what accounts for a teenage pregnancy. If we assume that adolescents often adopt deviant behaviors as a way of bolstering their self-esteem, then the younger they are when self-esteem is measured, the more likely we are to obtain an accurate view of the feelings that may later lead to deviant behavior. Self-esteem assessed early in or prior to adolescence should be a better predictor of teenage pregnancy than self-esteem assessed later in adolescence; the high self-esteem some older adolescents report may have derived from their deviant behavior or from devaluing acceptable behavior.


The adolescent's cohort may well affect whether self-esteem predicts teen pregnancy. The percentage of adolescent females who report engaging in premarital sex has increased markedly since the early 1960s.


Although the causes of that increase cannot be determined conclusively, because so many other changes occurred at the same time, it is unlikely that a large-scale decrease in self-esteem accounts for the increase in premarital sex. More reasonable explanations are the increasing availability of contraceptives and abortion and the associated changes in opportunity for and acceptability of teenage sexual activity. To the extent that more adolescent females with high self-esteem also engage in premarital sex and become pregnant, self-esteem is less likely to predict pregnancy among those reaching adolescence in the 1970s and 1980s than it may have been in previous decades.

Availability of Contraceptives

The extent to which self-esteem, or any other psychosocial variable, predicts pregnancy may depend on the accessibility of contraceptives and contraceptive information or on fears associated with using contraceptives. For example, an adolescent girl with relatively high self-esteem and a desire to attend college may be motivated to prevent pregnancy, though not to the extent of foregoing sexual intercourse with her boyfriend. If she can obtain access to birth control easily, that is, conveniently and privately, she is more likely to use it effectively and to prevent pregnancy than a peer with lower self-esteem and less motivation would be. The more difficult it is to obtain contraceptives, however, or to maintain her privacy in doing so, the greater the probability that she will forego contraception and increase the risk of pregnancy. Thus, to the extent that access to contraceptives varies among the samples of adolescents studied, that access will be a confounding factor in testing the association between self-esteem and pregnancy in adolescence.

Because of these possible confounding factors, we have approached this review of the research on self-esteem and teen pregnancy, first, by eliminating studies in which differences of race or social class confound the results in obvious ways. Thus, a study that compared pregnant adolescents, the large majority of whom were black, with nonpregnant adolescents, the majority of whom were white, was discarded. Second, for the studies included, we note the ethnic or racial composition, social class, and age distribution of the sample and consider the implications of these factors for understanding the results or for limiting our ability to generalize them.

Third, to reduce possible cohort effects, as well as to identify data most relevant to adolescent pregnancy in the late 1980s, we have relied


almost entirely on studies of those who reached adolescence in the 1970s or 1980s. This cut-off was selected to correspond to the increase in premarital sexual activity discussed earlier. It does not control entirely for differences in the accessibility of legal abortion as a way to terminate an unwanted pregnancy, a factor that also affects the adolescent pregnancy and birth rates. None of the studies reviewed includes information on abortion. Nor, toour knowledge, has anyone studied the association between self-esteem and the adolescent's decision to abort. We are therefore unable to address this important issue in our review.

Fourth, availability of contraceptives is another confounding factor for which there is no good control. Most studies do not consider access to contraceptives as a predictor of pregnancy, much less as a factor that may confound or interact with self-esteem. Thus, for the most part, we must infer the possible effect of such access from other information presented about the sample. Because this information is usually incomplete, availability of contraceptives will remain a factor that confounds the interpretation of the results of most studies linking self-esteem and teen pregnancy.

Important as these considerations may be to interpreting the reviewed research, the most serious potential confounding factor is the pregnancy itself.

Causal Inferences

The issue in this review is not simply whether adolescents who become pregnant have low self-esteem, but, rather, whether low self-esteem leads in some way to an increased risk of pregnancy during adolescence. To support such an inference, the measure of self-esteem must be obtained before the pregnancy and, for the reasons presented earlier, preferably before premarital sexual intercourse begins. The reason for this is obvious: if self-esteem is measured after the pregnancy or birth, the association may reflect the impact of the pregnancy on self-esteem, rather than the reverse. A pregnancy during adolescence may elicit disapproval and result in a lowering of self-esteem or, alternatively, self-esteem may rise, for reasons suggested above.

From this analysis, we conclude that it will be very difficult indeed to identify a causal link between self-esteem and teenage pregnancy. To support an inference of causality between self-esteem and pregnancy, longitudinal studies are necessary, in which self-esteem is measured before pregnancy and the adolescents are followed over time to determine


whether in fact they become pregnant. To reduce the possibility that high self-esteem might be based on deviant rather than normative behavior, these longitudinal studies should begin very early in adolescence, before deviant behaviors are adopted. Unfortunately, very few longitudinal studies have considered adolescent pregnancy as an outcome measure, and an even smaller number have included some measure of self-esteem as a predictor. Our conclusions about the probable role of self-esteem in the etiology of adolescent pregnancy will be based, therefore, on a very small number of studies.

Review of the Research

Adolescent pregnancy is the consequence of engaging in sexual intercourse without adequate contraceptive protection. Thus, to understand the possible effect of low self-esteem on becoming pregnant, we will consider, first, the association between self-esteem and teenage sexual intercourse; second, the association between self-esteem and contraceptive use; and third, the association between self-esteem and pregnancy.

Self-Esteem and Teenage Sexual Intercourse

Four studies have investigated the association between self-esteem and either attitudes toward or actual engagement in sexual intercourse during adolescence (Cvetkovich and Grote 1980; Jessor and Jessor 1975; Herold and Goodwin 1979; and Miller, Christensen, and Olson 1987). Only the Jessor and Jessor study includes longitudinal data. As shown in Table 4.1, no consistent pattern of findings with respect to self-esteem and sexual behavior or attitudes is apparent from these studies.

Only Miller, Christensen, and Olson report a significant correlation between low self-esteem and permissive sexual attitudes and premarital sexual experience. The sample, made up of more than 2,400 males and females between the ages of fourteen and nineteen, was predominantly conservative and Mormon. The association between self-esteem and sexual behavior and permissive attitudes was apparent only for those who attended church weekly. Even in this group, the association was low, indicating that an adolescent's self-esteem provides very little practical information about his or her sexual attitudes and practices. Moreover, because self-esteem measures and sexual information were collected concurrently, it is not possible to determine whether engaging


Table 4.1. Studies Examining the Association Between Self-Esteem and Teenage Sexual Activity/Attitudes



Self-Esteem Scale


Self-esteem related to sexual activity

Herold and Goodwin 1979

486 white females; 13–20 years old

MacKinnon Self-Esteem Scale


Jessor and Jessor 1975 (longitudinal)

483 white subjects, males and females; grades 9–12

Authors' own ten-item scale

Positive, for males only

Miller, Christensen, and Olson 1987

1,599 females, 824 males; of these, 2,060 were white, 363 Hispanic; 14–19 years old

Rosenberg Self-Esteem Scale

Negative, for active Mormons only

Self-esteem not related to sexual activity

Cvetkovich and Grote 1980

195 white males, 253 white females, 117 nonwhite males, 119 nonwhite females; 15–18 years old

Personal Characteristics Inventory


a A positive association indicates that high self-esteem is associated with greater sexual permissiveness.

in sexual intercourse produced low self-esteem in this highly religious sample of adolescents, rather than the reverse.

In contrast, two other studies report that high self-esteem was associated either with permissive attitudes toward sexual intercourse or with loss of virginity. Herold and Goodwin (1979) investigated this association in a sample of 486 white females attending birth control clinics in Canada. The young women ranged in age from thirteen to twenty, and most were attending school and living at home. Self-esteem was assessed by the MacKinnon Self-Esteem Scale, a ten-item, five-point scale with good internal validity. High self-esteem correlated with rejection of sexual abstinence, lack of sexual guilt, and endorsement of premarital intercourse involving strong affection; but it did not correlate with approval of intercourse without affection or intercourse with many partners.

We do not know whether the young women who endorsed these views were in fact sexually active, and we cannot therefore rule out the


possibility that both permissive attitudes and high self-esteem are the result of that behavior. Nevertheless, these data do confirm that the association between self-esteem and sexual attitudes and behavior may vary with the perceived acceptability of those attitudes and behaviors. If permissive sexual attitudes and behavior are approved in a particular social group, high self-esteem should be associated with those attitudes and behavior, either as a determinant, a consequence, or both.

Jessor and Jessor (1975) investigated the transition from virginity to nonvirginity in a sample of 483 middle-class, Anglo-American students who were tested in each of four years between 1969 and 1972, beginning when they were in junior high school. The authors' self-esteem scale included ten items related to self-evaluation in four areas: intellectual competence, social attractiveness, decision-making ability, and potential for self-development. The scale has good internal validity and moderately high stability over the course of a year. At the fourth testing, when students were in grades ten to thirteen, self-esteem was significantly higher for nonvirgin than for virgin males. Moreover, males who had initially been virgins but reported that they had engaged in sexual intercourse by the time of the fourth testing had higher self-esteem before the sexual experience. This finding is consistent with the interpretation that high rather than low self-esteem leads to sexual intercourse during adolescence, at least for males. The results may be less straight-forward than they appear to be, however. The two groups of males differed in other ways that might have affected their sexual behavior (e.g., grades and expectations for achievement), and those who became sexually active admitted to a higher level of general deviance prior to that activity. Thus, the high self-esteem these males reported may have been based on nonnormative rather than normative experiences and would fail for that reason to disprove the expected association between low self-esteem and early sexual intercourse.

The fourth study, by Cvetkovich and Grote (1980), investigated the association between self-esteem and sexual intercourse in a sample of 684 white and nonwhite males and females ranging in age from fifteen to eighteen. Seven intercorrelated items from a thirty-four-item self-reported Personal Characteristics Inventory were combined to form a self-esteem cluster. Self-esteem was not associated with sexual activity for either males or females. Some sexually active females reported, however, that they were likely to become sexually involved because they couldn't say "no," because they wanted to please and satisfy a boy-


freind or because it seemed to be expected of them. No attempt was made to determine whether females who gave this reason for entering into a sexual relationship also had lower self-esteem.

In sum, these studies do not support an association between self-esteem and sexual intercourse during adolescence, perhaps because premarital sexual intercourse can no longer be considered a deviant activity in the culture at large. This is the strongest claim that can be made, although it can be argued that because of design flaws none of the studies can be considered a good test of the hypothesized association. Low self-esteem may account for the behavior of the female adolescents described above, but this is sheer speculation at this point.

Self-Esteem and Use of Contraceptives

Four of the five studies investigating the association between selfesteem and contraceptive use report similar findings: low self-esteem is associated with less frequent or less sustained use of contraceptives. As shown in Table 4.2, the effect is sometimes apparent only for males, or only for females, or only under certain conditions. Always, however, when an effect is present, it is in the same direction. No study demonstrates a link between low self-esteem and effective use of contraceptives.

Two Canadian studies, one by Herold, Goodwin, and Lero (1979) and the other by Hornick, Doran, and Crawford (1979), investigated self-esteem in relation to contraceptive use by females. The sample and the measure in the former study were the same as those used in Herold and Goodwin's (1979) study investigating predictors of sexual attitudes. Females with high self-esteem expressed more positive attitudes toward using birth control pills, were more likely to have used effective contraception at last intercourse, and were more consistent in their use of birth control than were females with low self-esteem. When two groups of "extremes" were compared (sixty-eight users of birth control pills who were renewing their pill prescriptions, and seventy-nine subjects who had never used the pill or an IUD and had come for pregnancy testing), the self-esteem scores of the effective contraceptors were significantly higher than those of the ineffective contraceptors. The researchers conclude that self-esteem influences both attitudes toward and the actual use of contraceptives. They suggest that women who have a low sense of self-esteem may fail to use effective contraceptive methods,


Table 4.2. Studies Examining the Association Between Self-Esteem and Contraceptive Use



Self-Esteem Scale


Self-esteem associated with contraceptive use

Ager, Shea, and Agronow 1982 (longitudinal)

30 white females, 113 nonwhite females; 13–17 years old

Coopersmith Self-Esteem Inventory

Positive, interacting with risk taking

Cvetkovich and Grote 1980

195 white males, 253 white females, 117 nonwhite males, 119 non-white females; 15–18 years old

Personal Characteristics Inventory

Positive, for white males only

Herold, Goodwin, and Lero 1979

486 white females; 13–20 years old

MacKinnon Self-Esteem Scale


Hornick, Doran, and Crawford 1979

144 females, 100 males; high school and university students

Coopersmith Self-Esteem Inventory

Positive, for females only

Self-esteem not associated with contraceptive use

Rogel and Zuehlke 1982

118 black females, 2 nonblack females; 12–19 years old

Rosenberg Self-Esteem Scale


a A positive association indicates that high self-esteem is associated with more effective use of contraceptives.

first, because the necessary planning would require acknowledging their intention to engage in sexual behavior and, second, because they would be concerned about negative reactions to their use of contraception.

These data on self-esteem and contraceptive use are open, however, to the alternative explanation that adolescents who have not used contraceptives and who believe they may be pregnant may have low self-esteem for precisely that reason. In a follow-up report, Herold and Samson (1980) attempted to address this issue by analyzing the differences between 48 females who had not yet had intercourse and had come to a clinic to obtain birth control and 183 women who were already sexually experienced at the time they visited a birth control clinic. The young women who obtained birth control before initiating sexual activity were older at the time of first intercourse (17.4 years old, as opposed to 16


years old) and had higher educational aspirations than the sexually experienced women. Unfortunately, no statistical tests were reported, and the measure of self-esteem was not mentioned.

The Hornick, Doran, and Crawford (1979) study of contraceptive use among sexually active adolescents was based on responses from 144 female and 100 male high school and university students in south-central Ontario. (No other sample characteristics were given.) Contraception included the high-risk methods of withdrawal and rhythm, as well as the low-risk methods of the birth control pill and the IUD. The average age of the high school females was 17; the average age for males was 16.9. The mean age of the university students was greater, 19.3 years for females and 20.1 years for males. Because only some of the respondents were adolescents and the data were analyzed for the combined sample, we can draw only limited generalizations about adolescents from this study. Nonetheless, the subject's age did not emerge as a "best predictor" of contraceptive use for either males or females, and the results are consistent with those of Herold, Goodwin, and Lero (1979). Along with a number of other variables, high self-esteem, as measured by the Coopersmith Self-Esteem Inventory, was associated with greater contraceptive use by females; this was not the case for males.

Ager, Shea, and Agronow (1982) studied 143 clients of a Planned Parenthood teen clinic for eighteen months, from the time the clients first came to the clinic to obtain contraceptives. All the subjects were female, 79 percent were black, and most lived in Detroit. Their ages ranged from thirteen to seventeen; the median age was 16.1 years at the start of the study. Continuance or discontinuance of contraception was charted over time, and reasons for discontinuance were investigated. The most frequent reasons given for discontinuing use of the birth control pill were experiencing side effects (42 percent) and fearing side effects (17 percent). Eleven percent indicated that the distance to the clinic or its eventual closing contributed to their decision to discontinue contraception. Self-esteem, as measured by the Coopersmith Inventory, did not differentiate those who continued and those who discontinued using birth control pills.

When the risk-taking behavior of the adolescents was identified, however, those with low reported self-esteem or a high inclination to take risks were significantly more likely to discontinue using the pill upon experiencing side effects than were those with high self-esteem and a low risk-taking personality. That is, the impact of side effects on


behavior depended on the adolescent's personal characteristics. If she had high self-esteem and was a low risk-taker, she continued using the pill despite the side effects. From these data, we may infer that although many factors influence an adolescent's decision to discontinue using a "more effective" method of birth control, having high self-esteem, perhaps in combination with other characteristics, may influence her to persevere in using such a method, despite the difficulties.

In the studies described above, high self-esteem was associated with some measure of contraceptive use for females. Only one of these studies included both males and females in the sample and, again, the association between self-esteem and contraception was apparent only for females.

This was not the case in the only other study to report results for both male and female adolescents (Cvetkovich and Grote 1980). The characteristics of the sample and the self-esteem measure have been described earlier. In this study, contraceptive use was defined as the frequency with which some effective form of contraception had been used by either partner during intercourse in the previous three months. For white males only, more effective contraceptors reported higher self-esteem and did not relegate the responsibility for birth control to their female partners. They also disagreed with items implying that it was sometimes all right to chance a pregnancy.

Only Rogel and Zuehlke's (1982) study of contraceptive behavior in adolescence failed to find an association between contraceptive use and self-esteem. The 120 females who participated in the study ranged in age from twelve to nineteen, were predominantly black (98 percent), and were recruited from three clinics at the Michael Reese Hospital in Chicago in 1979. The majority of the girls were sexually active, and 75 percent either were or had been pregnant at the time of the study. The median age of first pregnancy was 15.6 years, with 81 percent of the pregnancies occurring by age seventeen. Self-esteem, measured by the Rosenberg Self-Esteem Scale, tended to be unusually high for the entire sample: 46 percent scored high on the scale (30 or higher on a scale that ranges from a low of 10 to a high of 40), and no one scored below 25. The high level and narrow range of self-esteem scores may explain why self-esteem failed to distinguish those who began contraception early from those who began late and from those who never used birth control.

The range of self-esteem scores does not explain why self-esteem should have been so unusually high in this group of adolescents. It may


have been the result, as Kaplan (1975) argues, of the sexual activity and the heterosexual relationships with which that activity is associated. The researchers suggest that girls may use sexual activity as a means of attaining intimacy and closeness with a valued person outside the family; they point out that most of the girls had infrequent sex with only one sexual partner, whom they had known for more than a year. Participation in the relationship may have bolstered self-esteem, resulting in a surprisingly high level of self-esteem in the sample and in the process obscuring any association that might have existed initially between low self-esteem and failure to use contraception. This interpretation, although speculative, is consistent with Kaplan's prediction that measures of self-esteem obtained after deviant behavior has been adopted may be the result rather than the cause of that behavior.

In sum, there is evidence linking high self-esteem to more effective use of contraception among sexually active adolescents. Because none of the studies controlled entirely for the possibility that pregnancy or guilt associated with not using contraception might account for the lower self-esteem reported by the less effective users, any causal inference must be tentative. Moreover, in the research available to date, high self-esteem has been associated with effective contraception primarily for white adolescents, thereby limiting the applicability of these findings to other groups. Nevertheless, there is sufficient correlational evidence to further consider a possible causal link between self-esteem and contraceptive use.

Self-Esteem and Teen Pregnancy

Although there have been numerous studies of the correlates of teenage pregnancy, we located only seven that both included a measure of self-esteem and met our review criteria. Four of the studies examined self-esteem only after the adolescents became pregnant (Barth, Schinke, and Maxwell 1983; Brunswick 1971; Streetman 1987; and Werner and Smith 1977). In two of these, there was no association between self-esteem and pregnancy status. In the other two, the self-esteem scores of pregnant girls were significantly lower than those of girls in the control groups.

Brunswick (1971) collected data on 483 low-income males and females between the ages of twelve and seventeen in 1969–1970. Because 86 percent of the subjects were black, most of the pregnant teenagers were black. The median age at first pregnancy was fifteen. The 16 ado-


lescents who were pregnant or who had already carried a baby to term were compared with 180 others on a self-esteem measure composed of three items from Rosenberg's scale and a fourth that asked the adolescent how much she would want to change herself if she could. There were no differences between the two groups either on the self-esteem measure or in their general mood or feelings of happiness. The pregnant women did report greater feelings of powerlessness, but, as the author points out, this may have reflected an accurate assessment of their life situation at the time.

In a more recent study, Streetman (1987) compared non-Caucasian teenage females without children to a group of teenage mothers and reported similar results. The sample included 93 females between the ages of fourteen and nineteen. More than 75 percent had at least one child. There were no differences between the groups on either the Coopersmith Self-Esteem Inventory or the Rosenberg Self-Esteem Scale.

Barth, Schinke, and Maxwell (1983) used a more sophisticated design and a more diverse sample in their study of pregnant adolescents. Participants were 185 young women, ranging in age from eleven to twenty-one, from three programs for school-aged parents and the alternative public high schools in which these programs operated. The schools were located in urban, suburban, and rural areas. Also unlike the previously discussed studies, only 49 percent of the young women were black; the rest were predominantly Anglo, with small percentages of Native Americans, Asians, and Hispanics. There were 62 pregnant females, 63 adolescent parents, and a comparison group of 60 female adolescents who were neither pregnant nor parents. The three groups were compared on five measures of well-being, including the Rosenberg Self-Esteem Scale. The self-esteem scores of both the pregnant teenagers and the adolescent parents were lower than those of the comparison group. Moreover, these differences continued to be significant after controlling statistically for differences associated with the adolescent's age, social class, and social support. Race does not appear to have affected the results, but this is not entirely clear from the report. In contrast to the Brunswick and Streetman studies, Barth, Schinke, and Maxwell used a larger sample of pregnant adolescents, distinguished between pregnant adolescents and adolescent parents, and controlled for a number of potential confounding factors, suggesting that their results should be given more weight.

A longitudinal study by Werner and Smith (1977) provides additional evidence for a link between low self-esteem and teen pregnancy.


The authors studied all the children born on the island of Kauai in 1955. During the eighteen-year follow-up conducted in 1973, the twenty-eight females who had become pregnant were compared with all other females in the sample. The teens who had become pregnant before turning eighteen differed from the comparison group on a large number of dimensions, including self-esteem as measured by a subset of questions from the California Personality Inventory. As in the Barth, Schinke, and Maxwell study, the pregnant teenagers had significantly lower self-esteem.

Because Werner and Smith's research was longitudinal, it was possible to investigate whether there were any childhood signs that indicated the risk of an early pregnancy. Unlike the children who later were identified as delinquents, those who became pregnant had not been identified as having a disproportionate number of learning disabilities or mental health problems at the age of ten. The variables at this age that did differentiate those who would become pregnant as teenagers were the family's social-economic status, the provision of educational stimulation, and ethnic background. Girls most likely to become pregnant were from the poorest families, with the least educational stimulation, and were at least part native Hawaiian—a group the authors described as valuing a nurturant maternal role and prizing children highly. No measure of self-esteem was obtained at age ten, and the measure of emotional support—a possible contributor to self-esteem—failed to distinguish the pregnant and nonpregnant adolescents, although emotional support was somewhat more likely tobe associated with subsequent pregnancy for the non-Hawaiians (Werner 1988). Only three of the twelve Hawaiians who were pregnant were identified as receiving little emotional support when they were ten years old, whereas nine of the sixteen pregnant non-Hawaiians were so identified. The small sample and the level of statistical significance (p <.10) preclude any definite conclusions, but this finding does suggest that different factors may be causally linked to adolescent pregnancy in different ethnic or racial groups.

In sum, although the cross-sectional studies of self-esteem and teenage pregnancy yield no consistent pattern of findings, the better-designed research links low self-esteem to adolescent pregnancy. Consistent with the studies on self-esteem and contraceptive use, no study shows self-esteem to be higher for pregnant than for nonpregnant adolescents. We must emphasize, however, that these results do not necessarily demonstrate that low self-esteem increases the risk of pregnancy


during adolescence. An equally plausible inference is that an adolescent pregnancy lowers self-esteem.

Three longitudinal studies offer a better test of the hypothesis that low self-esteem increases the likelihood of a teenage pregnancy. All three measured self-esteem at one point and later obtained information on pregnancies that subsequently occurred. Two of the three, based on the same data set studied at different time intervals, reported an association between low self-esteem and subsequent pregnancy; the third study reported no association.

Kaplan, Smith, and Pokorny (1979) obtained their sample from a 1971 survey of seventh-graders in a large urban school system. The survey included the Self-Derogation Scale as a measure of self-esteem. More than one year after the administration of the baseline questionnaire (and before each subject's eighteenth birthday), the researchers identified eighty-two adolescents who had given birth to their first child. (Evidence of birth was obtained from a clinic that provided perinatal services to the indigent, pregnant adolescents of the county.) The authors contrasted the unwed mothers with two comparison groups: one in which each unwed mother was matched with two adolescents by race, mother's education, and school; and one consisting of random controls selected from the female respondents from the baseline survey in seventh grade. Racial makeup was the only significant demographic difference between the groups: 90 percent of the unwed mothers and the matched comparison group were black, whereas only 25 percent of the subjects in the random control group were black.

Before becoming pregnant, the adolescents who later became unwed mothers were significantly more likely to have reported self-devaluing experiences associated with family and school and were less likely to have perceived themselves as succeeding, either at the time or in the future, than were the adolescents in either control group. They were also more likely to have had higher self-derogation scores (low self-esteem). Thus, low self-esteem as a result of family and school experiences distinguished adolescents who had babies from those who did not. Moreover, the black adolescents who did not become mothers thought it was more important to obey their parents and teachers than did those who had children. Together, these findings support Kaplan's (1975) theory that if children have positive family and school experiences, they feel good about themselves. They will want to maintain the good will and respect of the people in these situations and will behave in ways that they believe will ensure this.


The second analysis of this 1971 data set is reported by Robbins, Kaplan, and Martin (1985). To obtain information on out of wedlock pregnancies, 2,158 young adults (both males and females) from the original sample were contacted again when they were twenty-one years old. Of this later group of subjects, 63 percent were white, 27 percent black, and 10 percent Hispanic, indicating that the original group of unwed adolescent mothers and their matched controls, both of which were predominantly black, were underrepresented in this follow-up. Six items from the Self-Derogation Scale were used as a measure of self-esteem (alpha =.79). The findings with respect to self-esteem were weaker than in the earlier report, as would be anticipated, given that the researchers obtained pregnancy data retrospectively from the adolescents themselves and that those identified as unwed mothers in the earlier study were underrepresented. Nonetheless, high self-derogation in seventh grade was significantly associated with a higher risk of pregnancy before age twenty-one for females. From additional analyses, it could be inferred that the association between self-derogation and pregnancy was limited to ages twelve to fifteen during the three years following the original testing, corresponding most closely to the period in the 1979 study by Kaplan, Smith, and Pokorny.

Additional findings indicate, however, that self-derogation may have different effects at different ages under different conditions. First, family stress was positively related to pregnancy when self-esteem (low self-derogation) was moderate or high for young women over eighteen. The authors suggest this may reflect a rejection of parental control in late adolescence by self-confident girls. Second, although the Hispanic girls in this study were significantly more likely than others to have high self-derogation scores, they were less likely than either whites or blacks to become pregnant out of wedlock during adolescence. This finding may indicate that other characteristics of Hispanic culture, such as religious affiliation or the degree of control exercised by the family over the adolescent's behavior, result in a lower adolescent pregnancy rate. This could occur, for example, if Hispanic parents encourage adolescents to marry at an earlier age than that favored by parents from different ethnic or racial backgrounds.

These two studies provide the clearest evidence that low self-esteem is causally associated with a subsequent teenage pregnancy. Another longitudinal study failed to confirm these findings, however. Vernon, Green, and Frothingham (1983) questioned 858 low-income females between the ages of thirteen and nineteen, predominantly black (86 per-


Table 4.3. Studies Examining the Association Between Self-Esteem and Teenage Pregnancy



Self-Esteem Scale


Self-esteem related to teenage pregnanc

Barth, Schinke, and Maxwell 1983

117 nonwhite females, 68 white females; 11–21 years old

Rosenberg Self-Esteem Scale


Kaplan, Smith, and Pokorny 1979 (longitudinal)

410 females

Self-Derogation Scale


Robbins, Kaplan, and Martin 1985 (longitudinal)

2,158 males and females; white, black, and Hispanic

Self-Derogation Scale

Negative, for females only

Werner and Smith 1977 (longitudinal)

614 males and females; 18 years old

California Personality Inventory


Self-esteem not related to teenage pregnancy

Brunswick 1971

196 black females; 12–17 years old

Rosenberg Self-Esteem Scale (subset)


Streetman 1987

93 nonwhite females; 14–19 years old

Coopersmith Self-Esteem Inventory; Rosenberg Self-Esteem Scale


Vernon, Green, and Frothingham 1983 (longitudinal)

745 black females, 22 other nonwhite females, 91 white females; 13–19 years old

Coopersmith Self-Esteem Inventory


a A negative association indicates that low self-esteem is associated with a greater risk of becoming pregnant during adolescence.

cent), who were enrolled in the ninth, tenth, and eleventh grades during the fall of 1980. Ninety-five of the subjects later became pregnant. The researchers measured self-esteem (using the Coopersmith Inventory) at the initial testing, as well as pregnancy outcome during the following year using reports from local clinical and laboratory facilities that provided health services. They found no differences in pregnancy rates for young women who scored in the low, intermediate, or high self-esteem groups. The pregnancy rate was higher, however, among those girls for


whom the costs of pregnancy might be assumed to be lower: those who had lower vocational expectations, who attended church less often, and who had indicated that they would like or not mind being pregnant and would expect that their families would feel similarly about a pregnancy.

Table 4.3 indicates that studies investigating the association between self-esteem and teen pregnancy report mixed results. Only four studies (and three data sets) corroborate the anticipated association between low self-esteem and teenage pregnancy.

The failure to replicate findings is often sufficient reason to discount or to treat cautiously the results of a particular investigation. In this instance, however, the contradictory findings can be explained and indeed would have been expected from Kaplan's (1975) theory of the way in which engaging in deviant behavior may improve self-esteem. Participants in the Vernon, Green, and Frothingham (1983) study were in the ninth through eleventh grades at the time self-esteem was initially assessed, in contrast to the subjects in the other longitudinal studies, who were in the seventh grade. It is reasonable to assume that many of the older subjects had already become sexually active or had engaged in deviant behavior that would have increased their self-esteem. In short, although the observed association between low self-esteem and teenage pregnancy has not been well replicated, the design of those studies that have demonstrated such an association increases our confidence in the validity of the association.

Summary of the Review

What can we reasonably conclude from this review? Given the disparate results and the differences in design of the studies, reasonable people could justifiably draw different inferences from the data. Our approach is to make the strongest case possible, given the research, for the existence of a causal link between self-esteem and teenage pregnancy.

We conclude, therefore, that low self-esteem does contribute to the risk of an adolescent pregnancy. Although it is likely to be valid, the association between low self-esteem and pregnancy is not strong. This finding, combined with evidence that a number of characteristics, conditions, or circumstances lead to an increased risk of pregnancy during adolescence, suggests that our understanding of teen pregnancy must be multifaceted.

We conclude also that self-esteem is more likely to have an impact on teenage pregnancy through its effect on increasing contraceptive use


than through any effect it might be expected to have on reducing premarital sexual intercourse. There simply is no compelling evidence on which to base a claim that increasing self-esteem will reduce the number of teenagers who engage in premarital sex. Even if some teenagers engage in sex out of esteem-related interests, we would not expect raising self-esteem to have a major impact on adolescent sexual behavior, because so many other factors influence decisions regarding sexual activity.

In contrast, we believe the data, though imperfect, are consistent with the expectation that raising normatively based self-esteem would increase contraceptive use by both males and females, thereby reducing adolescent pregnancy. Adolescents with higher normatively based self-esteem would be more likely to have goals that would be compromised by an early pregnancy; they would thus be more motivated to practice effective contraception. They would presumably also be more willing to deal with the potential embarrassment and inconvenience often associated with obtaining and using contraceptives.

We had hoped to comment on the applicability of the findings to different ethnic or racial groups, but the relatively few studies that include adolescents from more than one group or analyze the association between self-esteem and outcome separately by race or ethnicity preclude this. We recommend caution in generalizing findings, because different factors may be causally linked to adolescent pregnancy in different ethnic or racial groups. To illustrate: Adolescents belonging to a recent immigrant group, the Hmong from Laos, are considered young adults by the age of thirteen and traditionally bear children soon after (Chan 1981). This cultural expectation may account for the group's inflated adolescent birth rate and would have to be considered in any attempt to reduce teenage pregnancy within this group.

The relatively high incidence of births to black adolescents noted throughout the chapter raises another important question: Do differences in self-esteem contribute to racial differences in the birth rate among adolescents? We have no data directly relevant to this question, for the reasons noted earlier. Even if black children are no more likely than others to develop low self-esteem, however, the conditions that give rise to low self-esteem may be more impervious to change for black children. To the extent that the opportunities for achievement are more restricted for blacks than for whites, attempts to raise self-esteem by focusing on families, schools, and community organizations may be seriously undermined.


Implications for Reducing Adolescent Pregnancy

It is beyond the scope of this review to fully consider all the factors associated with adolescent pregnancy. Nonetheless, even a cursory review of the research literature reveals numerous correlates of adolescent pregnancy, at least some of which also affect the likelihood of becoming pregnant (Hayes 1987b). Thus, attempts to reduce the incidence of adolescent pregnancy are not likely to be effective without using a multifaceted approach. We must keep this in mind when considering the potential impact of raising self-esteem.

Building Self-Esteem

As noted earlier, positive self-esteem results from experiences in membership groups that convey the idea that the individual possesses positively valued attributes, performs positively valued behaviors, and is the object of positive attitudes expressed by highly valued others. To the extent that these experiences occur in so-called normative membership groups such as the family and school, family- and school-related achievements and participation will be valued. If achievements and participation in these groups are incompatible with a pregnancy, the individual would be motivated to avoid it. In Luker's (1975) terms, the cost of a pregnancy to the adolescent would be high.

Thus, to encourage high self-esteem, we must consider the experiences of children and adolescents in their everyday environments. Our intent is not to design programs to promote high self-esteem, but rather to identify the kinds of family, school, and community experiences that should lead to higher self-esteem in children and adolescents.


In the sample used in the study by Kaplan, Smith, and Pokorny (1979), adolescents who later became unwed mothers received the highest scores on measures of subjectively perceived self-devaluing experiences associated with family, school, and peers, as well as the highest self-derogation (lowest self-esteem) scores. The nature of those experiences was not described, but from other measures of maternal rejection we may infer that such experiences generally have to do with the extent to which parents convey that they enjoy spending time with the child,


recognize and appreciate the child's characteristics and achievements, and avoid harsh criticism when the child engages in disapproved behavior (Coopersmith 1967; Sears 1970). It is reasonable to argue that family experiences characterized by this sort of "positive communication" form the basis of a child's positive or high self-esteem. Attempts to build this type of communication should therefore be at the center of efforts to reduce adolescent pregnancy by building self-esteem. To our knowledge, no program designed to prevent or reduce adolescent pregnancy has adopted this approach.

Kaplan, Smith, and Pokorny also report that the parents of the girls who did not become pregnant, but who were otherwise matched with those who did, consistently exerted social control over their children—control that the girls perceived as legitimate. This finding suggests that attempts to control adolescent behavior that are not firmly rooted in the adolescent's willingness to accept the control may be ill fated. The adolescent's perception of social control as legitimate depends in part on how the control is exercised (positive communication) and also on how salient the parents have been as sources of the adolescent's esteem-bolstering experiences. We may conclude that the enterprise of building self-esteem must begin well before the onset of adolescence if it is to affect adolescent pregnancy.

The effective exercise of social control by parents may be facilitated by contact with other families. In the Kaplan, Smith, and Pokorny study, the families of the girls who were at risk but did not become pregnant were likely to have lived in the area for more than five years and to have known one another well. This contact between families may have played an important role in establishing the legitimacy of familial control. If one family establishes rules that are at odds with those established by the families of the adolescent's friends, the adolescent may perceive the action as unreasonable and as a personal statement about how the parents view him or her. The adolescent in such a family also may successfully undermine those rules by pressuring parents to be more lenient. Thus, a family's ability to promote self-esteem and to exercise control over adolescent behavior may be facilitated by supportive connections with other, like-minded families. Encouraging such connections where they do not already exist may be one facet of successful programs to prevent teenage pregnancy.

Of course, families cannot always provide the kind of experiences that seem to be important in building self-esteem and exercising legitimate control over teenagers' behavior. Families may be split, and one


parent may have to assume all the responsibilities that are shared in two-parent families. If the family is intact, the parents may have personal problems, sometimes linked to conditions of poverty, that may make simple survival, rather than the well-being of any one family member, the primary focus of the family. For children in such families, high self-esteem may be better encouraged by someone other than the parents. Indeed, given the number of mothers who are employed outside the home today (49.3 percent of those with children under six in 1986 [U.S. Department of Labor 1986]), even children in well-functioning families may be spending as much time with other adults, including teachers, as they do with their own parents. And of course these other adults may play an important role in encouraging high self-esteem.

Support for the value of alternative adult contacts for adolescents comes from Vincent (1961; cited in Kaplan, Smith, and Pokorny 1979), who reported that the only major difference between pregnant girls who had been rejected or had withdrawn from their parents and similar nonpregnant girls was that the nonpregnant girls had identified with a teacher or some other adult in the community who offered acceptance and counseled against premarital sex. Schools and other community organizations may therefore be an important aspect of attempts to raise self-esteem and reduce teenage pregnancy.


If positive experiences in school contribute to positive self-esteem, then ways must be found to make school a positive experience for children—not just for some children, but for all the children who are required to be there.

Success in school is defined primarily as achieving good grades, or at least as "passing." Intervening with children who are doing poorly in their schoolwork is thus essential to any school-based attempt to raise self-esteem. What that intervention should be remains to be determined. We do know, however, that the quality of schools—as measured by staff training, availability of learning resources, and teacher/student ratios—affects achievement and school retention, especially among the poor and racial and ethnic minorities (Rutter 1983).

Even if such interventions are effective in reducing failure, substantial differences in achievement among children are likely to remain, and some children will experience these differences as failures. One implication of this reality is the need to design a range of acceptable academic


goals, along with alternative educational strategies. This has taken place already at the secondary level, in the form of alternative schools that stress individualized learning, counseling, social supports, remedial education, and work-study arrangements. Programs such as these not only reduce some of the more invidious comparisons between students, because "high achievers" are elsewhere, but also incorporate opportunities for success through work. Although assessments indicate that alternative programs can be effective in keeping young people in school and in boosting achievement, there are no data on whether such programs lower pregnancy rates (Hofferth 1987a).

We have focused thus far on achievement as the basis for success, positive responses from others, and subsequent positive feelings toward the self. Kaplan (1975) also concluded that high self-esteem is based on the perception, derived from group membership, that one possesses positively valued attributes and is the object of positive attitudes from highly valued others. These positive experiences can occur even in the face of failure, through communication between students and teachers—what is communicated about the child or adolescent, and how it is communicated, conveys whether the student is liked, appreciated, and respected. This dimension of the school experience is incorporated as "social support" in the alternative-school approach. Its value is suggested by Rutter's (1983) finding that disadvantaged children achieved more in schools in which teachers made more positive comments to them. As suggested earlier, another consequence of what we have referred to as positive communication may be that the school becomes or remains a legitimate source of control over the adolescent's behavior.


To the extent that programs such as Girl Scouts, 4-H, church groups, and team sports provide experiences that build competence and encourage relationships that convey appreciation, self-esteem should be affected positively when children and teenagers participate in them. The character and quality of the experiences and relationships identified earlier as determinants of high self-esteem are the same for any context, and we will not repeat them here. The special value of community groups is that children and adolescents participate voluntarily, in contrast to their participation in family or school life, and for that reason they may be motivated to engage fully in the activities. Training in child development, and especially in positive communication, for adult vol-


unteer leaders and coaches, and a screening process to identify adults who lack the necessary skills to build and maintain high self-esteem are important to ensure that children benefit from their experiences in community programs.


We have suggested that attempts to reduce the incidence of adolescent pregnancy by building self-esteem should focus on, but not be limited to, the school and the family. We have left unspecified, however, the effect that high self-esteem may have on adolescent behavior. One effect could be to increase the age at which teenagers engage in premarital sexual intercourse. Although there is no evidence that self-esteem directly affects sexual behavior, there is evidence that age of first intercourse tends to be earlier for adolescents with lower school achievement. Thus, raising achievement level might be expected to influence sexual behavior. Moreover, individuals with high self-esteem may decide to become sexually active for reasons different from those of individuals with low self-esteem. For example, an adolescent with high self-esteem may engage in sex because she is involved in a loving relationship, whereas an adolescent with low self-esteem may do so because she is afraid of being rejected.

We argued earlier that the stronger link between self-esteem and pregnancy appears to be mediated by contraceptive use: adolescents with high self-esteem are more likely to use effective contraception. From this, we may conclude that attempts to build self-esteem will have a stronger effect on the incidence of adolescent pregnancy if they are linked with encouraging both sexes to use contraception. If families encourage high self-esteem and at the same time convey the unacceptability of using contraceptives, they must focus their efforts on preventing sexual intercourse—a difficult task, if the available research is to be trusted. Moreover, if they are unsuccessful, they may be faced with a choice between an abortion, which may be even less acceptable to them than contraceptive use, or a birth to an adolescent mother, which carries its own negative consequences. Thus, it seems reasonable to suggest that reducing adolescent pregnancies through raising self-esteem will be considerably more successful if such efforts are accompanied by information about, access to, and permission to use contraceptives.

There is another twist in the association between self-esteem and contraceptive use. Luker (1975) argues that women weigh the perceived


cost of a pregnancy against the cost of preventing the pregnancy. Thus, the higher the psychological cost of obtaining contraceptives, the less likely the adolescent will be to try to obtain them. This cost may be particularly high for adolescents with low self-esteem, who may lack the assurance and assertiveness required to obtain and fill prescriptions in a context that lacks privacy and invites criticism. Reducing that cost should increase the probability that contraceptives will be used. If we acknowledge that self-esteem is most likely to affect teenage pregnancy through its effect on contraceptive use, it would seem self-defeating not to simultaneously attempt to make it easier for adolescents to obtain contraceptives.

Needed Research

Research of two types is needed to further our understanding of self-esteem as it relates to adolescent pregnancy and to determine how the adolescent pregnancy rate might be reduced. First, we need longitudinal studies designed to identify the characteristics and conditions that put an adolescent at risk for a pregnancy. Available research linking low self-esteem with adolescent pregnancy is suggestive, rather than compelling; the better studies are twenty years old; and few data are available on pregnancy among different ethnic groups, most notably Hispanics. In California, where almost 15 percent of Hispanic births in 1985 were to teenagers, in contrast to 7.9 percent of non-Hispanic white, 4.2 percent of Asian, and 18.2 percent of black births (Brindis and Jeremy 1988), this knowledge is critical. Second, we need research investigating the effects of programs designed to enhance self-esteem and to reduce the adolescent pregnancy rate.

Longitudinal Studies

We can identify several criteria against which any proposal for research on self-esteem and adolescent pregnancy should be evaluated. First, the research should be conceptually based; decisions about measures and analyses should be guided by well-developed ideas of the factors that might explain the likelihood of an adolescent pregnancy.

Second, the research should focus on many variables, not just one or two. Low self-esteem may predict adolescent pregnancy only in combination with other characteristics of the adolescent or her environment. By including multiple variables, we will be better able to discern


such complexities. Race/ethnicity is one such variable; social-economic status is another. To design effective prevention efforts, we need to know whether different factors explain the incidence of adolescent pregnancy in different ethnic groups that vary in degree of acculturation (Becerra and de Anda 1984).

Third, the study should begin prior to the onset of puberty. Using chronological age as a marker variable, the first phase of data collection should begin no later than the child's tenth birthday, to reduce the possibility that sexual activity has already contributed to high or low self-esteem.

Fourth, the research should consider both process and outcome in studying adolescent pregnancy. We need to know not simply that the adolescent has or has not become pregnant, but whether she has been sexually active, whether she has used effective contraception, and her reasons for doing or not doing so.

Research on Prevention

Another approach to research is to test the effectiveness of programs designed to reduce the number of teenage pregnancies by raising self-esteem. We know from past experience that experimental social programs will be short-lived unless their effectiveness in meeting stated goals can be demonstrated convincingly. Prevention studies must have control groups; control groups and experimental groups must be comparable before intervention (with respect to self-esteem, ethnicity, achievement, age, or any other variable that may affect the likelihood of a teenage pregnancy); and researchers must obtain outcome data on sexual behavior, contraceptive use, and pregnancy over a significant period of time.

Equally important, the prevention programs must have a reasonable chance of succeeding. Success will be more likely if the programs are appropriate to the group they are intended to serve and if individuals at risk for an adolescent pregnancy, or adults in contact with them, participate in the programs. Ensuring that this will happen is one of the primary challenges of prevention programs and prevention-oriented research.


Measures of Self-Esteem

In measuring any psychological construct, we want to know that the instrument accurately reflects the theoretical construct on which it is based and truthfully assesses the individual's internal reality. The first issue can be addressed by the measure's "face validity"—the extent to which individuals familiar with the theoretical construct agree that the measure adequately represents the construct; its "internal validity"—the degree to which the items in the measure intercorrelate, indicating a degree of psychological unity; and its "convergent validity"—the extent to which the measure is associated with other measures of the same construct.

Three additional types of evidence are relevant to determining whether the measure accurately describes the individual. The first is test-retest reliability—the extent to which individuals achieve the same scores relative to others in the sample over a short period of time, typically a few days to a few weeks. High test-retest reliability is consistent with the interpretation that the measure reflects something relatively enduring about the individual, rather than a fleeting or momentary mood state. The other two types of evidence are concurrent and predictive validity—the extent to which scores on the measure correlate with some other relevant measures assessed either at the same time (concurrently) or over a longer period (predictively).

Information concerning the reliability and validity of the three measures of self-esteem used most frequently in the studies we review—the Rosenberg Self-Esteem Scale (1965), the Coopersmith Self-Esteem Inventory (1967), and the Self-Derogation Scale from Kaplan, Smith, and Pokorny (1979)—is included below. We provide information on other measures when describing the individual study.

Rosenberg Self-Esteem Scale

The Rosenberg Self-Esteem Scale consists of ten items (e.g., "On the whole, I am satisfied with myself"), with one of four responses possible for each item: respondents are asked to strongly agree, agree, disagree, or strongly disagree with each test item.

Three properties of the measure are worth noting. First, the scale is designed to measure the respondents' global self-esteem . The items do not specify particular areas of activity or qualities that individuals must


take into consideration when judging themselves. The scale attempts to gauge a respondent's basic attitude toward his or her own worth by allowing individuals to invoke their own frame of reference. Second, the scale is designed to capture the respondent's enduring, longstanding self-estimate. The emphasis is not on one's immediate or momentary self-perception; rather, the scale stresses the more permanent, more stable components of the self-image. Finally, a high score on this scale does not mean that the respondent stands in awe of himself or herself, nor does it mean that a respondent expects such awe or deference from others. Rather, it reflects the feeling that one is "good enough"—a person of worth, who merits self-respect.

The psychometric properties of this scale have been summarized by Wylie (1974). She points out that the Rosenberg Scale's face validity appears to be good and that its convergence with other measures of self-esteem is acceptably high, ranging from .67 to .83. A two-week test-retest reliability coefficient is similarly high—.85 for twenty-eight college-age respondents. In addition, the scale appears to have the ability to predict and concur with behaviors, attitudes, and experiences to which self-esteem is theoretically expected to be related (e.g., depressive affect, anxiety and psychosomatic symptoms, interpersonal insecurity, participation in activities, leadership, and parental disinterest).

Regarding the scale's ability to provide an accurate assessment of the individual's internal reality, there remains, as there does for all self-concept measures, the possibility that respondents may distort reality in order to provide socially desirable answers. Researchers hope that if they are able to establish rapport and guarantee anonymity, respondents will answer truthfully.

Coopersmith Self-Esteem Inventory

The Coopersmith Self-Esteem Inventory (SEI) for children is a fifty-item questionnaire intended to measure the evaluation that children from ages eight to fifteen make and customarily maintain with regard to themselves. The questionnaire presents respondents with generally favorable or generally unfavorable statements about the self (e.g., "I am pretty sure of myself," "I'm easy to like"), which they designate as "like me" or "unlike me." Assuming that self-efficacy may vary across different areas of experience, Coopersmith includes questions from five different domains: peers, family, self, school, and general social activities.


The scores from these subscales are combined for a general self-esteem score. The scale is accompanied by an eight-item lie scale to assess defensiveness.

Coopersmith developed the measure with the assistance of several "self-esteem experts," and all the items in the final scale were agreed upon by five psychologists, supporting the scale's face validity. Coopersmith, like many self-esteem researchers, assumes that one's global self-esteem score consists of the sum of scores in five separate areas, as described above. Whether or not this assumption is valid is not known, for no item analyses or internal factor analyses have been performed. Wylie (1974) reports low to moderate convergence, ranging from .17 to .40, between scores on the Coopersmith SEI and other measures of self-esteem, as well as similarly moderate correlations with measures to which self-esteem is theoretically expected to be associated (e.g., the Iowa Achievement Tests, r = .36; and a sociometric rating of popularity, r = .29). Test-retest reliability is high: .88 over a five-week interval for fifth graders (Coopersmith 1967).

Coopersmith attempts to control for acquiescent responses by including an equal number of favorably and unfavorably worded items. Again, it is hoped that guaranteeing anonymity and establishing rapport with the respondents will cause them to answer truthfully rather than providing socially desirable answers.

Self-Derogation Scale

Kaplan's self-derogation scale consists of the seven items that make up the first factor derived from a factor analysis of the Rosenberg Scale (Kaplan and Pokorny 1969). The scale indexes a lack of pride and self-respect and feelings of personal failure and worthlessness. Thus a low score indicates high self-esteem. Because the scale is made up of items from the Rosenberg Self-Esteem Scale, we may presume it is equally valid on its face.

The inter-item correlations for the seven items making up the scale, as reported by Kaplan (1980), are not high but are statistically significant. The scale's internal consistency is estimated at .79 (Cronbach's alpha) (Robbins, Kaplan, and Martin 1985). Kaplan does not report the scale's convergence with other measures of self-esteem, but it may be presumed that its convergent validity does not differ appreciably from the Rosenberg Self-Esteem Scale, on which it is based.


Unlike Coopersmith, Kaplan does not expect high long-term test-retest reliability scores, especially for children with low self-esteem. Accordingly, test-retest correlations ranged from .55 (over one year) to .40 (over a two-year interval) during adolescence. In addition, Kaplan and Pokorny (1969) report that high scores on the self-derogation scale are associated with several measures of psychosocial adjustment, including self-reports of psychological symptoms, scores on a depressive affect scale, and use of psychiatric services during the preceding year.



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