Introduction

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,

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

[*] * No comparative data concerning Hispanics are available, because birth rates have been calculated separately for Hispanic and non-Hispanic whites only since 1978.

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.