Statistics

Continuing Education Mitigates the Negative Consequences of Adolescent Childbearing

Kate Sullivan • Jamie Clark • Brian Castrucci •

Rachel Samsel • Vincent Fonseca • Imelda Garcia

Published online: 5 March 2010

� Springer Science+Business Media, LLC 2010

Abstract Beginning childbearing during adolescence is

consistently linked with negative outcomes for both chil-

dren and parents. Many have attributed this association to

maternal background characteristics which are often diffi-

cult to change through policy. Though maternal educa-

tional attainment is often a side effect of adolescent

childbearing, it also represents a potential avenue through

which we can help young mothers overcome the obstacles

associated with an early birth. The data for this study come

from the 1997 Child Development Supplement of the Panel

Study of Income Dynamics, a nationally representative

sample of mothers and their children (N = 3,193). Data are

used to explore the cognitive stimulation and emotional

support in the home, measured using the HOME Scale

(Caldwell and Bradley in Home observation for measure-

ment of the environment. University of Arkansas at Little

Rock, Little Rock, 1984). OLS regression models how

maternal education moderates the association between age

at first birth and quality of children’s home environment.

Adolescent mothers scored significantly lower on the

indicator of home environment than older mothers. How-

ever, when continuing education was considered, maternal

age at first birth was no longer significantly associated with

the home environment. The negative consequences of early

births were mediated by adolescent mothers’ continuing

education efforts. While interventions are needed to reduce

adolescent childbearing, these results highlight the need to

ensure that adolescent mothers are provided support to

continue their education following delivery. The negative

consequences of adolescent births are not inevitable.

Encouraging school retention may help young mothers

form a safe, healthy, nurturing, and developmentally

appropriate home environment.

Keywords Adolescent childbearing � Education � Child development � Home environment

Introduction

After over a decade of declining adolescent birth rates,

recent data indicate an increase in the rate of adolescent

births [2]. For women aged 15–19 years, the birth rate in

2006 was 41.9 births per 1,000 females, a three to four

percent increase compared to previous years. Nearly half a

million infants are born to adolescent mothers every year in

the United States.

For most adolescents, these births are unexpected and

have long reaching implications for both mothers and

children [3, 4]. Children born to adolescent mothers are at a

greater risk for a variety of negative behavioral and

developmental outcomes across the life course. Children

born to adolescent mothers are more likely to have both

internalizing and externalizing behavior problems [5–14].

Children with adolescent mothers also have lower reading

and math scores during childhood and poorer academic

trajectories through adolescence [15–17].

Compared to children born to adult mothers, children

born to adolescent mothers are also at greater risk for

growing up in home environments marked by lower emo-

tional and cognitive support [18, 19]. Adolescent mothers

fare less well in evaluations and observations of their home

environments than older mothers. Early childbearing is

K. Sullivan (&) � J. Clark � B. Castrucci � R. Samsel � V. Fonseca � I. Garcia Office of Program Decision Support, Texas Department of State

Health Services, MC1922, PO Box 149347, Austin,

TX 78714-9347, USA

e-mail: [email protected]; [email protected]

123

Matern Child Health J (2011) 15:360–366

DOI 10.1007/s10995-010-0585-8

linked with difficulties in constructing a safe and devel-

opmentally appropriate home environment for children.

New research has indicated that many of these disad-

vantages in children’s home environment and development

may be attributed to mothers’ family background and so-

ciodemographic characteristics rather than to the timing of

first birth. Adolescent mothers are more likely to come

from families with fewer resources, poorer neighborhoods,

and more family instability [5, 10, 14, 17, 20, 21, 22].

Research also suggests that young mothers have lower

levels of educational attainment and aspirations than

women who delay childbearing [23–25]. Adolescent

mothers are more likely to drop out of school and receive

no postsecondary education [26–29].

In previous studies, mothers’ educational attainment has

been grouped into the broad range of family of origin and

sociodemographic factors that increase the likelihood that

women will have an adolescent birth and thus lead to neg-

ative outcomes for their children. This range of variables,

like annual household income or family structure, are often

defined as static variables and not easily changed through

policy or interventions. However, a mother’s educational

attainment may be better understood as a dynamic variable

that can change over the course of her child’s life.

Maternal educational attainment can and often does

change after first birth. Over the course of young adult-

hood, many adolescent mothers are able to catch up to their

counterparts and achieve comparable rates of high school

completion [18, 30, 31]. The rebound in educational

attainment that some adolescent mothers experience by

later adulthood may also be paralleled by higher quality

home environments mothers are able to establish for their

children. Continuing education after an adolescent birth

may hold promise for mitigating the negative consequences

of early childbearing on child development.

Taking advantage of the longitudinal and intergenera-

tional nature of the Panel Study of Income Dynamics and

the Child Development Supplement, we investigate how

maternal age at first birth and educational attainment

impacts children’s home environments. We examine

whether continuing education mitigates the negative rela-

tionship between adolescent childbearing and home envi-

ronments. Though lower educational attainment is often a

side effect of adolescent childbearing, encouraging

continuing educational efforts represents a potential avenue

through which we can help young parents overcome the

obstacles associated with an early birth.

Data and Methods

The data for this study come from the Panel Study of

Income Dynamics (PSID). This survey was started in 1968

with 4,800 families, a national probability sample of

households in 1967, and was supplemented with a Latino/

Hispanic sample added in 1990. The survey was repeated

on an annual basis until 1997 when assessments took place

every other year. In 1997, a sample of PSID families with

children younger than 13 was selected for the Child

Development Supplement (CDS-I). This sample consisted

of one or two children from selected families (N = 3,563)

and included an oversample of low-income and minority

families. This supplement to the PSID original survey was

intended to provide an in depth look at child development.

This study uses an analysis sample of CDS-I families with

complete data on maternal education, marital history, and

the focal child development outcome (n = 3,193).

The primary outcome measure for this study was an

observational measure of cognitive stimulation and emo-

tional support parents provide children, known as the

Home Observation for Measurement of the Environment

Scale (HOME) [1]. The HOME Scale is based on obser-

vations and interviews conducted at the family’s home and

is widely used [32–35]. Depending on the child’s age, the

home environment was assessed for specific conditions,

facilities, and the social and emotional tone of mother–

child interactions. Higher scores indicate better, more

supportive home environments, the score ranging from 7 to

24. One of four comparable versions of the HOME Scale

was administered depending on the child’s age at assess-

ment: infant/toddler, early childhood, middle childhood, or

early adolescence.

Mothers of these children were classified into one of

three categories depending on age at first birth. The three

groups included women who were younger than 18 at first

birth, 18–19 years old, and 20 years or older. These cate-

gories were created based on previous literature while also

ensuring adequate cell sizes for each category [3, 17].

The PSID collected information annually on the edu-

cational attainment of all members of participating

households. To capture a dynamic indicator of maternal

education attainment, mothers’ education level was based

on two measurements: women’s grade level at the time

their first child was born and highest grade achieved when

their children participated in the CDS-I in 1997. A three

level variable was constructed to represent education prior

to first birth: not a high school graduate, a high school

graduate, and had attended some college. Continuing

education efforts were determined by changes in educa-

tional attainment by 1997. Changes were based on

improvements in education defined as graduating from

high school or attending at least some college.

Several control variables were also constructed based on

factors determined to be influential on children’s home

environment in previous work. Demographic variables

included child’s age and gender, maternal race/ethnicity,

Matern Child Health J (2011) 15:360–366 361

123

and family structure. Maternal race/ethnicity was catego-

rized as non-Hispanic White, non-Hispanic Black/African

American, Hispanic, and Other. Family structure was

measured by mother’s marital status at birth, the presence

of a father figure in 1997, and presence of siblings. The

indicator of socioeconomic well being was computed from

reports of Aid to Families with Dependent Children

(AFDC) receipt from 1994 through 1997 to determine

exposure to poverty during childhood. AFDC was awarded

to families with children and low or no income.

Plan of Analysis

The goal of the analyses is to examine variance in home

environments by timing of first birth and maternal educa-

tional attainment. We focus on first births that occurred

while women were younger than 18 years old to determine

if continuing education can make up for the disparity

in these families home environments. Analyses explore

whether educational attainment after first birth helps

mothers rebound from early births, thereby mitigating the

negative consequences of having an early birth. The first

step of the analysis includes bivariate analyses of home

environment by maternal age at first birth and educational

attainment. The second step of the analysis involves mul-

tivariate regression analyses to isolate the association

between continuing education and age at first birth on

home environment. As the HOME score is a continuous

variable, Ordinary Least Squares (OLS) regression will be

used to model the linear association between the home

environment and timing of first birth and maternal educa-

tion. Coefficients from OLS regression models can be used

to predict HOME scores, adjusted for variables in the

model. Model 1 provides a baseline examination of the

association between timing of first birth and home envi-

ronment. Model 2 examines whether continuing education

efforts moderate the relationship between age at first birth

and home environment. Given the complex sampling nat-

ure of the PSID and CDS, complex survey techniques and

1997 sampling weights were used in all analyses.

Results

Sample Description

Half of the children in the sample were female. The

average age of children was 7 years. Most mothers iden-

tified as non-Hispanic white (67%) while the remaining

families were non-Hispanic black (17%), Hispanic (14%),

or Other race/ethnicity (3%).

On average, mothers were 34 years old at the 1997

assessment. At first birth, most women were at least

20 years old (76%), 15% of women were 18–19 years old,

and 9% were less than 18 years old. Most women (71%)

were married at first birth. Two-thirds of households

reported a father figure was present in the 1997. Over 90%

of women reported having more than one child. 13% of

families reported receiving AFDC assistance between 1994

and 1997.

Forty-one percent of women had not graduated from

high school prior to first birth, 22% graduated from high

school, and 35% of women had attended at least some

college. Measurement of continuing education efforts after

first birth revealed that 25% of mothers graduated from

high school and 15% of mothers had attended at least some

college by 1997.

Bivariate Analyses

Nearly one out of ten children were born to mothers who

were 17 years or younger at first birth. None of these young

mothers were able to graduate from high school prior to

first birth and over half never graduated from high school.

The second group, mothers who were 18-19 years old at

first birth, had moderately better educational attainment.

Less than 30% of these mothers never graduated from high

school. Eighteen percent graduated from high school prior

to first birth and 3% attended college prior to first birth.

Older mothers, those at least 20 years old at first birth,

reported better educational attainment than younger

mothers. Only 8% of these women never graduated from

high school. Nearly half of the women attended at least

some college before first birth.

The mean HOME score was 19.4 though HOME scores

evidenced significant variation across maternal age at first

birth and educational attainment (Table 1). Women who

were at least 20 years at first birth received the highest

Table 1 Mean HOME scores by independent and control variables

N HOME scores

Mean 95% Confidence

interval

Overall 3,193 19.44 19.28–19.60

Maternal age at first birth

\18 Years 425 17.41 16.94–17.87 18–19 Years 615 18.11 17.75–18.47

20? Years 2,153 19.95 19.77–20.13

Educational attainment at first birth

No high school graduation 1,539 18.30 18.08–18.53

High school graduate 704 19.53 19.18–19.87

Attended at least some college 950 20.67 20.41–20.93

Note: Categories with non-overlapping confidence intervals are significant different

362 Matern Child Health J (2011) 15:360–366

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mean HOME score at 19.9 (95% CI 19.8–20.1). Adolescent

mothers have the lowest mean score at 17.4 (95% CI 19.6–

17.9) though not significantly different than 18 and 19 year

old mothers (M = 18.1, 95% CI 17.7–18.5).

Mothers who attended at least some college before first

birth have the highest mean scores (M = 20.7, 95% CI

20.4–20.9). Mothers who had not graduated from high

school had the lowest mean HOME scores (M = 18.3, 95%

CI 18.1–18.5). Mothers who had graduated from high

school had HOME scores that fell between more and less

educated women (M = 19.5, 95% CI 19.2–19.9). These

results are likely confounded by maternal age. Independent

effects will be explored in the following multivariate

analyses and will also explore how continuing education

moderates this association.

Multivariate Analyses

The multivariate analyses explore how maternal educational

attainment may moderate the effect of maternal age and

education at first birth (Table 2). That is, can continuing

education following an adolescent birth mitigate the nega-

tive consequences associated with being an adolescent at first

birth? Even with child, maternal, and family characteristics

as well as maternal education at first birth as control vari-

ables, younger mothers received lower HOME scores than

households with older mothers. Young mothers received

HOME scores that were 3% lower than older mothers.

When indicators of continuing education after first birth

were included in the model, maternal age at first birth was

no longer significantly associated with HOME scores. The

negative consequences of an early birth were mediated by

women’s continuing education efforts among adolescent

mothers and mothers aged 18–19 years. Model 2 demon-

strates that there was no significant difference in HOME

scores by age. Differences in the home environment are

due to variation across categories of educational attainment

and continuing education efforts. Regardless of age,

mothers who never graduated high school had the lowest

HOME scores. These mothers were at the greatest risk for

negative home environments while more educated mothers,

young and old alike, received higher scores on home

environment.

In both models, disparity in children’s HOME scores

persisted by family structure and race/ethnicity. Even after

accounting for education and the other control variables,

Hispanic and black children received significantly lower

HOME scores than their white counterparts. Similarly,

children without a father figure in the household in 1997

scored significantly lower than children living with a father

figure.

For the adolescent mothers, continuing education efforts

generally included returning to and graduating from high

school. At first birth, none of these adolescent mothers had

graduated from high school. Among those who had not

graduated from high school, 46% of the women returned to

school to graduate from high school. Very few of the

youngest mothers (9%) who had not graduated from high

school before first birth went onto attend college by the

1997 assessment. Model 2 indicates that for the youngest

mothers, returning to high school or attending some college

was associated with significant increases in HOME scores.

Young mothers who returned to school had up to 5%

higher HOME scores than young mothers who did not

return to school. Continuing education for adolescent

mothers was associated with more positive home envi-

ronments for their children.

Table 2 OLS regression models for HOME scores

Model 1 Model 2

Coefficient SE Coefficient SE

Intercept 13.96*** 0.44 13.21*** 0.44

Child characteristics

Age in years 0.45*** 0.02 0.45*** 0.02

Gender

(Male)

Female 0.27* 0.11 0.30** 0.11

Family characteristics

Mother’s marital status at first

birth

-0.19 0.17 -0.15 0.17

Father figure present (1997) 1.87*** 0.14 1.90*** 0.14

Mother had more than 1 child -0.15 0.20 -0.11 0.20

AFDC receipt (1994-1997) -0.11 0.19 0.03 0.19

Maternal characteristics

Maternal age (1997) 0.04*** 0.01 0.04** 0.01

Race/ethnicity

(White)

Black, African American -1.37*** 0.17 -1.39*** 0.17

Hispanic -1.50*** 0.22 -1.23*** 0.21

Other 0.02 0.32 -0.06 0.35

Maternal age at first birth

(Older than 20 years)

17 Years and younger -0.51* 0.24 -0.13 0.24

18–19 Years -0.47* 0.20 -0.31 0.20

Maternal education at first birth

(Less than HS graduation)

HS graduate 0.18 0.19 0.86*** 0.23

Attended at least some

college

1.11*** 0.18 1.96*** 0.22

Continuing education efforts by 1997

HS graduate 0.60** 0.20

Attended at least some

college

0.92*** 0.19

Note: * P \ 0.05, ** P \ 0.01, *** P \ 0.001

Matern Child Health J (2011) 15:360–366 363

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Among the 18 and 19 year old mothers, nearly three out

of four of these women had not graduated from high school

before first birth. Even for these slightly older mothers, the

most common continuing education efforts included grad-

uating from high school. Among mothers who had not

graduated from high school prior to first birth, 45% of these

women returned to finish high school and 12% attended at

least some college by 1997. Mothers who returned to

school after first birth at age18 or 19 received significantly

higher HOME scores, even after controlling for educational

attainment at first birth, family structure, and SES indica-

tors among other controls. Among mothers who were

18–19 years old at first birth, continuing education efforts

were associated with a 4–10% higher HOME score, a sig-

nificant increase in the quality of their home environments.

Discussion

The goal of this study was to explore ways that the negative

consequences of adolescent childbearing for child well

being can be mitigated by maternal education. Using a

nationally representative sample of women and their chil-

dren, we examined whether continuing education could

help adolescent mothers overcome the challenges of an

early birth. The results from this study suggest that

maternal educational attainment has more lasting effects on

children’s well being and development than her age at first

birth.

Baseline models of the relationship between timing of first

birth and home environments revealed that early births are

associated with disadvantages in children’s home environ-

ments. Adolescent mothers were less likely to construct

emotionally and cognitively supportive and engaging envi-

ronments for their children. Women who delayed child-

bearing until their adult years provided better home

environments. However, this link disappeared when mater-

nal continuing education was considered. Rather, children’s

home environments depended more on mothers’ educational

attainment and continuing education efforts than the timing

of first birth. Continuing education following an adolescent

birth was associated with significant improvements in the

home environment, increasing the emotional and cognitive

support available to children. Mothers who went back to

school following early births provided substantially better

family environments for their children.

The data support previous findings that women are able

to overcome the hardships associated with an early birth if

they return to school. Many children born to young mothers

actually fare quite well suggesting that early childbearing

does not ‘‘inevitably or irreversibly’’ lead to lifelong

hardships for young mothers and their children [36]. The

results from this study suggest that educational attainment

is an important factor for helping young mothers improve

the long term outcomes for their children, even when

mothers return to school after the birth of their first child.

These results suggest that encouraging continued educa-

tional efforts may be fruitful in helping young mothers

overcome the obstacles associated with early births.

Studies have also highlighted the importance of making

comparisons of maternal age at first birth beyond a dichot-

omous variable of younger than versus older than 19 years.

Researchers and public health officials have specified addi-

tional categories such as 15–17 and 18–19 years old at first

birth compared to women aged 20–21 and 22 years and older

[3, 17]. The data from this study are consistent with this in

finding that none of the youngest mothers had graduated

from high school prior to first birth and some of the

18–19 year old mothers had already graduated. Though the

regression models suggested returning to high school yielded

similar benefits for both groups of young mothers, programs

developed to help young mothers should consider the dis-

parate barriers to continuing education that very young

mothers may face. Programs aimed at 18 year old mothers

can have a shorter duration as these adolescents are closer to

graduating. Helping a 15 year old mother graduate or com-

plete her GED requires longer interventions as these ado-

lescents may have more ground to cover in order to graduate

from high school or receive a GED.

Though young mothers who returned to school fared

better on the HOME Scale, continuing education efforts did

not erase all disparity in home environments. Even after

educational attainment and age at first birth were consid-

ered, racial/ethnic minority families and single parent

families scored considerably lower than their counterparts.

Children who were white and lived with a father figure

lived in significantly better home environments. Additional

research and intervention is required to help minority and

single parent families improve their home environments.

Additional limitations in this study included the diffi-

culty controlling for any inherent and confounding differ-

ences that may exist between adolescent and adult mothers.

It is unknown if adolescent mothers differ from older

mothers in meaningful ways that could account for dif-

ferences in the home environment (e.g., IQ, mental health,

neighborhood characteristics, history of abuse, family

size). Though these factors are important to consider, they

are often not available in the data, as is the case with PSID

and CDS data. Data quality issues are common when using

prospective, intergenerational data.

Conclusion

The costs of adolescent childbearing exceed nine billion

dollars annually [3, 4]. Several strategies are needed to

364 Matern Child Health J (2011) 15:360–366

123

reduce these costs. A significant portion of these costs are

attributed to the behaviors, needs, and actions of the chil-

dren of adolescent mothers. While funding and interven-

tions are needed to reduce primary and secondary

adolescent childbearing, these results highlight the need to

ensure that adolescent mothers are provided support to

ensure educational achievement following delivery. Ado-

lescent mothers provide an identifiable target for intensive

case management or other interventions that can mediate

outcomes through encouraging educational achievement.

Investments in the educational attainment of adolescent

mothers can be measured in the improved success and

reduced costs associated with children of adolescent

mothers, as evidenced here.

Reducing the costs of adolescent births requires multi-

dimensional strategies. Prevention should be a priority to

ensure that adolescent births are avoided. However, when

an adolescent birth occurs, it is important to ensure that

young mothers have opportunities to continue education.

The findings in this study are consistent with the call from

others to consider schooling a public health priority, given

the benefits associated with educational attainment [37].

Strategies that ensure pregnant and postpartum adolescent

mothers can continue to attend school, online educational

solutions, and cooperatives with local community colleges

to facilitate high school and post-secondary educational

attainment are examples of policy and program strategies

needed to ensure that one undesired outcome is not allowed

to have additional and long lasting negative impacts for the

adolescent mothers, their children, and society.

This study provides evidence that encouraging school

retention and returning to school among adolescent may

yield direct benefits for children. Mothers who have greater

educational attainment are more likely to provide healthy

and supportive home environments for their children.

Helping adolescent mothers form a safe, healthy, nurturing,

and developmentally appropriate home and family envi-

ronment for children may depend on educational

attainment.

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