21/07/2016

Predictors of early childbearing in the

Cordillera Administrative Region

Josefina N. Natividad, ScD

Population Institute, CSSP
University of the Philippines

Dissemination forum on the results of the YAFS Further Analysis for the
Cordillera Administrative Region,
Prince Plaza Hotel, Baguio City, July 21, 2016

University of the Philippines Population Institute

OUTLINE
Why is teenage childbearing a cause for concern?
YAFS 4 as a source of data on teenage childbearing
Definition of teen childbearing
Trends in teenage childbearing in the Philippines
Teen childbearing in CAR
Predictors of early childbearing in CAR
Conclusions and recommendations

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Why is teenage pregnancy a cause for concern ?

Teenage mothers are at increased risk of pre-term delivery
and low birth weight (Gordon, 2001, Kurth, et.al.,2010,
Suwal, 2012, Eure et.al., 2002)

Also for maternal death, early neonatal death, postpartum

hemorrhage, puerperal endometritis, operative vaginal
delivery ( Conde-Agudelo, 2005)

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Why is teenage pregnancy a cause for concern ?

.Risks are not specifically linked to the level of development
of a countrys health care system and the availability of
appropriate maternal care for very young pregnant women
(Kurth, et.al., 2010)

Rather the risks are specific to the age group and its
accompanying implication of biological immaturity for
childbearing. (Natividad,2013)

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But even within the teenage years, the risks of

adverse outcomes are not uniformly distributed.

Risks tend to be higher in the younger teens than

those closer to age 20 (Neal, et.al., 2012)

So, timing of early childbearing is an important factor

to consider

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Why is teenage pregnancy a cause for concern ?

A teenage mother is also exposed to non-health risks

Not finishing school

Limited future chances for realizing her full

potential

Being burdened with child care while still a child

herself
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What causes a high prevalence in teenage

childbearing
It may result from culturally sanctioned practice of early
marriage and early marital childbearing
It may result from early premarital intercourse resulting in
unintended pregnancy
Both may be present at the same time

One exacerbating factor: Decreasing age at menarche

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The Young Adult Fertility and Sexuality Study

A series of representative surveys on young adults aged 15-24

Conducted first in 1982 with a nationally representative sample of

women age 15-24

Other YAFS rounds had male and female samples, representative at

national and regional levels

Subsequent YAFS rounds in 1994, 2002 and 2013

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Coverage of YAFS 4

17 regions
78 provinces
681 cities and
municipalities
1,121
barangays

18,547
households

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Respondents YAFS 4

19,178 respondents

11,425 15-19 year olds and 7,753 20-24 year olds

About 1,000 respondents per region

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Teenage childbearing: the national level

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Definition of teenage childbearing

Women aged 15-19 at the time of the survey

who fulfilled either of the ff conditions:

had already given birth

were pregnant at the time of the survey

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The proportion of 15-19 year old females who have begun

childbearing DOUBLED in the past decade

Percent of females 15-19 who have begun

childbearing

13.7

7.0 6.9

1994 2002 2013

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The percentage who have began childbearing increased at

every age. The increase is most pronounced at ages 17, 18
and 19. The rate at age 15 has tripled in the past decade.

35.2

22.9
19.1
19.1

10.4 10.7 11.0

0.6 0.5 1.7 2.9 2.7 4.3 6.1 5.1

15 16 17 18 19
1994 2002 2013
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The regions with the highest teenage childbearing

rates are CAR, Region 2 and NCR.
The regions with the lowest are Regions 4A, 5 and 8

13.6 18.4 18.1 17.7 17.3 16.7 16.3 15.1 15.1 13.7 13.1 13.0 12.7 12.3 11.8 11.8 8.8 8.1
Philippines CAR II NCR CARAGA XI IX VI III XII VII X I IV-B ARMM VIII V IV-A

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Predictors of early
childbearing in CAR

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Early childbearing is defined as having given birth before age 20

To avoid truncation, we limited the analysis to young women

aged 20-24 at the time of the survey

N of cases is 262 women.

Of these, 1 in 4 (25 percent) had experienced early childbearing/

had a birth before age 20.

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Predictors of early childbearing are conceptualized as factors

that clearly preceded the event they are supposed to predict

We looked primarily at the conditions that the young woman

experienced while growing up

Specifically we focus on the socialization practices in the

young womans family

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We explored the following practices

Reported levels of strictness of parents/guardians from birth to age

18 . Based on whether the parent/guardian approved of the ff:

- Going out of town with friends

- Staying out late
- Spending overnight in a friends house
- Going to a party at short notice
- Going out on a single date
- Having a boyfriend before age 18
- Living away from home
- Going out at night with friends
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Family relationships based on the ff statements

- Family members are supportive of each other

- It is easier to discuss problems with people outside the family than with
members of my family
- In our family, everyone goes his/her way
- Discipline is fair in our family
- In our family, everyone shares responsibility
- Family members eat together at least one meal a day

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Parenting style

- based on two dimensions

Demandingness
(Your parent/guardian) had clear standards of behavior for the children in your
home when you were growing up
When you were growing up your parent/guardian often told you exactly what she
wanted you to do and how she expected you to do it.

Responsiveness
(Your parent/guardian) listened to your opinions and feelings when you have
problems when you were growing up
When you were growing up, (parent/guardian) often knew how you felt about
different things in your family and personal life
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Punishment style
During your childhood up to age 18, when you did something wrong or
something that your parent/guardian disapproved of , what was their usual
reaction?

- Counsel/talk
- Ground me
- Withhold allowance
- Give me a scolding
- Verbally abuse me
- Physically punish me
- Give me the silent treatment
- No reaction

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Our general hypothesis was that the type of socialization practices in

the family while the young woman was growing may predispose her to
engaging in behaviors that will put her at risk for early pregnancy.

In particular, too strict or too permissive parenting practices may be a

risk factor for early childbearing.

Lastly, we also looked at one family-related factor:

-Whether or not the woman was raised by both parents

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We also hypothesized that there are background characteristics that may

also be associated with the risk of early childbearing. These are:

- Urban-rural residence
- Ethnicity (Cordilleran compared with non-Cordillerans)
- Poverty status (poor vs. non-poor)
- Current education (elem, HS undergrad, HS grad, any college)

Analysis is limited by the small number of cases

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To explore bivariate relationships between each hypothesized

predictor or correlate, we did cross-tabulations and survival analysis.

Survival analysis allows us to investigate the timing of childbearing.

In survival analysis, we show the comparative proportion of young
women who had begun childbearing at each age, by categories of the
hypothesized predictor.

We used logistic regression for the multivariate analysis, which looks

at the combined effects of all factors on the probability of
experiencing early childbearing

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RESULTS

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Parenting variables
Bivariate analysis of the levels of strictness indicated the following

- There is little variability in the level of parental strictness in that

most respondents report their parents to be on the strict side.

- A comparison of the level of strictness of parents of women who

started childbearing early with those who did not did not show
significant differences in parental strictness between the two groups.

We found the same results for family relationship and punishment style
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The one promising result was in the parenting style variables,

specifically the item

Your parent/ guardian had clear standards of behavior for the children in your
home when you were growing up

The response categories are: always true, often true, sometimes true, rarely
true and never true.

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Your parent/ guardian had clear standards of behavior for the

children in your home when you were growing up

With a birth before

age 20
Never/rarely 71.4
Sometimes 33.3
Often/always 21.9

The proportion who experienced early childbearing increases as the level of

clarity of standards of the parents on the behavior of children decreases.

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Proportion of women who had a birth before age 20 by

Residence Poverty status

Rural 26.2 Non-poor 25.0

Urban 16.0 Poor 25.6

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Proportion of women who had a birth before age 20 by

Ethnicity
Education

College 15.6
Non-Cordilleran 29.6

High school graduate 30.0

High school undergraduate 57.1

Cordilleran 22.1
Elementary 37.5

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Proportion of women who had a birth before age 20 by

Marital status Raised by both parents

Currently living in 40.9

No 35.3

Currently married 41.7

Yes 23.2
Never married 3.6

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Odds ratios for factors predicting the probability of early childbearing

among 20-24 year olds in CAR

95.0% C.I. for OR

Odds Ratio Lower Upper Sig.
High school undergrad 2.25 0.53 9.54 n.s.
High school grad 0.67 0.19 2.39 n.s.
College 0.25 0.07 0.94 0.040
Urban 0.73 0.22 2.43 n.s.
Cordilleran 0.76 0.41 1.42 n.s.
Poor 0.56 0.26 1.18 n.s.
Raised by both parents 0.56 0.24 1.27 n.s.
Clear standards often/
always 0.43 0.21 0.87 0.019
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The timing of early childbearing

The graphs show the proportion of women who have

had a birth at each given age

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By residence By poverty status

100.00

80.00

60.00

40.00

20.00

0.00

12 13 14 15 16 17 18 19 12 13 14 15 16 17 18 19
rural urban non-poor poor

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By ethnicity By current education

100.00

80.00

60.00

40.00

20.00

0.00 12 13 14 15 16 17 18 19
12 13 14 15 16 17 18 19
elementary HS undergraduate
Non-Cordilleran Cordilleran HS graduate/vocational college and above

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By person who raised the youth By clear standards

100.00

80.00

60.00

40.00

20.00

0.00

12 13 14 15 16 17 18 19 12 13 14 15 16 17 18 19

not raised by both parents raised by both parents Clear sometimes/rarely/never Clear often/always

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Summary, Conclusions and Recommendations

Among 20-24 year old women in CAR, 25 percent or 1 in 4 had a birth

before age 20 or were teenage mothers

The risk of early childbearing is not affected by urban-rural residence,

poverty status, ethnicity or being raised by both parents.

All are equally at risk

Having a college education significantly decreases the risk of

early childbearing
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The study suggests that parenting styles may be protective against the risk
of early childbearing.
Specifically, if the parents set clear standards for children to follow while
growing up.

The timing of early childbearing shows that most teenage births

happen in the late teen years, ages 17, 18 and 19

Intervention programs to curb high teen fertility should take into

account these difference, especially the timing issue.

Interventions should be age-and gender-specific

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Thank you.

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