You are on page 1of 12

CHILDREN & SOCIETY VOLUME 24, (2010) pp.

188199
DOI:10.1111/j.1099-0860.2009.00217.x

Repeat Teenage Pregnancy in Two


CulturesThe Meanings Ascribed by
Teenagers
Jean Clarke
Brunel University, Uxbridge, UK

This qualitative study charts the views, feelings and experiences of two diverse, yet in many
ways similar, groups of respondents from two cultures one group of 26 respondents from
the Caribbean islands of Jamaica and Barbados and the other group of 26 respondents from
London, who have experienced repeat teenage pregnancies. The study uses a comparative
approach to provide a psychosocial, emotional and economic understanding of the factors,
which lead to repeat pregnancies. This study cautions against an over reliance on a mechanis-
tic understanding and management of both single and repeat teenage pregnancies, and
emphasises the fact that economic, social, psychological and emotional processes are also
crucial to our understanding of repeat teenage pregnancies.  2009 The Author(s). Journal
compilation  2009 National Childrens Bureau.

Contextualising the research

In the UK and the Caribbean, persistent rates of high teenage pregnancies have resulted in
the centre staging of teenage pregnancy as a subject of immense social concern. (Social
Exclusion Unit, 1999; United Nations Childrens Fund (UNICEF), 2000). As a result of these
concerns, successive governments in the UK have focused efforts on reducing the rates of
teenage pregnancies; the latest initiatives are spearheaded by the New Labour governments
Social Exclusion Unit, which has been examining teenage pregnancy since July 1998. Teen-
age mothers were seen as victims of low expectations, ignorance and misinformation (Social
Exclusion Unit, 1999). The units aim was to develop strategies to reduce the rate of teenage
pregnancies and to minimise social exclusion. Since the unit published its findings in 1999,
a wide number of recommendations, strategies and initiatives have emerged (Teenage Preg-
nancy Unit (TPU), 2000).

A central aspect of the governments strategy focuses on the use of contraception and sex
education to address the issues of ignorance and misinformation. However, this approach
stifles discussion of contextual or structural influences on sexual behaviour and reproduc-
tive outcomes, such as socioeconomic inequality and educational underachievement (Arai,
2003, p. 91). Questions have therefore been raised about the extent to which the teenage
pregnancy strategy in its current form is successful in meeting its aims (Arai, 2003; Graham
and McDermott, 2005).

Additionally, the mainly quantitative research on teenage pregnancy has been central to the
development of government policy (Graham and McDermott, 2005) and placed more empha-

 2009 The Author(s)


Journal compilation  2009 National Childrens Bureau
Repeat Teenage Pregnancy in Two Cultures 189

sis on abnormal behaviour, such as deviance, delinquency and declining morality (Greig
and Taylor, 1999). This has resulted in failure to present more than a one-dimensional pic-
ture which is unable to capture the thoughts and feelings of teenage mothers themselves.
(Wilson and Huntington, 2005, p. 64).

Also missing from this research, is an examination and exploration of the issues related to
repeat teenage pregnancy, despite reference to the need to prevent repeat pregnancies and
the fact that in the United Kingdom 20 per cent of births conceived to under-18s are to teen-
age women who are already teenage mothers; and 7.5 per cent of abortions to under 18s are
repeat abortions (DfES, 2006).

In the Caribbean, 1600 out of 6456 births to teenage mothers in Jamaica were repeat preg-
nancies (Registrars General Department, 2004). No repeat teenage pregnancy figures are pro-
vided for Barbados. However, 14 per cent of all births and between 1623 per cent of
abortions are to teenage mothers. (United Nations Childrens Fund (UNICEF), 2000). Persistent
poverty in the Caribbean region due to long standing debt servicing commitments, stabilisa-
tion and structural adjustment programmes, leads to drastic cuts in state spending on health,
education, housing and welfare, resulting in increased exposure to exploitation and abuse
among at risk groups of children, which include pregnant teenagers (Girvan, 1997). These
issues severely curtail the development of comprehensive social policies and strategies to
address teenage pregnancy. Nevertheless, owing to collaborations between non-governmental
agencies and public partnerships, strategies to reduce teenage pregnancies centre on Family
Life Education, family planning activities and reducing the impact on curtailing education
and limiting the mothers future job prospects and subsequent economic well-being (National
Family Planning Board (NFPB), 2007). However, the challenge of teenage pregnancy preven-
tion is compounded by a context of conservative sexual ideals coexisting with tacit approval
of early childbearing (National Family Planning Board (NFPB), 2007).

Teenage pregnancy in general is extensively covered in the literature, but research on repeat
pregnancy is scant and American in origin. These have identified a number of predictors
of repeat teenage pregnancy. Among these are: early age at first pregnancy (Manlove and
others, 2000), school dropout (Kalmuss and Namerov, 1994), negative attitude towards con-
traceptive use (Stevens-Simon and others, 1998) and a high degree of wantedness of
the first pregnancy (Boardman and others, 2006).

Evidence also suggests that teenagers who have repeat pregnancies were likely to face many
obstacles to education and economic self-sufficiency (Manlove and others, 2000). Conse-
quently, some researchers have focused on evaluating the effectiveness of post-natal multi-
service programmes to reduce repeat teenage pregnancies. Some of these programmes have
reported successes in reducing the rate of repeat teenage pregnancies (Black and others,
2006; Klerman and others, 2003) while others have reported a lesser degree of success (Scott
and others, 2004).

Largely absent from these studies are the perspectives of the teenagers themselves. Since the
UK government launched its Teenage Pregnancy Strategy in 1998, there has been a growing
acknowledgement that to fully understand the factors that contribute to teenage pregnancy
and respond appropriately to identified need, the perspectives of these teenagers must be
heard (Independent Advisory Group on Teenage Pregnancy (IAGTP), 2003). This study
was an attempt to develop a deeper and more complex understanding, by going beyond the

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
190 Jean Clarke

identified predictive factors and unearthing the meanings that teenagers in the UK and the
Caribbean ascribe to their repeat pregnancies.

Research sample and method

In-depth qualitative semi-structured interviews, facilitated by a set of themes, were con-


ducted. Fifty-two respondents 26 from London and 26 from the Caribbean islands of Bar-
bados and Jamaica were interviewed. All respondents were up to 20 years old and had had
two or more pregnancies, regardless of the outcome of the first pregnancy. To prevent
respondents accounts being clouded by a state of crisis, which can follow the confirmation
of an unplanned pregnancy and subsequent birth, pregnant respondents at the time of the
interview were at least six months pregnant. For those who had recently given birth, this
had occurred at least six months prior to the interview.

Through a purposive sampling approach, the London respondents were recruited from 14
London boroughs, with the majority from teenage antenatal clinics and the remainder from a
mixture of statutory and voluntary social services agencies. The Barbadian sample was
drawn from the social work department of the major hospital and the Family Planning Unit.
The Jamaican sample came from the antenatal clinics of the two public general hospitals and
a handful from two Polyclinics in the Kingston metropolitan area. All procedures for gaining
permission, consent and ethical approval were followed in all locations.

One in-depth interview per respondent was conducted and all interviews were tape recorded,
subsequently transcribed and systematically analysed.

Characteristics of the samples


Table 1: Age of respondents

Jamaica Barbados London

Age 15 1
Age 16 1 1 2
Age 17 1 4 2
Age 18 5 4 7
Age 19 5 4 13
Age 20 2

Although the majority of the respondents were aged 18 plus at the time of their interviews,
the key issue is the age at which they had conceived their first child, which was an average
of 15 years. See Table 1.

Table 2: Ethnic composition

Ethnic groups London Caribbean

Asian 3
Black (includes Afro-Caribbean and African origins) 10 26
Mixed race 3
White 11

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
Repeat Teenage Pregnancy in Two Cultures 191

Despite the ethnically mixed composition of the London sample, no discernible differences
that could be attributed to ethnicity emerged from the findings. See Table 2.

Table 3: Formal qualifications obtained at secondary school level

Barbados Jamaica London

Respondents with formal examination passes 2 1 15


Awaiting results of examinations Nil 1 2
Without formal examination passes 11 11 9

In the Caribbean, 98 per cent of all respondents did not return to school after the first preg-
nancy. One-third of these attributed this to a refusal by their schools to allow them to return
to school. In some cases, the respondents simply stopped attending school in anticipation of
being asked to leave. There was no other alternative provision for those girls who were asked
to leave school. This lack of opportunity to return to school also featured prominently in the
respondents sense of loss in terms of lost educational opportunities. See Table 3.

For the London respondents, there was an overall lower incidence of teachers refusing to
allow the young women to return to school following teen pregnancies. One could therefore
argue that in relative terms, a teen pregnancy in London stands less of a chance of adversely
affecting a young womans educational achievements than is generally the case in the
Caribbean.

Table 4: Employment income

Barbados Jamaica London

In employment 2 1 6 (prior to first pregnancy)


Receiving welfare benefits 2 0 16
Relying on family and putative 9 12 1
fathers for financial assistance
Receiving maternity benefits 3

Caribbean respondents were vulnerable in terms of income and job profiles, and with little or
no recourse to welfare benefits, they were often forced to rely on a succession of putative
fathers to provide a form of welfare role. Conversely for the London respondents, welfare
benefits provided a greater measure of security and rendered them less at risk of exploitation
and abuse. See Table 4.

Table 5: Accommodation arrangements London

Category Numbers

Living in council accommodation with sole tenancy 4


Living at home with parents 8
Living in council accommodation with husband 1
Living in council accommodation with boyfriends putative fathers 10
Living in privately rented accommodation 1
Living with mother and baby home 2

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
192 Jean Clarke

Table 6: Accommodation arrangements Caribbean

Category Barbados Jamaica

Living with parents and siblings 8 7


Living with boyfriends putative fathers 1 3
Living with relatives 3 1
Living with friends 1 2

These accommodation arrangements provided a greater measure of security for the London
respondents. See Tables 5 and 6 .

Only one London respondent was married. One-third of the sample had more than two preg-
nancies, with a greater number of London respondents having more than three pregnancies.
First pregnancies were unplanned, with a mixture of planned and unplanned second preg-
nancies. Third and subsequent pregnancies were all planned. Among the London respondents,
there were also two cases of repeat abortions. The average gap between first and second
pregnancies was one year.

Emerging themes

Several themes emerged from the accounts of the young women or as a result of being intro-
duced by me because of their prominence in the literature on teenage pregnancy. These
included educational achievement, knowledge and attitudes about contraceptives, experiences
of sex education. However, another set of themes arose spontaneously and repeatedly as the
young women spoke about their reasons for repeat pregnancies. This study focuses on two
of those themes; these are loss in its various forms because it arose repeatedly in the three
locations and reversed life course rationalisation, which was a prominent theme among the
London respondents.

The loss factor

Throughout the interview process, the link between loss and repeat pregnancies emerged
forcefully and repeatedly. Using Frears and Schneiders (1981) categorisation of loss, three
types of losses emerged from the accounts of the respondents. These were: apparent loss,
which is most commonly associated with death and dying; unnoticed loss, which is not
immediately obvious, but nevertheless triggers loss responses in the individual and loss as
part of change, which occurs in the normal run of life changes and is normally referred to
as life transitions.

Apparent losses
Loss following stillbirths, abortions and neonatal deaths featured prominently in the narra-
tives of the young women, (11 out of 26 respondents in the Caribbean and 12 out of the 26
London respondents). For many of them, this sense of loss was a very isolating experience,
as these losses, which should have been apparent, went unnoticed by family members and
professionals. In cases of stillbirths and miscarriages, the lack of medical explanations

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
Repeat Teenage Pregnancy in Two Cultures 193

compounded their sense of bewilderment and often resulted in feelings that they must have
contributed in some way to this loss. In cases of abortion, there were accompanying feelings
of guilt.

In explaining the full extent of their loss, they spoke of the compelling need to fill the emo-
tional void created by the loss by becoming pregnant again as quickly as possible. Some
claimed that although initially unconscious of their attempts to replace the child that they
had lost, in retrospect they felt that the loss had a strong bearing on the second pregnancy.
To avoid being pressured into a second termination, others went to great lengths to conceal
a further pregnancy from relatives and sometimes, putative fathers.

Additionally, 19 Caribbean and 21 London respondents forcefully expressed strong anti-


abortion views, which appear to be rooted in a range of complex societal views about fertil-
ity, morality, religion and sin, the role of the mother and the importance of the first child.

London
The following story summed up the feelings of many respondents in both sample groups:

I was a week overdue and I went down to the hospital just for a normal scan and they done all the
tests and the man said to me oh the heart monitor aint working. I am just going out to get another
monitor. But I knew then because I had seen the scan that there wasnt a heartbeat and I knew that
my baby had died, so he went out and got the consultant. And he came in and done a scan and said
to me like I am so sorry but your baby has died, we cant find a heartbeat. And I had to be taken
upstairs to be induced to have the baby. I was induced at 3oclock and gave birth to my baby at a
quarter to eight that night. And they done all the tests and said that there was nothing wrong with
me. And they have never found any reason why it had happened. They just said it was one of those
things that happen. But to me a 15-year-old girl that was heavily, heavily pregnant, they should
have induced me.

I AM VERY ANGRY ABOUT IT they could have induced me earlier before this happenedIt was
awful, it was terrible to think that I had been through a pregnancy 9 months, to come away from
it at the end with nothing, was the most awfulest experience I have ever had. And to give birth and
not to hear that baby cry once its come out of youespecially like that you have felt that baby
move and you have seen it growing, and all the scans was fine you know, and just for a week over-
due it had to die never to be explained, is the most awfulest thing in the world to happen to anyone.
I just blamed myself, cause I thought I must have done something wrong, or there must have been
something I could have stopped doing.

As soon as I lost the baby I thought thats it, I am going to have another baby. Its because you
have lost something and you want that baby so much that you just straight away think. I am
going to get pregnant and have another one. I will never stop hurting and wanting that baby..
(H aged 16).

I felt really bad about what happened last time (after the abortion), when I found out that I was
pregnant again I thought I am going to keep it a secret, because I knew that everyone was going to
pressure me to have an abortion again, and I didnt want to do it. I thought I am not having an
abortion this time because I felt really bad about what happened the last time, but I told my
boyfriend. He wasnt very happy about it, but I said to him that I was gonna have the baby anyway
and if you wanted anything to do with the baby then I wanted him to be there, but if not, I was
going to have the baby regardless. (B aged 17).

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
194 Jean Clarke

Following two abortions, I felt like I had murdered somebody, really guilty and it was my own fault.
I was also thinking about my own body, what things I would get later in life (by having the abor-
tions). I felt this even more after the second one because I also thought I had put my lower regions
through so much hell. After I got pregnant the third time, its no way that I could have had an abor-
tion because it would have been three dead babies. (J aged 19).

I thought about an abortion, but I didnt want one at all because it was my first child and I have
always thought that if you have an abortion once, I might not be able to have another child again.
(V aged 17).

For the next respondent, loss as a result of having a child taken into care by the Local
Authority also generated similar feelings of loss and grief. She described the sense of loss
thus:

An empty feeling. I just felt lost really. I was never given a chance, thats something that really
annoys me, that I never got a chance with him for people to see how capable I was. It is terrible. It
is something you cant even explain because it runs deep. I was just devastated carrying a baby for
nine months and feeling it move, going through labour and everything and seeing him for the first
time and him just going. It was horrible. (C aged 19).

The Caribbean
I was pressured a lot (to have an abortion). I feel kind of sad, bored and sometimes I think about it
and ask myself what I did. I feel young girls like my age should not get rid of children because it
is not a good thing to do and sometimes when you get rid of it, you have many thoughts. I would
like to tell all the young girls out there, dont get rid of babies. (Barbados, N aged 19).

after the abortion I tried all the time to get pregnant again. I was being punished. I was relieved
when I did (become pregnant). (Jamaica, D aged 19).

It was my first, sometimes you throw away the first and you never know if you will have another
one. Sometimes when you do really want a child you cant make one. Sometimes that is the only
one you could make. (Jamaica, L aged 18).

I dont feel that people should kill something that they dont really know about. Well I feel that if
you are pregnant and you are constantly bleeding or whatever, you would let nature take its course.
If it is to die it would die. If it is to live it would live, but thats nature. I wouldnt like to interfere
because the Lord said, thou shall not kill, so why should you take a life you dont know about. (Bar-
bados, S aged 18).

The journey of search as a symptom of unnoticed loss and loss as part of change
The narratives of these young women demonstrated that these losses resulted in an endless,
often painful and fruitless search for fulfilment, love and nurturing, which had been absent
throughout their lives. In all cases, this was a search that began before the first pregnancy
and later manifested itself in repeat pregnancies.

London
In this study, for nine London respondents, their experiences of unnoticed loss resulted from
a combination of different forms of abuse emotional, sexual and physical, often starting

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
Repeat Teenage Pregnancy in Two Cultures 195

from early childhood. They embarked on a journey of search to find fulfilment and meaning
to their lives. Their narratives pointed to a link between sexual abuse, early sexual activity
and teenage pregnancies. This link between sexual abuse and teenage pregnancy has also
been found by Saewyc and others (2004).

Among those respondents who had experienced one or multiple forms of abuse, was a young
woman who had suffered sexual abuse at age 6 by her father and at age 13 by her step-
father, which led to her first pregnancy. There was also a very strong element of emotional
neglect and abuse, which together conditioned her responses and attitude towards sex later
on. When discussing her early sexual activities she remarked:

I was sexually abused (at age 13) when I was younger by my father, family friend and my brother
and like it was natural as far as I was concerned. If my father could do it then anyone could.. In
my eyes it was natural whether it was like with a guy that I was going out with for two months let
alone two years. It was natural to me. (M aged 18).

When she was asked about her mothers whereabouts while this sexual abuse was going on,
she replied:

She was at home. She was an alcoholic. She didnt protect us or anything. We (her brother as
well) used to steal from her purse to scrape for food. Penny for the guy. Do that down the pubs.
We got picked up by the police at half past twelve at night. There was no boundaries, nothing. It
was like we were allowed to roam the streets till God knows what hour trying to scrape some
money to go down to the chippie and get some chips or something like that. And when we did ask
for food we would get a slap across the back. So it was like scraping for love, scraping for food.
It was like that all the way through life, so me expecting something from someone else, I had to give
in return. To get food from my mum, we would have to get her up, get her sober and get her to
make us food. It was us giving something to someone else to get something back.

The Caribbean
17 respondents often described their understanding of their repeat pregnancies as the end
result of this search.

I would say it was lack of love or something. Like you trying to find a person who love you, and who
ended up continually telling you that them love you and you believe the person, so thats the per-
son you want to spend the rest of your life with and get commitment and it ended up thats the person
who breaks your heart. You want to find a next one who would push out more interest and the same
thing happen again, till you get fed up. I am finished. I wasnt getting much attention because my
father leave me about the same day as I born. I found out from my mother that him didnt really want
me, because him give her money for abortion it was lack of love from my father and my mother
because the treatment I get from my mother it wasnt nice. She have six of us, one die, so she raised
five of us by herself. She alone have to struggle, so she wasnt showing much attention or love. I was
looking for love from my mother and I ended up getting three pregnancies. (Jamaica, E aged 19).

When I needed a father he wasnt there. So when I got pregnant on both occasions, I guess I was
looking for a mans love in place of his because I didnt feel needed or wanted by him (Barbados,
I aged 17).

The next two quotes indicate that a lack of financial support also featured highly in the lives
of the respondents and had a distinct link with early sexual activity.

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
196 Jean Clarke

They (boyfriends) had to do so much for me because your mother give you something and then take
everything she give you, you have to start from scratch, including panties, brassieres. You have to
start from scratch and somebody pulling their pocket. You aint washing, cooking and living at
them, you dont have to do anything for them. I thought that (sex) was a way to repay them that
was one of the reasons I got pregnant. No money, nobody to give you anything like no adult. No
mother, no father, no uncle, nobody that you could say if you are hungry you want $5 to buy some-
thing. So in a case like that you turn to your boyfriend, and once you had sex so, its like something
that got magnet that will pull you back again like dope, even though you dont enjoy it. (Barbados,
T aged 19).

I didnt have anybody to back me as a strong mother and a strong father; I was almost on my own.
My mother couldnt afford to support me. Me was living in the country at that time with my grand-
mother and I dont know my father. when I reached about 7, I had to send myself to school,
so that is some of the things why I have to have sex before, yes someone to support me. (Jamaica,
R aged 19).

Reversed life course rationalisation


A theme, which emerged from 10 London respondents, I have termed a reversed life course
rationalisation. These respondents, having had a first unplanned pregnancy, very quickly
rationalised to themselves that it would make sense to repeat their pregnancies and complete
their childbearing role at an early age, which would enable them to pick up on other life
interests and career developments later.

I have done it the other way round. My sister and my brother done it the other way round. They
have their careers and then they got married and they had their lives for a little while and then they
had children, but I dont think I would want to change it. Its hard and you are going to miss out on
a lot in life. But now that I have my children the way that I look at it now is that other people they
go to school, they go to college, they get a job, they have their career, they get married and then
they have a baby. I have just done it the other way round. I missed out on school. I have my chil-
dren when I am young and now I am at college and I am getting a career. So I have done it back to
front. (F aged 18).

They say education comes first, but its more important for me to have the children first because
when you get your education, you go to university, you could be offered a job and you cant take
the job because you are pregnant, and that would hold you back, but if you get all these out of
the way first my mum had me early and she is in a good job now. (G aged 17).

Its just a path. Instead of going straight on my path, I have sort of gone backwards on my path. Its
just that I had kids early, so when I am 32 I am going to have a 14 year old and a 16 year old. Thats
when most people are actually having kids. So my life will start when theirs is stopping. (P, aged 19).

Discussion

This study highlights some factors, which have powerfully fuelled the young womens jour-
neys into repeat pregnancies. Similar to other studies (Anderson, 1990; Rains and others,
1998), none of the respondents in this study viewed their pregnancy as unwanted. They
often viewed them as mistimed or unintended, but not unwanted. However, the central
theme of loss in its various forms and specifically apparent loss, has been shown to have a
distinct link with repeat pregnancies.

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
Repeat Teenage Pregnancy in Two Cultures 197

Theories of loss have categorised the experiences of bereavement into different stages or
phases (Kubler-Ross, 1969; Parkes, 1996). Many respondents in articulating their experiences,
expressed classic feelings and emotions associated with bereavement and loss such as guilt,
anger, ambivalence, shock and disbelief and depression (Kubler-Ross, 1969; Parkes, 1996).
Also evident in their narratives, were examples of the specific search component, which is
an inherent feature of grief and described by Parkes (1996, p. 200) as an urge to search for
and to find the lost person in some form. This search component was displayed in the com-
pelling need to fill the void created by experiences of stillbirth, abortions and neonatal
deaths by repeating their pregnancies. It was also evident in the quest to find meanings as
depicted by the journey of search. In this study, therefore, knowledge of the grieving process
could be applied equally to those who have experienced apparent losses as well as to other
types of unnoticed loss and therefore help to give meaning to the range of emotions, mani-
festations and responses to loss expressed by these respondents.

In addition to their experiences of loss, what is also clear is that all respondents attached a
great deal of importance to their role as mothers and this factor might be a more accurate
indicator of their sense of loss. The current preoccupation with teenage pregnancy as a cause
for concern fails to consider that for some teenagers, commitment to their maternal identi-
ties, provided a buffer against the potential threats to self-esteem (Graham and McDermott,
2005: p. 29). This is evident in studies such as (Bell and others, 2004; Black and others,
2006), which reported that for some of the young mothers in their study, motherhood
increased their self-esteem and provided some security and stability in lives otherwise char-
acterised by instability, detachment and low economic expectations.

This study has highlighted the silent, but influential nature of the impact of unnoticed loss
in many guises on repeat teenage pregnancies. The journey of search has challenged the
blanket notion that teen pregnancies lead to social and economic disadvantage. Indeed, it
has shown that while teenage pregnancies are usually associated with socially excluded
communities, it cannot be taken for granted that early childbearing is a cause of exclusion
(Arai, 2003). The current tendency to view the middle class pattern of delaying childbearing
until careers have been established as the norm to be emulated (highlighted by Wilson and
Huntington, 2005), often fails to take account of the increasing polarisation of adolescent
transitions, which contribute to inequalities in life chances and standards (Graham and
McDermott, 2005). For young women growing up in disadvantaged communities, which
impact on their life chances, motherhood offers an alternative way to forge an adult identity
providing more security and stability than education and employment without children (Gra-
ham and McDermott, 2005). Motherhood for them is therefore part of a complex attempt to
maintain present status when confronted with overwhelming change and loss (Walkerdine
and others, 2001).

The theme of reversed life course rationalisation suggests that clearly defined aged-linked life
course transitions that are carefully scripted from birth are increasingly being eroded, as
young people seek to negotiate risks at an individual level (Beck, 1992). Additionally for
some teenagers, what appears to observers as a lack of goal orientation may simply be a
different frame of reference for mapping their lives. Therefore, for these teenagers, instead of
viewing their repeat pregnancies as an indication of failure or deviancy, they were able to
ascribe positive meanings to them. This finding has been supported by other studies, includ-
ing (Black and others, 2006; Kirkman and others, 2001).

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
198 Jean Clarke

Conclusion

The process of allowing the young women the opportunity to tell their stories, and make
sense of their experiences, helped to unearth the potent impact of many frequently underesti-
mated and poorly understood underlying emotional factors and rationalisation processes that
have been found to have a strong bearing on repeat teenage pregnancies. Additionally, the
international comparative element of this study has contributed significantly to our under-
standing of the phenomenon of repeat teenage pregnancies in two important respects.

On the one hand, the similarity of themes that have emerged from the countries compared,
despite their socioeconomic and ethnic differences, has highlighted the commonality of fac-
tors that have been shown to have a bearing on repeat teenage pregnancies. Conversely, it
has also highlighted the intrinsic relationship between socioeconomic deprivation and repeat
teenage pregnancies, and the crucial role that the state must play in minimising the
detrimental effects of economic stringency and insufficiency on teenage pregnancy.

The powerful impact of intentional, masked and hidden motivations for repeat pregnancies,
suggests the need for professionals and policy-makers to have a full understanding of both
the overt and the underlying social, economic and emotional motivating factors, which often
compel young women to embark on a journey of search. Unless urgent attention is paid to
these issues, the traditional areas of focus in teenage pregnancy prevention and sexually
transmitted diseases, such as sex education and contraceptive provision will have minimal
impact in reducing repeat teenage pregnancies.

References

Anderson N. 1990. Pregnancy resolution decision in juvenile detention. Archives of Psychiatric Nursing
4: 32531.
Arai L. 2003. British policy on teenage pregnancy and childbearing. Critical Social Policy 23: 89102.
Beck U. 1992. Risk Society: Towards a New Modernity. Sage: London.
Bell J, Clisby S, Craig G, Measor L, Petrie S, and Stanley N. 2006. Living on the Edge: Sexual Behaviour
and Young Parenthood in Seaside and Rural Areas. Department of Health: London.
Black M, Bentley M, Papas M, Oberlander S, Teti L, McNary S, Le K, OConnell M. 2006. Delaying sec-
ond births among adolescent mothers: a randomized, controlled, trial of a home-based mentoring
program. Pediatrics 118: e1087e1099. DOI: 10. 1542 Peds.2005-2318.
Boardman LA, Allsworth M, Phipps MG, Lapane KL. 2006. Risk factors for unintended versus intended
rapid repeat pregnancies among adolescents. Journal of Adolescent Health 39: 597.e1e8.
DfES. 2006. Teenage Pregnancy Accelerating the Strategy to 2010: Every Child Matters, Change for Chil-
dren. DfES Publications: Nottingham.
Frears L, Schneider J. 1981. Exploring loss and grief within a holistic framework. Personnel and Guid-
ance 592: 341345.
Girvan N. 1997. Poverty, Empowerment and Social development in the Caribbean. Canoe Press: UWI.
Graham H, McDermott E. 2005. Qualitative research and the evidence base of policy: insights from
studies of teenage mothers in the UK. Journal of Social Policy 35: 2127.
Greig A, Taylor J. 1999. Doing Research with Children. Sage: London.
Independent Advisory Group on Teenage Pregnancy (IAGTP). 2003. Annual Report 2002 3. Teenage
Pregnancy Unit, Department for Education & Science: London.
Kalmuss DS, Namerov PB. 1994. Subsequent childbearing among teenage mothers: determinants of a
closely spaced birth. Family Planning Perspectives 26: 149153.
Kirkman M, Harrison L, Hillier L, Pyett P. 2001. I know I am doing a good job: canonical and auto-
biographical narratives of teenage mothers. Culture Health & Sexuality 3: 279294.

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau
Repeat Teenage Pregnancy in Two Cultures 199

Klerman L, Baker B, Howard G. 2003. Second births among teen mothers: program results and statisti-
cal methods. Journal of Adolescent Health 32: 452455.
Kubler-Ross E. 1969. On Death and Dying. Tavistock: London.
Manlove J, Mariner C, Romano A. 2000. Subsequent fertility among teen mothers: longitudinal analysis
of recent national data. Journal of Marriage and the Family 62: 430448.
National Family Planning Board (NFPB). 2007. Adolescent Reproductive Health Issues. Available at:
http://www.jnfpb.org/adolescentbackgroung.htm [Accessed 21 November 2007].
Parkes CM. 1996. Bereavement Studies in Grief in Adult Life. Routledge: London.
Rains P, Davies L, McKinnon M. 1998. Taking responsibility: an insider view of teen motherhood. Fam-
ilies in Society 79: 308309.
Registrars General Department. 2004. Vital Statistics Report Teenage Deliveries. Kingston: Jamaica.
Saewyc E, Magee L, Pettingell S. 2004. Teenage pregnancy and associated risk behaviors among sexu-
ally abused adolescents. Perspectives on Sexual and Reproductive Health 36: 98105.
Scott A, Amodeis N, Hoffman T. 2004. Preventing repeat pregnancies and other negative outcomes:
among pregnant and parenting hispanic adolescents. Journal of Multi-cultural Nursing and Health
10(2): 3238.
Social Exclusion Unit. 1999. Teenage Pregnancy. The Stationery Office Ltd: London.
Stevens-Simon C, Kelly L, Singer D, Nelligan D. 1998. Reasons for first teen pregnancies predict the rate
of subsequent teen conceptions. Pediatrics 101: e8.
Teenage Pregnancy Unit (TPU). 2000. Implementation of the Teenage Pregnancy Strategy, Progress
Report. Teenage Pregnancy Unit Department of Health: London.
United Nations Childrens Fund (UNICEF). 2000. Situational Analysis of Children and Women in Twelve
Countries of the Caribbean. Available at: http://www.unicef.org/barbados/resources_66.htm [Accessed
11 October 2008]
Walkerdine V, Lucey H, Melody J. 2001. Growing up Girl. Palgrave: Hampshire.
Wilson H, Huntington A. 2005. Deviant (M) others: the construction of teenage motherhood in contem-
porary discourse. Journal of Social Policy 35: 5976.

Correspondence to: Jean Clarke, Mary Seacole Building, Brunel University, Uxbridge UB8 3PH, UK, Tel.: 01895
268748; Fax: 01895 269853. E-mail: jean.clarke@brunel.ac.uk

Accepted for publication 1 January 2009

Contributors details

Dr Jean Clarke has been a course leader and lecturer of the undergraduate BA degree in
social work at Brunel University for 13 years. Her research interests are teenage pregnancy
and sexual health, stillbirths, women from ethnic minority communities and HIV & AIDS.

 2009 The Author(s) CHILDREN & SOCIETY Vol. 24, 188199 (2010)
Journal compilation  2009 National Childrens Bureau