Maltreatment and Adolescent Pregnancy and Parenting Lynn Blinn Pike, PhD University of Missouri

1. Maltreatment and Adolescent Pregnancy and ParentingLynn Blinn Pike, PhDUniversity of Missouri

2. MAPPP Funding Sources • Missouri Children’s Trust Fund • University of Missouri Outreach and Extension • US Department of Agriculture, CYFAR

4. CASPP Programs • MVRM-Missouri Volunteer Resource Mothers • PTW-“Programs That Work” to prevent pregnancy and sexually transmitted diseases • AMJP-Adolescent Mother Journaling Program • MAPPP-Maltreatment and Adolescent Pregnancy and Parenting Program

5. MAPPP Background • “I only had sex once and I did it because he was going to beat me” • “The principal doesn’t treat my girls right so I knocked him side of the head” • “He brings home a paycheck and doesn’t beat me” • “I slipped on the ice and broke my baby’s leg”

11. MAPPP Video NBC Dateline Video May, 1999 Raylene’s Story Story of a girl who was: an incest victim teen mother in an abusive marriage

12. National Satellite ConferenceSeptember 19, 2002 • Use the MAPPP Model as the basis for: • Adding cultural sensitivity content • Web site • USDA funding • National teleconferences

13. Maltreatment PriortoAdolescent Pregnancy

14. Research is just beginning to establish a link between childhood maltreatment and adolescent pregnancy

15. Definition ofSexual Victimization • Noncontact molestation: someone looked at the child or forced the child to look at them while naked; sexual photographs • Contact molestation: fondling • Attempted Rape: trying to have unwanted sexual intercourse • Rape: forced sexual intercourse

16. Prevalence of Sexual Victimization In a study of 535 adolescent mothers who were 19 or younger at the time of their first pregnancy, 66% (or 351) had been sexually victimized • 36% or 190 had experienced non contact molestation • 51% or 275 had experienced contact molestation • 42% or 225 had experienced attempted rape • 44% or 235 had experienced rape

17. Emotional ExperiencesLinked to Abuse Trauma • Triggers • Flashbacks • Dissociative responses

18. Effects of Childhood Sexual Abuse Linked to Adolescent Pregnancy • Poor emotional development due to trauma • Poor cognitive development due to trauma • Poor physical condition due to trauma

19. Research Issues • Most studies are retrospective and rely on recall • Problem behavior may have precede the maltreatment • Indirect link between childhood abuse and adolescent pregnancy • Small samples, not randomized • Few studies completed specifically with adolescents • Some forms of maltreatment are not addressed

20. Maltreatment DuringAdolescent Pregnancy

21. Maltreatment DuringAdolescent Pregnancy • One in five adolescents, compared with one in six adult women, report maltreatment during pregnancy Research Findings: • Between 17% and 26% of adolescents report maltreatment during pregnancy • Maltreatment prior to pregnancy is a primary predictor of maltreatment during pregnancy

22. Maltreatment DuringAdolescent Pregnancy • When they report maltreatment, pregnant adolescents are more likely to report physical abuse (i.e. hitting, slapping, etc.) • Pregnant adolescents are subject to maltreatment from multiple perpetrators • Pregnant adolescents enter prenatal care late in pregnancies • Adolescents are at higher risk for poor pregnancy outcomes-this is compounded by maltreatment

23. Signs of Intimate Partner Violence • Multiple injuries at various stages of healing • If pregnant, injuries are generally to breast, abdomen or genitals • Injuries may be inconsistent with explanation • Time lag between actual injury and being seen Linda Bullock, University of Missouri, 1999

24. Intimate Partner Violence Involves Coercive ControlIntentional use of force such as slapping, pushing, shaking, choking, punchingPhysical force to compel the girl to engage in sexual acts against her willHumiliation and embarrassmentControlling victim’s movements and activitiesControlling financesThreats of retaliation, inducing fear

25. Working with Maltreated Pregnant AdolescentsPregnancy provides a window of opportunity to intervene during prenatal visitsLegal factors complicate the situationHomelessness effects service deliveryRoutine use of abuse screens at each encounter

26. Maltreatment of Children of Adolescent Mothers

27. Child maltreatment is a complex phenomenonwith multiple causes • Not all adolescents maltreat their children • Not all children of adolescents are maltreated

28. Adolescents maynot be able to deal effectively withthe stressors in their lives and this can put their children at risk for maltreatment.

29. Risk Factors forMaltreatment of Children of Adolescent Mothers • Family disorganization or disruption • Lack of emotional support from an adult during childhood • Violence in family of origin

30. Risk Factors for Maltreatment of Childrenof Adolescent Mothers continued • Less education • Unemployment or underemployment • Number of children in the household Economic Factors related to:

31. Risk Factors for Maltreatment of Childrenof Adolescent Mothers continued • Lack of social support for the adolescent parent • Changes in primary care-giver of the child

32. Implications for Practice Early intervention with mothers who show a negative attitude toward the baby • Parenting education • Home visits • Increased social support • Mentoring

33. Research Issues Related to Maltreatment and Adolescent Parenting • Studies are retrospective • Samples are not random • Samples are not racially diverse • No comparison groups • Adolescent mothers may be under higher scrutiny from professionals

34. Cultural Issues and MAPPP • Cultural values can determine: • how child abuse, domestic violence, rape are viewed • who has power in sexual relationships • whether men and women discuss sex • whether parents discuss sex with their children • how others view girls dating older males • whether women have some control over their fertility • who should initiate sex • how infidelity is viewed

35. Cultural and Racial/Ethnic Attitudes toward Maltreatment • Not all cultural and racial/ethnic groups view maltreatment of children in the same way • Not all cultural and racial/ethnic groups view teen pregnancy in the same way

36. Racial/Ethnic Differences • White parents may differ from parents in other racial/ethnic groups in attitudes toward corporal punishment, teen pregnancy, abortion, adoption, child abuse, etc.

37. Examples • African-American parents may have more positive attitudes toward corporal punishment • Hispanic parents may have more positive attitudes toward young girls dating older males • Native America parents may be less likely to report child abuse but more likely to “take matters into their own hands” and physically assault the alleged perpetrator.

38. Examples of Cultural Values • Vietnamese women not wanting to bathe after delivery • Native Americans having a tribal member be the “disciplinarian” for their children • Hispanic women enduring domestic violence for the sake of the family

39. Implementing MAPPP • Increase awareness of the issues using the MAPPP manual • Incorporate MAPPP content into parenting education programs • Include MAPPP information in professional development programs for Extension staff

40. National Satellite ConferenceSeptember 19, 2002 • Use the MAPPP Model as the basis for: • Adding cultural sensitivity content • Web site • USDA funding • National teleconferences