Outcomes of teen parenting programs in New Mexico.

Philliber, Susan ; Brooks, Linda ; Lehrer, Linda Phillips 等

While teen pregnancy rates in the United States have declined some 22% (U.S. Department of Health and Human Services, 2001), the need for programs for pregnant and parenting teenagers has not decreased. The actual number of births to teens is slightly up, owing to larger proportions of young people in the population. Moreover, upcoming increases in the number of teens portend increases in teen births.

The programs for these young parents assume many forms and use many techniques to assist both them and their offspring. Some programs are school-based (e.g., Walruff, 1994; Fuscaldo et al., 1998; Higginson, 1998). Guidelines on how to create programs in school settings have been presented (Sipe et al., 1994); the National Education Association (2000-2001) has also issued guidelines on the desirable features of these programs. Other programs are located in health facilities (e.g., Fischer, 1997), and still other programs serving pregnant and parenting teens are located in communities (Maynard & Rangarajan, 1994) or are residential (e.g., Collins et al., 2000). The American Academy of Pediatrics has issued guidelines for the care of adolescent parents (Committee on Adolescence, 2001).

Some programs offer many services, while others try more limited interventions such as health passports (Stevens-Simon et al., 2001), videotapes to promote mother-child communication during mealtime (Black & Tei, 1997), and use of technology in classrooms (Cocalis, 1995). Case management, home visits, counseling, and workshops are all prevalent interventions (Key et al., 2001; Granger & Cytron, 1999; Long et al., 1994; Olds, 1992; Olds et al., 1988). More recently, with the advent of welfare reform, programs have included incentives and punishments to encourage participation and reduce attrition (Maynard, 1995). Most of these programs serve young mothers only, neglecting young fathers (Kiselica et al., 1998; Kiselica & Sturmer, 1993) even though they too experience negative consequences from early parenthood (Maynard, 1996).

The goals and outcomes of these programs also vary widely. Some target health-related gains for both mothers and children, such as use of medical services, early entry into prenatal care, greater prevalence of immunization, less use of emergency rooms for care (Stevens-Simon et al., 2001; Wiemann et al., 1997), and reduction in low birth weight babies (Cameto & Wagner, 1995; Fischer, 1997; Olds et al., 1988; Wagner et al., 1995). While improvements in birth weight have been reported (e.g., Olds et al., 1988; Wagner et al., 1995), improvements in the use of health care have been more elusive.

Other programs have focused on increased use of contraceptives, primarily as a strategy to reduce subsequent pregnancies. Highly effective methods that do not require user motivation, such as implants and long-acting hormonal contraceptives, have been found to be particularly successful (Coard et al., 2000; Polaneczky et al., 1994; Stevens-Simon et al., 1999). On the other hand, some comprehensive programs have not been able to bring about change in the use of contraceptives among young parents (Cameto & Wagner, 1995; Quint et al., 1994; Polit, 1989).

The effects of these programs on repeat pregnancy have been decidedly mixed. Repeat pregnancies among young mothers are particularly problematic (Kalmuss & Namerow, 1994; Martin & Wu, 1998) and the second children born to teens have higher infant mortality rates (Cowden & Funkhouser, 2001). While some programs have reported success in reducing repeat pregnancies (Fuscaldo et al., 1998; Key et al., 2001; Kuziel-Perri & Snarey, 1991; Olds, 1992; Olds et al., 1998; O'Sullivan & Jacobsen, 1992; Ruch-Ross et al., 1992; Solomon & Liefeld, 1998), others have had much less impact on this important outcome (Cameto & Wagner, 1995; Marsh & Winick, 1991; Maynard, 1993; Maynard & Rangarajan, 1994; Stevens-Simon et al., 1997).

Some programs have aspired to enhance education and employment, thus lessening welfare dependency. Again, the findings are mixed across programs, although there is near unanimous recognition that education is the key to self-sufficiency (Long et al., 1994; Maynard, 1993). Several programs have been shown to increase educational achievement or decrease drop-out rates (Maynard, 1993; Quint et al., 1994; Ruch-Ross et al., 1992; Warrick et al., 1993). Even when gains in education or employment have occurred, they have often been modest and have not always led to less welfare dependency (Brindis & Philliber, 1998; Polit, 1989).

Like the programs themselves, the evaluations of programs for pregnant and parenting teens have varied tremendously in quality. Many lacked comparison groups and some programs suffered so severely from attrition during the study period that the intervention and its evaluation were severely compromised (Stevens-Simon et al., 1997; Walruff, 1994).

Taken together, these findings suggest that we do not yet know precisely how to produce the best outcomes among pregnant and parenting teens. The search for the best programs is made more difficult by the growing diversity in the nation and the likelihood that a single program design will not be equally effective among all groups. Further, in any program, staff often recognize that their work is challenging, particularly given the risk factors present among the teens they seek to help. Numerous investigators have pointed out the relationship between abuse and subsequent early pregnancy (Becker-Lausen & Rickel, 1995; Stevens-Simon & Reichert, 1994), while others have noted the prevalence of depressive symptoms and other mental health challenges in this population (Barratt et al., 1996; D'Andrea, 1994).

The Present Report

Programs for pregnant and parenting teens have met with uneven success. This result is perhaps not surprising since these programs are varied in their approaches, measure a wide range of outcomes, and serve different populations. This report presents information from 53 programs that served pregnant and parenting teens in New Mexico between 1997 and 2000. Data on 3,194 teens, including their characteristics, the services they received, and several key outcomes, are examined.

PROGRAMS IN NEW MEXICO

Like many other states in the nation, New Mexico has a substantial and tenacious rate of births to teenagers. In fact, New Mexico has one of the 10 highest teen birth rates in the nation (U.S. Department of Health and Human Services, 2000). While this rate has declined in recent years, it has not declined as rapidly as the national rate. In 2000, the birth rate for teenagers in the United States was 48.5 live births per 1,000 women aged 15-19 years. In New Mexico, this rate was 66.2 per 1,000. Among Latino teens there were 94.4 births per 1,000, and among Native American teens the rate was 67.8 per 1,000 (U.S. Department of Health and Human Services, 2002b).

Each year, between 1997 and 2000, New Mexico had from 40 to 48 programs serving pregnant and parenting teens (53 different programs overall, representing 23 of the 33 counties). Given the high costs of teen pregnancy to the state, it is important that these programs produce the best outcomes possible for young parents and their children. However, before the 1996-1997 program year, data were available to track services and outcomes for only a subset of programs in New Mexico.

In 1996-1997, the New Mexico Teen Pregnancy Coalition created a common database to track program services, participant characteristics, and outcomes. The coalition convened a working group to help design this database and tested its utility in 1997. By 1997-1998, all but a few programs in the state were contributing information.

Table 1 shows the number of clients served (in each year) by kind of program in New Mexico. The Graduation Reality and Dual Role Skills (GRADS) program is conducted at about three-fifths of the statewide sites. GRADS is an in-school, vocational program that has been implemented in 36 of New Mexico's 89 school districts. The GRADS program has also piloted a juvenile justice model, and there are plans to replicate it. A variety of teen parent programs are conducted at the other sites, which include alternative schools, school-based health centers, and residential and community case management programs.

Since the data source includes virtually all teens in programs in New Mexico, it was not possible to create a control group. However, for the outcomes examined here, national statistics, state statistics, or rates from other programs are presented to help with interpretation of the findings.

PROGRAM SERVICES

Table 2 shows the percentage of reporting sites that provided various services to pregnant and parenting teens in the third year of data collection (1999-2000). The services most commonly provided at program sites included prenatal education, life skills training, counseling, home visits, and school lunch. During 1999-2000, these sites provided from 7 to 19 of the 22 services listed in Table 2, or an average of 12 services each.

Overall, the percentage of sites offering these services increased over the three years for 13 of the 22 services. The greatest increase was in the percentage of sites offering case management and "other" services.

There are several services for which the programs generally made referrals, rather than providing the service directly. These include clinical prenatal care, immunizations, medical care for both mothers and babies, and dental care. Some services, notably child care for children aged 5 years or older, were often not available either on-site or through referral.

Table 3 provides more detail about home visits. Home visits have been shown in previous studies to be particularly successful interventions with teen parents (Olds, 1992; Olds et al., 1998). Overall, 87% of the programs made at least some home visits to their clients. The average number of such visits was 2.6 per client. Many clients (44%) did not receive any home visits, due in part to the fact that some of the programs are residential and thus do not make such visits. The percentage of sites making home visits remained steady from year to year at around 80%, but the average number of home visits per client dropped steadily.

The teens included in the database had spent an average of 8.8 months in their respective program. Among those in each of the single-year samples, the average time in the particular program ranged from 7.5 to 8.1 months. Those in the total sample could have been in a program for multiple years.

CHARACTERISTICS OF PROGRAM PARTICIPANTS

Program participants ranged in age from 11 to 19 years, except for a few who were special needs students or working on a general equivalency diploma (GED) and thus older (see Table 4). The average age was 16.7 years. Some had other children besides those born very recently. Two-thirds were Latino/Hispanic. The "other" ethnic category included multiracial youth, Asians, and African Americans.

The programs also attracted 276 males, who made up 9% of their clients. Forty-two of 53 programs had from 1 to 27 male clients. On average, these males were slightly older than the female clients (17.0 versus 16.6 years), but were distributed similarly to the females by ethnicity. While almost half of the youth had "some ties" to the other parent, very few were married.

Between 1997 and 2000, there were few changes in the characteristics of those enrolled in these programs. However, at program entry, the percentage who were pregnant with a first child, rather than already a parent, increased dramatically (from 18% to 53%).

PROGRAM OUTCOMES

Prenatal Care

Seventy-one percent began prenatal care in the first trimester of pregnancy, 23% began care during the second trimester, and 6% began care during the third trimester or had no prenatal care at all. Statewide in New Mexico, a low level of prenatal care has been reported in 28% of births to mothers under age 15 and 18% of births to mothers aged 15-19 (Department of Health, 2001). It was found here that either there was no prenatal care or prenatal care was begun in the third trimester of pregnancy in 4% of births to mothers under age 15 and 7% of births to mothers aged 15-19. Thus, those enrolled in teen parenting programs were much more likely to receive early prenatal care.

Financial Support Services

Table 5 shows the various kinds of entitlements/financial support the youth were receiving at program entry and, later, at program exit or at the end of the reporting period. The most common forms of support received were WIC services and Medicaid.

Table 6 indicates that, overall, there was no change in receipt of entitlements for three-quarters of the youth. For virtually all of these kinds of support, however, some increases occurred after program enrollment. Table 6 also shows that there were more changes in support received among the youngest teens (age 14 years or younger), those in the "other" ethnic group, and females.

Educational Attainment

Overall, in the time period covered by this study, 77% of the young people maintained or improved their educational level (see Table 7). For 1999-2000, this figure was 81%.

In each year, significantly more educational progress was made by those who received home visits (Table 7). Age, ethnicity, and gender were not consistently related to educational progress over the three years.

Not shown in this table, however, is another very positive set of outcomes among those most at risk of truncated education. While 924 of the young people recruited to participate in the teen parenting programs were not in school when they were recruited, 777 (or 84%) had returned to school by the time they entered these programs. Most of the programs were school-based, which accounts in part for this achievement.

Among the 146 young people who were still dropouts at program entry, 62 (or 42%) were high school graduates, held a GED, or were in school or working on their GED at program exit or at the end of the reporting period. Overall, then, these programs were quite successful in producing additional educational attainment among pregnant and parenting teens.

A national comparison may be helpful in understanding the significance of this finding. Among the Project Redirection sample (Polit, 1989), 56% were in school or had graduated at the time of the 1-year follow-up, compared to 77% of the young people enrolled in the New Mexico programs. Sample variations between these two studies encourage caution in interpreting this difference, but the New Mexico results nevertheless are very positive, perhaps owing to most of these programs being school-based.

Obtaining Employment

Young people were classified as maintaining or obtaining a job versus being unemployed or losing a job between the time of program enrollment and the end of the reporting period. Overall, 26% improved or maintained their employment situation during this time period (see Table 8).

As might be expected, this achievement was significantly more likely among older teens than among younger ones. Table 8 also shows that males were significantly more likely than females to be employed during this interval, perhaps owing to the greater child care responsibilities of the mothers. Those who made educational gains during this time period were also more likely to make employment gains;

A comparison with Project Redirection again suggests that these are greater gains than some others have achieved. In their similarly aged sample, 14% were employed at the end of 18 months (Polit, 1989); 26% of the New Mexico youth were employed afar 6 or 7 months. Even the females in the New Mexico sample were more likely to have gained or maintained employment than was the case in the national sample. These comparisons are imperfect, owing to variations in the two samples, but they are offered to provide at least some context within which to understand the employment outcomes.

Repeat Pregnancy

One of the most difficult outcomes to achieve among teen parents is the postponement of a subsequent pregnancy. The percentage of females becoming pregnant after program enrollment was higher in 1999-2000 than in 1998-1999. Overall, among these New Mexico teen parents, 4% became pregnant after enrolling (see Table 9).

Most studies of repeat pregnancy among teens report the percentage who become pregnant within a given time interval after the birth of their first child or the percentage who become pregnant at a set interval after program enrollment. The data collected here allow an estimate of the latter percentage. Among the 552 women enrolled in these programs for 12 months or longer, 12 (or 2%) had a repeat pregnancy.

This rate seemed low, and we feared underreporting. Therefore, a random and proportional sample (by size of site) was interviewed by telephone in July 2000. Thirteen of the 202 interviewed (6%) said that they had experienced a new pregnancy after program enrollment. This rate matched that obtained from program records for 1999-2000 (see Table 9).

Table 9 also shows that the percentage becoming pregnant after enrollment did not vary significantly by age or ethnicity; however, it did vary significantly by whether or not the teen had received home visits (in 1998-1999 and in the total sample). Those with home visits were more likely to have had repeat pregnancies. Perhaps subsequent pregnancies caused staff to visit these teens more often.

Again comparisons with other studies may be helpful. Some programs stressing the use of effective contraception have produced rates comparable to these (Fischer, 1997; Stevens-Simon et al., 1999), but other programs have had rates as high as 64% in 2 years (Maynard & Rangarajan, 1994).

Preventing Low Birth Weight

Table 10 shows that, overall, 6% of the mothers who were pregnant at program entry had babies who weighed less than 5.5 pounds. Low birth weight did not vary significantly by any of the variables presented in Table 10, but the rate of low birth weight babies was highest among the youngest teens (8%) and white teens (8%).

Both the statewide rate of low birth weight babies among teens aged 15-19 (8.4%) and the national rate (7.8%) are higher than the 6% reported here.

DISCUSSION

In 1998, New Mexico programs for pregnant and parenting teens began contributing information to a statewide database seeking to track the services of these programs, the characteristics of their clients, and outcomes. By 1999, data were received from 45 programs, and in 2000, data were received from 48 programs.

Between 1997 and 2000, 3,194 youth were enrolled in these programs, which offered a wide variety of services, including prenatal education, life skills training, counseling, and home visits. On average, the programs offered 12 on-site services, as well as referrals for many others.

Most of the young people in these programs were Latino/Hispanic. Close to one-tenth were male. Some had more than one child at program entry.

Based on comparisons with national rates, these programs seemed quite successful in promoting additional educational attainment. Some gains were also apparent in employment. The prevalence of late prenatal care and low birth weight babies was lower than statewide and national averages. Perhaps the most impressive finding here, however, was the low rate of repeat pregnancy. This rate was lower than that reported by many other programs. How did these programs produce such positive outcomes on these dimensions?

The GRADS sites receive welfare reform funds and there are program staff statewide to assure professional development and annual on-site reviews, ongoing technical assistance, and the provision of relevant resources. Staff reinforce the notion of personal responsibility for birth control. This emphasis compels students to constantly assess what is best for "my child, my society, and me." In addition, school districts require teachers to provide case management throughout the summer. Further, students benefit from having extremely dedicated teachers, who often become surrogate parents. Advisory committees provide community support for referrals and accountability within the local collaborative effort.

Staff from other programs in the state have argued that one-on-one attention, follow-up in discussion groups and home visits, peer interaction, ongoing education in birth control choices, and counseling as needed are responsible for low rates of low birth weight babies and repeat pregnancies. Other services believed to be important include transportation to office visits, advocacy by program staff and health providers, and the inclusion of the whole family in home visits and counseling sessions.

The data presented here suggest that it is possible to produce a variety of positive outcomes for pregnant and parenting teens, using a combination of these interventions.

Table 1
Clients in the Database

Clients and Sites All GRADS Other
in the Database Sites Sites Sites

Number of Sites for Which
Data Were Provided
 1997-1998 40 25 15
 1998-1999 45 29 16
 1999-2000 48 31 17

Number of Clients for Whom
Data Were Provided (Range)
 1997-1998 4 to 88 4 to 70 4 to 88
 1998-1999 3 to 215 6 to 78 3 to 215
 1999-2000 3 to 87 7 to 68 3 to 87

Average Number of Clients for
Whom Data Were Provided
 1997-1998 26.4 26.8 25.9
 1998-1999 31.0 29.0 34.5
 1999-2000 27.0 28.8 23.5

Note. GRADS = Graduation Reality and Dual Role Skills.

Table 2
Services Provided in 1999-2000 (48 Sites)

 Referral Not
Service On-Site Only Provided

Prenatal Education 98% 2% 0%
Life Skills 90% 6% 4%
Counseling 89% 11% 0%
Home Visits 83% 4% 13%
School Lunch 81% 8% 11%
Homework Help 80% 10% 10%
Child Care for 0-12 Months 77% 19% 4%
Case Management 77% 10% 13%
Bilingual or Translation 76% 12% 12%
 Services
Child Care for 1- to 75% 19% 6%
 4-Year-Olds
Other Services * 73% 7% 20%
Employment Training 73% 19% 8%
Transportation 58% 2% 40%
Other Pregnancy Prevention 56% 40% 4%
 Services
Family Planning Services 54% 44% 2%
WIC 40% 58% 2%
Medical Care for Mother 34% 62% 4%
Medical Care for Baby 26% 68% 6%
Immunizations 24% 72% 4%
Child Care for Children Aged 15% 26% 59%
 5 Years or Older
Clinical Prenatal Care 11% 85% 4%
Dental Care 2% 69% 29%

* "Other services" included the following: GRADS student conferences,
adoption counseling, volunteer work, independent living services, free
meals to teen parents and children, infant massage, parenting education,
car seat program, Even Start, transition counseling, Families First,
homebound instruction after delivery, parents and teachers program,
and self-esteem program.

Table 3
Home Visits

 1997-1998 1998-1999 1999-2000 Total
Home Visits (n = 1,058) (n = 1,394) (n = 1,295) (N = 3,194)

Number of Home
Visits Made to
Clients
 None 43% 42% 43% 44%
 1 12% 12% 16% 11%
 2-10 36% 31% 32% 34%
 11-20 3% 2% 2% 4%
 21 or more 2% 1% 1% 1%
 Missing 4% 12% 6% 6%

Percentage of Sites 80% 82% 83% 87% *
Making Any Home
Visits

Average Number of 2.9 2.1 1.9 2.6
Home Visits per
Client

* Ever made home visits in any of the three years.

Table 4
Characteristics of Participants

 1997-1998 1998-1999
Characteristics (n = 1,058) (n = 1,394)

Age at Program Entry
 14 or younger 5% 5%
 15 15% 13%
 16 26% 26%
 17 28% 28%
 18 15% 15%
 19 or older 8% 9%
 Missing data 3% 4%

Age of Youngest Child at
End of Reporting Period
 Less than one year 37% 36%
 1 year 23% 24%
 2-3 years 11% 11%
 4-5 years 1% 1%
 No children or 28% 28%
 missing date of
 birth or not yet
 born

Ethnicity
 White 14% 14%
 Native American 12% 13%
 Latino/Hispanic 68% 66%
 Other 5% 5%
 Missing data 1% 2%

Gender
 Male 9% 8%
 Female 91% 90%
 Missing data 0% 2%

Number of Children
at Entry
 0 18% 39%
 1 70% 42%
 2 5% 3%
 3-4 1% <1%
 Missing data 6% 16%

Relationship with
Other Parent
 None 22% 22%
 Some ties 45% 47%
 Living together 25% 25%
 Married 8% 6%

 1999-2000 Total
Characteristics (n = 1,295) (N = 3,194)

Age at Program Entry
 14 or younger 6% 5%
 15 16% 15%
 16 26% 25%
 17 28% 29%
 18 14% 15%
 19 or older 8% 8%
 Missing data 2% 3%

Age of Youngest Child at
End of Reporting Period
 Less than one year 37% 41%
 1 year 28% 23%
 2-3 years 11% 9%
 4-5 years 2% 1%
 No children or 22% 26%
 missing date of
 birth or not yet
 born

Ethnicity
 White 16% 15%
 Native American 15% 13%
 Latino/Hispanic 63% 66%
 Other 6% 5%
 Missing data 0% 1%

Gender
 Male 8% 9%
 Female 92% 90%
 Missing data 0% 1%

Number of Children
at Entry
 0 53% 41%
 1 44% 50%
 2 2% 4%
 3-4 <1% 1%
 Missing data 1% 4%

Relationship with
Other Parent
 None 23% 23%
 Some ties 42% 44%
 Living together 30% 27%
 Married 5% 6%

Table 5
Kinds of Financial Support Received at Program Entry and at Program Exit
or at the End of the Reporting Period (N = 3,194)

 At At Program Exit or End
Support Program Entry of Reporting Period

Women, Infants & Children (WIC) 76% 80%

Medicaid 70% 72%

Food Stamps 22% 23%

Child Support 9% 12%

Temporary Aid for Needy 9% 11%
Families (TANF)

Housing 6% 9%

Supplemental Security Income 5% 5%
(SSI)

Table 6
Change in Financial Support at End of the Reporting Period by
Characteristics of Participants

 More Support Less Support No Change
Characteristics (n = 569) (n = 220) (n = 2,405)

Overall 18% 7% 75%

Age
 14 or younger 22% 8% 70%
 15 19% 6% 75%
 16 17% 6% 77%
 17 17% 8% 75%
 18 18% 5% 77%
 19 or older 21% 8% 71%

Ethnicity
 White 19% 8% 73%
 Native American 15% 4% 81%
 Latino/Hispanic 18% 7% 75%
 Other * 27% 7% 66%

Gender
 Male 9% 3% 88%
 Female 19% 7% 74%

* "Other" included African American, Asian American, multiethnic
and other ethnicities.

Table 7
Participants Who Improved or Maintained Educational Level
by Characteristics

 1997-1998 1998-1999 1999-2000 Total
Characteristics (n = 797) (n = 1,116) (n = 1,053) (N = 2,461)

Age
 14 or younger 75% 88% 83% 77%
 15 79% 77% 84% 79%
 16 77% 82% 77% 75%
 17 73% 83% 84% 79%
 18 75% 83% 82% 80%
 19 or older 73% 83% 79% 77%

Ethnicity
 White 70% 79% 84% 76%
 Native American 92% 79% 79% 80%
 Latino/Hispanic 73% 82% 81% 77%
 Other 74% 88% 79% 80%

Gender
 Male 84% 76% 76% 76%
 Female 74% 82% 82% 78%

Home Visits
 Yes 80% 86% 83% 82%
 No 68% 76% 79% 72%

Table 8
Participants Who Obtained or Maintained Employment by Characteristics

 1997-1998 1998-1999 1999-2000 Total
Characteristics (n = 261) (n = 326) (n = 348) (N = 829)

Overall 25% 24% 27% 26%

Age
 14 or younger 12% 14% 16% 16%
 15 17% 18% 16% 18%
 16 20% 22% 25% 24%
 17 30% 26% 29% 29%
 18 34% 29% 38% 34%
 19 or older 37% 32% 44% 36%

Ethnicity
 White 33% 24% 28% 29%
 Native American 25% 19% 26% 23%
 Latino/Hispanic 23% 25% 28% 29%
 Other 26% 33% 29% 26%

Gender
 Male 45% 46% 57% 53%
 Female 23% 22% 25% 24%

Education
 Increased or 27% 26% 28% 28%
 maintained grade
 level
 Dropped out 19% 18% 25% 20%
 and/or stayed out

Table 9
Females Who Became Pregnant After Program Enrollment

 1998-1999 1999-2000 Total
Characteristics (n = 49) (n = 67) (N = 77)

Overall 4% 6% 4%

Age
 14 or younger 3% 3% 3%
 15 4% 3% 3%
 16 5% 6% 4%
 17 3% 6% 3%
 18 3% 6% 3%
 19 or older 4% 9% 6%

Ethnicity
 White 5% 8% 5%
 Native American 6% 8% 6%
 Latino/Hispanic 3% 5% 3%
 Other 3% 4% 3%

Home Visits
 Yes 6% 6% 5%
 No 2% 5% 2%

Table 10
Low Birth Weight Babies Among Mothers Pregnant at Program Entry

 1997-1998 1998-1999 1999-2000 Total
Characteristics (n = 41) (n = 35) (n = 45) (N = 69)

Overall 9% 6% 7% 6%

Age
 Less than 15 19% 10% 11% 8%
 15-19 8% 6% 6% 6%

Ethnicity
 White 11% 12% 5% 8%
 Native American 15% 7% 5% 6%
 Latino/Hispanic 7% 4% 8% 6%
 Other 14% 3% 5% 3%

Trimester of First
Prenatal Care Visit
 No prenatal care 25% 10% 0% 6%
 Third 17% 6% 3% 5%
 Second 10% 7% 5% 6%
 First 7% 5% 8% 6%

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This study was supported by a grant from the New Mexico Department of Health, Public Health Division, Family Planning Program. The authors gratefully acknowledge the extensive data collection carried out by the staff of New Mexico's teen parent programs.

Linda Brooks, Consultant, New Mexico Teen Pregnancy Coalition.

Linda Phillips Lehrer, Director of Education and Outreach, New Mexico Teen Pregnancy Coalition.

Merry Oakley, Analyst, Philliber Research Associates.

Sharon Waggoner, Director, New Mexico GRADS.

Requests for reprints should be sent to Susan Philliber, Senior Partner, Philliber Research Associates, 16 Main Street, Accord, New York 12404. E-mail: sphilliber@compuserve.com