The Commission for the Elimination of Child Abuse and Neglect Fatalities (CECANF) has developed a long list of draft recommendations. One overarching recommendation is to “ensure access to high-quality prevention and intervention services for children and families at risk.”
Many prevention services are mentioned, but one was left out in my opinion: services to prevent teen and unplanned pregnancies.
It is not surprising that pregnancy prevention was not often recommended to CECANF as a strategy to prevent child abuse and neglect fatalities, and that this recommendation did not make its way into CECANF’s draft.
As National Campaign to Prevent Teen Pregnancy co-founder Sarah Brown recently pointed out, groups that focus on child and family well-being rarely propose interventions that begin before conception of a child. CECANF could begin to rectify this omission by including teen pregnancy prevention in its recommendations for reducing child abuse and neglect fatalities.
In her testimony before CECANF, Angela Diaz, director of New York’s Mount Sinai Adolescent Health Center, discussed the connection between teenage parenthood and child maltreatment fatalities. In serving for many years on a child fatality review panel, she noticed that in many of these cases, the mother began childbearing in adolescence, and had more closely spaced children thereafter.
Dr. Diaz cited a national study of deaths of infants born between 1983 and 1991, which showed that “childbearing at an early age was strongly associated with infant homicide, particularly if the mother had given birth previously.”
A second or subsequent infant born to a mother younger than 17 years old was 11 times more likely to be a homicide victim than the first child of a mother 25 or older. A second or subsequent infant born to a mother age 17 to 19 was over nine times more likely to be a homicide victim.
Based on her observations and the research, Dr. Diaz recommended ensuring that adolescents have access to comprehensive sexuality education and reliable family planning methods. I hope the Commission will add this to its recommendations.
It is true that teen pregnancy has been decreasing rapidly. But there were still 249,067 births to teenage girls in the United States in 2014, or 24 births for every 1,000 girls. Estimates from 2013 data show that 11 percent of adolescent girls in the United States will give birth by their 20th birthday.
And rates are still higher among Blacks and Hispanics, girls in poor neighborhoods, and teenagers in foster care. Nearly one third of teenage girls in foster care have at least one child.
Most teens in foster care have been abused or neglected, which makes them statistically more likely to abuse or neglect their children. A large study in California found that 40 percent of children born to teen mothers involved in the child welfare system will be reported for child abuse by age five.
We need to know what proportion of child fatalities involve children who were born when their mothers were teens, as well as those born to mothers who began having kids as teenagers. CECANF should recommend that Congress require the collection of these data.
Even without knowing the proportion of child maltreatment deaths occurring to children of teen mothers, we already know that teen motherhood is a risk factor for child abuse and neglect. CECANF should recommend increased emphasis on teen pregnancy prevention, especially for young women in high poverty areas and those in foster care.
The Commission should recommend that all teens, especially those at higher risk of pregnancy, have access to contraceptive methods and education. Clinics in low income areas and those serving youth in foster care and juvenile justice should provide the full array of contraceptive options including the long-lasting methods that are most effective, along with education and counseling.
Special attention should be devoted to preventing a second birth to a teenage mother by ensuring that she is provided with a contraceptive method at the time of the first birth. The federal Teen Pregnancy Prevention Program, which has been under attack in Congress, should be fully funded or expanded.