Effects of a school for pregnant students on the incidence of low-birthweight deliveries.

To evaluate effects of an alternative public school for pregnant teenagers in New Haven, CT, medical and school records were reviewed for a 1-year birth cohort of 230 adolescent mothers. Nearly three-quarters of all school-aged primiparas who were enrolled in the city's public schools when they became pregnant attended the alternative school. Because of summer vacation, however, students who conceived in January through April began attending later in pregnancy than did those who conceived in May through December; these mothers were significantly more likely to deliver a preterm, low-birthweight infant. No such seasonal effects were found for other teenagers in the city who were not enrolled in public school at conception. Positive birth outcomes for early program attenders are similar to those reported for a nurse-home-visitation program. The results suggest that school programs have considerable potential to be an effective service delivery model for providing prenatal intervention to adolescents.

Parent-focused intervention: diffusion effects on siblings.

This study examined whether intervention provided to parents of firstborn children produced delayed benefits for later-born children. We studied younger siblings of children in the Yale Child Welfare Project, a family support program previously shown to result in better school adjustment for the firstborns. Information was obtained from the siblings' teachers and school records for 3 academic years. As was true for the older children, intervention group siblings had better school attendance than did control group siblings, were less likely to need supportive or remedial services, and were more likely to be making normal school progress. The results suggest that changes in the caregiving environment resulting from early family support lead to benefits for all the family's children. Parent-focused programs thus appear to provide a particularly efficient strategy for intervention efforts.

Adolescent mothers and repeated childbearing: effects of a school-based intervention program.

This study examined the effectiveness of a public school program for pregnant teenagers in preventing rapid repeated childbearing. Students permitted to attend longer than seven weeks postpartum were much more likely to avoid having another child in the next five years than were students required to return to their regular schools. The results indicate the potential of school-based programs to improve life outcomes for adolescent mothers and their children.

PIP: If an adolescent mother bears a second child soon after her first, her chances of becoming educationally and economically self-sufficient are severely limited. Whereas prenatal services to pregnant adolescents are designed to optimize the obstetrical outcomes, research has indicated that adolescent mothers involved in postnatal programs show a substantial decrease in subsequent pregnancy rates, a decrease which may continue for years beyond actual program involvement. In a study at the Polly T. McCabe Center, an alternate public school for pregnant students in New Haven, Connecticut, students who were allowed to remain at least 7 weeks postnatally were almost 3 times less likely to have another baby within the next 2 years than students who were not allowed to remain so long. The 102 adolescent mothers in this study were part of a cohort of residents of New Haven who delivered a live first-born infant on or between March 1, 1979 and February 29, 1980, were less than 19 years old at delivery, were not high school graduates when they became pregnant, were from low-income families, were Black, were regular attendees at the McCabe Center, and either returned to school or graduated after delivery. The duration of the students' assignment to McCabe depended on the timing of their pregnancy. They were referred to McCabe when their pregnancy became apparent or when they notified their current school that they were pregnant. They typically remained at McCabe during the academic quarter in which their baby was delivered and then returned to their home school. However, students delivering during the third quarter were allowed to complete the year at McCabe. These rules had the effect of random assignment to postpartum services. Information on the deliver of a second child was available for 99 mothers. Medical records were collected for the period from the first prenatal checkup until the first baby was 6-years-old. Postnatal time at McCabe was determined to be short if it was or=7 weeks and long if it was 7 weeks. 19 or 52 (36%) of students with a short postnatal period at the school delivered a second child within 2 years compared with 6 of 50 (12%) with a long period (p=.005). At 5 years, 35 of 50 (70%) of the short time group had additional children vs. 22 of 49 (45%) of the long time group (p=.015). After recoding 4 mothers who miscarried and 6 who had involuntary sterilization, it was found that almost half of the presumably fertile mothers who were at McCabe for a long postnatal time avoided subsequent childbearing for 5 years vs. only about 25% of the fertile short-time mothers. The 2 groups were similar in incidence of abortion, in receiving a postpartum check-up and effective means of contraception, in living arrangements, and in child care help received. These findings indicate that the effectiveness of school programs for pregnant adolescents may be greatly enhanced and lead to a longterm improvement in the young mothers' chances for a self-sufficient life if they are extended into the postpartum period, which is an especially optimum time for intervention.

Effects of an intervention program for pregnant adolescents: educational outcomes at two years postpartum.

Examined postpartum effects of a school-based intervention program for pregnant adolescents. Interviews were conducted with 102 innercity black, low-income, school-aged mothers who had attended the program, and their academic and medical records were reviewed. For teenagers who had been poor students prior to becoming pregnant, a strong linear effect was found for duration of program attendance: with sufficient time in the program, poorer students became indistinguishable from better students in educational success. Most of the better students were educationally successful at 2 years postpartum, independent of their length of time in the program. For all students, longer durations of postnatal intervention were predictive of lower likelihood of subsequent childbearing. Numerous academic, medical, social, and demographic variables were ruled out as possible confounding factors that might have produced the positive educational outcomes for poorer students. The results suggest that adolescents who appear to have minimal academic promise prior to their pregnancy are nevertheless very responsive to school-based intervention.

Effects of family support intervention: a ten-year follow-up.

The delivery to impoverished mothers of a coordinated set of medical and social services, including day-care for their children, had effects that were evident a decade after the intervention ended. Intervention mothers were more likely to be self-supporting, and they had higher educational attainment and smaller family sizes than did control mothers. Intervention children had better school attendance, and boys were less likely to require costly special school services than were corresponding control children. The financial implications of these results were considerable, totaling about $40,000 in extra estimated welfare costs and documented school service costs needed by the 15 control families in the single year in which these follow-up data were gathered. There were no indications that the intervention had lasting effects on the children's IQ scores. The results suggest that family support procedures, including quality day-care, have considerable promise as a general model for intervention programs.