Payal H. Patel • Bisakha Sen
Published online: 8 June 2011
� Springer Science+Business Media, LLC 2011
Abstract The objective of this article is to examine the
association of teen motherhood and long-term physical and
mental health outcomes. The physical and mental health
components (PCS and MCS) of the SF-12 Healthy Survey
in the NLSY79 health module were used to assess long-
term health outcomes of women who experienced teenage
motherhood. Various familial, demographic, and environ-
mental characteristics were indentified and controlled for
that may have predicted teen motherhood and long-term
health outcomes. The two comparison groups for teen
mothers were women who experienced teen-pregnancy
only and women who were engaged in unprotected sexual
activity as a teenage but did not experience pregnancy.
Multivariate ordinary least squares regression was used for
analysis. The average PCS and MCS for teen mothers was
49.91 and 50.89, respectively. Teen mothers exhibited
poorer physical health later in life compared to all women
as well as the comparison groups. When controlling for
age, teen mothers had significantly lower PCS and MCS
scores compared to all other women. Furthermore, when
controlling for familial, demographic, and environmental
characteristics, teen mothers exhibited significantly lower
PCS and MCS scores. When comparing teen mothers to the
two comparison groups, PCS was not statistically different
although MCS was significantly lower in the teen-preg-
nancy group. Teen motherhood does lead to poorer phys-
ical health outcomes later in life. On the other hand, poorer
mental health outcomes in later life may be attributed to the
unmeasured factors leading to a teen pregnancy and not
teen motherhood itself. Additional research needs to be
conducted on the long-term consequences of teen
Keywords Teen motherhood � Physical health � Mental health � Health outcomes
The US has continued to experience higher rates of teenage
pregnancy and motherhood than most developed nations
. Each year, approximately 750,000 women aged 15–19
experience a pregnancy  and the majority of these
pregnancies result in live births. After falling to a low of
40.5 births per 1,000 women in 2005, the average birth
rates for 15–19 year olds increased in 2006 to 41.9 births
per 1,000 women. Approximately 10% of all US births in
2006 were to teenagers .
The total annual government expenditures on public aid
to teen-mothers in 2006 were $11.3 billion . But apart
from the costs imposed upon taxpayers, teen-mothers
themselves exhibit adverse outcomes subsequently in life,
including poor educational and economic outcomes. In this
study, we extend that literature by exploring the relation-
ship between teen-motherhood and mid-life health out-
comes for women. Little research has been done regarding
this particular outcome. However, rising health costs are a
grave concern in the US, and if teen-motherhood is asso-
ciated with poorer health outcomes in later life, then
increases in teen birthrates may have important conse-
quences to society in terms of the greater health needs and
costs in future decades.
P. H. Patel (&) � B. Sen Department of Healthcare Organization & Policy,
University of Alabama at Birmingham, Birmingham, AL, USA
Matern Child Health J (2012) 16:1063–1071
It is fairly well established in the social science literature
that experiencing teen-motherhood is associated with sub-
sequent adverse life outcomes for women. Several studies
find strong associations between teen-motherhood and poor
education, underemployment, and lower socioeconomic
status for women [4–11]. British teenage mothers had a
significantly higher level of depression in medium term
postpartum compared to older mothers . Additionally,
teen-mothers often face stigmatization and criticism for
contributing to adult poverty .
While experiencing teen-motherhood is correlated with
adverse outcomes, it is also fairly well-established that
experiencing teen-motherhood in itself can be a manifes-
tation of poor socioeconomic status (SES) during child-
hood, as well as a combination of household factors,
environmental stressors, and psychological factors [6, 7,
12–14]. Teen-mothers also exhibit lower cognitive scores
than their counterparts  and score higher on the Dean
Romanticism Scale  suggesting that they may have
more naı̈ve beliefs about romantic love and the perma-
nency of relationships.
While teen childbearing is found to have a strong
association with a variety of subsequent adverse outcomes
in women, teen childbearing itself seems to be predicted by
a variety of negative childhood experiences, family back-
ground characteristics, and personal psychological factors.
Thus, it remains unclear whether it is experiencing teen-
motherhood per se that leads to the subsequent poor out-
comes, or whether these outcomes are more a result of the
same underlying factors that predict teen-motherhood in
the first place. It is important from a policy perspective that
this be better analyzed. If the poor educational, economic
and health outcomes can be attributed to experiencing teen-
motherhood per se, then resources directly targeted towards
preventing teen-motherhood will benefit the women.
However, if the poor outcomes are more a result of the
underlying factors predicting teen-motherhood per se, then
merely preventing the latter may not yield the expected
improvements in outcomes for these women. Thus, the
challenge for researchers is to decipher whether outcomes
for teen-mothers differ from their counterparts who had
virtually identical familial, environmental and personal
characteristics, but who happened not to become teen-
Researchers have attempted to address this through a
variety of methods. One approach is to include as com-
prehensive a set of control variables as data permits for
childhood and family background. Studies have examined
the outcomes of teenage mothers while controlling for
various background characteristics and have shown that the
association between teenage motherhood and subsequent
outcomes were reduced [17, 18].
Another approach is to find an appropriate ‘control’
group likely to have circumstances very similar to teen-
mothers, but simply not experiencing the actual event of
teen-motherhood themselves. This allows researchers to
infer whether differences in outcomes between the control
group and teen-mothers are attributable to teen childbear-
ing per se . Sisters of teen-mothers who were raised in
the same household (thus, presumably, experiencing the
same household and environmental stressors) but did not
experience a teenage birth are one favored control group
[20–22]. Another control group is teenagers who had
become pregnant but did not actually experience a birth
Very little research currently exists on the association of
teen-motherhood with long-term health outcomes. With
this article, we help fill that gap. We use data from the
NLSY79, and derivations of some of the methods estab-
lished in the literature to help control for underlying con-
founders that may both lead to teenage births and
subsequent poor health outcomes. We describe further
details of the data used in the study below.
Data and Methods
National Longitudinal Survey of Youth 1979
The NLSY79 is a nationally representative sample com-
prised of 12,686 young people aged 14–22 years old on the
date they were first surveyed in 1979, and who were
residing in the US. The respondents were interviewed
annually from 1979 through 1994. After 1994, the survey
was conducted biennially. The NLSY79 initially comprised
of three subsamples:
(1) A cross-sectional sample (n = 6,111) designed to
represent non-institutionalized civilian youths aged
(2) A supplemental sample (n = 5,295) that oversampled
blacks, Hispanics, and poor Non-black Non-Hispanics
aged 14–22 years.
(3) A military sub-sample (n = 1,280) representative of
the population who enlisted in an active military
branch by September 30, 1978 aged 17–21 years by
Due to funding constraints, the military subsample and
the poor Non-black Non-Hispanic respondents in the sup-
plemental sample were subsequently dropped from the
1064 Matern Child Health J (2012) 16:1063–1071
Beginning in survey year 1998, an extended Health module
was created to accurately assess the occurrence of chronic
health problems in the aging NLSY79 cohort. It was
administered to NLSY79 respondents in the first survey
they took after reaching age 40. This occurred anywhere
from 1998 to 2006, depending on the respondents’ year of
birth. We use the physical and mental health components
of the SF-12 Health Survey in the NLSY79 Health module
The SF-12, which stands for ‘‘short-form 12-question’’, is a
brief inventory of self-reported mental and physical health
using twelve standardized questions. The health concepts
include physical functioning, role functioning physical,
general health, bodily pain, social functioning, vitality, role
functioning emotional, and mental health (ALSFRS, 2009).
The exact questions and the distributions of responses in
our sample are in Table 1. Results of the SF-12 are sum-
marized in terms of two meta-scores in the NLSY79
dataset, the Physical Component Summary (PCS) and the
Mental Component Summary (MCS). Scores are created in
NLSY79 according to the manual by Ware et al. ,
though the precise scoring formula is kept confidential.
These meta-scores are our main outcomes of interest.
Higher scores represent better health.
The PCS and MCS scores were designed such that the
representative US population mean scores are 50, and the
standard deviations 10. Thus each one-point difference
above and below 50 corresponds to one-tenth of a standard-
deviation (ALSFRS, 2009). Because the US population
mean score includes the elderly for whom scores decline
rapidly, a better comparison for the NLSY79 sample might
be the scores for the sub-group of US populations aged
35–44 years, for whom the mean PCS and MCS scores,
respectively, are 52.18 (std. dev. 7.30) and 50.1 (std. dev.
The participants in this study include 4,271 NLSY79
female respondents for whom PCS and MCS scores were
reported by 2006. Our primary group of interest is women
who had a live birth as a teenager (‘‘teen-mother’’). When
comparing PCS and MCS scores for teen mothers with
other women in a multivariate regression framework, we
attempt to control for underlying confounders that may
predict both teen-motherhood and future health outcomes
using the following tactics. First, we control for an exten-
sive array of measured familial, demographic and envi-
ronmental characteristics available in the NLSY79 dataset
(described later under ‘‘other variables’’). Next, we attempt
to identify women who are likely to share unmeasured
characteristics with teen-mothers, but who do not actually
become teen-mothers. We consider two comparison
groups: (1) women who became pregnant as teenagers but
then experienced a miscarriage, abortion, or stillbirth
(‘‘teen-pregnancy-only’’); and (2) women who reported
unprotected sexual activity as a teenager, but did not
experience a teen-pregnancy (‘‘teen-unprotected-sex’’). We
identify respondents in the teen-mothers, teen-pregnancy-
only and teen-unprotected-sex groups using information
from the NLSY79 Fertility module, which informs on
contraceptive use and pregnancy outcomes. Specific fer-
tility variables, including age of first (and subsequent)
pregnancies and outcomes of these pregnancies were added
to the NLSY79 beginning in 1984. We use information
from the 1984, 1985 and 1986 surveys to identify the
groups as described below.
We use ‘‘age 18 or less’’ to define a teenager. Therefore,
respondents who meet this criterion for ‘‘age of pregnancy’’
are identified. In 1984, a majority of respondents were
already past the age of 18, in which case our identification
is based on information provided retrospectively. If in 1984
the respondent reports a past pregnancy where age of
pregnancy is 18 or younger, and the outcome of the
pregnancy is a live birth, then they are identified as a ‘teen-
mother’. For respondents 18 years or younger and cur-
rently pregnant in 1984 (1985), data from survey year 1985
(1986) are used to identify the outcome of the pregnancy. If
it is a live birth, then they are also identified as a ‘teen-
mother’. Otherwise the variable is set to 0. Finally, all
responses are compared across the 3 years for consistency.
This procedure results in 1,310 respondents qualifying as
‘teen-mothers’ for our analysis. These numbers are con-
sistent with Hotz et al. .
This group includes respondents who experienced a first
pregnancy at age 18 or less, but it ended in a miscarriage,
abortion, or stillbirth, and they did not experience a sub-
sequent pregnancy ending in live birth while still a teen-
ager. Again, 1984, 1985, and 1986 interview data were
used to identify the occurrence and outcomes of the teen
pregnancy. This procedure resulted in 467 women quali-
fying for this group. Of them, 129 respondents reported
having a miscarriage, 320 respondents reported having an
abortion, and 18 respondents reported having a stillbirth as
a teenager. It is important to note that data on abortions,
miscarriages, and pregnancies in NLSY79 interview data
are based on self-reports, and it is also fairly well-estab-
lished that the numbers of abortions among the young is
highly underreported . We speculate that some of the
Matern Child Health J (2012) 16:1063–1071 1065
reported ‘miscarriages’ are likely to have been abortions,
and that some teen pregnancies would have been termi-
nated via abortion if they did not happen to end in a mis-
carriage. Thus, we avoid the approach by Hotz et al.  of
only using information on women who report a miscar-
riage. Instead, we combine women who report a miscar-
riage/stillbirth as a teenager with those who report an
abortion as a teenager in one group.
This group includes respondents who report engaging in
non-contraceptive sexual activity as a teenager, but did not
experience a pregnancy. We argue that this is a useful
comparison group to teen-mothers, because their unmea-
sured personal and environmental characteristics lead them
to engage in the risky behavior that leads to teen-mother-
hood, and it is likely a matter of chance that they did not
become pregnant. The Fertility module in NLSY79 pro-
vides specific contraceptive related questions. Specifically,
the respondents identifying themselves as ‘‘not using con-
traception, sexually active’’ when 18 years and under were
included in this group. This procedure resulted in 238
respondents reporting non-contraceptive sexual activity
(another 1,480 respondents reported sexual activity with
contraception, but we do not consider them an appropriate
comparison group). Again, the usual caveats exist about
misreporting in self-reported, retrospective data.
We acknowledge that our comparison groups are unli-
kely to have the identical unmeasured characteristics to
teen-mothers. For example, respondents in the teen-
Table 1 SF-12 questions and distributions in the sample
Question Frequency (N) Percentage (%)
Assessment of general health
Excellent 1,782 21.1
Very Good 3,204 37.9
Good 2,350 27.8
Fair 895 10.6
Poor 219 2.6
Does health limit moderate activities?
Yes, limited a lot 367 4.3
Yes, limited a little 516 6.1
No, not limited at all 7,570 89.6
Does health limit climbing stairs?
Yes, limited a lot 455 5.4
Yes, limited a little 703 8.3
No, not limited at all 7,293 86.3
Have accomplished less than would like in past 4 weeks?
Yes 1,053 12.5
No 7,395 87.5
Does health limit kind of work or other activities?
Yes 917 10.9
No 7,530 89.1
Emotional problems caused to accomplish less in past 4 weeks?
Yes 888 10.5
No 7,559 89.5
Emotional problems made actions less careful?
Yes 728 8.6
No 7,714 91.4
Pain interfered with normal work in past 4 weeks?
Not at all 6,186 73.2
A little bit 1,243 14.7
Moderately 432 5.1
Quite a bit 371 4.4
Extremely 215 2.5
How often felt calm and peaceful in past 4 weeks?
All the time 1,471 17.4
Most of the time 3,635 43.1
A good bit of the time 1,262 14.9
Some of the time 1,320 15.6
A little of the time 538 6.4
None of the time 216 2.6
How often had a lot of energy in past 4 weeks?
All the time 1,493 17.7
Most of the time 3,590 42.5
A good bit of the time 1,169 13.8
Some of the time 1,433 17.0
A little of the time 484 5.7
None of the time 273 3.2
How often felt down-hearted and blue in past 4 weeks?
All the time 134 1.6
Table 1 continued
Question Frequency (N) Percentage (%)
Most of the time 247 2.9
A good bit of the time 193 2.3
Some of the time 1,242 14.7
A little of the time 1,924 22.8
None of the time 4,703 55.7
Physical/Emotional problems interfere with social activities in past
All the time 153 1.8
Most of the time 216 2.6
A good bit of the time 148 1.8
Some of the time 560 6.6
A little of the time 646 1.7
None of the time 6,717 79.6
Summarized results from the SF-12 scores are given in the NLSY79
dataset as the Physical Component Summary (PCS) and Mental
Component Summary (MCS) scores. Scores are computed based on
algorithms in the manual by Ware et al. , but the precise formula
is kept confidential
1066 Matern Child Health J (2012) 16:1063–1071
unprotected sex group may have timed the sexual inter-
course more carefully to avoid pregnancy,—which could
suggest differences in cognitive ability or in the desire to
get pregnant between them and teen-mothers. Some teen-
pregnancy-only respondents may have chosen an abortion
or induced a miscarriage because they wanted to avoid the
socio-economic consequences of teen-motherhood. Abor-
tions and miscarriages may also be more indicative of
experiencing sexual assault and having worse access to
prenatal care, respectively. compared to teen-mothers.
However, while the unmeasured personal and environ-
mental characteristics may not be identical across the
groups, they are likely to have a number of similarities.
Taken in conjunction with a list of measureable charac-
teristics we also control for other variables, which are listed
below. We believe our approach allows us to minimize the
effects of confounders when analyzing the association of
teen-motherhood with future health outcomes.
In our multivariate regression framework, we control for
several measureable demographic, familial and other
background characteristics that are available in the
NLSY79 that may be associated with teen-motherhood and
the outcome of interest in our study. These include race-
ethnicity, region of residence, whether the teenager lived
with both parents at age 14, two proxy variables to control
for the extent reading and learning were encouraged in the
home, the number of siblings, highest grade completed by
respondent’s mother, self-reported bad health in 1979,
poverty status prior to 1979, if parents were alcoholics,
and if the respondents themselves reported substance-use
before age 14.
All statistical analyses were conducted using STATA,
version 11.0. Table 2 illustrates the mean, and standard
deviations for our outcome variables, as well as for the
other demographic, familial and other background char-
acteristics available in the NLSY79. The average PCS and
MCS among teen-mothers were 49.91 and 50.89, respec-
tively, while for all women they were 50.79 and 51.10,
respectively. Notably, while teen-mothers have lower PCS
and MCS compared to other women, they also have several
other differences in their background characteristics com-
pared to other women. For example, teen-mothers are less
likely than counterparts to be living with both parents at
age 14 (54% vs. 63%), more likely to belong to a minority
group, and much more likely to be in poverty prior to 1979
(49% vs. 19%).
Table 3 presents the results of t-tests with unequal vari-
ances to test the equality of mean physical and mental scores
for three categories. The first column compares PCS and
MCS for teen-mothers to all other women. The second col-
umn compares teen-mothers to teen-pregnancy only. The
Table 2 Means and standard deviations of key variables
(N = 1,310)
All other women
(N = 2,961)
Obs Mean SD Obs Mean SD
PCS 959 49.91 (9.62) 186 50.79 (9.04)
MCS 959 50.89 (9.92) 186 51.10 (9.91)
Hispanic 959 0.22 (0.46) 186 0.17 (0.42)
Black 959 0.46 (0.50) 186 0.30 (0.46)
Non-black/Non-Hispanic 959 0.32 (0.47) 186 0.53 (0.50)
Lived with both parents at age 14 959 0.54 (0.50) 186 0.63 (0.48)
Newspaper in household growing upa 952 0.61 (0.49) 185 0.76 (0.43)
Library card in household growing upa 954 0.60 (0.49) 185 0.72 (0.45)
In poverty before 1979 920 0.45 (0.50) 179 0.19 (0.39)
Alcoholic parents 959 0.18 (0.38) 186 0.16 (0.37)
Number of siblings 958 3.56 (2.47) 185 3.15 (2.21)
Highest grade completed 896 11.52 (2.90) 181 11.75 (2.82)
Bad health in 1979 959 0.04 (0.21) 186 0.05 (0.23)
Alcohol at age 14 or younger 959 0.08 (0.27) 186 0.15 (0.35)
Marijuana at age 14 or younger 959 0.06 (0.23) 186 0.06 (0.24)
a These variables serve as proxy variables for the extent to which reading and learning were encouraged in the household where the respondent
Matern Child Health J (2012) 16:1063–1071 1067
last column compares teen-mothers to teen-unprotected-sex.
These simple bivariate analyses reject the null hypothesis of
equality of means for PCS in all cases. Thus, teen-mothers
appear to exhibit poorer PCS later in life compared to all
women, but also compared to women who had a pregnancy
but not a live birth as a teen, or engaged in unprotected sex as
a teen. However, while we reject the null of equality of means
for MCS between teen-mothers and all other women, we do
not find any statistical differences between the teen-mothers
and the teen-pregnancy only groups, and only a weak sta-
tistical difference (significant at 10% but not 5%) between
the teen-mothers and teen-unprotected-sex group.
Table 4 presents results from three sets of multivariate
Ordinary Least Squares (OLS) regressions (referred to as
OLS Regression 1, 2 and 3 respectively) with PCS and MCS
as the outcome variable. Regression 1 includes a binary
measure for teen-mothers, with all other women being the
comparison group or omitted category, and it only controls
for the age at which PCS and MCS scores were measured.
Regression 2 extends Regression 1 by controlling for the
full set of variables listed under ‘other variables’. This allows
us to inspect how teen mothers differ from all other women in
their PCS and MCS scores after accounting for differences in
measureable demographic, familial and other background
characteristics. Regression 3 adds in separate binary mea-
sures for teen-pregnancy-only and teen-unprotected-sex in
addition to the binary measure for teen-mothers, with the
omitted category now being women not in any of these
groups. This allows us to inspect whether the association
between teen-motherhood (compared to the omitted-cate-
gory) and PCS and MCS are statistically different from the
associations between the other two groups (compared to the
base-category) and these outcomes.
When interpreting the magnitudes of the estimated
results, it is useful to remember that a 1 point reduction in
the PCS or MCS score is equivalent to a one-tenth of one
(population) standard-deviation reduction.
Regression 1 results show teen mothers have lower PCS
(b = -2.095, P \ 0.01) and lower MCS (b = -1.336, P \ 0.01) scores compared to all other women. Regres- sion 2 results show that, when the other demographic,
familial and other background characteristics are controlled
for, the estimated reductions in PCS (b = -1.596, P \ 0.01) and MCS (b = -0.903, P \ 0.01) for teen mothers compared to all other women are smaller, but still
highly significant. Regression 3 results show that, compared
to the omitted-category, teen mothers have significantly
lower PCS (b = -1.590, P \ 0.01) and MCS (b = -1.065, P \ 0.01). In contrast, neither the teen-pregnant-only nor teen-unprotected-sex respondents have PCS that are statis-
tically different than the omitted category. However, in case
of MCS, while the teen-unprotected-sex group is not statis-
tically different from the omitted category, the teen-preg-
nancy-only group shows statistically lower MCS compared
to the omitted category (b = 1.379, P \ 0.01), with the magnitude of the negative association being even greater
than the teen-mothers group. In an F-test, we failed to reject
the null hypothesis that teen-mothers and teen-pregnancy-
only groups are equivalent in terms of reductions in MCS.
Discussion and Conclusion
Extant literature has explored whether teen-motherhood is
linked to outcomes such as educational attainment, or
employment, poverty and welfare dependency in early
Table 3 T-test statistics with unequal variances
Variable PCS score
Mean (Group 1, Group2)
Mean (Group 1, Group2)
compared to All other women (Group 2)
(5.85)c 50.89, 52.20
Teen-mothers (Group 1)
compared to teen-pregnancy-only (Group 2)
(2.09)b 50.89, 51.12
Teen-mothers (Group 1)
compared to Teen-unprotected-sex (Group 2)
(3.57)c 50.90, 51.87
Teen-mother group includes teenagers who had a live birth at age 18 or younger (N = 1,310)
Teen-pregnancy only includes teenagers who had a pregnancy but resulted in an abortion, miscarriage, or stillbirth at age 18 or younger
(N = 467)
Teen-unprotected-sex group includes teenagers who engaged in sexual activity at age 18 or younger but did not experience teen pregnancy
(N = 238) a Significant at the P \ 0.10 level b Significant at the P \ 0.05 level c Significant at the P \ 0.01 level
1068 Matern Child Health J (2012) 16:1063–1071
Table 4 Results of multivariate ordinary least square regression analysis
Variable name Regression 1 Regression 2 Regression 3
b (t stat)
b (t stat)
b (t stat)
b (t stat)
b (t stat)
b (t stat)
Teen-pregnancy only -0.652
Teen unprotected sex 0.309
Age when MCS, PCS score computed 0.115a
Not in SMSA 0.571
SMSA not central city 0.687
SMSA central city 0.455
Region (North central) -0.631
Region (South) -0.393
Region (West) 0.877a
Poverty status when young -0.569
Drink before 14 years -1.941c
Smoke before 14 years -0.168
Marijuana before 14 years -1.557a
Bad health condition -4.888c
Highest grade completed -0.004
Newspaper in household 0.815b
Library card in household 0.205
Lived with both parents at age 14 0.796b
Matern Child Health J (2012) 16:1063–1071 1069
adulthood. To our knowledge, this is the first study to
examine whether teen-motherhood has long term conse-
quences in terms of women’s physical and mental health
later in life.
We find significant and negative associations between
teen-motherhood and women’s physical and mental health
in their 40 s as measured by the Physical Component
Summary and Mental Component Summary meta-scores
from NLSY79 Health module. Our approach involves
using regression models that control extensively for mea-
sured background factors, and also comparing teen-moth-
ers with women at a very high risk of experiencing teen-
motherhood—specifically, women who experienced a teen
pregnancy but not a live birth, and women who had
unprotected sex as a teen but chanced not to get pregnant.
The motivation is to investigate whether it is teen-moth-
erhood per se that leads to adverse health outcomes, or
whether the adverse outcomes are a function of measured
and unmeasured factors that increase the likelihood for
Our results strongly suggest that teen-motherhood does,
indeed, lead to poorer physical health in later life. While
further research is needed to verify exactly why this hap-
pens, we speculate that perhaps the economic conse-
quences of teen-motherhood as well as the stresses of
childrearing at a young age leave these women with fewer
resources to invest in their own physical health. These
results suggest that resources devoted to reducing teen-
motherhood may lead to health cost savings in future
Results regarding mental health are more challenging.
Both teen-motherhood and teen pregnancies not ending in a
live birth have significant and statistically similar negative
associations with future mental health. This may indicate
that it is not teen-motherhood per se, but the unmeasured
factors leading to a teen pregnancy, that actually lead to
worse mental health. It may also indicate that experiencing
a teen pregnancy per se has a negative effect on mental
health, regardless of whether the pregnancy results in a live
birth, and that a pregnancy ending in a non-live birth may
be worse for mental health than those ending in live
births—which is similar to what another set of researchers
found using similar data .
We acknowledge several shortcomings of this study.
There are the usual concerns regarding accuracy in self-
reported data, particularly given the sensitive nature of issues
like pregnancy outcomes. We do not have information on
some crucial factors that may predict teen pregnancy out-
comes as well as subsequent health, such as experiences with
sexual abuse and rape. Such factors have been found to be
associated with women having abortions and also suffering
from anxiety/depression and may help explain why mental
health outcomes were more negative for the teen-pregnancy-
only group compared to teen-mothers in our sample [26, 27].
We also lack information on health insurance status and
access to pre-natal care among the teens in our sample.
Finally, as acknowledged previously, there is good reason to
believe that the teen-mothers and our two comparison groups
are not identical in terms of their unmeasured characteristics.
Therefore, there may remain other unmeasured confounders,
hence even for physical health outcomes we must use caution
before interpreting our results as being ‘causal’.
This paper also suggests that more research needs to be
done on the long-term consequences of teen-motherhood.
Table 4 continued
Variable name Regression 1 Regression 2 Regression 3
b (t stat)
b (t stat)
b (t stat)
b (t stat)
b (t stat)
b (t stat)
Number of siblings 0.0628
Tee-mother group includes teenagers who had a live birth at age 18 or younger
Teen-pregnancy-only group includes teenagers who had a pregnancy but resulted in an abortion, miscarriage, or stillbirth at age 18 or younger
Teen-unprotected-sex group includes teenagers who engaged in sexual activity at age 18 or younger but did not experience a teen pregnancy
Comparison group (or omitted-category) in Regressions 1 and 2 are all women who did not become teen mothers.
Comparison group (or omitted-category) in Regression 3 is all women who neither became teen mothers, nor experienced a teen pregnancy, nor
had unprotected sex as a teen
Race: reference group = Non-Hispanic white
SMSA: reference group = SMSA central city not known
Region: reference group = East a Significant at the P \ 0.10 level b Significant at the P \ 0.05 level c Significant at the P \ 0.01 level
1070 Matern Child Health J (2012) 16:1063–1071
The NLSY79 Health module provides a rich array of health
information beyond the SF-12, which permits further
research into the association of teen-motherhood with dif-
ferent health-outcomes. Finally, longitudinal information is
also available the children of the female respondents of
NLSY79, which provide a rich resource for comparing
outcomes of the children of teen-mothers to the children of
their counterparts, to understand whether the effects of
teen-motherhood persist across generations.
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