Guided by principles of life history strategy development, this study tested the hypothesis that sexual precocity and violence are influenced by sensitivities to local environmental conditions. Two models of strategy development were compared: The first is based on indirect perception of ecological cues through family disruption and the second is based on both direct and indirect perception of ecological stressors. Results showed a moderate correlation between rates of violence and sexual precocity (r = 0.59). Although a model incorporating direct and (...) indirect effects provided a better fit than one based on family mediation alone, significant improvements were made by linking some ecological factors directly to behavior independently of strategy development. The models support the contention that violence and teenage pregnancy are part of an ecologically determined pattern of strategy development and suggest that while the family unit is critical in affecting behavior, individuals’ direct experiences of the environment are also important. (shrink)

I will do two things in this paper. First, I examine the issue of construction in the social sciences by using “teenage pregnancy” as an example. Following Michel Foucault's genealogical studies, I show that new categories were constructed to study teenage pregnancies, but that the construction involved does not support an extreme theory of construction—a theory which allows of nothing like “reality”. Second, I study the interaction between the categories used in investigations of teenage pregnancies and (...) those to whom such categories are applied, namely the young mothers themselves. The interaction illustrates what Ian Hacking has described as a “looping effect” characteristic of categories used to study people and their behaviour. I claim that with teenage pregnancy, the looping effect is much more complex than Hacking suggests. (shrink)

Critical discourse analysis (CDA) has been evident in disciplines such as sociology and cultural studies for many years, and is of increasing interest to nurse scholars internationally. This paper outlines what CDA is and how it might be used as an approach to analysing any health text, using an example from the UK — the teenage pregnancy strategy. Discourses and linguistic techniques used within this document are discussed, together with the potential impact they may have, both on health (...) professionals as readers, and on pregnant teenagers as targets of the strategy. Teenage pregnancy itself is an international concern, prompting different responses from the various governing bodies. When approaches to a health matter are so diverse across the developing world, it is useful to consider how policy analysis using CDA can advance our understanding of the positions taken up by the authors of the policies that might not otherwise be made explicit. (shrink)

This article presents a genealogical examination of the emergence of governmental concern with ‘children having children’, focusing on the work of the London County Council and local voluntary organizations in the 1950s and 1960s. The article explores the moral-Christian discourse shaping governmental work with ‘unwed mothers’ and identifies the discursive shifts associated with the ascent of the problematization of ‘teenage motherhood’. It is argued that within the moral-Christian discourse, a woman’s subjectivity was delineated primarily according to her ‘character’ not (...) her age or her ‘maturity’. Furthermore, the prospect that a young unwed mother will raise her child was viewed positively as it was seen to contribute to the desired transformation of her character. The shift to a concern with ‘children having children’ was linked with a rise in the influence of psychological discourse on government work. Two psychological notions were particularly important: the proposition that teenagers are emotionally immature and the assertion that inadequate mothering has a lasting effect on the health of a child. The article concludes that unless contemporary scientific claims regarding young people’s psychological and physiological maturity are challenged, the ‘problem’ of teenage parenthood will persist in the years to come. (shrink)

Feminists have argued that the association made between teenage childbearing and long-term lower socioeconomic status hides a multitude of socially constructed inequalities. I extend this position by analyzing how the association is linked in the South African literature on teenage pregnancy to economic security. I utilize Foucault's conceptualization of the method of security. Security refers to institutions and practices that defend and maintain a national population as well as secure the economic, demographic, and social processes of that (...) population. I analyze how the traits of the method of security are deployed with regard to teenage pregnancy; how reproductive adolescents are viewed as disrupting the production of the economic self and fracturing population control, thereby threatening economic security; and how the invocation of economic security allows for the legitimation of various regulatory practices. (shrink)

A number of studies have explored the underperformance of learners. However, there is a paucity of research in South Africa, which focuses primarily on how school leadership, commonly referred to as school management teams, accounts for the underperformance of learners and thus the underperformance of schools. To fill this gap, the current study, undertaken in two schools in a district in KwaZulu-Natal province, aimed to explore through a qualitative approach the opinions of SMTs regarding underperformance in the further education and (...) training phase. School management teams were interviewed using a semi-structured interview guide and in-depth face-to-face interviews. The interview guideline had a set of broad flexibly worded questions that allowed for in-depth discussion. Data were analysed using a thematic data analysis method. The school management team accounted for, and linked underperformance to a range of reasons. In this article, we present findings which emerged in relation to leadership weaknesses, particularly female leadership weaknesses, socio-economic challenges such as child-headed households and its consequences, teenage pregnancy, violence experienced by female learners, health of learners and educators and poverty. Systemic and structural societal challenges were flagged in the interviews as also impacting on the overall cognitive and psycho social development of learners. School management teams addressed the challenges by implementing a number of interventions that they reported were not successful. There is no simple answer to address the problem and we argue for a social compact which is inclusive of all stakeholders and suggest that intervening at the local level may not have a nation-wide impact but it would have an impact on a particular school. Sensitivity training, which includes gender sensitivity training, and leadership training and support is suggested as part of the interventions. Certain best practices could then be shared with other schools which face similar challenges. (shrink)

The Philippines has a young population with an estimated median age of 22.9 years in 2010. About 19.8 million or are 15–24 years old. About 48 % of these young people are adolescents aged 15–19. Studies in local settings provide varied information on the prevalence of adolescent pregnancy in the Philippines, depending on source and time of survey as well as age of respondents. The Cordillera Administrative Region has the highest teen pregnancy rate based on the 2013 Young (...) Adult Fertility and Sexuality Study. In the YAFS survey, the region registered 18.4% for teen fertility, making the Cordillera top all other regions. Likewise, a dramatic increase of teenage pregnancy is also evident in Barangay Irisan, Baguio City. Barangay Irisan is the biggest and most populated barangay in Baguio City. It had a population of 28,357 as of the 2010 Census, which accounts for about seven percent of the city's total populace. The barangay is located at the northwestern tip of the city, and is primarily accessible via the Naguilian Road. It is widely known for the dumpsite in the area. The Philippines is a signatory to numerous international agreements related to women in general, with implications for teenage pregnancy. These include the International Conference on Population and Development Programme of Action signed in Cairo, Egypt, in 1994; the Beijing Declaration and Platform for Action, developed during the Fourth World Conference on Women in Beijing, China, in September 1995; the Fourth World Summit on Social Development, the World Conference on Human Rights Programme of Action; and the Convention on the Elimination of all forms of Discrimination Against Women. The country is not lacking in laws nor policies and programs that could protect and empower women of all ages. Political bickering, religious interference, and the population’s ambivalent attitudes toward sex and reproductive health have, however, negatively affected the effective implementation of adolescent reproductive health programs in the Philippines. Adolescents having unprotected heterosexual intercourse are at risk of both HIV infection and unwanted pregnancy. (shrink)

This book focuses on social phenomenon that impact the lives of adolescent females of color. The authors highlight the daily challenges that African-American, Chicana, and Puerto Rican teenage girls face with respect to peer and family influences, media stereotyping, body image, community violence, pregnancy, and education. The authors also emphasize the incredible resiliency that young women possess in countering many of the social barriers confronting them.

Fundamento: Los adolescentes constituyen un grupo vulnerable y la maternidad en esta etapa, una problemática de actualidad. Objetivo: exponer particularidades sociodemográficas y de la maternidad en madres adolescentes del municipio de Cumanayagua, en el período septiembre a mayo del año 2014. Método: estudio descriptivo, corte transversal. Se trabajó con el universo conformado por 35 madres adolescentes y sus hijos. Se operó con un formulario de datos sociodemográficos, el análisis de documentos y la entrevista semiestructurada. Los resultados fueron procesados por el (...) paquete estadístico SPSS 15.0 para Windows y se utilizaron tablas de frecuencia y porcientos. Resultados: predominaron madres adolescentes de la etapa tardía con una media de edad 17,89; deserción escolar, más del 50% conviven con los padres con pareja o sin ella; embarazos deseados ; ocurrencia de nacimiento a términos, partos eutócicos, estados buenos de salud física y psicológica percibidos ; percepción de apoyo familiar. Conclusiones: las madres adolescentes de la etapa tardía que se caracterizaron por una maternidad percibida de manera satisfactoria contaron con apoyo familiar, vínculo de pareja, baja percepción de riesgos para su salud física y psicológica. Basis: Teenagers constitute a vulnerable group and motherhood during this period is a topical problem. Objective: Setting out socio-demographic and motherhood characteristics in teenage mothers from Cumanayagua municipality from September to May 2014. Method: Descriptive study, cross section. The population consisted of 35 teenage mothers and their children. A socio-demographic data form, document analysis as well as semi-structured interview were used. The results were processed by the SPSS statistical package for Windows and frequency and percentage tables were used. Results: Late stage teenage mothers with the average ages of 17, 18 and 19 prevailed; school dropouts ; more than 50 % of them live with their parents with or without a partner; planned pregnancies ; occurrence of full-term births ; ectopic childbirths ; good physical health states ; good psychological states ; family support perception. Conclusions: Those late stage teenage mothers who were characterized by motherhood perceived in a satisfactory way, counted on family support, romantic ties, low physical and psychological health risk perception. (shrink)

What is sex and why is it important? Does marriage have a basic rationale? How should couples manage their fertility, and when and how should pregnancy be achieved? How should we respond to 'embryo adoption', teenage pregnancy, population growth, HIV/AIDS and other STIs, same-sex attraction? This collection of original essays looks at these and other pivotal issues in reproductive and sexual ethics, from the perspectives of philosophy, theology, psychology and economic science.

In the United States, low-income or minority populations tend toward earlier births than the more advantaged. In disadvantaged populations, one factor that may exert pressure toward early births is “weathering,” or pervasive health uncertainty. Are subjective perceptions of health related to fertility timing? Drawing on a small sample of intensive interviews with teenage mothers-to-be, I suggest that low-income African American teenagers may expect uncertain health and short lifespans. Where family economies and caretaking systems are based on kin networks, such (...) perceptions may influence the decision to become a young mother. Heuristic typologies of ways socially situated knowledge may contribute to the reproduction of fertility timing practices contrast the experiences of poor African American interviewees, working class white interviewees, and middle-class teens who typically postpone childbearing. (shrink)

The growing phenomenon of teenage pregnancy introduces the problem of who should serve as surrogate decision makers for the children of adolescent parents. The justifications which sanction society's grant of presumptive decision making authority for adult parents, and the rationales and empirical evidence supporting a central role for adolescents who wish to make medical decisions regarding their own care, together suggest that older adolescent parents should be viewed as the presumptive decision makers for their children. There is, however, (...) empirical evidence that adolescent parents lack the cognitive abilities of childless adolescents of the same age and that many exhibit lower levels of emotional stability, sensitivity to infant needs, and social adjustment. These deficiencies, where present, undermine the very justifications for allowing adolescents to make medical decisions for their children. These findings are strong enough to justify a greater level of watchfulness over the competency and decisions of those adolescents who wish to make decisions for their children, but not definitive enough to conclude that, as a group, they be presumed incapable of making those decisions. (shrink)

Decreasing unintended teenage pregnancy, especially repeat teenage pregnancy, is an important public health goal. Unfortunately, legal barriers in the USA impede this goal as all minors are unable to consent for birth control in 24 states, and only 10 of those states allow consent after the minor has given birth according to state statutory law. Placement of long-acting reversible contraception is one of the most effective methods of preventing rapid repeat pregnancies. However, restrictions are placed on (...) adolescents who may not have the option of parental consent if the parents are unwilling, or not present, to give consent. A predicament arises when healthcare professionals are willing to place the contraceptive for the patient, but cannot due to the restrictions and guidelines outlined by each state. Even though these adolescents are legally viewed as minors, adolescent mothers should be able to consent to the placement of LARC. Notably, adolescents have the legal ability to give consent for the healthcare of their child starting in the prenatal period. I argue that this ability should be extended to include adolescent consent for their own healthcare. Additionally, the procedure to place LARC is relatively low risk and highly effective, which is an opportune situation to allow minors to consent. Allowing adolescents to consent to LARC after delivery is a simple and effective way to decrease rapid repeat pregnancy rates in the USA. All data relevant to the study are included in the article. (shrink)

Ethical Issues in Youth Work presents a systematic analysis of some of the core ethical dilemmas facing youth workers in their day to day practice. Among the topics discussed are: *when to break confidentiality *the ethics of religious conversion *conflicts between cultures *balancing the autonomy and control of young people *maintaining an equilibrium between accountability to funders, empolyers and young people This book also examines some of the key issues facing youth workers in the context of public fears of youth (...) crime, lawlessness, drug use, teenage pregnancy and policies designed to control and contain as well as educate and care for young people. Ethical Issues in Youth Work offers a timely and unique insight into both the perennial dilemmas of youth work practice and some of the more recent challanges faced by youth workers in the light of current public attitudes and government policy towards young poeple. (shrink)

_Ethical Issues in Youth Work_ presents a systematic analysis of some of the core ethical dilemmas facing youth workers in their day to day practice. Among the topics discussed are: *when to break confidentiality *the ethics of religious conversion *conflicts between cultures *balancing the autonomy and control of young people *maintaining an equilibrium between accountability to funders, empolyers and young people This book also examines some of the key issues facing youth workers in the context of public fears of youth (...) crime, lawlessness, drug use, teenage pregnancy and policies designed to control and contain as well as educate and care for young people. _Ethical Issues in Youth Work_ offers a timely and unique insight into both the perennial dilemmas of youth work practice and some of the more recent challanges faced by youth workers in the light of current public attitudes and government policy towards young poeple. (shrink)

This article examines the blesser phenomenon in South Africa, which gained rapid popularity in 2016. A large body of research exists that reveals that transactional sex is a significant theme within the phenomenon of blesser and blessee relationships. Scholarship has demonstrated that transactional sex has contributed to an increase in human immunodeficiency virus infection rates, especially amongst women aged 15–24 years, as well as a concerning increase in teenage pregnancy. Whilst these are dire realities of blesser–blessee relationships, the (...) one that is most concerning in the current climate in South Africa is the increase in gender-based violence, intimate partner violence and femicide. Therefore, this article concerns itself primarily with this epidemic as it seeks to demonstrate how the blesser phenomenon contributes to GBV and IPV. Blessees are the young women in the blesser–blessee relationships who experience trauma and shame because of the violence and abuse inflicted on them by the older male blessers. The article argues that the church should be seen to be taking decisive action in addressing the scourge of GBV and IPV. The narrative approach is used to give the blessees the opportunity to share their stories. By applying the techniques of narrative therapy, positive deconstruction and the art of holy listening, the study reaches its key outcome: to offer to the church a framework for a pastoral care and healing methodology to help our sisters in Christ to experience healing and to move from shame to self-worth.Contribution: The Blesser phenomen has never been dealt with in theology, especially from the African perspective. Both sides of the problem need pastoral care. The major issue is where do we begin? I started, pastorally working with the blessee, who is in relationship with an older man. The main question that could be pastorally followed is, why pursue an older man for provision? This is a major pastoral issue, especially in poor communities. The younger women are in need of finance, in order to complete their studies and eke out a living. Beside the Covid 19 pandemic, this is the second major issue affecting black townships. (shrink)

Discusses a number of social issues which include worldly enjoyment, religion, educational life, consequences of careless living, consequences of teenage pregnancy and the duty and responsibility of parents.

This article examines the regulation of Latina youth sexualities in the context of sexual and reproductive health care provision. In-depth interviews with health care providers working in two Latino-serving community health centers are analyzed for how they interpret and respond to the sexual and reproductive practices of their low-income Latina teen patients. The author finds that providers emphasize teenage pregnancy as a social problem among this population to the exclusion of other dimensions of youth sexualities and encourage Latina (...) girls’ adherence to a life course trajectory that conforms to middle-class, heteronormative ideals as a solution to this problem. By relying on such understandings, providers construct meanings of sexual citizenship that require participation in bourgeois heteronormativity. These findings suggest that Latino-serving community health centers, their providers, and their teen patients could benefit from questioning the assumptions that inform providers’ appraisals of Latina youth and developing a more inclusive approach to Latina youth sexualities beyond a discourse of pregnancy prevention. Such efforts could allow community health centers to actively participate in disrupting the structural inequalities that shape their young patients’ lives. (shrink)

In this article, I analyse the discursive construction of adolescent pregnancy and childbearing as a development ‘problem’ in Plan’s ‘Because I’m a Girl’ campaign. I draw on existing scholarship that configures teenage pregnancy prevention campaigns in the ‘developed’ world as a site of biopolitics that seeks to maximise the well-being of the population by governing adolescent girls’ reproductive and sexual behaviours. Identifying Plan’s campaign as part of a larger turn towards adolescent girls in development discourse and policy, (...) I also draw on a growing body of scholarship that examines how campaigns targeting adolescent girls reinforce neo-liberal understandings of ‘development’ as achievable through the empowerment of individuals rather than through structural change. I argue that by discursively constructing adolescent pregnancy and parenthood as risky, Plan’s campaign reinforces reproductive norms of delayed reproduction and sexual debut, according to which adolescent girls in the ‘developing’ world are expected to comply. The campaign’s goal of ‘empowerment’ thus acts as a means of constructing adolescent girls as responsible reproductive decision makers who will break the ‘cycle of poverty’ by making rational reproductive and sexual choices. Thus, although Plan’s ‘Because I’m a Girl’ campaign addressed important issues, including adolescent girls’ right to reproductive autonomy, their focus on empowerment operates as a form of biopower that pursues the project of development through the regulation of girls’ reproduction and sexuality. (shrink)

The sexual revolution that took place in the late 1960s and early 1970s is one of the most profound social changes during the second half of the twentieth century in America. Before the revolution, there existed a norm proscribing premarital sex (PS norm); premarital sex was not accepted. After the sexual revolution, the PS norm no longer existed; premarital sex became accepted. In the literature on how premarital sex became accepted, little attention is given to the institutional change that transpired—the (...) collapse of a sexual norm. This study specifies one micro-mechanism of this social change. Specifically, adopting methodological individualism and the prisoner's dilemma game, I develop a theory that explains how a technological innovation for contraception triggered a change in individuals' perception of premarital sex, which led to their behavioral change. As a result, premarital sex became accepted, and the norm proscribing premarital sex collapsed. I use General Social Survey data to test the hypothesized micro-mechanism of the institutional change. The empirical analysis supports the hypothesis derived from the theory. Based on the above analyses, I discuss two alternative explanations and the issue of teenage pregnancy. (shrink)

Academics and professionals working with young women face a series of paradoxes. Over the last 20 years, the lives of young women in the UK and Europe have been transformed. They have gained considerable freedom and independence, but at the very same time, new, less tangible forms of constraint and subordination now play a defining role in the formation of their everyday subjectivities and identities. Young women have come to exemplify the pervasive sensibility of self-responsibility and self-organisation. This new ‘gender (...) regime’ demands both conceptualisation and practical response, drawing on educational research, social and cultural theory, and contemporary feminist thought. Within the overarching theme of pedagogical responses to these trends, through work in schools and within young women’s online and face-to-face communities, this book interrogates the field of sexuality and its visualisation across new and old media in the context of often predictable and endemic ‘moral panics’ about teenage pregnancy rates, sexually transmitted diseases, and internet pornography. In exploring how girls and young women respond to increasing expectations of them as the vanguard of economic, social, and cultural change, contributors to this volume interrogate the ways in which social and educational aspiration interact with young women’s developing and embodied identities. This book was originally published as a special issue of _Pedagogy, Culture and Society. _. (shrink)

This essay demonstrates, and critiques, the pervasiveness of economic assumptions in the jurisprudence of privacy in US constitutional law as it extends from birth control and abortion rights to the so-called right to die. Finding in these cases metaphors of neoliberal productive practices and the assumption of the self as human capital, the self understood as a site of investment rather than a repository of worth, the essay brings privacy law into conversation with Kristin Luker's empirical work on abortion politics (...) and teenage pregnancy. The essay does not treat the right to die as a moral or political problem to be resolved, but is instead interested in the revelatory character of the jurisprudence of privacy — namely, in what it can tell us about the contemporary political economic order. Are recent developments in contemporary political economy, in the emerging neoliberal order, potentially illiberal? (shrink)

Hace dos décadas se incorporó a la agenda pública el interés por el embarazo adolescente en tanto expresión de la pobreza y la vulnerabilidad de la población femenina juvenil. Este artículo presenta un análisis integral del problema a través de cuatro entradas: 1) un breve panorama de las políticas públicas adoptadas en estas dos décadas y diagnóstico que les dio origen; 2) profundiza en la magnitud del embarazo de mujeres menores de 20 años (a partir de datos sobre embarazadas y (...) no del número de hijos nacidos vivos de madres) y compara tres registros: 1995-1996 -Censo de alumnas embarazadas en el sistema escolar, MINEDUC-; 2006 y 2009 -CASEN, registro de menores de 20 años embarazadas-; 3) Profundiza en las vulnerabilidades de estas jóvenes a partir de testimonios sobre el sentido y ejercicio de la sexualidad en la experiencia juvenil; 4) Plantea que la condición de madre adolescente conlleva la vulnerabilidad a mayores condiciones de pobreza, y de exclusión a derechos y beneficios otorgados por el sistema educacional, fundamentándolo en el análisis de las bases de datos de la CASEN 2006 y 2009. (shrink)

Teenagers enjoy better physical and mental health when they avoid early sexual debut and reserve the sexual act for marriage. Teens who initiate sexual relations outside of marriage risk contracting sexually transmitted diseases, and those who also use hormonal contraception to avoid pregnancy often suffer unwanted physical and emotional side effects. Teens who have multiple partners may have later attachment or bonding difficulties. The consequences of an unintended pregnancy after a casual sexual relationship are often abortion or single (...) motherhood and an increased likelihood of poverty. Teenagers who save sexual relations for marriage experience freedom from these negative consequences and are more likely, in marriage, to experience the beauty of self-giving love. (shrink)

The pregnancy rate among teenagers has increased overall in the past years in most industrial countries, especially in urban population. The aim of our study was to estimate the incidence of adolescent deliveries in Szczecin population and to analyze problems associated with maternity in teenagers (adolescent childbearing).The study population consists of 90 teenagers, the control group contains 2707 adult women delivered between Jan. 1, 2000 and Dec. 31, 2000 at two Obstetrics Clinics of Pomeranian Academy of Medicine and Municipal (...) Hospital in Szczecin. Data on outcomes for children of adolescents were obtained from hospital documentation and anonymous questionnaires. Findings show that newborns of adolescents suffer many negative complications and problems and that pregnancy in adolescents is a clear risk for abnormal outcomes. Special programs for pregnancy prevention and intervention in adolescents should be prepared. (shrink)

Cass Sunstein and Richard Thaler's proposal that social and legal institutions should steer individuals toward some options and away from others-a stance they dub "libertarian paternalism"-has provoked much high-level discussion in both academic and policy settings. Sunstein and Thaler believe that steering, or "nudging," individuals is easier to justify than the bans or mandates that traditional paternalism involves. -/- This Article considers the connection between libertarian paternalism and the regulation of reproductive choice. I first discuss the use of nudges to (...) discourage women from exercising their right to choose an abortion, or from becoming or remaining pregnant. I then argue that reproductive choice cases illustrate the limitations of libertarian paternalism. Where choices are politicized or intimate, as reproductive choices often are, nudges become not much easier to justify than traditional mandates or prohibitions. Even beyond the context of reproductive choice, it is not obvious how much easier nudges are to justify than bans or mandates. -/- Part I of this Article briefly introduces Sunstein and Thaler's libertarian paternalism. Part II then turns to the context of reproductive choice. Part II.A reviews restrictions on the right to choose an abortion-particularly post-Casey regulations such as waiting periods, requirements that women receive certain types of information, and requirements that women undergo ultrasound-that pitch themselves as steering choice without entirely closing off the right to choose an abortion. This distinction between nudges and prohibitions echoes Sunstein and Thaler's proposals, but works to subordinate women's choices to the judgment of (often male) experts and administrators-hence my term "libertarian patriarchalism." Part II.B reviews efforts to nudge women-particularly teenagers, HIV-positive women, and others thought to be unsuitable mothers-to avoid pregnancy. -/- Part III considers the normative implications of nudging reproductive decisions. In Part III.A, I argue that the political nature of reproductive choices presents a problem for nudges. I do so by considering a parallel with voting rights. Empirical research shows that voters are more likely to choose the candidate listed first on the ballot. Yet we do not empower the administrator in charge of ballot design to choose a default rule that nudges individuals toward the candidate he sincerely believes would promote choosers' welfare. Given the political nature of reproductive choices, a policymaker's attempting to nudge reproductive decisionmaking in the direction he prefers-or indeed in any direction-fails to show adequate respect for the chooser's agency. In Part III.B, I offer an argument that targets the use of nudges in the context of pregnancy. Finally, in Part III.C, I argue that nudges do not merely add choices to an existing menu, but change the substantive choices available to individuals and thereby impose more-than-trivial costs on them. I conclude by exploring the implications of my arguments for nudges more generally. (shrink)

Megan1 is a young teenage patient who suffered a stillbirth at 28 weeks, leading to a year long police investigation dropped only after postmortem tests found that her pregnancy was lost due to natural causes. The stress of the investigation and her isolation from friends and support network following the seizure of her mobile and laptop compounded the trauma of the stillbirth, leaving her requiring emergency psychiatric care. Aisha1 is a vulnerable patient who suffered a premature delivery, having (...) experienced similar problems in earlier pregnancies. Things happened so quickly that Aisha delivered on her own at home, only then seeking medical care. She told hospital staff that earlier in her pregnancy she had considered an abortion. As a result, she found herself interviewed under police caution and was required to surrender her phone and tablet, limiting access to friend and family support just when most needed. Aisha was denied unsupervised access to her baby in the intensive care unit, needing to hand over expressed breast milk to a receptionist. These stories, which were reported in a recent meeting in Parliament,1 are sadly far from unusual. They reflect the collateral damage of a growing trend towards more enthusiastic enforcement of the archaic abortion laws of England and Wales.2–5 In such cases, women who present with miscarriage, stillbirth or a premature delivery have aroused the suspicion of health professionals, sometimes because—like Aisha—they speak honestly about having considered abortion earlier in their pregnancies. They then find themselves reported to the police, required to surrender electronic devices and sometimes advised by duty solicitors to speak to no one about events leading to their investigation, thus being denied emotional and full clinical support at a time of significant trauma. These women are not the only victims of British abortion laws: so …. (shrink)

Divya is a surrogate mother from India. Aaliyah, an African-American teenager, has just terminated her pregnancy. Samantha, on the other hand, is childless and looking for ways to adopt. What connects these three women? Other than being sites for reproduction, one tends to think nothing else brings them together. This fantastic book shows us otherwise by revealing the interconnection of three reproductive lifecycles through neoliberalism and its biopolitical impact on their "choices". Modhumita Roy and Mary Thompson have thematically married (...) twelve impactful and unique essays that bring the stories of actual and fictional women to life.To understand how the... (shrink)

The morning-after pill has been promoted as a solution to the growing teenage sexual health problem being witnessed in Scotland. The continuing increase in sexually transmitted infections (STIs), recorded in recent reports of the Scottish Centre for Infections and Environmental Health2, has come as a shock to members of the health profession across Scotland. Documenting a marked increase in teenage sexual activity, the report raises urgent questions about the impact of the “safe sex” message in our classrooms and (...) the Scottish Executive’s overall approach to teenage sexual health. One specific feature of this approach that has prompted concern from General Practitioners (GPs), parents and educators (and others) has been the official policy on the promotion of the morning-after pill as a method of contraception. When appropriately initiated within 72 hours of unprotected coitus, emergency contraception will prevent approximately 80% of pregnancies in teens and young women who are mid-cycle and, thus, at risk of pregnancy.3 But this policy has not been based on a clear and rigorous understanding of the properties, the function and the efficacy of the morning-after pill. Neither has there been adequate and in-depth research on the short and long-term safety implications of the morning-after pill. In light of proposals to increase the availability of the morning-after pill, the overall aim of this Briefing Paper is: 1. to provide specific answers to the questions raised above, based on research evidence; and 2. to provide an independent source of information on the most recent research on the morning-after pill and STIs, for parents, teachers, politicians, members of the health and legal professions and other interested parties. (shrink)

This study identified the influences of maternal socio-demographic and antenatal factors on stillbirths and neonatal deaths in New South Wales, Australia. Bivariate and multivariate analyses were used to explore the association of selected antenatal and maternal characteristics with stillbirths and neonatal deaths. The findings of this study showed that stillbirths and neonatal deaths significantly varied by infant sex, maternal age, Aboriginality, maternal country of birth, socioeconomic status, parity, maternal smoking behaviour during pregnancy, maternal diabetes mellitus, maternal hypertension, antenatal care, (...) plurality of birth, low birth weight, place of birth, delivery type, maternal deaths and small gestational age. First-born infants, twins and infants born to teenage mothers, Aboriginal mothers, those who smoked during the pregnancy and those of lower socioeconomic status were at increased risk of stillbirths and neonatal deaths. The most common causes of stillbirths were conditions originating in the perinatal period: intrauterine hypoxia and asphyxia. Congenital malformations, including deformities and chromosomal abnormalities, and disorders related to slow fetal growth, short gestation and low birth weight were the most common causes of neonatal deaths. The findings indicate that very low birth weight (less than 2000 g) contributed 75·6% of the population-attributable risks to stillbirths and 59·4% to neonatal deaths. Low gestational age (less than 32 weeks) accounted for 77·7% of stillbirths and 87·9% of neonatal deaths. The findings of this study suggest that in order to reduce stillbirths and neonatal deaths, it is essential to include strategies to predict and prevent prematurity and low birth weight, and that there is a need to focus on anti-smoking campaigns during pregnancy, optimizing antenatal care and other healthcare programmes targeted at the socially disadvantaged populations identified in this study. (shrink)

Zika infection in pregnant women is associated with an elevated probability of giving birth to a child with microcephaly and multiple other disabilities. Public health messaging on Zika prevention has predominantly targeted women who know they are pregnant or intend to become pregnant, but not teenage females for whom unintended pregnancy is more likely. Vulnerabilities among this population to reproductive risks associated with Zika are further amplified by restrictive abortion laws in several Zika-impacted states. Key to prevention is (...) enhanced, targeted public health messaging centered on teens nationally and particularly in certain high-risk regions. (shrink)

In cases in which we must choose between either (i) preventing a woman from remaining unwillingly pregnant or (ii) preventing a fetus from being killed, we should prevent the fetus from being killed. But this suggests that in typical cases abortion is wrong: typical abortions involve preventing a woman from remaining unwillingly pregnant over preventing a fetus from being killed. And so abortion is typically wrong—and this holds whether or not fetuses are persons.

Elselijn Kingma argues that, in cases of mammalian placental pregnancy, the foster (roughly, the post-implantation embryo/foetus) is part of the gravida (the pregnant organism). But she does not consider the possibility of proper overlap. I show that this generates a number of serious problems for her argument and trace the oversight to a quite general issue within the literature on biological individuality. Doing so provides an opportunity to pull apart and clarify the relations between some importantly distinct questions concerning (...) organismality and organismic parthood, and to identify the implications that this has for those who want to draw on this literature when making metaphysical or mereological arguments. (shrink)

In this paper, I suggest that, if we are committed to accepting a threshold approach to personhood, according to which all beings above the threshold are persons with equal moral status, there are strong reasons to also recognise a second threshold that would be reached through human pregnancy, and that would confer on pregnant women a temporary superior moral status. This proposal is not based on the moral status of the fetus, but on the moral status of the pregnant (...) woman. It is not only the fetus which is an organism sui generis: the pregnant woman, also, is a unique being. Following almost any view on the moral status of the fetus, the pregnant woman should be regarded, herself, as more than a singular individual. She is, herself, ‘more than one’. Pregnant women are also necessary for the continued survival of the human species, and there are important justice-based reasons to recognise the higher status. Furthermore, the recognition of a superior moral status for pregnant women does not imply that pregnancy should always be viewed as desirable, or imply any position on the permissibility of abortion. My proposal is not as radical as it might seem, as it does not require that pregnant women should always receive superior treatment, but only that they should to some extent. It could have a range of potential positive practical consequences. Finally, my approach does not threaten, but rather promotes, human equality. (shrink)

This paper summarizes the findings of a three-year exploratory qualitative study of teenage childbearing in 20 low-income multigeneration black families. Teenage childbearing in these families is part of an alternative life-course strategy created in response to socioenvironmental constraints. This alternative life-course strategy is characterized by an accelerated family timetable; the separation of reproduction and marriage; an age-condensed generational family structure; and a grandparental child-rearing system. The implications of these patterns for intergenerational family roles are discussed.

In their paper, Romanis and Adkins delve into the potential impact of artificial amnion and placenta technology (AAPT) on cases of pregnancy loss1 that do not involve procreative loss. First, they call for more recognition of the negative feelings a person might have due to the premature end of their pregnant state. They claim that, should AAPT minimise concerns about prematurity as anticipated, individuals might feel pressured to opt for partial ectogestation to preserve their or their fetus’ well-being; moreover, (...) they point out that the feelings of loss in the context of AAPT are likely to be worse than the ones reported in neonatal intensive care units cases. Finally, they advocate for care pathways focusing on how the transfer of a fetus to the AAPT could affect the pregnant person, with particular attention to managing the grief potentially caused by the pregnancy loss. I praise the authors for such a call to action—especially since partial ectogestation is expected to become a reality in the short-term future—and I share their demands for additional and more attentive care of (formerly) pregnant patients. However, I am concerned that their approach is so focused on negative feelings towards pregnancy loss that it risks becoming …. (shrink)

Romanis and Adkins explore the near-term prospect of artificial amnion and placenta technology (AAPT) which is being developed to supplement the gestational process following the premature ending of a pregnancy.1 While fetal-centric narratives prevail in discussions surrounding AAPT, the authors subvert this trend by centering the experience of pregnant persons with respect to pregnancy loss. The overarching aim of their paper is to move beyond a ‘philosophical understanding of pregnancy towards practical-orientated conclusions regarding the care pathways surrounding (...) [AAPT]’ (Romanis and Adkins,1 p1). This commentary will critically examine the viability of this aim. Romanis and Adkins use the term ‘pregnancy loss’ to refer to the phenomenon where individuals experience a complex set of emotions following the premature ending of pregnancy, despite the survival of the gestated entity. Following Golish and Powell, the authors note how parents may experience contradictory emotions, such as joy mixed with grief, as well as a range of negative feelings including shame, disappointment and a sense of failure.2 At present, this phenomenon has been recognised among parents, particularly the (formerly) pregnant person, in the context of neonatal intensive care units (NICUs) when the infant survives preterm delivery and …. (shrink)

This book provides extensive and critical engagement with some of the most recent and compelling arguments favoring abortion choice. It features original essays from leading and emerging philosophers, bioethicists and medical professionals that present philosophically sophisticated and novel arguments against abortion choice. The chapters in this book are divided into three thematic sections. The first set of essays focuses primarily on unborn human individuals--zygotes, embryos and fetuses. In these chapters it is argued, for example, that human organisms begin to exist (...) at conception and that zygotes, embryos and fetuses are persons. These chapters also explore questions about whether or not zygotes, embryos and fetuses are part of their mothers' bodies. The second set of essays focuses primarily on elective abortion and the debates surrounding it. These chapters consider whether or not opponents of abortion are commonly hypocritical, how opponents of abortion should think about adoption, how emerging technologies may affect the current debate and whether or not those participating in the debate should rely on analogies to support their case. Finally, the third set of essays shifts focus from the legal and moral status of elective abortion to its place in medical practice. In these chapters it is argued that elective abortion embodies a kind of ableism, and that elective abortion is medically unnecessary, harmful to women's mental health and that telemedicine abortion poses significant risks to women's health. Agency, Pregnancy and Persons offers an up-to-date examination of unborn human beings, the debates surrounding elective abortion and the place of elective abortion within medical practice. It will be of interest to medical professionals and those who work in philosophy, bioethics and medical ethics alike. (shrink)

This paper aims to problematize pregnancy and support the development of a safe alternative method of gestation. Our arguments engage with the health risks of gestation and childbirth, the value assigned to pregnancy, as well as social and medical attitudes toward women’s pain, especially in labor. We claim that the harm caused by pregnancy and childbirth provides a prima facie case in favor of prioritizing research on a method of extra corporeal gestation.

In this paper, we identify some key features of what makes something a disease, and consider whether these apply to pregnancy. We argue that there are some compelling grounds for regarding pregnancy as a disease. Like a disease, pregnancy affects the health of the pregnant person, causing a range of symptoms from discomfort to death. Like a disease, pregnancy can be treated medically. Like a disease, pregnancy is caused by a pathogen, an external organism invading (...) the host’s body. Like a disease, the risk of getting pregnant can be reduced by using prophylactic measures. We address the question of whether the ‘normality’ of pregnancy, its current necessity for human survival, or the value often attached to it are reasons to reject the view that pregnancy is a disease. We point out that applying theories of disease to the case of pregnancy, can in many cases illuminate inconsistencies and problems within these theories. Finally, we show that it is difficult to find one theory of disease that captures all paradigm cases of diseases, while convincingly excluding pregnancy. We conclude that there are both normative and pragmatic reasons to consider pregnancy a disease. (shrink)

The commentaries in response to our feature paper1 are indicative of the varied perspectives that can be taken towards artificial amnion and placenta technology (AAPT) and more specifically its relationship with pregnancy (loss). Kennedy rightly argues that empirical research is essential for understanding the experiences of pregnancy loss and AAPT2 and our own advocacy of empirical research is evident in previous work.3–5 Kennedy also acknowledges the current impossibility of researching AAPT experiences since it has not yet been applied (...) in clinical settings. It is precisely for this reason that we draw on the reported experiences of neonatal intensive care (NICU) parents since they present the closest analogy which can be drawn with the technology.1 What we reject in Kennedy’s response, however, is the claim that the experiences of NICU parents have been ‘exploited’ by us.2 Studies documenting the experiences of NICU parents were drawn on to indicate that our considerations are more than mere speculation. As stated, the experiences of NICU parents, particularly the pregnant individual who experiences pregnancy loss, are the closest indication we have of how AAPT and what it entails may be experienced. To claim that this data is being exploited by us is to undermine the very purpose that such research is undertaken—to indicate how future care may be improved. It would be much more harmful to not use this information. While we believe that experiences of …. (shrink)