Adverse fetal outcome following maternal rubella after the first trimester of pregnancy.
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Biomedical subjects
Publications and source records attributed to J B Hardy.
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Fathers of babies born to a sample of urban mothers younger than 18 at delivery ranged in age from 14-50 and were, on average, 2-4 years older than the mothers. Among the adolescent women who had given birth to their first child, 28 percent of the partners of black women and 45 percent of the partners of white women were 20 years of age or older. The educational attainment of the fathers was very low, particularly among older whites. At approximately 15 months after the child's birth, 36 percent of the fathers were neither in school nor working. Three-quarters of the pregnancies among the young white mothers and 95 percent of those among the black mothers were unplanned, but only six percent of the white mothers and 16 percent of the black mothers were using a contraceptive at the time of conception. Only 16 percent of the fathers were living with or married to the mother of their child at 15 months after birth. About 90 percent of the fathers had spent time with their child during that period, but frequency of contact declined markedly with time. Overall, 20 percent of the fathers had children by other women.
Although the potential of school-based programs in the prevention of adolescent pregnancy is well recognized, few have been evaluated. This paper describes the use of a reproductive health care clinic associated with a school pregnancy prevention program which had demonstrated success. The program operated in one junior and one senior high school in a large city during the 3 school years from 1981 to 1984. Three facets of the 818 users of the program clinic are explored: who enrolled in the clinic, why they enrolled and what contraceptive methods they received, and their continuation with the clinic. Chi-square analysis and Student's t-tests were used to test for significant differences between the two school and sex groups. Life table and regression techniques were employed to examine clinic continuation. The main findings are teens of both sexes used the clinic, and junior high males used it in surprisingly large numbers; there were no major school or sex differences in the characteristics of those who enrolled; most students enrolled to obtain a contraceptive method; although many females served by the clinic had previously used another family planning clinic, the majority of them had unmet needs; the rate of clinic continuation was high; and certain factors contributed to clinic continuation. These findings suggest that a clinic in a school-linked setting can successfully attract students to use its services and it may offer certain advantages for reaching sexually active teens in search of contraceptive protection.
An experimental pregnancy prevention program for junior and senior high school students consisted of classroom lectures, informal discussion groups and individual counseling in the schools and group education, individual counseling and reproductive health care in a nearby clinic. The structure of the program allowed for extensive individual counseling for students who desired it, and the reported costs are thus considered generous. School-based services utilized 40 percent of a total three-year budget of $409,250, and clinic services, 60 percent. The average cost per student served was $122, with the average per female student almost four times that per male and the average per senior high student more than twice that per junior high student. Students who utilized more expensive types of services, such as individual counseling and medical services in the clinic, also used other program offerings more frequently. Services to students who attended only class lectures cost an average of $13.20 to deliver, while students who utilized all services cost the program an average of $546 each.
Two teams, each consisting of a social worker and a nurse, delivered the bulk of services in an experimental pregnancy prevention program for junior and senior high school students that combined school and clinic components. In-school components were classroom presentations, informal discussion groups and individual counseling; clinic services consisted of group education, individual counseling and reproductive health care. Eight-five percent of the total student enrollment had contact with at least one component of the program. More males than females were among the 15 percent with no contact. When estimates of chronic absenteeism are taken into account, the program is believed to have reached all students in regular attendance. Approximately 22 percent of staff-student contacts occurred in the classroom, and the remaining 78 percent were voluntary on the part of the student. About 68 percent of contacts occurred within the school, with small group discussions especially popular--they represented 41 percent of all contacts. The proportion of contacts that occurred in the clinic was highest among senior high females (46 percent) and lowest among senior high males (12 percent).
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