Jack C. Westman
University Press of America
“Adolescent childbirth,” says Dr. Jack C. Westman, a veteran of 45 years of clinical practice and research as a psychiatrist working with youth and families, “is a disruptive crisis with profound repercussions for the adolescents, their families, schools, communities and society.” It is also “the most preventable cause of crime and welfare dependency.”
Professor emeritus of psychiatry at the University of Wisconsin School of Medicine and Public Health and president of the nonprofit Wisconsin Cares, Westman is a national leader in the child advocacy movement who devotes this thick volume to a blueprint for public policy to strengthen “childrearing families.”
Although some of his conclusions may seem exaggerated and his course of remediation revolutionary, he paints a vivid portrait of the effects of children having children.
Competent parents, he says, manage the challenging job of taking responsibility for their own and their children’s lives, which includes providing for basic needs and education, setting limits, sacrificing some of their own interests and offering hope for the future. The children of competent parents become productive citizens, while also contributing $1.2 million to the American economy during their lifetimes.
At least 4 percent of all parents (and probably more) are incompetent – unable to handle responsibility for their own lives or for their offspring, Westman says. Their neglected or abused children never learn attachments and social skills, and resulting negative or destructive behaviors have a double impact on society: for each one, the American economy loses $2.4 million and many suffer.
Westman’s aim is to ensure that every baby born in the United States has competent parents, and that our society values parenthood as a lifelong career in which “parents and children bond with each other and grow together.” This book is Westman’s road map toward reaching that goal.
One enormous roadblock is adolescent parenthood, what he calls “the prime example of parental incompetence.” Westman asserts that adolescents occupied with their own developmental tasks are not equipped to perform as competent parents, even with help.
Two-thirds of U.S. adolescent girls who bear children are 18 or 19 when they give birth. Although considered adult by some legal standards, they struggle to perform parental roles. Eight percent of all girls under 18 are mothers; because they are still minors, they cannot be legal custodial guardians of their babies.
These are just some of the book’s exhaustive statistics that give the details of adolescent parenthood:
• The overall U.S. adolescent birth rate has declined since its 1991 peak. In 1960, 85 percent of girls who gave birth between ages 15 and 19 were married, but by 2003, the share of married mothers in that age range had plunged to 19 percent. Now more than one-third of all babies in the U.S. are born outside marriage. As unwed parenthood becomes more accepted, the economic insecurity of these families is an issue that Westman explores throughout the book.
• Less than 30 percent of pregnancies in adolescents end in termination. Adoption, once the most frequent choice of pregnant girls, is now chosen by only 2 percent of all unwed mothers.
• Black and Latino girls are more than twice as likely to become pregnant as whites; girls from low-income, single-parent families are far more likely to give birth than higher-income girls from two-parent families.
• Fifty-five percent of all welfare recipients gave birth as adolescents.
• Half of all children in the U.S. don’t live with their biological fathers at some point in childhood.
• The U.S. birth rate among adolescents remains higher than in any other developed nation – more than twice as high as Canada’s, four times as high as Western Europe’s, and seven times
Although most pregnant girls are doubtful about parenthood, the adults in their lives often don’t reinforce this wisdom. “To deprive adolescents” of a full understanding of consequences,” states Westman, “is an abrogation of professional and parental obligations.” Some segments of the population, such as poor urban blacks, seek single parenthood as a way of life – “discouraged, disadvantaged girls are most likely to desire to become pregnant.”
Westman urges advocates of abstinence-only and comprehensive sex education to cease their squabbles and focus on how to persuade American teenagers to be more reliable in using either abstinence or contraception. Trying to prevent pregnancy in adolescents, but then supporting adolescent parenthood exposes our “conflicting messages,” he says.
Westman is clear about Americans’ duty: As adolescents “deliberately choose to become parents,” American adults must induce them to change their behavior and change their own “ambiguous social values and professional practices that promote premature parenthood.” Adults must help young people find fulfillment and hope for the future through “realistic achievements other than parenthood,” he says.
Westman doesn’t shy away from controversial recommendations: When parents’ inability to protect their child’s interests is “evident before childbirth, the state has an obligation to intervene … to ensure that newborns have competent parents,” he says. In this volume, Westman offers many tools to help cope with this crisis:
• Theoretical foundations from chaos/complexity theory to treatises on the rights of babies, adolescents and parents.
• A parenthood model based on a youth’s developmental needs that treats parenthood itself as a developmental stage.
• Profiles of actual adolescent parents that show the impact of parenthood on them and their children, who often repeat the adolescent parenthood cycle.
• Reviews of pregnancy prevention programs and social marketing campaigns; the few successful models demonstrate the value of healthy behaviors.
• Examinations of families, neighborhoods and communities, culture and society in relation to adolescent parenthood, including profiles of parenthood practices of black, Latino, American Indian, Muslim and Hmong cultures within the U.S.
Westman contends that adolescent parenthood is “a symptom of core dysfunction in our society.” Noting that U.S. child poverty rates are highest among developed nations and childrearing benefits such as parental leave from work are lowest, he says Americans adulate children but undermine parenthood with self-involved social values.
He concludes with a proposal for public health practice to break what he calls this “intractable cycle of adolescent parents.” His simple, yet radical solution: required parenting certification. He calls for mandating parenthood planning counseling for minors and dependent adults who intend to proceed to childbirth. Like crisis intervention teams, parenthood planning teams of professionals from family planning, prenatal care, child welfare and courts would provide counseling and begin a parenthood certification process.
The birth certificate would become a certificate of parenthood that includes all parents’ acknowledgment of parental responsibilities. For the child of a minor or dependent adult, the certificate would require fulfillment of minimum standards for parenthood with an appointed legal custodial guardian. Counseling would help such parents choose among three options: keeping both mother and baby under a relative’s guardianship, a voluntary adoption or an involuntary adoption when relatives cannot be guardians.
The book’s final chapter “puts a human face on the process and consequences of adoption.” Rarely chosen by pregnant teenagers, adoption is “the most practical and available access to competent parents for many babies,” Westman says. Instead of an adult-centered concept of “providing children for parents who want them,” he advocates that adoption should be seen as a child-centered concept that “provides competent parents for children who need them.” Westman perceptively discusses the mix of emotions that adoption evokes for parents and children young and old. “Ironically,” he observes, “the immature, emotionally wounded and vulnerable mothers who would most benefit from … making an adoption plan for their babies are the least likely to do so.”
Expanding beyond its title’s scope, this holistic analysis of key issues for American adolescents benefits professionals who work in any capacity with youth and families. Although better editing would have telescoped repetitions and the book’s length, Westman’s views could transform the approach to parenthood in America. His message might gain traction if translated into a pithy New York Times Op Ed column for the general public. (800) 462-6420, www.univpress.com.