Teenage Childbearing,Reproductive Justice,and Infant Mental Health

Reproductive justice advocates emphasize the rights of women to choose to have children, to decide the conditions under which they give birth, and to parent their children with support, safety, and dignity. This article examines what a reproductive justice perspective contributes to infant mental health work with teenage mothers and their families. It explores the historical framing of teenage pregnancy in which young mothers are the cause of a variety of social problems and in which the primary policy and practice approach is pregnancy prevention. The article offers alternative framings of teenage childbearing, based on reproductive justice principles, which focus on social conditions surrounding teenage parenthood and the meaning of motherhood in the lives of young women. These alternative frames shift the practice agenda to eradicating unjust social conditions and providing supports for young women in their roles as parents. The article then describes ways in which two infant mental health programs have incorporated reproductive justice principles into their work with young families: Chicago's community doula model and Florida's Young Parents Project for court-involved teenage parents. Finally, the article extracts a set of principles deriving from a reproductive justice perspective that are relevant to infant mental health work with young families.     

Expanding perspectives: A social inequities lens on intimate partner violence,reproductive justice,and infant mental health

Intimate partner violence (IPV) poses a threat to the attainment of reproductive justice. Women who experience IPV are limited in their ability to parent their children in a secure and nurturing environment, which can have negative effects on the mother and child immediately and long-term, potentially distressing reproductive well-being across generations. Societal inequities faced by women, particularly women of color, within education, economic, and legal systems are associated with risk factors for IPV. This article will use national- and state-level data with case examples and the lens of reproductive justice to consider the impact of and potential solutions to historical and institutional inequities related to IPV.     

Long-acting reversible contraception: A route to reproductive justice or injustice

This article presents information on unintended pregnancies and the ongoing efforts of policy makers to promote long-acting reversible contraception (LARC) to reduce the numbers of such pregnancies. Also discussed is the tension between the encouragement of LARC to promote the public's interests in achieving that goal versus the need to assure that all women can decide about their bodies and reproductive needs. Our discussion includes information, primarily from the United States, on (a) risks associated with unintended pregnancies, (b) LARC devices approved in the United States (copper intrauterine devices (IUDs), hormone IUDs, and implants), (c) public and social benefits of increasing the use of LARC, (d) disadvantages and barriers to using LARC, (e) dangers of promoting LARC in unjust ways, and (f) the meaning of reproductive justice and its connection to social justice. By sharing the information with the audience of this journal, we hope that it will be integrated into clinical work and research on mental health and development. We also hope that experts in those fields will become discussants in the conversation regarding women's reproductive health and social justice that is taking place in the United States and elsewhere.     

Reproductive justice for incarcerated mothers and advocacy for their infants and young children

The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well-being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research on the reproductive health of incarcerated women, (b) characteristics and experiences of pregnant incarcerated women, (c) outcomes of infants and young children with incarcerated parents, (d) implications of research findings for policy and practice, and (e) the need for increased research, public education, and advocacy. We strongly recommend that correctional policies and practices be updated to address the common misconceptions and biases as well as the unique vulnerabilities and health needs of incarcerated women and their young children.     

Reflective Capacity: An Antidote to Structural Racism Cultivated Through Mental Health Consultation

Effecting a paradigm shift from “reproductive health” to “reproductive justice” within the perinatal field requires changes simultaneously at the levels of the individual healthcare provider and the system of care. The Infant-Parent Program at the University of California, San Francisco (UCSF) has extended its pioneering infant and early childhood mental health consultation to perinatal service systems applying an infant mental health approach to programs caring for expecting and new parents. In partnership with two nursing programs, UCSF consultants direct their efforts at supporting reflective practice capacities and use-of-self in patient–provider relationships. Both nursing programs serve vulnerable groups of expectant and new parents who grapple with challenges to health and well-being stemming from structural racism. As reflective capacities are supported within the consultation case conferences, providers spontaneously identify the need for tools to effectively address issues of race, class, and culture and to combat structural racism throughout the healthcare system. Policies and procedures that uphold structural racism cease to be tolerable to providers who bring their full selves to the work that they are trained to do. Using these nurse consultation partnerships as organizational case studies, this article describes a range of challenges that arise for providers and delineates steps to effective engagement toward reproductive justice.     

Role of psychosocial risk factors in predicting maternal and paternal depressive symptomatology during pregnancy

The aim of the present study was to investigate the role of several psychosocial risk factors in predicting depressive symptomatology during pregnancy in mothers and fathers, respectively. A total of 146 primiparous mothers and 105 primiparous fathers reporting a psychosocial risk condition were recruited independently from maternity and child health services, during the second trimester of pregnancy. All parents were evaluated for depressive symptomatology, anxiety, and perceived social support. Two hierarchical multiple regression analyses were performed to determine the role of psychosocial factors in predicting depressive symptomatology during pregnancy, in mothers and fathers. Marital dissatisfaction, personal history of depression, and personal trait anxiety were identified as significant predictors of depressive symptomatology during pregnancy, both in mothers and in fathers. Family history of substance abuse, conflictual relationship with the parents in the past year, and bereavement in the past year were identified as significant factors contributing to elevated depressive symptoms during pregnancy in mothers, but not fathers. In this study, several psychosocial risk factors were consistently related to an increase in maternal and paternal depressive symptoms during pregnancy; some of these factors seem to be specifically related to maternal depressive mood.     

“Weathering the storm:” Mothers’ and fathers’ experiences of parenting a preterm infant

Parenting preterm infants is a unique experience distinct from parenting full-term infants, characterized by a delayed transition to parenthood and limited caregiving opportunities. This study explored mothers’ and fathers’ lived experiences of parenting during infancy in the context of preterm birth. Semistructured qualitative interviews were conducted with 13 parents (6 fathers, 7 mothers) of preterm infants. Data were analyzed using interpretative phenomenological analysis. Four superordinate themes emerged: (a) An unnatural disaster: The traumatic nature of preterm birth, (b) The immediate aftermath: Disconnected and displaced, (c) Breaking the ice: Moving from frozen to melted, and (d) Aftershocks: Transitioning home. Both parents experienced preterm birth as traumatic. Similarities and differences in mothers’ and fathers’ experiences were identified. Preterm birth posed challenges for nurturant and social caregiving and resulted in anxiety, hypervigilance, and overprotective parenting behavior. The results highlight the need for trauma-informed care and further research developing and testing empirically based interventions.     

Supporting communication in young children with developmental disabilities

The behavior of parents, adult caregivers, and peers comprises the critical features of community support for the development of communication in young children with developmental disabilities. In a bio-ecological model of development, communication development is the result of the interactions of individuals with specific characteristics, in particular contexts over time. From the perspective of this model, foundational findings of intervention research to current views of communication development in children with developmental disabilities are summarized. The contributions of individual child characteristics to child-caregiver interactions that support language development are illustrated based on research with children who have autism, Williams syndrome, Down syndrome, and children who use augmentative communication systems. Parent-child interaction and the quality and quantity of parent talk are discussed as factors in children's language development. The effects of young children's delayed language on their interactions with peers, the contributions of peers to children's language learning and use, and the critical features of classroom settings that support child language development are reviewed. MRDD Research Reviews 7:143-150, 2001.     

Family Functioning and Coping Behaviors in Parents of Children with Autism

We analyzed family dynamics and coping behaviors of parents with a child with an autistic spectrum disorder. Previous research suggests that moderate levels of cohesion and adaptability are associated with higher levels of positive coping, and that the more coping strategies a family implements, the greater their satisfaction with family functioning. Using a family systems approach, the relationships among the familial variables of cohesion, adaptability, and social support were evaluated for their contributions to coping in the family unit. We also compared the responses of mothers and fathers. Surprisingly, for these parents of children with autism, those who rated their family as enmeshed implemented more positive coping strategies than did those from other cohesion styles. This finding suggests that the enmeshed style may be more adaptive for a family that encounters extreme challenges. Notably, mothers and fathers agreed on all variables except for perception of social support from family and friends. Mothers perceived more social support from family and friends. The results lead to several interesting suggestions for future research.     

Good Partners,Good Parents: Parent Relationship Satisfaction Predicts Parenting Efficacy for Young Children

Both maternal and paternal parental involvement are critical for child development. What is unclear, nonetheless, is how parents’ own relationships contribute to the growth of children. Addressing the question, we predicted marital satisfaction strengthens parenting efficacy, making parental involvement more effective in increasing children’s functioning. To test the hypothesis, we analyzed a nationally representative large-sample survey of 3-year-olds (N = 2164), wherein their language, cognitive, social, and emotional development, maternal and paternal parental involvement, as well as the marital satisfaction of the parents were assessed. The results supported the predictions by showing the critical role of fathers—the mother parents through the father in a satisfying marriage, more than she does in a dissatisfying marriage, and their young children subsequently grow better when their parents are satisfying partners. Together, the findings reveal potential mechanisms through which well-being may be passed down from one generation to the next.

     

CLOSE RELATIONSHIPS AS SOURCES OF STRENGTH OR OBSTACLES FOR MOTHERS COPING WITH HIV

The current study explores the impact of HIV disease on the interpersonal relationships and social support experiences of mothers living with HIV. Analysis of interviews with 25 mothers with HIV focused on their perceptions of the impact of HIV on close relationships with significant others, including family of origin, children, friends, intimate partners, and parents. The results revealed the following major relationship challenges that mothers had to cope with after the discovery of their HIV-positive status: weighing reasons for and against disclosure of their HIV status, whether HIV disclosure brings relationship partners closer together, finding future caregivers for young children if one's health declines, and coordinating safer-sex practices with sexual partners, especially with the many males who are reluctant to use condoms. The study suggests the importance of understanding both the positive and negative aspects of social interactions in coping with HIV and the struggles that mothers have with the consequences of the HIV diagnosis for both themselves and their significant others.     

Direct Social Support for Young High Risk Children: Relations with Behavioral and Emotional Outcomes across Time

This study is unique in addressing developmental correlates of direct social support for young children in a high risk sample, in contrast to previous studies addressing social support for caregivers. Participants were drawn from a prospective, longitudinal study of at-risk children. Social support was rated from maternal interviews throughout early childhood. Support from the mother was assessed from mother-child observations. Outcomes included internalizing and externalizing behavior problems measured from first through tenth grades. The most common support providers were biological fathers, followed by grandparents and other providers. Using multilevel modeling, higher quantity, higher quality, and lower disruption of support predicted lower starting levels of behavior problems, controlling for support from the mother. Disruption was associated with change in slope. Gender differences were found for externalizing behavior intercepts. Social support provides a promotive factor for young high risk children. Implications include involving children's social support providers in prevention and intervention programs.     

STRONG MILITARY FAMILIES INTERVENTION ENHANCES PARENTING REFLECTIVITY AND REPRESENTATIONS IN FAMILIES WITH YOUNG CHILDREN

Military families face many challenges due to deployment and parental separation, and this can be especially difficult for families with young children. The Strong Military Families (SMF) intervention is for military families with young children, and consists of two versions: the Multifamily Group, and a Home‐based psychoeducational written materials program. The Multifamily Group was designed to enhance positive parenting through both educational components and in vivo feedback and support during separations and reunions between parents and children (n = 78 parents). In the present study, we examine parenting reflectivity and mental representations in mothers versus fathers in military families, service members versus civilian spouses/parenting partners, and before versus after participation in the SMF Multifamily Group and Home‐based interventions. Parenting reflectivity and mental representations were coded from the Working Model of the Child Interview (WMCI; C.H. Zeanah & D. Benoit, 1995). Results suggest that neither parenting reflectivity nor WMCI typology differs between mothers and fathers in military families, or between service members and civilian parenting partners. Furthermore, there was substantial stability in parenting reflectivity and WMCI typology from baseline to posttest, but participation in the Multifamily Group, relative to Home‐based, was associated with improvements in both parenting reflectivity and WMCI ratings from baseline to postintervention.     

Teaching and Doing Gender in African American Families

In this article, based on in-depth interviews with a nonrandom sample of 35 African American parents (25 mothers and 10 fathers), I explore the gender socialization of children in their families. Using the conceptual framework advanced by multiracial feminism, I explore how both race and class shape the gender ideologies and behaviors of parents. The findings reveal significant support for teaching children gender role equality; however, that support is mediated by social class status (defined by education) and patterns of social mobility. In this study, 21 respondents were classified as middle-class and 14 as lower-income parents. Social class status predicts religiosity, homophobia, and structural factors that may militate against full support for gender equality or foster contradictions between ideology and behavior. The results show the role of Black parents as active agents in the lives of their children and expand our knowledge about child socialization processes in Black families. The study also contributes to multiracial feminist theory and the emerging literature on the growing social class diversity among African Americans.     

A Glimpse into Co-Occupations: Parent/Caregiver's Support of Young Children's Playfulness Scale

Cooperative play between parents/caregivers and children is a positive and significant contributor to the development of children’s emotional, social, and cognitive skills and may set the stage for the formation of co-occupations. This article discusses the rationale for the development of Parent/Caregiver’s Support of Young Children’s Playfulness (PSYCP), an assessment that is based on children’s play and playfulness, adult’s playfulness, and parent–child interaction. The use of the PSYCP to assess co-occupations will allow therapists to identify the specific behaviors that either hinder or support playfulness and mutual play.     

The Role of Play in Contemporary Child Psychotherapy: A Developmental Perspective

ABSTRACT

This article reviews evidence for the importance of play in children’s social and emotional development. Play is an essential pathway toward social maturity in young children. Children experience interactive play with admired adults as a form of affirming responsiveness, a basic nutrient of emotional health that all children want and need. Children learn through interactive play how to make accommodations and cooperate with others, how to cope with frustration and disappointment, and to develop self-restraint. Improved problem solving, creativity, and cognitive flexibility are also intrinsic to children’s play. All of these aspects of emotional maturity come together, synergistically, when we play with children. They are not learned, however, in front of a screen. The many benefits of play to children’s social maturity leads to a first clinical implication: As child therapists, we should help parents understand the importance of play and regularly encourage both mothers and fathers to play, frequently and enthusiastically, with their children.     

My Mother: My Best Friend? Adults’ Relationships with Significant Others Across the Lifespan

In order to investigate the significance of adults’ relationship to their parents, this relationship is compared to relationships with siblings, friends, partners, and children. German adults (N = 902) between the ages of 20 and 86 completed the Network of Relationships Inventory (Furman and Buhrmester 1992). Participants felt most supported by their partners, followed by their children, mothers, friends, fathers, and siblings. Conflicts were more frequently found within the family (especially with the partner, followed by children, mothers, fathers, and siblings) than with friends. Except for partner relationships, both conflict and support decreased with age. Concerning relative power within their relationships, partners, mothers, and siblings are seen as equals, friends and especially fathers are perceived as more powerful, and children as less, yet increasingly powerful. Regarding all relationship types and relationship qualities, the differences between women and men were small.     

Parenting Disruptive Preschoolers: Experiences of Mothers and Fathers

This study examined parental functioning and interactions with young children with Oppositional Defiant Disorder (ODD), with emphasis on differences between mothers and fathers in their responses to their child and in their unique contributions to the prediction of child disruptive behavior. Participants were 53 3- to 6-year olds with ODD who presented for treatment with two parents. Mothers reported more severe disruptive behavior and higher parenting stress than fathers. During parent-child interactions, mothers showed more responsiveness than fathers, even though children were more compliant during interactions with fathers. Regression analyses showed that fathers' parent-related stress was predictive of both mothers' and father's reports of disruptive child behavior; mothers' marital satisfaction was predictive of behavioral observations of child compliance with both mothers and fathers. This study revealed several important differences in the experiences of mothers versus fathers of disruptive children and indicates the importance of including the father in the child's assessment and treatment.