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Original article
Domestic violence, single parenthood, and fathers in the setting of
teenage pregnancy
Louisa H. Tan, A.M.S. and Julie A. Quinlivan, M.B.B.S., Ph.D.*
Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia
Manuscript received April 26, 2004; manuscript accepted October 14, 2004
Abstract Purpose: To explore the relative impact of demographic and early interpersonal family relation-
ships as associations of fatherhood where the mother is a teenager, compared to where the mother
is over 20 years of age.
Method: A prospective cross-sectional cohort study was undertaken. Institutional ethics committee
approval and informed consent were obtained. Data were analyzed from interviews with consecutive
males about to become fathers where the mother was aged less than 20 years (teenage) and
compared to information from males about to become fathers where the mother was aged 20 years
or more (control). Subjects were interviewed to obtain information covering their early life expe-
riences, demographic information, drug use, opinion of the pregnancy, and future planning.
Results: In multivariate analysis, and after controlling for family income and education, the
following factors had a significant independent association with fatherhood in the setting of teenage
pregnancy: a history of parental separation/divorce in early childhood, exposure to family violence
in early childhood, and illicit drug use (ever or in pregnancy).
Conclusions: Fathers, in the setting of teenage pregnancy, are more likely to report adverse early
family relationships, such as exposure to domestic violence or parental separation or divorce. As
such, these fathers may lack a positive role model for parenting and fatherhood. © 2006 Society for
Adolescent Medicine. All rights reserved.
Keywords: Teenage pregnancy; Father; Family; Early life stress; Family violence; Divorce
To date, most studies on adolescent pregnancy have
focused on the female, with their male partners largely
escaping scrutiny; however, it is the male who may have the
decisive role in initiating the sexual encounter. The few
studies that have examined fathers in the setting of teenage
pregnancy have come from the United States and Taiwan.
These studies have tended to focus on their demographic
characteristics or participation in actual childrearing [1–11].
What is known is that, compared to partners of older
women, males involved in teenage pregnancy have typically
achieved a lower level of education, have a greater age
difference between themselves and the adolescent mother,
have higher rates of unemployment, are more financially
dependent, lower in socioeconomic status, have more be-
havioral problems such as smoking, drinking, and illicit
drug use, have more simultaneous sexual partners and sex-
ual transmitted infections, engage in more aggressive be-
havior, and adopt poorer attitudes toward their partner’s
pregnancy by being less involved in the postpartum care of
the mother and infant [1–11]. These negative associations
may aggravate the problems of teenage mothercrafting.
There is limited data on early family backgrounds in the
setting of teenage pregnancy. The few studies in teenage
mothers on early family life have found that the early family
relationships experienced by the teenage mother can pro-
vide important information in defining the parenting models
to which teenage mothers may have been exposed. These
studies have reported that parental divorce and separation,
domestic violence, and negative parental relationships may
*Address correspondence to: Julie A. Quinlivan, Department of Ob-
stetrics and Gynaecology, The University of Melbourne, Royal Women’s
Hospital, 132 Grattan Street, Carlton 3053 Victoria, Australia.
E-mail address: julieq@unimelb.edu.au
Journal of Adolescent Health 38 (2006) 201–207
1054-139X/06/$ – see front matter © 2006 Society for Adolescent Medicine. All rights reserved.
doi:10.1016/j.jadohealth.2004.10.014
be more prevalent in teenage, as compared to older child-
bearing [12–16]. No studies have examined the early family
relationships experienced by fathers in the setting of teenage
pregnancy.
In the present study, we explored the childhood family
relationships experienced by fathers in the setting of teenage
pregnancy.
Methods
A prospective cross-sectional cohort study was under-
taken. Institutional ethics committee approval and individ-
ual informed consent from study participants were obtained.
Access to fathers occurred after obtaining consent from
the pregnant woman. Pregnant women aged less than 20
years were defined as teenage mothers, and the father of
their baby was defined as a father in the setting of teenage
pregnancy (teenage). Those women over 20 years were
defined as non-teenage mothers and the father of their baby
was defined as a father in the setting of a control pregnancy
(control).
For the father to be eligible for participation, the mother
of the baby had to (1) have no plans to abort or relinquish
the baby, (2) know the name and contact details of the father
of the baby, (3) be nulliparous, (4) have no known fetal
anomalies in the pregnancy, and (5) provide consent for the
father to be contacted. All subjects were recruited and in-
terviewed at a large metropolitan tertiary referral hospital.
Assessment tools
Males were interviewed by a researcher on a single
occasion during the antenatal period at a mean maternal
gestation of 22 weeks (standard deviation [SD] 3.5) and
completed several questionnaires. The interviewer was a
senior medical student who was undertaking an elective
1-year advanced medical science degree, and who had ex-
perience in interviewing patients in multiple settings from
previous years of clinical rotations in large metropolitan
hospitals, general practice, and other clinical settings. Data
were collated in the hospital. We have previously validated
the questionnaires [12]. In a previous study, pregnant women,
half of whom were teenagers, were interviewed by an experi-
enced social worker about issues covered in the questionnaires.
Answers in questionnaires administered by the senior medical
student were validated by cross-referencing against data pro-
vided in the interview by the social worker. From the total
of 575 variables directly compared, there was agreement in
564 (agreement 98%,
-test ratio 0.96). Thus, interobserver
agreement was extremely high.
The first questionnaire asked about demographic vari-
ables such as the subject’s age, smoking, alcohol and illicit
drug use patterns before and during the pregnancy, ethnic
background, level of education, and family income. Sub-
jects also provided feedback regarding their personal assess-
ment of their support levels by selecting an answer from a
series of options relating to their social supports, housing
security, emotional impression of the pregnancy, and future
plans.
The second questionnaire asked questions about the sub-
ject’s early interpersonal family relationships with and be-
tween their parents. The use of this questionnaire has been
previously described [12]. Briefly, the first part of the family
relationship questionnaire asked about their relationship
with their mother. An example question was: “Please take a
moment to think about your relationship with your mother
(or stepmother, mother figure) while you were growing up
(that is, while you were a child). Please tick all the re-
sponses that apply.” The possible responses to the question
included: “loving and affectionate,” “critical and rejecting,”
“strict and demanding,” “respectful and accepting,” “atten-
tive and caring,” “unresponsive and disinterested,” “under-
standing and sympathetic,” “intrusive and overprotective,”
or, “there was no woman like this in my life.” According to
the items selected, responses were coded as negative, pos-
itive, mixed, or absent. A negative response was coded if
subjects only indicated options from the following items:
“critical and rejecting,” “strict and demanding,” “unrespon-
sive and disinterested,” or “intrusive and overprotective.”
Alternatively, a positive response was coded only if subjects
indicated options from the following items: “loving and
affectionate,” “respectful and accepting,” “attentive and car-
ing,” or “understanding and sympathetic.” A combination of
the above positive and negative responses was coded as a
mixed response. Finally, subjects who indicated that “there
was no woman like this in my life” were coded as absent.
The second and third parts of the family relationship
questionnaire asked about their relationship with their fa-
ther, and between their parents. Data were collected and
coded in a similar manner. The selection of the “violent”
option to describe the relationship between parents was
considered separately as family violence. These responses
were explored by discussing the types of violence, age
exposed, and perpetrators, in formal social work appraisals.
Finally, subjects were asked to indicate whether they had
experienced parental separation or divorce during their
childhood.
Primary outcome and power calculation
The primary hypothesis was that males in the setting of
teenage pregnancy would be significantly more likely to
describe their relationships with, and between, their own
parents in a negative or absent fashion, compared to males
not in the setting of teenage pregnancy (controls). It was a
priori estimated that 50 males in each arm of the study
would have greater than 80% power to detect as significant
at a two-sided
␣
error of .05, a difference in the incidence of
negative or absent parental descriptions in the teenage and
control subgroups of 35% and 10%, respectively. Therefore,
the study required 100 males.
202 L.H. Tan and J.A. Quinlivan / Journal of Adolescent Health 38 (2006) 201–207
Secondary outcomes
There were several secondary outcomes. These were that
males, in the setting of teenage pregnancy, compared to
controls, would be
●more likely to describe the relationships between their
parents as violent,
●more likely to have experienced parental separation or
divorce under 5 years of age,
●have significant differences in lifestyle factors such as
drug use, and social factors such as education, income,
housing, and support
Statistical analysis
Data were entered onto a database and analyzed using
SAS (Cary, North Carolina, 2002). In group comparisons of
discrete data, the
2
or Fischer exact tests were applied
according to cell size. The
statistic, degrees of freedom
and p-value are presented for tables with more than 1 degree
of freedom. Otherwise, the p-value, odds ratio, and 95%
confidence interval (CI) are presented. The Student ttest or
Mann-Whitney U test were applied to generate p-values of
continuous data with normal and skew distributions, respec-
tively. To evaluate for independent associations with father-
hood in the setting of young maternal age of childbirth,
ordinal and linear regression analyses were applied, incor-
porating all variables significant at a univariate level. This
allowed a statistical model to be generated that could incor-
porate demographic data, such as the age of the father, race,
and family income, along with current social behaviors such
as illicit drug use, smoking, alcohol, housing, and career
planning, as well as early family relationship data such as
relationships with their own mother, father, or between their
parents, and parental separation, divorce, or family violence
as a child. A secondary analysis was undertaken controlling
outcomes for family income and level of education to con-
trol for the separate impact of socioeconomic status. A
p-value less than .05 was considered significant.
Results
Of 56 consecutive eligible pregnant teenage women ap-
proached to participate in the study (teenage group), in-
formed consent was obtained from 50 (89% response). All
partners subsequently provided consent for interview. The
principle reason for the eligible mothers’ declining partici-
pation in the study was fear of a breach of confidentiality.
Of 60 consecutive eligible pregnant women over 20 years of
age approached to participate in the study (control group),
informed consent was obtained from 50 (83% response).
Again, all approached males subsequently provided consent
for interview. The principle reasons for eligible females’
declining participation were disinterest in the study and
concern over confidentiality. The high response rate in the
males approached may be explained by the eligibility crite-
ria that stipulated that participation had to have the support of
the mother, an institutional ethics committee requirement. Sev-
eral males who were initially reluctant to participate subse-
quently did so at the encouragement of their female partner.
The majority of males agreed to participate at first approach
(82%), largely because they were in the presence of their
partner (78%). The remaining males were initially ambiva-
lent but agreed to participate after a second contact remind-
ing them about the study.
Table 1 summarizes the demographic background of the
male cohort. The mean age of the teenage fathers group was
20.7 years compared to 29.6 years in older controls
(p⬍.0001). The mean age difference between teenage
mothers and their partners was greater than that seen in
older controls (age difference: teenage 3.2 years, control 2.5
years, p⬍.0001). The duration of the relationship between
mother and father was significantly shorter for fathers in the
setting of teenage pregnancy compared to controls (teenage:
duration relationship 0.6 years, control: 1.9 years, p⬍
.0001). Significantly fewer of the fathers were married to
the mothers in the teenage subgroup, compared to the con-
trols (p⬍.0001). Despite the fathers in the teenage sub-
group being significantly younger than the control fathers,
the prevalence of prior known paternity was similar (p⫽
.14). There were no significant racial differences between
the 2 groups (p⬎.05). After adjusting for age, the educa-
tional background of the teenage group was significantly
lower than controls (p⬍.0001). Family income was also
significantly lower in the teenage group compared to con-
trols (p⬍.0001). Significantly more teenage fathers were
homeless or living in a very unstable house than controls
(homeless/very unstable house: teenage 46%, control 10%,
p⬍.0001). Teenage fathers were significantly less likely to
have plans for a job in the future compared to controls
(job-any/semi-skilled/professional: teenage 56%, control
88%, p⬍.0001). Teenage fathers were also significantly
less likely to state that they had a religious belief than
controls (teenage 38%, control 82%, p⬍.0001).
Table 2 summarizes the drug use of the 2 male sub-
groups. At the start of their partners’ pregnancy, signifi-
cantly more of the teenage group smoked compared to
controls (teenage 86%, control 32%, p⬍.0001). With the
onset of their partner’s pregnancy, 26% of cigarette-
smoking teenage fathers ceased smoking, compared to 31%
of control fathers. There was no significant difference in the
citation of reason for stopping tobacco use between the 2
groups (p⬎.05). However, significantly more teenage
fathers continued to smoke into their partners’ pregnancy
than controls (teenage 64%, control 22%, p⬍.0001).
There were significantly more teenage fathers who used
alcohol at the start of their partner’s pregnancy compared to
controls (teenage 78%, control 34%, p⬍.0001). With the
onset of their partner’s pregnancy, 21% of alcohol-drinking
teenage fathers stopped drinking alcohol compared to 18%
of control fathers. There was no significant difference be-
203L.H. Tan and J.A. Quinlivan / Journal of Adolescent Health 38 (2006) 201–207
tween the 2 groups in the indication for ceasing alcohol use
(p⬎.05). Significantly more teenage fathers continued to
consume alcohol into their partner’s pregnancy than con-
trols (teenage 62%, control 28%, p⬍.0001).
Significantly more teenage fathers were illicit drug users
at the start of their partner’s pregnancy than controls (teen-
age 58%, control 14%, p⬍.0001). With the onset of their
partner’s pregnancy, 59% and 86% of illicit drug-using
teenage and control fathers ceased using, respectively.
There was no significant difference in the citation of reason
for stopping drug use between the 2 groups (p⬎.05).
Significantly more teenage fathers continued to abuse drugs
into their partner’s pregnancy compared to controls (teenage
24%, control 2%, p⫽.001). While rates of marijuana,
amphetamine, and ecstasy usage were similar between the 2
groups, heroin abuse was entirely confined to the teenage
cohort (teenage 7%, control 0%).
Table 3 summarizes the social supports of the 2 male
subgroups and their attitudes toward their partners’ preg-
nancy. Significantly more teenage fathers commented that
the pregnancy was unplanned than controls (unplanned:
teenage 82%, control 30%, p⬍.0001). There were no
significant differences between the 2 groups in terms of
their belief of the impact that the pregnancy would have on
their life or their feelings toward the pregnancy (both p⬎
.05). Social support was significantly lower amongst teen-
Table 2
Drug use in the 2 male subgroups
Variable Teenage N (%) Control N (%) p-Value
Smoking current
Yes 32 (64) 11 (22) ⬍.0001
No 17 (34) 39 (78)
Don’t wish to state 1 (2) 0 (0)
Ex-smoker
Yes 11 (22) 5 (10) ⬍.0001
No 6 (12) 34 (68)
Don’t wish to state 1 (2) 0 (0)
Reason stopped
Pregnancy 3 (27) 1 (20) ⬎.99
Other 8 (73) 4 (80)
Alcohol current
Yes 31 (62) 14 (28) ⬍.0001
No 18 (36) 36 (72)
Don’t wish to state 1 (2) 0 (0)
Ex-alcohol user
Yes 8 (16) 3 (6) .005
No 11 (22) 33 (66)
Don’t wish to state 0 (0) 0 (0)
Reason stopped
Pregnancy 4 (50) 1 (33) ⬎.99
Other 4 (50) 2 (67)
Illicit drugs current
Yes 12 (24) 1 (2) .001
No 35 (70) 49 (98)
Don’t wish to state 3 (6) 0 (0)
Ex-drug user
Yes 17 (34) 6 (12) .005
No 18 (36) 43 (86)
Don’t wish to state 3 (6) 0 (0)
Reason stopped
Pregnancy 4 (23) 1 (17) ⬎.99
Other 13 (77) 5 (83)
Types of drugs used
Marijuana 27 (93) 7 (100)
Amphetamine 7 (24) 2 (29)
Ecstasy 6 (21) 3 (43)
Heroin 2 (7) 0 (0)
Other 2 (7) 0 (0)
Table 1
Demographics of fathers in the two subgroups
Variable Teenage Control p-Value
Age of fathers (years) Mean (SD) 20.7 (2.8) 29.6 (4.3) ⬍.0001
Age of mothers, (years)
Mean (SD) 17.5 (1.3) 27.1 (4.1) ⬍.0001
Race N (%) .13
Caucasian 33 (66%) 26 (52%)
Asian 6 (12%) 13 (26%)
Aboriginal 2 (4%) 0 (0%)
Other 9 (18%) 11 (22%)
Duration of relationship with
mother (years); Mean (SD) .6 (0.4) 1.9 (.8) ⬍.0001
Marital status N (%) ⬍.0001
Married 6 (12%) 37 (74%)
Defacto 23 (46%) 6 (12%)
Single 20 (40%) 6 (12%)
Other 1 (2%) 1 (2%)
Fatherhood status* .14
Paternity of a living child 4 (8%) 10 (20%)
Paternity of an aborted fetus 5 (10%) 8 (16%)
Paternity of a miscarried fetus 1 (2%) 2 (4%)
No previous paternity 41 (82%) 35 (70%)
Completed education N (%) ⬍.0001
Year 7 2 (4%) 0 (0%)
Year 8 8 (16%) 0 (0%)
Year 9 11 (22%) 1 (2%)
Year 10 11 (22%) 6 (12%)
Year 11 5 (10%) 5 (10%)
Year 12 5 (10%) 9 (18%)
University 8 (16%) 29 (58%)
Family income N (%) ⬍.0001
⬍$15,000 23 (46%) 4 (8%)
$15,000–$30,000 21 (42%) 12 (24%)
⬎$30,000 6 (12%) 34 (68%)
Housing N (%) ⬍.0001
No fixed address 14 (28%) 0 (0%)
Unstable house (0–6 month) 9 (18%) 5 (10%)
Stable (6 months–1 year) 17 (34%) 6 (12%)
Very stable (more than 1 year) 10 (20%) 39 (78%)
Career objective N (%) ⬍.0001
Not sure 16 (32%) 2 (4%)
To be a father 6 (12%) 4 (8%)
Any job 7 (14%) 1 (2%)
Semi-skilled job 11 (22%) 18 (36%)
Professional job 10 (20%) 25 (50%)
Religion N (%) ⬍.0001
Yes 19 (38%) 41 (82%)
No 31 (62%) 9 (18%)
* Numbers greater than 100%, as may fit into more than one category.
Includes only known paternity.
204 L.H. Tan and J.A. Quinlivan / Journal of Adolescent Health 38 (2006) 201–207
age fathers than controls (partner and/or self only for sup-
port: teenage 32%, control 0%, p⬍.0001). The majority of
older couples could rely on 3 or more other people to help
them with their newborn (3 or more other people available
for support: teenage 44%, control 78%, p⬍.0001). There
was no significant difference in the incidence of a previous
psychiatric history (p⬎.05).
Table 4 summarizes the primary and secondary hypoth-
eses outcomes data relating to childhood familial relation-
ships of the 2 male subgroups. Significantly more teenage
fathers reported a negative or absent relationship with their
mother and/or father compared to older controls (mother:
teenage 56%, control 16%, p⬍.0001; father: teenage 68%,
control 20%, p⬍.0001). Teenage fathers reported more
negative and absent relationships between their parents than
controls (teenage 66%, control 18%, p⬍.0001). Corre-
spondingly, they reported significantly fewer positive pa-
rental relationships than controls (teenage 28%, control
82%, p⬍.0001).
Childhood exposure to a violent parental relationship
was significantly more common in the teenage group, as
compared to controls (teenage 22%, control 2%, p⬍.0001).
Childhood experience of parental separation and/or divorce
was also significantly more common in the teenage group,
as compared to controls (teenage 50%, control 12%, p⬍
.0001).
To determine the demographic, drug use, social, and
early-life variables that might have an independent relation-
ship with fatherhood in the setting of teenage pregnancy,
regression analysis of significant demographic variables on
univariate analysis was undertaken. The model included
level of education, family income, housing status, career
plans, religion, smoking, alcohol, illicit drug use, pregnancy
planning, social supports, the childhood relationship with
their mother, their father, and between their parents, child-
hood exposure to a violent parental relationship, and child-
hood parental separation or divorce. The dependent variable
was their partner’s age at the time of delivery of the new-
born. Paternal factors with a significant independent asso-
ciation with maternal age at delivery were childhood expe-
rience of parental separation or divorce (p⬍.0001),
childhood exposure to domestic violence (p⬍.0001), illicit
drug use (p⬍.0001), level of education (p⬍.0005), family
income (p⬍.006), and smoking (p⬍.006). To control for
the influence of socioeconomic status on outcomes, the
multivariate anlaysis was repeated, adjusting for the impact
of family income and education. Only the paternal variables
of parental separation or divorce (p⬍.0001), childhood
exposure to domestic violence (p⬍.0001), and illicit drug
use (p⬍.003) retained a significant independent association
with age of onset of motherhood as a teenager.
Table 4
Childhood familial relationships
Variable Teenage
N (%)
Control
N (%)
p-Value
Childhood relationship with
mother
Positive 12 (24) 33 (66) ⬍.0001
Mixed 10 (20) 9 (18)
Negative 16 (32) 3 (6)
Absent 12 (24) 5 (10)
Childhood relationship with
father
Positive 8 (16) 26 (52) ⬍.0001
Mixed 8 (16) 14 (28)
Negative 20 (40) 6 (12)
Absent 14 (28) 4 (8)
Childhood relationship between
subject’s parents
Positive 14 (28) 41 (82) ⬍.0001
Mixed 3 (6) 0 (0)
Negative 22 (44) 7 (14)
Absent 11 (22) 2 (4)
Childhood exposure to violent
parental relationship
Yes 11 (22) 1 (2) ⬍.0001
No 29 (58) 47 (94)
Don’t know 10 (20) 2 (4)
Childhood experience of
parental separation/divorce
Yes 25 (50) 6 (12) ⬍.0001
No 20 (40) 44 (88)
Don’t know 5 (10) 0 (0)
Table 3
Attitudes toward pregnancy and social supports of the 2 male subgroups
Variable Teenage
N (%)
Control
N (%)
p-Value
Planned pregnancy
Yes 2 (4) 30 (60) ⬍.0001
Semi-planned 7 (14) 5 (10)
No 41 (82) 15 (30)
Impact of pregnancy
Huge 22 (44) 15 (30) .49
Big 21 (42) 27 (54)
An impact 4 (8) 5 (10)
Minor 3 (6) 2 (4)
No real impact 0 (0) 1 (2)
Feelings toward the pregnancy
Single most exciting event 15 (30) 19 (38) .11
One of the most exciting events 14 (28) 20 (40)
A pretty exciting event 15 (30) 10 (20)
A somewhat exciting event 6 (12) 1 (2)
Neutral, neither exciting nor
unexciting event 0 (0) 0 (0)
Support
Partner and/or self only 16 (32) 0 (0) ⬍.0001
Plus 1 other 6 (12) 4 (8)
Plus 2 others 6 (12) 7 (14)
Plus 3 or more others 22 (44) 39 (78)
Psychiatric history
Yes 4 (8) 1 (2) .07
No 43 (86) 49 (98)
Don’t wish to state 3 (6) 0 (0)
205L.H. Tan and J.A. Quinlivan / Journal of Adolescent Health 38 (2006) 201–207
Discussion
This is one of the first studies to specifically explore the
early childhood background of fathers in the setting of
teenage pregnancy. We found that the fathers were just as
likely as the mothers to have been raised in a home envi-
ronment where the childhood relationships with and be-
tween their parents were negative or absent, and childhood
experiences of violent parental relationship and/or parental
separation or divorce were present. As with the teenage
mothers, childhood experiences of domestic violence and/or
parental separation or divorce were found to have a signif-
icant independent association with fatherhood in the setting
of teenage pregnancy [12]. Although at a univariate level,
many other significant demographic differences such as
homelessness, a lack of career planning, lack of a religious
belief, smoking, drinking, drug abuse, unplanned preg-
nancy, and poor social support were identified, many of
these effects were not found to have an independent asso-
ciation with maternal age of childbearing in multivariate
analysis. Furthermore, after adjusting for family income as
a surrogate for socioeconomic background, and paternal
education, only parental separation or divorce, childhood
exposure to domestic violence, and illicit drug use retained
a significant independent association with age of mother-
hood as a teenager.
It has previously been reported that fathers in the setting
of teenage pregnancy are more likely to be from single-
parent families [17]. However, whether this situation is due
to the death of a parent or parental divorce was not clearly
established. In one study, the prevalence of teenage parent-
hood was much higher for adolescents who had lived with
only one parent up to 16 years of age than it was for
adolescents from 2-parent families. Moreover, those who
came from single-parent families due to parental separation
were at the highest risk of becoming teenage parents [18].In
another retrospective study from the United States, where
births occurring from the years 1995–1996 were analyzed, a
strong positive relationship of single-parent households
with teenage pregnancy was also indicated [16]. Our find-
ings indicate that an overwhelming 50% of teenage fathers
had experienced parental separation or divorce during their
early childhood. This is in sharp contrast to just 12% of
older fathers.
In the present study, 22% of fathers in the setting of
teenage pregnancy admitted to witnessing a violent child-
hood relationship between their parents, compared to 2% of
older fathers. Early childhood was defined as up to 5 years
of age. The finding is consistent with a retrospective US
study, which explored the childhood background of 4127
men, of which 784 (19%) were involved in teenage preg-
nancy. It looked at the correlation of childhood exposure to
abused and battered mothers with subsequent involvement
in teenage pregnancy, and found that men whose mothers
had been most frequently abused during their childhood had
approximately double the chance of impregnating a teenage
girl, compared to men whose mothers had not been abused
[13].
A similar risk has been reported in pregnant females,
with an Australian study reporting a significant association
with maternal age of first birth and childhood exposure to
domestic violence [12] and a small Israeli study, where
teenage mothers were found to have a higher chance of
experiencing childhood family violence than their non preg-
nant peers [14].
Drug abuse was a significant problem among the fathers
of the teenage antenatal subjects, with half having ever tried
drugs and a quarter continuing to use illicit drugs into the
pregnancy. Several other studies have also observed this
trend. In one U.S. study, fathers in the setting of teenage
pregnancy were 3 times more likely to be tested positive for
drugs compared to peers who were not involved in teenage
pregnancy [18]. In a second U.S. study of 367 teenagers
who had fathered a child, 20% of fathers in the setting of
teenage pregnancy used drugs compared to 5% of non-
father peers (n ⫽997) [17]. However, these studies pro-
vided no data as to the types of drugs used. We found that
cannabis was the drug of choice, with 54% of teenage
fathers admitting to its use. Heroin use was entirely confined
to teenage fathers.
Our findings indicate that poor educational attainment
was a significant predictor of fatherhood in the setting of
teenage pregnancy. This has been well documented in other
research, where poor academic achievements antedate fa-
therhood in the setting of teenage pregnancy by as much as
a decade [19]. In a U.S. study, the length of education of
adult partners of teenage mothers was at least 3 years
shorter than that expected of their age [20]. Moreover,
academic and school problems, such as school expulsion,
suspension, and truancy were common amongst fathers in
the setting of teenage pregnancy [17,21,22]. Fathers in the
setting of teenage pregnancy were more likely to be from
educationally disadvantaged families, where the motivation
for academic achievement is low [17]. A lack of education
may severely disadvantage the long-term outcomes for the
father, his partner, and their child, by limiting employment
and income opportunities.
In the present study, coming from a background of low
socioeconomic status was a significant predictor of fa-
therhood in the setting of teenage pregnancy. In one other
U.S. study, partners of teenage mothers typically came
from families earning 31% lower than that of non-father
peers [17]. This was hypothesized to be due to a single-
parent family income-earning situation or where the par-
ents of the teenage father were unemployed due to a low
level of education [17]. Our figures have confirmed this
trend, where the majority of teenage fathers came from
the lowest earning families. No other study has explored
the family income status of fathers in the setting of
teenage pregnancy.
206 L.H. Tan and J.A. Quinlivan / Journal of Adolescent Health 38 (2006) 201–207
The study has a number of limitations. Firstly, there was an
inability to involve men who were fathers and had abandoned
their partners before their first antenatal visit. There may be
unique differences in the demographics and childhood familial
characteristics amongst this group of fathers. It is likely that
both the teenage and control fathers recruited into the study
were “more responsible and supportive” than those fathers
already separated from their pregnant partners. This may also
reflect the high response rate of males approached to partici-
pate in the study. The institutional ethics committee placed
restrictions on the fathers who could be approached for the
study. The eligibility criteria that stipulated that participation
had to have the support of the mother, who, as a direct patient
of the institution, was seen as an important co-responsibility by
the ethics committee. Several males who were initially reluc-
tant to participate subsequently did so at the encouragement of
their female partner. The majority of males agreed to partici-
pate at first approach because they were in the presence of their
partner, and the remaining males who were initially ambivalent
agreed to participate after a second contact reminding them
about the study. Interestingly, the principle block to paternal
access was mothers who declined involvement because of
concerns of confidentiality on behalf of either themselves or
their partner.
Secondly, as this study was conducted in a major met-
ropolitan hospital, indigenous and rural teenagers were un-
der-represented, and this may impose constraints on gener-
alizability. Although events inquired into are highly likely
to be accurately recalled, the study includes retrospective
data; therefore the potential for recall bias is present, which
could influence findings.
Studies exploring teenage pregnancy have largely focused
on teenage mothers. This has resulted in the focus of interven-
tions being directed at the mother, with interventions for fa-
thers being largely unexplored [23,24]. Future studies should
place an equal emphasis on both genders.
The present study suggests that childhood exposure to
domestic violence and parental separation or divorce, and
use of illicit drugs are key associations of fatherhood in the
setting of teenage pregnancy. A better understanding of how
and under what circumstances these factors influence in-
volvement in teenage pregnancy is needed to develop inter-
ventions to prevent unplanned pregnancy. Such data can
come from longitudinal studies. However, the current data
suggest that exposing fathers in the setting of teenage preg-
nancy to positive parenting and, particularly, fathering role
models, may be desirable.
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