Structural Influences on Adolescent Pregnancy and Birth

Simple item page
dc.contributor.advisorScott, Catherine
dc.contributor.advisorTough, Suzanne
dc.contributor.authorRamage, Kaylee
dc.contributor.committeememberMetcalfe, Amy
dc.contributor.committeememberMcLaughlin, Anne-Marie
dc.contributor.committeememberNickel, Nathan
dc.date2021-11
dc.date.accessioned2021-07-16T20:22:59Z
dc.date.available2021-07-16T20:22:59Z
dc.date.issued2021-07-07
dc.description.abstractBackground: Adolescent pregnancy and childbirth have been associated with adverse health and social outcomes for both adolescent mothers and their children. Although rates of adolescent pregnancy and birth have declined in high-income countries with increased access to effective contraception, rates in at-risk populations have not seen similar declines. Structural determinants of adolescent pregnancy, such as foster care involvement, contraception availability and affordability, and pregnancy prevention programming, may affect girls’ ability to make informed reproductive decisions, highlighting the need to move beyond individual-level analyses and examine structural influences on adolescent pregnancy. Aim: Thus, this dissertation aims to describe adolescent pregnancy and birth rates in at-risk populations, including girls in the foster care system and adolescent girls who have already had a pregnancy; and to explore the potential influence of structural determinants on adolescent pregnancy and birth rates, such as sexual health education curriculum, type of child welfare involvement, and transition-to-adulthood programming for adolescents in foster care. Methods: This dissertation includes three manuscripts examining adolescent pregnancy and childbirth in at-risk populations in Canada and the United States. We conducted a quantitative analysis of trends in adolescent rapid repeat childbirth using administrative data in a Canadian context, comparing maternal and neonatal outcomes from adolescent girls’ rapid repeat childbirth to their index childbirth. We conducted a systematic review and meta-analysis of adolescent pregnancy and birth in girls involved in the foster care system. Finally, we used the National Youth in Transition Database to analyze service use and impact for adolescent mothers emancipating from foster care in the United States. Results: We found that adolescent pregnancy and childbirth remain high among girls in foster care, and that repeat birth is common among adolescent girls who have already had one birth. We found evidence that structural determinants may impact adolescent childbearing, including access to contraception, access to services, and involvement in foster care. Conclusion: The findings of this dissertation highlight the health and social outcomes of adolescent childbirth for at-risk girls and the need for structural change to prevent adolescent childbirth and to support adolescent mothers and their children as they transition to adulthood.en_US
dc.identifier.citationRamage, K. (2021). Structural Influences on Adolescent Pregnancy and Birth (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/39014
dc.identifier.urihttp://hdl.handle.net/1880/113634
dc.language.isoengen_US
dc.publisher.facultyCumming School of Medicineen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectadolescent pregnancyen_US
dc.subjectchild welfare systemen_US
dc.subjectstructural determinants of healthen_US
dc.subject.classificationEpidemiologyen_US
dc.titleStructural Influences on Adolescent Pregnancy and Birthen_US
dc.typedoctoral thesisen_US
thesis.degree.disciplineMedicine – Community Health Sciencesen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameDoctor of Philosophy (PhD)en_US
ucalgary.item.requestcopytrueen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
ucalgary_2021_ramage_kaylee.pdf
Size:
2.29 MB
Format:
Adobe Portable Document Format
Description:
Dissertation 2021
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
2.62 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Open Theses and Dissertations