Maternity Group Homes Classification and Literature Review. Introduction


Although the rates of pregnancy among teenagers have fallen steadily throughout the past decade, teenage pregnancy and parenthood remain serious problems in the United States. More than 850,000 teenagers become pregnant each year, and more than three-quarters of the resulting births are to unmarried teens (Henshaw 2003; and Alan Guttmacher Institute 1999). The majority of teenagers who become pregnant come from disadvantaged backgrounds, and early pregnancy and childbirth create additional challenges. These teen parents and their children struggle with difficult circumstances in the short term and throughout their lives.

The problems facing pregnant and parenting teens are well documented. Teen mothers tend to be very poor, and most are single parents; this stress is often compounded by physical or sexual abuse and other health issues (U.S. Department of Health and Human Services 2000). Pregnancy can interrupt teens' educational pursuits and early employment experiences (Maynard 1996). The negative outcomes associated with teenage pregnancy, including lifelong poverty and lengthy spells on public assistance, can follow mothers and their children for the rest of their lives (U.S. Department of Health and Human Services 2000). The daughters of teen mothers often become teen mothers themselves, with all the accompanying negative outcomes, thus perpetuating the intergenerational cycle of poverty and disadvantage. Teens with tenuous living situations before their pregnancies have additional needs and may be more disadvantaged than other pregnant and parenting teens, and homelessness would increase their risk of negative outcomes.

The negative consequences of teenage pregnancy and parenthood for teen parents, their children, and society have prompted policymakers to search for strategies to reduce teenage pregnancy and improve the life chances of teens who do have children. The federal government sponsored a number of rigorous evaluations in the late 1980s to examine the effectiveness of programs designed to improve the well-being and eventual economic self-sufficiency of welfare-dependent teenage parents. These included studies of the Teenage Parent Demonstration and Home Visitor Services for Welfare Dependent Teenage Parents. In addition, state government agencies and private foundations sponsored studies of programs such as New Chance and Ohio's Learning, Earning, and Parenting Program. More recently, evaluations have focused on teenage pregnancy prevention strategies, such as Abstinence-Only Education Programs.

Because those who become parents as teenagers are at high risk of being dependent on welfare for a longer period of time than other parents, special attention has been paid to this group under various welfare reforms. For instance, the Family Support Act of 1988 specifically targeted young mothers for the Job Opportunities and Basic Skills program and included special provisions for teenage mothers. As a condition of welfare receipt, mothers ages 16 to 19 who had not yet completed high school were required to participate in educational activities and could not be exempted from participation based on their child's age, as older mothers caring for very young children were. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) included requirements concerning the education and living arrangements of teenage parents on welfare. Unmarried parents under the age of 18 who have not earned a diploma must either attend school or participate in some type of educational or training activity. Unmarried minor parents must live with a parent or guardian, with few exceptions, as a condition of receiving benefits. States are required to provide or facilitate alternative adult-supervised living situations for those unable to live with a parent.

In addition to federal government requirements and programs, a number of national organizations and faith- and community-based programs provide services for pregnant and parenting young women. Some of these organizations  such as the Nurturing Network, Heartbeat International, Care Net, the National Council for Adoption, and various local crisis pregnancy centers  focus exclusively on serving pregnant young women. These groups operate pregnancy resource centers to provide support for women of all ages who are dealing with unplanned pregnancies. For other organizations, such as Catholic Charities and Lutheran Social Services, aiding pregnant and parenting young women is only part of their broader social service missions.

While these organizations can provide a variety of services, most are unable to directly meet one specific need of some pregnant and parenting teens  that of safe, supervised housing. There are few housing options for pregnant and parenting teens who cannot live with a parent or responsible adult, and teens with tenuous living situations may have to leave their homes when they become pregnant. Pregnancy may be the final straw in an already unstable living situation, or their homes may be unsuitable environments in which to raise their babies due to issues of overcrowding, unsafe living conditions, domestic violence, or other extenuating circumstances. Teens in foster care who become pregnant may find that their current home is unable to accommodate their infant, and foster care placement cannot always ensure that a teen and her child will be placed together. Furthermore, homeless shelters and battered women shelters often do not accept minor teens or their young children. Few teens have the financial and personal resources to live independently, particularly while caring for a young child, and teens facing housing instability are likely to be among the most disadvantaged.

Maternity group homes are a potential solution to this housing issue, and possibly to other challenges facing teen parents. Maternity group homes can offer an intensive package of services to meet the short- and longer-term needs of pregnant and parenting teens. In the short term, these homes provide a secure living environment with adult supervision and material and emotional support for teen-headed families. Maternity group homes can also promote more positive long-term outcomes for teen parents and their families, by providing more extensive services, such as education, training, counseling, and parenting instruction, to better prepare residents for independence. Maternity group homes can also provide necessary supports such as child care to enable teen parents to pursue those avenues to better their lives and their families' futures.

While maternity group homes have the potential to address some important consequences of teen pregnancy, little is known about their effectiveness in improving the outcomes of teen parents and their children. Although interesting descriptive data exist, there is a need to document and synthesize their findings, as well as to identify gaps in the existing research that must be filled to determine the effectiveness of maternity group homes. The Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services (DHHS) is interested in assessing the feasibility of conducting a rigorous evaluation to assess the effectiveness of maternity group homes. To this end, ASPE contracted Mathematica Policy Research, Inc. (MPR) to explore options and design an evaluation of maternity group homes. Components of this design study include:

  • Telephone calls to a number of maternity group homes to collect basic information for assessing their potential for evaluation
  • Site visits to select homes to assess their evaluability and identify sites for inclusion in an evaluation
  • Development of questionnaires for collecting baseline and follow-up data from sample members
  • Drafting evaluation and data collection plans

The design effort will culminate in a final report on the feasibility of conducting a rigorous evaluation of maternity group homes in the selected sites.

The current report, which reviews prior research and creates a classification framework for maternity group homes, is an important first step in this study and lays the foundation for the design report. The rest of the report focuses on the research conducted to date on maternity group homes. Chapter II describes the characteristics of maternity group homes, discusses the similarities and differences between individual homes, and develops an initial classification system for the homes. Chapter III reviews the research on maternity group homes, describing the types of studies that have been conducted in the past and summarizing their findings, then discusses their limitations and how a rigorous evaluation might fill some of the gaps in the research.


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