High school completion programs for pregnant and parenting teens
High school completion programs for pregnant and parenting teens typically offer services such as education, vocational training, case management, health care, transportation assistance, and child care. These programs, also known as dropout prevention programs, can focus on attendance monitoring interventions and can include contingencies or financial incentives for teens to attend school, for example, making welfare receipt contingent on school attendance. Dropout prevention programs for parenting teens are usually comprehensive, intense, and last about a year. Such programs are also usually conducted in multiple community settings rather than exclusively at school1. In 2019, there were 16.7 births for every 1000 women between the ages of 15 and 192. Nationwide, half of all teenage mothers do not graduate from high school3.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased high school completion
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Reduced teen pregnancy
Improved health outcomes
What does the research say about effectiveness?
There is strong evidence that high school completion programs for pregnant and parenting teens, also known as dropout prevention programs, increase high school completion rates1, 4, 5, 6. High school completion programs for pregnant and parenting teens demonstrate multiple effective approaches, which suggests that programs should consider the strengths and needs of the teens and communities they serve4.
Multi-component programs substantially increase the likelihood that teenage mothers will graduate from high school, with or without financial incentives to bolster attendance. On average, such programs increase high school completion rates by 11 to 13 percentage points1, 5. Attendance monitoring and contingency programs that include mentoring services also increase completion rates among pregnant and parenting students by 12 percentage points, on average5.
Research suggests that nurse home visiting programs that include life skills and educational counseling can increase high school graduation rates among teenage mothers7. Teen-Tot programs that offer counseling and medical care have been shown to help mothers graduate, decrease repeat pregnancies, and improve infant health outcomes in some circumstances8. A multi-component program based in Washington, D.C. decreased unexcused absences, increased attendance and credits received among participants9.
Effective high school completion programs for pregnant and parenting teens often provide intensive one-on-one support4. Research also suggests that establishing and maintaining diverse partnerships can help meet the multifaceted needs of pregnant and parenting teens10. Programs that support teenage fathers can be designed similarly to those for teenage mothers, but often face unique challenges that include identifying fathers and societal pressure for young fathers to be employed11. Experts suggest hiring male staff, developing a welcoming environment for fathers, and offering father-specific services as key strategies to serve teenage fathers11.
Implementation challenges can reduce the effectiveness of high school completion programs for pregnant or parenting students. Low program attendance and completion rates, administrative challenges (e.g., staffing, record access, eligibility, or bonus/sanction processing), and staff reluctance to discuss sexual behavior and birth control use with teen participants are common challenges to program implementation6.
One cost-benefit analysis found that a high school completion program for pregnant and parenting teens that provided daycare services alongside education in a traditional high school setting was cost-effective12.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: supported by strong evidence.
There is strong evidence that high school completion programs for teens who are pregnant and parenting have the potential to reduce disparities in high school completion between students who are Black, Hispanic, or Native American and students who are white or Asian1, 4, 5, 6. Students who are Hispanic, Black, or Native American graduate from high school at lower rates than students who are white or Asian14. Birth rates are higher among teens who are Hispanic, Black, or Native American compared to teens who are white or Asian2.
What is the relevant historical background?
Teenage pregnancy was not regarded as a major problem in the U.S. until the mid-1960s15 when early marriage rates began declining, particularly among teenagers who were Black or from other racially minoritized groups16. Declining early marriage rates led to increases in out-of-wedlock births15. In the late 1970s, policymakers framed these teen birthrates as an “epidemic,” even though teen birth rates were declining overall. Programs for pregnant and parenting teens emerged in the 1970s to reduce shared taxpayer costs and improve maternal and child outcomes17, as young single mothers were viewed as a social problem15. Teen pregnancy rates have been declining in the U.S. since 19912 but are still higher than in other high-income countries. Racial and geographic disparities also exist within the U.S.;18 birth rates remain higher for young women of color18, 19, 20 and pregnancy rates are three times higher among Black and Hispanic teens than whites in some states21, particularly in the South22. Teen pregnancy rates among those who have been in foster care have also not declined at the same rate23.
Equity Considerations
- Which schools in your community have students at risk of dropping out due to pregnancy or parenting responsibilities? What resources are available to support programs for these students?
- What available knowledge and services are useful for pregnant and parenting teens? What knowledge or services are not available? How can high school completion programs coordinate knowledge and services or develop partnerships to meet the multifaceted needs of pregnant and parenting teens?
- Who is making decisions about allocating school support resources for students at risk of dropping out in your community? How could you involve parents, students, and other stakeholders and strategic partners in those decisions?
Implementation Examples
Various high school completion programs for pregnant and parenting teens are implemented in school districts and communities across the country2. Florence Crittenton High School, a public-private partnership between Denver Public Schools and Florence Crittenton Services, provides comprehensive services to pregnant and parenting girls aged 14 to 2113
Implementation Resources
‡ Resources with a focus on equity.
US DHHS-Asheer 2017a - Asheer S, Alamillo J, Keating B. Sustaining programs for expectant and parenting teens: Lessons learned from former Pregnancy Assistance Fund grantees. Washington, D.C.: U.S. Department of Health and Human Services (US DHHS); 2017.
Healthy Teen Network - Healthy Teen Network (HTN). Making a difference in the lives of teens and young families.
WI DPI-School-age parents - Wisconsin Department of Public Instruction (WI DPI). School-age parents.
NDPC-Resources - National Dropout Prevention Center/Network (NDPC) at Clemson University. Resources.
Footnotes
* Journal subscription may be required for access.
1 Campbell-Wilson 2011 - Wilson SJ, Tanner-Smith EE, Lipsey MW, Steinka-Fry KT, Morrison J. Dropout prevention and intervention programs: Effects on school completion and dropout among school-aged children and youth: A systematic review. Campbell Systematic Reviews. 2011:8.
2 CDC-Teen pregnancy - Centers for Disease Control and Prevention (CDC). Reproductive health: Teen pregnancy.
3 Child Trends-Manlove 2018 - Manlove J, Lantos H. Data point: Half of 20- to 29-year-old women who gave birth in their teens have a high school diploma. Child Trends. 2018.
4 Harding 2020 - Harding JF, Knab J, Zief S, Kelly K, McCallum D. A systematic review of programs to promote aspects of teen parents’ self-sufficiency: Supporting educational outcomes and healthy birth spacing. Maternal and Child Health Journal. 2020;24(Suppl 2):S84-S104.
5 CG-HS Completion - The Guide to Community Preventive Services (The Community Guide). High school completion programs.
6 Steinka-Fry 2013 - Steinka-Fry KT, Wilson SJ, Tanner-Smith EE. Effects of school dropout prevention programs for pregnant and parenting adolescents: A meta-analytic review. Journal of the Society for Social Work and Research. 2013;4(4):373-389.
7 Koniak-Griffin 2000 - Koniak-Griffin D, Anderson N, Verzemnieks I, Brecht ML. A public health nursing early intervention program for adolescent mothers: Outcomes from pregnancy through 6 weeks postpartum. Nursing Research. 2000;49(3):130-138.
8 Akinbami 2001 - Akinbami LJ, Cheng TL, Kornfeld D. A review of teen-tot programs: Comprehensive clinical care for young parents and their children. Adolescence. 2001;36(142):381-393.
9 US DHHS-Asheer 2017 - Ahseer S, Bukander P, Deke J, Worthington J, Zief S. Raising the bar: Impacts and implementation of the New Heights program for expectant and parenting teens in Washington D.C. Washington, D.C.: U.S. Department of Health and Human Services (US DHHS), Office of Adolescent Health; 2017.
10 Margolis 2020 - Margolis A, Rice T, Banikya-Leaseburg M, et al. Meeting the multifaceted needs of expectant and parenting young families through the Pregnancy Assistance Fund. Maternal and Child Health Journal. 2020;24(Suppl 2):S76-S83.
11 Niland 2020 - Niland K, Selekman R. Challenges and successes of Pregnancy Assistance Fund programs supporting young fathers. Maternal and Child Health Journal. 2020;24(Suppl 2):S178-S182.
12 Macchia 2021 - Macchia SE, Therriault DJ, Wood RC. A cost-benefit analysis of a teen pregnancy program employed as a high school dropout intervention. Planning and Changing. 2021;50(1/2):20-36.
13 Florence Crittenton High School - Denver Public Schools, Florence Crittenton Services. Florence Crittenton High School.
14 NCES-Young adult education - U.S. Department of Education (U.S. ED), Institute of Educational Sciences (IES), National Center for Education Statistics (NCES). Educational attainment of young adults.
15 Vinovskis 2003 - Vinovskis MA. Historical perspectives on adolescent pregnancy and education in the United States. The History of the Family. 2003;8(3):399-421
16 Furstenberg 2007 - Furstenberg FF. Chapter 1: The history of teenage childbearing as a social problem. In: Destinies of the Disadvantaged: The Politics of Teen Childbearing. New York: Russell Sage Foundation; 2007.
17 SmithBattle 2017 - SmithBattle L, Loman DG, Chantamit-o-pas C, Schneider JK. An umbrella review of meta-analyses of interventions to improve maternal outcomes for teen mothers. Journal of Adolescence. 2017;59(1):97-111.
18 CDC-About teen pregnancy - Centers for Disease Control and Prevention (CDC). About teen pregnancy.
19 KFF-Hill 2022 - Hill L, Artiga S, Ranji U. Racial disparities in maternal and infant health: Current status and efforts to address them. KFF. 2022.
20 Fuller 2018 - Fuller TR, White CP, Chu J, et al. Social determinants and teen pregnancy prevention: Exploring the role of nontraditional partnerships. Health Promotion Practice. 2018;19(1):23-30.
21 Mathematica-Goesling 2020 - Goesling B, Wood RG. Promoting lasting, equitable change by reaching youth in need. Princeton: Mathematica Policy Research (MPR); 2020.
22 Dumas 2018 - Dumas A, Terrell I, Gustafson M. Health and social needs of young mothers. The American Journal of Maternal/Child Nursing. 2018;43(3):146-152.
23 King 2022 - King B, Shpiegel S, Grinnell-Davis C, Smith R. The importance of resources and relationships: An introduction to the special issue on expectant and parenting youth in foster care. Child and Adolescent Social Work Journal. 2022;39(6):651-656.
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