What If We Didn’t Shame Teen Moms?
Ranika was a talkative, curious 17-year-old when she first walked through the doors of the Bronx community clinic where I worked as a resident. She loved Beenie Man’s reggae music and dreamed of one day becoming a professional painter. I first saw her for a routine school physical exam where I gave her adolescent immunizations and we discussed her irregular periods.
Soon, Ranika appeared frequently on my clinic schedule. She would come in for cold symptoms or a skin rash but actually spent most of her visit chatting about her new boyfriend or asking my advice on the argument she’d just had with her best friend. We developed the kind of doctor-patient bond that I always imagined would be how I practiced adolescent medicine: a relationship with a young person built on trust as we partnered to keep her healthy.
On one routine Wednesday clinic afternoon, instead of seeing my usually upbeat patient, I was met by a tearful face full of fear and disbelief. Ranika told me that she had missed two periods and the pregnancy test she took that morning came back positive. She didn’t know how this happened—she and her boyfriend were mostly using condoms and she came into the clinic consistently to get her birth control shots. Even though she was still in shock, she was adamant that she wanted to “keep my baby.” But she was scared. She didn’t know what to do or who was going to help her through this. I stood in the room with Ranika, trying to work through my own shock and figure out how I could console her. I was a young resident, and this was the first time that I was going to care for a pregnant young person. The truth is: I was scared too.
Our fear arose from a culture that heaps stigma on teen pregnancy. A culture that tells us again and again how tragic it is and how hard it will be—holding teen mothers up as symbols of failure instead of providing the resources and affirmation they need to actually thrive. The real tragedy is the United States’ attitude toward young motherhood, an especially cruel contradiction in this post-Roe era when many young people’s rights have been restricted and girls are being pushed toward parenthood. Every person, no matter their age, deserves to raise their families with safety and dignity, and our society’s approach to young motherhood needs to reflect that.
The vilification of unmarried, teen mothers really began in the years following the sexual revolution of the 1960s and reached a fever-pitch during the Reagan administration. Right alongside conservatives’ crusade against maligned Black “welfare queens” were reckless girls, lost youth, and high-risk teens. This propaganda ultimately became bipartisan, with everyone from George Bush to Bill Clinton raising the alarm about the “plague of teen pregnancy,” even as rates declined. There was plenty of scorn and not even a little bit of compassion, as newspapers ran salacious headlines about “babies having babies” and painted teen mothers as irresponsible Black girls living off of welfare in the inner city. This racist visual imagery was a deliberate strategy to align young motherhood with the most “undesirable” racial status—Blackness.
This political agenda fueled a groundswell of federal and state policies that discouraged teen pregnancy at all costs, while demonizing pregnant young people and depriving them of resources. Some examples of the appalling, hardline tactics: Legislators in several states proposed bills in the early ’90s that would’ve compelled young mothers to get a birth control implant as a condition of receiving federal assistance. The child welfare system meanwhile targeted pregnant youth for increased surveillance and mandated social worker involvement during their pregnancies and births. Even as teen pregnancy rates have dramatically plummeted, young mothers and their children continue to suffer from poor medical and social health outcomes—from higher rates of maternal preterm birth to lifetime poverty to increased incarceration rates for the children of young mothers, with little being done to address the root causes.
Meanwhile, high schools have been allowed to ignore Title IX laws, creating illegal and discriminatory policies that deny pregnant girls accommodations and pressure them to attend specialized schools. In Ranika’s case, when she informed her school about the pregnancy, the principal told her that she would have to leave when her “belly began to show” and that she could transfer to the borough’s pregnant and parenting school. He said that she would get a better education there, but she felt like he just wanted her out because she was seen as a bad influence on the other girls.
This kind of mistreatment is often reserved for pregnant and parenting Black girls, who are singled out for derision. Although their rates of teen pregnancy have plummeted alongside other groups, they remain the prominent face of teen pregnancy, harking back to the hysteria of earlier decades. Like Black women, pregnant and parenting Black girls are marginalized and their pregnancies devalued. They are judged and deemed unworthy of support, creating barriers that severely limit their futures.
My visits with Ranika became even more frequent as she began prenatal care. She always reminded me that she wanted to be a good mother and do the right thing for her baby. We spent hours searching for community services that provided resources for young mothers. We quickly discovered that ones for girls her age were nearly nonexistent. No one was offering information on balancing breastfeeding while in high school, how to deal with the emotions of teen puberty and pregnancy, and navigating friendships as a pregnant teen. Supporting Ranika with this dearth of resources and negative messaging was stressful to say the least. And although she was remarkably resilient and determined throughout, I always felt like contending with such glaring social opposition was too much for a young person to have to bear.
Like all mothers, pregnant and parenting youth need the right support to successfully parent and develop into thriving adults. The systems that have restrained them for decades need to shift dramatically. Resources like comprehensive high-quality education, parenting and childcare support, career and employment development, and mentorship can have a monumental impact. Federal agencies like the Office of Adolescent Health and the Centers for Disease Control and Prevention, as well as state-level offices for children, youth, and families, can start shifting attitudes and policy around young motherhood to create widespread and long-lasting reforms.
At the Dream Youth Clinic in Oakland, where I’m the founder and CEO, we’ve worked hard to create a model of supporting young motherhood that government programs can emulate and fund, while my coauthor, April Bell, is an assistant professor of family and community medicine at the University of California San Francisco doing innovative research on how such interventions can improve the reproductive lives of Black girls. The Dream Youth Clinic’s Young Mothers Rising program affirms and celebrates young mothers’ experiences with a youth-centered health model that helps ensure both teen parents and their children can thrive with developmentally-appropriate resources, peer support groups, basic needs funding, and career advancement scholarships.
Supporting the principles of reproductive justice for all individuals—the right to have a child, the right not to have a child, and the right to parent one’s children in healthy and safe communities—means also supporting pregnant and parenting youth, plain and simple. This support is not theoretical. It is up to national lawmakers, public health agencies, and medical societies to uplift pregnant and parenting youth by endorsing affirming and empowering resources. It is the practice of centering young mother’s voices and leadership to tell the true story of young motherhood. It is dismantling the stigmatizing narrative of young motherhood that forbids their success.
Ranika eventually gave birth to a beautiful baby girl. As her physician, I felt honored to be in the delivery room alongside her mother and grandmother as we coached her through her labor. With every push, squat, and Lamaze breath, I saw Ranika embody the essence of motherhood—stepping wholly into the unknown, trusting that her body knew best, and believing that her community would be by her side. With her last push, her daughter emerged, presenting herself to the world. When I handed Ranika her beautiful baby, tears filled both of our eyes. This sacred experience, in which Ranika was provided unwavering support, affirming community, love, and celebration, is what I wished for her during her pregnancy and what I knew that she and her daughter deserved every day of their lives.
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