Long shadow of adversarial family caregiving as teen mothers enter mid-life

Background: Teen mothers experience significant health and social disparities. In spite of keen interest in their long-term outcomes, few studies follow teen mothers prospectively and even fewer examine how their lives are situated in larger family systems. This multigenerational study began 21 years ago when 16 families were interviewed intensively after the teen's infant reached 8-10 months of age. Families were reinterviewed every 4-5 years. Family patterns of responsive and adversarial caregiving were identified at Time 1; the latter refers to a process that derailed mothering as grandparents took over the care of the baby or became critical bystanders. The Time 6 study examined how family caregiving practices unfolded over two decades and shaped teen mothers' long-term outcomes.

Methods: The study followed a hermeneutic approach. Eleven of the original 16 families participated in the larger study in 2010. Transcripts were coded and interpretive family profiles were created to facilitate the comparison of families within and between time periods.

Results: Family landmines, power struggles, and poor outcomes associated with adversarial caregiving practices are highlighted with two cases. The disconnection and despair of these two mothers reflect the long shadow of family adversities. A third case demonstrates that adversarial practices are difficult but not impossible to repair.

Conclusions: Multigenerational, longitudinal studies provide a rich account of the links between adversarial family practices and teen mothers' long-term outcomes. Identifying red flags associated with adversarial practices and developing interventions to prevent or repair them are described.