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Brittany D Chambers and Jennifer Toller Erausquin
For decades, adolescent pregnancy prevention strategies focused on proximal determinants. These strategies resulted in impressive declines in US adolescent pregnancy and birth rates, reaching historic lows in 2014. However, disparities in adolescent birth rates by race/ethnicity and socioeconomic status persist. Further, not only are adolescents of color and those who live in underserved communities more likely to become pregnant, they are also more likely than their white and more affluent peers to experience negative health and social consequences of pregnancy and parenthood. More distal or “upstream” factors, such as social stigma, may cause these persistent disparities. This paper aims to build upon a nascent framework, intersectional stigma, and show how it may shape efforts to address the needs of adolescent mothers. Stigma is defined as a deeply discrediting attribute that marginalizes groups of people as “other.” Intersectional stigma posits that individuals may experience stigma resulting from the dynamic interaction of multiple marginalized social identities. Adolescent pregnancy and motherhood often cross multiple oppressed identities (e.g., minority race/ethnicity, single motherhood, low socioeconomic status), resulting in intersectional stigma. This stigma is experienced at school, in healthcare and social services, through media, and in public. As a result, adolescent mothers describe experiencing shame, guilt, and unhealthy coping strategies including avoiding the locations and institutions involved in their experience of stigma. Doing so can lead to repeat births and delinquent behaviors. The intersectional stigma framework provides a guide to the development of interventions to reduce stigma and improve outcomes for pregnant and parenting adolescents.