Pregnancy and Street-Involved Youth: Examining Female and Male Experiences

Background and Purpose: Pregnancy rates among street youth are high. While some studies have been conducted with female street-involved youth, less has been done to examine pregnancy involvement and young street-involved males. The purpose of this analysis was to a) examine factors predicting reported pregnancy involvement among female and male street-involved youth, and b) to explore the views of street-involved youth on pregnancy/having children.

Methods: Community-based research methods were used to conduct a mixed methods study to examine health outcomes and service needs of street-involved youth in Calgary, Canada. Representatives from 13 community agencies and street-involved youth were involved as partners in all phases of the study.

A survey instrument was developed, pretested, and pilot tested in collaboration with community partners. Trained street outreach workers collected 355 anonymous surveys at a variety of indoor, outdoor and agency locations, targeting youth with varying levels of street-involvement. Logistic regression modeling was used to predict pregnancy involvement separately for females and males. Final models included age, ethnic identity (White/Aboriginal/other), ever lived on the street, ever charged with a crime, experienced childhood abuse or neglect, ever injected drugs, ever asked to exchange sex for food or shelter, and ever attempted suicide.

Forty-two in-depth interviews were undertaken by trained outreach workers. Participating youth were recruited to achieve variation in sex, ethnic group, and level of street involvement. Thematic analysis was used to explore meanings of pregnancy/having children with the subset of transcripts from 8 interview participants where pregnancy was reported.

Results: Overall, 48% of survey participants indicated they had been pregnant or gotten someone pregnant (52% for females, 46% for males, Χ² = n.s.). Independent pregnancy predictors for females included lived on the street (OR 5.8, p<.01), charged with a crime (OR 3.2, p<.01), and attempted suicide (OR 2.8, p<.05). For males, independent pregnancy involvement predictors included injected drugs (OR 2.4, p<.05), asked to exchange sex for food/shelter (OR 2.3, p=.05), and age (compared to <20: 20-24 OR 2.2, p<.05; 25-30 OR 5.5, p<.05). Among the interview participants who described the experience of having and/or preparing for children, pregnancy and children were described as being a motivator to “smarten up” or take “responsibility” to reduce their street involvement, including acting as motivators to find a job, avoid criminal activities or reduce or quit drug dealing or substance use. No differences in views were evident for young men and women, although several of the young men had little contact with their child(ren).

Conclusions and Implications: Results suggest that predictors of pregnancy are different for females and males, although for both, pregnancy is associated with risks and survival tactics that are part of street life. However, pregnancy is perceived as a positive outcome by both male and female street-involved youth, and is seen as part of a passage to adulthood, responsibility and a means of moving away from the street. These findings have implications for services delivery, including the need for sexual health training for shelter and youth service workers, and services to support young parents.