Mexican American Adolescent Mothers’ Lived Experience: Grounded Ethnicity and Authentic Mothering

Abstract

We conducted this qualitative, phenomenological study to further understanding of how second-generation Mexican American adolescent mothers perceive their young motherhood experience, drawing on the context of their Mexican heritage background. Through in-person interviews with 18 young mothers, we discerned shared essential meanings reconstructed around two major domains: (a) grounded ethnicity, a firm desire to remain true to and share their heritage culture, and (b) authentic mothering, strong relationality to their infants. We found that young mothers embraced their Mexican heritage mothering approaches, such as fostering familismo, valuing family above other obligations. The adolescents in this study sensed their young motherhood as an opportunity to protect and improve qualities of traditional familial cultural heritage, while absorbing elements of American culture to enhance the future for themselves and their infants. We discuss how providers can help reduce stigmatization and promote self-efficacy by respecting and partnering with young mothers to provide culturally congruent services.

Introduction

Adolescent pregnancy and motherhood continue to be closely linked to human rights issues, as young mothers in many countries worldwide are denied their education, endure social stigma, and face lifelong poverty (Fearnley, 2018; Maly et al., 2017; United Nations Population Fund [UNFPA], 2018; World Health Organization [WHO], 2018). Complications from adolescent pregnancy and childbirth are the leading causes of death among young women globally (UNFPA, 2018; WHO, 2018), and contribute to increased rates of low birth weight, prematurity, and severe neonatal conditions for their babies (UNFPA, 2018; WHO, 2018).

Adolescent motherhood comprises about 11% of all births worldwide, approximately 16 million births annually, with 95% of these births taking place in low- and middle-income countries (UNFPA, 2018; WHO, 2018). Although adolescent birth rates have declined worldwide from 65:1,000 to 47:1,000 births since the 1990s, it is projected that the number of adolescent births will increase globally by the year 2030 due to population momentum (WHO, 2018).

Burgeoning migration has placed more than 3% of the world’s population living outside of their country of origin (UNFPA, 2018). The Sustainable Development Goals for 2030 include acknowledging contributions of immigrants and the need to reduce inequalities and discrimination within and among countries worldwide (United Nations [UN], 2018). Almost half of all migrants are women, most of whom are of reproductive age. Many young women find themselves pregnant during their transit, while “on the run” to their adoptive countries, or after they have settled in their new country, bringing their own and their children’s health care needs with them (UNFPA, 2018). Cultural distance from their countries of origin will contribute to adolescent mothers’ stressors as they face discrimination and try to understand unfamiliar health care policies and procedures that may contradict their own cultural beliefs and preferences (Higginbottom, Hadziabdic, Yohani, & Paton, 2014). Children of immigrants, second generation, tend to internalize their parents’ heritage countries’ class orientations, values, and beliefs, resulting in both advantages and disadvantages that may be repeated across generations (Feliciano & Lanuza, 2017).

Even as we acknowledge that adolescent birth rates in the United States have declined steadily across all racial groups, the United States maintains its status quo of having the leading teen birthrate for high-income nations (20.3:1,000; Martin, Hamilton, Osterman, Driscoll, & Drake, 2018; Sedgh, Finer, Bankole, Eilers, & Singh, 2015). This rate is twice as high as adolescent birth rates for Canada and the European Union (10: 1,000), and 5 times higher than Japan and the Netherlands (4: 1,000; World Bank, 2018).

Mexican Americans represent 65% of the growing Hispanic population in the United States and have a substantially higher teen birthrate than other Hispanic groups (35.5: 1,000; Martin, Hamilton, Osterman, Driscoll, & Mathews, 2017). Addressing the needs of Mexican American adolescent mothers is critically important as they are more likely to suffer adverse psychosocial and economic consequences as the result of cumulative disadvantage and minority status (Toomey, Umaña-Taylor, Updegraff, & Jahromi, 2013; Umaña-Taylor, Updegraff, & Gonzales-Backen, 2011). Cultural stressors, along with health and social inequities, intersect with young parenting, placing their own children at higher risk for adverse cognitive, behavioral, developmental, and health outcomes (Recto & Champion, 2017; SmithBattle & Freed, 2016; Umaña-Taylor et al., 2011). Challenges of ethnic identity and their impact on the mental health and externalizing behaviors of Mexican American adolescent mothers can also influence parenting and psychosocial well-being overall (Toomey et al., 2013; Umaña-Taylor et al., 2011; Updegraff & Umaña-Taylor, 2015).

Despite the persistently high numbers of Mexican American adolescents becoming mothers, little is known about their experience of young motherhood from their own perspective.

We conducted this qualitative, phenomenological study to further understanding of how second-generation Mexican American adolescent mothers perceive their young motherhood experience, drawing on the context of their Mexican heritage background. No prior studies to our knowledge have examined these phenomena collectively among Mexican heritage young mothers. Results will provide a basis for future knowledge and a foundation for facilitating more culturally tailored and patient-centered health and social services, improving the development and well-being of adolescent mothers and their infants.

Background

The United States has 50 million immigrants, the highest number of immigrants in the world, and Mexican immigrants comprise 25.5% of this foreign-born population (UN Department of Economic and Social Affairs, 2017). One out of every four babies born in the United States today is born to a Hispanic mother, and nearly one third (32%) of all Hispanic teenagers are mothers (Livingston & Cohn, 2010; Martin et al., 2017). Many of the teen mothers in the United States are children of first-generation immigrants. Not only are they navigating multiple cultural identities, they are also going through adolescent development while facing young mothering challenges (Toomey et al., 2013; Umaña-Taylor et al., 2011). In addition, Mexican American adolescent mothers are at risk for living in poverty, having higher rates of depression, lacking a high school diploma, and having lower quality of life than older mothers (Campos, Barbieri, Torloni, & Guazzelli, 2012; Dinwiddie, Schillerstrom, & Schillerstrom, 2017; Umaña-Taylor et al., 2011; Zeiders, Umaña-Taylor, Updegraff, & Jahromi, 2015a). Financial and psychosocial adversities have been identified as risk factors impairing young mothers’ ability to respond positively to their infants, promoting harsh parenting. Children of teen mothers have more developmental delays, behavioral problems, and risk for poor health overall (Pogarsky, Thornberry, & Lizotte, 2006; Recto & Champion, 2017; SmithBattle & Freed, 2016; Wall-Wieler, Lee, Nickel, & Roos, 2019).

Most of what is known about Mexican American adolescent mothers is based on national data and quantitative scholarship that examines issues such as sexual correlates of teen pregnancy (e.g., initiation of sexual debut), family planning usage, birth outcomes, breastfeeding practices, and general socioeconomics (Callister & Birkhead, 2002; Chapman & Pérez-Escamilla, 2013; Rocca, Doherty, Padian, Hubbard, & Minnis, 2010). Recent studies have broadened awareness of the impact of ethnic identity affirmation as a moderating influence in the lives of Mexican American adolescent mothers and their ability to cope with the forces of minority status, low socioeconomics, discrimination, acculturative stress, and family dynamics (Delgado, Updegraff, Roosa, & Umaña-Taylor, 2011; Toomey et al., 2013; Umaña-Taylor et al., 2011; Umaña-Taylor, Zeiders, & Updegraff, 2013; Zeiders et al., 2015a).

Umaña-Taylor et al. (2011) suggest that familismo (commitment to family as foremost), and its cultural values of familial obligations, interdependence, and social support, protects Mexican American adolescent mothers from negative psychosocial functioning, resulting from exposure to ethnic minority discrimination. Research is limited concerning gender role attitudes and how they affect Mexican American adolescent mothers’ psychosocial functioning. However, it is widely acknowledged that adherence to traditional cultural gender roles affects educational attainment and socioeconomic status over time (Judge & Livingston, 2008; Updegraff et al., 2014; Vasquez, 2010).

Qualitative studies provide an in-depth portrait of the complexity of the adolescent motherhood experience, but no studies focused on Mexican Americans were identified. Clemmens’s (2003) meta-synthesis of 18 qualitative studies with predominantly non-Hispanic participants described young motherhood as a hardship, especially when trying to maintain self-growth by continuing school or working while shouldering adult responsibilities caring for a new baby. Two recent studies described the experiences of young, non-Hispanic mothers who participated in community-based parenting programs in Canada (Berman, Silver, & Wilson, 2007; Hamilton et al., 2018). Authors emphasized the favorable and unfavorable components of the program for young mother attendees. In addition to the programs’ financial assistance, they felt empowered by social support from peers and some staff. Simultaneously, however, they felt diminished self-esteem and confidence due to punitive and disciplinary monitoring and surveillance related to mothering behaviors; this was interpreted as a reminder that they were a “social problem” (Berman et al., 2007; Hamilton et al., 2018). Fearnley (2018) reported similar feelings of legitimized vilification from the perspective of young non-Hispanic mothers in the United Kingdom. Mothers felt their young age and lower socioeconomic class identified them as social failures. They expressed feeling like easy targets for aggressive hostility from complete strangers in public places.

From a more optimistic vantage, Bergum (1997) described her conversations with non-Hispanic, adolescent mothers also in Canada. She captured their struggles and resilience toward young motherhood, offering a positive lens of hope and respect. Although Bergum acknowledged the young mothers’ vulnerabilities, she emphasized their personal strengths and strong attachments as mothers toward their babies. SmithBattle (2007) also reported positive findings from her longitudinal study concerning non-Hispanic White and African American adolescent mothers. She emphasized that it appeared to be the young mothers’ childhood socioeconomic disadvantage and not their young age that weighed most heavily toward shaping the mothers’ life courses into their 30s. Despite their disadvantage, SmithBattle reported that most young mothers perceived more “gains than losses” by early mothering (p. 410). Dole and Shambley-Ebron (2016) used a community-based participatory research approach to explore how African American adolescent mothers engaged in beneficial mothering practices. Using a Photovoice process and an intersectional framework, they found that building supportive social networks, sharing parenting responsibilities, and looking positively toward the future were all vital themes for these young African American mothers (Dole & Shambley-Ebron, 2016).

In this study, we focused on Mexican American adolescent mothers, whose voices are largely absent in the literature, albeit their particularly relevant eminence. Among Mexican American adolescent mothers, common challenges inherent to early parenting as described in previous literature are complicated further by sociocultural stressors such as multiple ethnic identities grounded in their Mexican heritage and mainstream-dominant Anglo-American influences, intensifying their vulnerability overall (Callister & Birkhead, 2002; Lara, Gamboa, Kahramanian, Morales, & Bautista, 2005; Umaña-Taylor et al., 2011; Zeiders, Umaña-Taylor, Updegraff, & Jahromi, 2015b). Ethnic identity includes self-identification and a sense of belonging as a member of an ethnic group, which is formulated over time and explored in a similar process as ego identity (Phinney, 1993; Toomey et al., 2013).

Method

Study Design and Participants

We chose this qualitative, phenomenological approach inspired by the construct of Husserl’s Lebenswelt, or the lifeworld (Husserl, as cited in van Manen, 1997, p. 184). Husserl describes the lifeworld as the everyday world in which we are situated in the “natural, taken for granted attitude,” prior to theoretical reflection (Husserl, 1999; van Manen, 1997, p. 182). This offers moments of “seeing meaning” (van Manen, 2007, p. 12), orienting ourselves in a way of knowing that focuses on how human beings make sense of experience, and transform experience into consciousness, both individually and as shared meaning (Patton, 2002). Our methodology is guided by van Manen using descriptions of lived experiences obtained through in-depth interviews with young mothers (van Manen, 1997).

In this study, we concentrated on adolescent mothers who were second-generation Mexican Americans, defined as either born in the United States or born in Mexico, but having lived in the United States 5 or more years (Portes & Rumbaut, 2001). Nineteen young mothers who self-identified as Mexican American were recruited from the pool of mothers who participated in a large prospective study comparing two models of prenatal care on maternal-infant outcomes (Vonderheid, Klima, Norr, Grady, & Westdahl, 2013). Only one mother did not meet the study criteria: She had not lived in the United States for at least 5 years. Inclusion criteria were (a) age 19 years or less at the time of delivery of her most recent child, (b) had one or two children up to 4 years of age, (c) had a least one parent born or raised in Mexico, (d) born in the United States or having lived in the United States for at least 5 years, and (e) were comfortable speaking English for the interviews. Demographic characteristics of Mexican American adolescent mothers are shown in Table 1.

Table 1.

Demographic Characteristics of Mexican American Adolescent Mothers.

Pseudonym	Age (Years) at Delivery	Age of Babies at Interview	Education	Young Mothers’ Birthplace
Angelina	18	3 weeks	Enrolled at alternative HS	USA
Camila	18	4 weeks	Graduated HS	USA
Catalina	16	1 year	Graduated alternative HS while pregnant, valedictorian	Mexico
Diana	16	2.5 years	Expelled from HS, enrolled in GED	USA
Esperanza	19	4 weeks	Graduated HS	USA
Fabiana	19	1 year	Graduated HS	USA
Flor	19	15 months	Graduated HS	USA
Guadalupe	15	2 years	Dropped out of HS	USA
	16	1 year	No GED
Luz	17	5 months	Dropped out of HS	USA
			No GED
Marisol	16	1.5 years	Dropped out of HS	USA
	18	5 months	No GED
Marta	18	3 weeks	Graduated HS while pregnant	USA
Paloma	17	2 years	Expelled from HS	USA
			Enrolled in GED
Patricia	19	14 months	Graduated HS	USA
			Dropped college, first semester
Rosalie	16	14 months	Expelled from HS	USA
			Enrolled in alternative program
Valería	16	1 year	Enrolled in HS	Mexico
Yolanda	19	8 months	Graduated HS	USA
			Enrolled second year college
Yasemin	18	6 months	Dropped out of HS	Mexico
			No GED
Zyañya	19	6 weeks	Graduated HS	Mexico

Note. HS = public high school; GED = General Education Development, a high school equivalent certificate achieved through alternative learning.

Before interviews were conducted, all study participants had the opportunity to ask questions, read, and sign a written informed consent form. This study was approved by the university Institutional Review Board.

Data Collection

The first author conducted first-person interviews with the 18 young mothers. Conversations took place situated in their own homes. Having their babies present was conducive for thinking about their mothering experiences. Observing the young mothers interact with their babies allowed the interviewer to enter their lifeworld and “stay close to the experience as lived” (van Manen, 2016, p. 316). One young mother was not able to meet in her own home due to privacy issues, so we spoke with her in a private room at the university.

Interviews lasted around 2 hours, which allowed enough time to gather in-depth, detailed, experiential accounts from the young mothers. To remain open to the living meanings, essences, or “eidos” (van Manen, 2017, p. 775), the interviewer self-acknowledged her own past experiences with other Mexican American adolescent mothers in clinical health settings and strove to put aside preconceived beliefs that might transfer to the young mothers who shared their stories. We posed broad, open-ended questions to explore the whole experience to its fullest (van Manen, 2016). The interviews focused on mothers’ experiences concerning their sense of identity as young Mexican American mothers and young age at motherhood. The aim of phenomenological interviewing is to gather prereflective experiential accounts, which includes personal descriptions of experiences, narratives, and stories, to reflect on the meanings inherent in them (van Manen, 2016). Therefore, direct questions such as personal definitions of ethnicity or motherhood were not consistent with a phenomenological approach, and therefore not solicited (van Manen, 2016). We continued to interview young mothers until conversation with the 18th mother revealed recurrent meaning structures concerning ethnicity and motherhood forming the basis for subsequent themes. This redundancy served as criterion for saturation of rich data, thus prompting the end of data collection (Patton, 2002).

Information was gathered conversationally and simultaneously audio recorded. Recordings served as a resource for written, verbatim transcriptions. Half of the mothers responded to the follow-up phone call 1 week after the interview for clarification of responses.

Data Analysis

We analyzed the data, connecting with Husserl’s zu den sachen, to the things themselves (van Manen, 2016, p. 50), striving to allow concealed meanings to show themselves within the text. Resources for analysis at the level of the “whole story” (van Manen, 2016, p. 320) included verbatim transcriptions of audio recordings of the interviews and observations and field notes. Pseudonyms were used to protect confidentiality and exemplify and validate themes. The written text embodied the young mothers’ experiences of motherhood in the context of their Mexican heritage identity, essential for the reflective process of recovering structures of meaning iteratively, hermeneutically. After reading the whole stories, evocative parts of the text pertaining to ethnicity and motherhood were collected as anecdotes that brought us nearer to our data. Anecdotes were reduced by reading selectively, line-by-line, and highlighting thematic expressions. In this process, we used qualitative software to organize the large volume of data (Friese, 2013). We employed themes for our phenomenological reflective writing using the iterative approach of reflecting back and forth between the mothers’ whole stories, their reduced parts, and back to the whole stories. Using a team approach, we generated subthemes as heuristics, reaching into deeper levels of understanding Mexican American young mothers’ experiential accounts of motherhood and perceived ethnicity. Through this analytic approach, we cultivated the hermeneutic, interpretive process (van Manen, 2016).

Results

Most of the young mothers we interviewed were raised by single mothers who also had their first child during adolescence. Young mothers lived across six low-income communities. More than half of the teen mothers graduated from high school or had the equivalent credential (see Table 1). Three of the adolescent mothers had served time in jail for drug use and/or violent behaviors before becoming mothers.

Two broad themes were identified in the lived experiences of these young Mexican American teen mothers: grounded ethnicity and authentic mothering. Findings emphasized meanings of the adolescent mothers’ perceived ethnic and motherhood identities. Subthemes were identified that deepened our understanding of recovered structures of meaning and broadened our insights.

Theme 1: Grounded Ethnicity

Subtheme: “Mexican although I live here.”

The adolescent mothers’ identities as Mexican and Hispanic were felt strongly and unquestioned. They resided in predominantly Hispanic neighborhoods and attended local schools. All but three mothers spoke Spanish at home. Personal contact with non-Hispanics their own age was limited. For example, Patricia felt her ethnic group was entirely Mexican and wanted her daughter, Reyna, to maintain a similarly strong ethnic identity:

Anyway, I am Hispanic. It’s like this big stereotype [checking boxes on forms] . . . she [Reyna] will grow up knowing that, even though I was born here, I am 100% Mexican, and I don’t want her to lose her roots and stuff. I will take her to visit [Mexico] and stuff like that. She’ll grow up with all the customs and traditions of American life, but she will know that she is 100% blood Mexican.

Even the adolescent mothers who never experienced life in Mexico firsthand felt solid in their ethnic identification. Esperanza was born and raised in the United States and lived in a very low-income neighborhood. When asked who she thought “Americans” were, she responded,

To be honest, without being racist or anything, I would not say Hispanics. Even if they’re born here, I feel like we’re not Americans. I would say American is someone who lives in a better environment, neighborhood. I would even say a person who has blue eyes and blonde hair. I know it sounds crazy . . . but yeah, that’s what I feel like. When I fill out an application . . . I put Hispanic . . . if I put American, they see me. They see where I come from. They would say, “Okay, you’re Hispanic.” That’s what they would label me as even if I have my Social Security card, everything; Hispanic.

Four of the mothers had one parent from a different Hispanic country (Puerto Rico, Ecuador, Peru), and five teen mothers had partners with other Hispanic origins. Although 14 young mothers were born and raised in the United States, and four were born in Mexico but raised in the United States, none of these mothers identified as being fully American. These mothers felt their babies would probably feel somewhat Americanized as they grew up in the United States and were exposed to American schools and media. Zyañya, who was born in Mexico, but lived in the United States since she was 11 years old, shared, “He’s (son) gonna know that in some point he’s American, but in another point he’s Mexican too.”

Relationships with their first-generation parents, grandparents, friends, boyfriends, husbands, and communities informed and authenticated adolescent mothers’ Mexican identity, even if they had never traveled to Mexico. Perceived daily life in Mexico served as a reference from which the young mothers constructed their own identities as Mexicans-in-America. As Yolanda put it, “My cousins [in Mexico] think we’re so Americanized, different from them. Well, we’re not really different. I eat tortillas here . . . it’s just that we live here.”

Subtheme: Habla Español, speaking Spanish

All of the young mothers wanted their babies to learn Spanish, sometimes even before they learned English. Some of the mothers feared losing their “Mexican roots” and wanted to guarantee a place for their child within the cultural boundaries of their communities by being able to speak Spanish fluently. As Paloma explained, “I really want her [daughter] to express her inner Hispanic.” Many mothers felt that once their child became fluent in Spanish at home, it would be easy for their children to learn English at school. However, one young mother, Flor, experienced conflicted feelings for choosing to teach her daughter, Véronica, only Spanish when she was hospitalized for congenital health problems:

’Cuz she [Véronica] was going to therapy and everything, and they would speak to her in English. That’s when I was like, I think I should have started in English first, because we’re in the United States. You should learn English. That was kind of a mistake that I thought I did, but then again, she only went to therapy for two months . . . The therapists were English . . . they’ll try to talk to her like, “give me this, give me that.” I’m like, she doesn’t really know English. I was like, it’s fine. But when she’s over here [home], with us, or with his [father of the baby’s] family, she needs to know Spanish.

Subtheme: Mexican is Catholic

Resonating the preponderance of Catholicism in Mexico, one young mother, Patricia, stated, “Everything [Mexican] has to do with religion. Everything that you do, every tradition or custom has a religious background, whether you know it or not.” Religious beliefs (16 Catholic, 2 Christian), practice, and spirituality varied in strength among the young mothers, however, all expressed the desire to share their religion with their children. Contemplating her young son’s potential resistance to attending church in the future, Valería shared, “He’ll have to go by force.” Fourteen mothers indicated a strong sense of their spirituality, exemplified by Guadalupe’s comment: “When I was pregnant, I did that [prayed] a lot, and my daughter’s healthy. Now I have God to thank for that.” Several young mothers expressed feeling a strong connection with the Virgin Mary, strengthened when they became mothers. Camila had this to say, “It just makes me admire her [the Virgin Mary]. She would protect Jesus no matter what, and do anything [for him]. I would do the same for my son. Yeah.”

Belief in religious doctrine and staunch spirituality did not necessarily mean all mothers attended church. Paloma explained, “We don’t really have time to go to church . . . but our family talks about it [religion] a lot . . . I make sure we have our prayers before we go to sleep.” Although four mothers did not indicate a strong sense of spirituality by referencing a belief in God or the Virgin Mary, they did express the desire to engage their children in Catholic traditions, such as baptism and quinceañera. Quinceañera, or sweet 15th birthday, is a celebration for young girls (assumed to be virginal) transitioning into young womanhood. Celebrating includes being blessed by a priest at a Catholic Church Mass, followed by a formal dance and dinner. Only one of the young mothers celebrated her own quinceañera. Six of the mothers were already pregnant by age 15. Lack of financial ability of families, disrupted family functioning from parental divorce, or her own lack of interest before becoming a mother herself were all reasons quinceañeras were forfeited for the young mothers. “No, I didn’t want one,” explained Flor:

You could say I was a tomboy. I never liked that [formal dress]. Now I wish I would have had it . . . I know she’s [daughter] gonna have her quinceañera, regardless if she wants it or not . . . I want her to have her culture.

Luz shared, “. . . cuz my [divorced] dad did the 15th for my sister. I told my mom I wanted mine but she was like, she has no money for it . . . I was sad.” These same challenges inhibited the young mothers from engaging in other church-related customs, such as baptizing their babies and appointing padrinos (godparents), even though these were perceived as priority cultural practices. None of the mothers mentioned having received tangible goods or financial support from their churches.

Subtheme: Resisting stereotypes—Proving them wrong

Almost all of the young mothers described invalidating interactions with their friends, families, and communities in reaction to their early motherhood. They felt they were perceived as “failures” with a guaranteed grim future. According to Valería, “Since you’re in Mexican culture, you’re not expected to have a baby [so young].” Guadalupe had her daughter Arianna at age 15 and her son Sergio at age 16. She shared,

Everybody was talking negative things . . . They thought I was stupid. To me, I’m not. They say I was young, but it doesn’t matter about a young age. It’s just you gotta love them. They’re your kids no matter what.

Diana felt negatively judged at her workplace, where her coworkers were mostly “American”:

I feel like in America, Americans don’t expect a Mexican person to be successful, to graduate high school, to go to a university, to get married like when you’re okay financially and all that stuff, when you have everything going for yourself. I feel like people saw me, “Hey, she got pregnant. Her parents don’t care. Where her parents at?” I felt very typical. “Her [baby’s] dad wasn’t even there in the pregnancy,” so it just made it more typical. “Hey, she got pregnant by a deadbeat. She’s a little Mexican girl that didn’t even graduate high school.”

Determination to overcome these perceived negative discourses provided impetus for young mothers to want to attain their high school equivalent after dropping out or being expelled. Marisol, who had given birth to her first son, Rubén, at age 16, and to her second son, Álvaro, at age 18 shared,

I’ve been told—everybody says I can’t do it, but when I wanna do it, I will. If I want to go back to school and everything, I can and will do it. I want to prove everybody wrong. You know what I mean? I can make it. I can do this. I can succeed. Doing anything I can just to make it back to school and finish and do what I can.

Catalina was 16 years when she became a mother. She attended an alternative high school while she was pregnant and graduated as valedictorian of her class:

I mean, I don’t want to be just another statistic. The expectation of everyone is that [Mexican American] teen moms will drop out of school and not get educated. I want to prove everyone wrong—that even though I am a teen mom, I can be as educated as everyone else and be something in life, and have a good life.

Marta was pregnant during her senior year in high school and was failing classes due to multiple stressors which she managed to overcome, and graduate:

I was going to quit high school and just get my GED. It was so stressful senior year. I thought, I can’t do this. But because of the baby, I thought, no, I have to finish this and get my diploma and walk at graduation, or how can I tell her that education is important and that she needs to get her education if I don’t?

Theme 2: Authentic Mothering

Subtheme: Enfolding Mexican motherhood

For most of the young mothers, striving toward “being a Mexican mother” meant sharing evidence of Mexicaniana (Mexican culture) such as cooking and eating Mexican cuisine, cleaning house, celebrating Mexican holidays, speaking Spanish, and working hard like their own mothers. One mother, Esperanza, felt that discipline in the form of threatening her child [in the future] with a shoe, chancla and stories about La Llorona or el cuyuy (bogeyman; mysterious figure provoking fright) were essential for maintaining the aura of Mexican motherhood authority. Fabiana strove to create a “Mexican comfort zone” in her home, by feeding her 2½ year old daughter, Morgana, “as much Mexican food as I can,” speaking Spanish, and having Morgana watch Spanish-language cartoons on the television.

All except two of the adolescent mothers had mothers who worked outside the home. The young mothers understood their own mothers’ relative independence as an Americanized influence over family dynamics, not typical for traditional families living in Mexico, where mothers stayed home and maintained domestic life, while fathers earned wages as “head of the household.” According to Fabiana, traditional mothers in Mexico do not drive cars or even go out of their homes without their husbands:

It’s just that what the man says-goes, especially in a Mexican family since the mother stays home, and the dad is “I am the man. I’m the one with the pants. I bring all the money in.” It’s just like that. In a Mexican home everyone respects the man.

Rosalie and her baby, Claudia, lived with both her mother and father:

Yeah. They both raised us like that, that we gotta listen to my dad—anything, if I ask my mom if I could go out or anything, I can’t ask her. She says I have to call my dad. Because she says, “If anything happens to you on the street, it’s not my responsibility. It’s your dad’s.” That’s how it is.

The transition to parenthood is recognized as an impetus for embracing more traditional gender role attitudes and behaviors, influencing parenting decisions (Katz-Wise, Priess, & Hyde, 2010; Toomey, Updegraff, Umaña-Taylor, & Jahromi, 2015). Because the majority of the study’s mothers came from single-parent homes, headed by their mothers, traditional Mexican heritage gender roles were not generally modeled (Delgado et al., 2011; Gil & Vazquez, 1996; Toomey et al., 2015). In fact, most of the young mothers in the study felt they were left to fend for themselves growing up. However, even those young mothers who were not raised in traditional two parent homes were acutely aware of Mexican gendered cultural expectations from observing deferential treatment of their brothers by parents. An alternative “family ecology” (Toomey et al., 2015, p. 3), or social context, was provided by their boyfriends/husbands, extended family, and from the Mexican community in their neighborhoods, who acted as resources for “ethnic raw materials” (Jiménez, 2010, p. 103).

Esperanza felt she was learning how to be both a Mexican woman and mother from her boyfriend, who was raised traditionally and expected them to live out traditional patriarchal gender roles. Esperanza’s son, Miguel, was 4 weeks old at interview. She had this to say,

I’m still learning how to be a Mexican [woman and mother] . . . in my culture a woman has to know how to cook, clean, take care of the kids. By the time she finds someone, she knows all of this. My boyfriend was raised like that. He would come home from work. He would have food, house clean, and baby well taken care of.

Subtheme: Improving Mexican motherhood for their child

Many of the young mothers in this study hoped to spend more time with their babies, and achieve open communication with their children, in a manner they never experienced with their own mothers. Almost all of the mothers felt their own mothers did not have “talks” with them about important feminine issues, such as menstruation, romance, and sex. Adolescent mothers voiced frustration, loneliness, and confusion, describing how their own mothers were not “there” for them, but instead followed their perceived traditional Mexican cultural approach of being “strict” and avoiding intimate conversations (Villarruel, 1998). Some young mothers explained that their own mothers assumed they were not thinking about sex, let alone engaging in it, so there was no need to talk about it. Rosalie shared,

She [mother] had no idea that maybe things like this could be happening to your [her] daughter. She didn’t stop and say, “Are you having sex?”All she could say is, “you gotta go to school.” I’m gonna talk to her [daughter] about sex. I’m gonna talk to her about boys.

Diana shared her experience of being confused about the onset of menstruation and general sexual knowledge. She attributed this experience to her mother’s strict Mexican upbringing, which she perceived did not foster open communication on those subjects. Diana wished to change this “cultural” approach and planned on initiating “sex ed.” conversations with her daughter in the future:

I mean, in our culture you don’t talk about sex ed. and stuff like that . . . I don’t know if it’s embarrassing or, I don’t know. It’s just they will never sit you down and have the talk like I know American parents do. They won’t do that. I had my period first. It was like I had never heard about it, so I was like, “I’m dying.” My mom’s like, “No, its fine. Just do this,” or whatever, but she never had a talk of why it happens . . . I don’t want her [daughter] growing up like that. I don’t want her just not knowing anything, so I mean I will raise her different in the matter that I will teach her what’s going on with her. Cuz it’s really scary not knowing what are you doing, or what’s happening.

Many of the adolescent mothers felt this lack of communication with their mothers contributed to finding themselves pregnant in their teens. These young mothers wanted to change this traditional Mexican cultural approach with their own children, and planned on becoming “friends” with their child, “being there, all up in their business,” as Angelina phrased it. They wanted to be able to talk about intimate topics and prevent subsequent adolescent pregnancies if they had daughters and gang involvement if they had sons. Marta’s daughter, Emerald, was 3 weeks old at the time of interview. She wished her parents could have been “more like American parents” because she could never discuss dating issues with them. Her impressions from television were that American parents were “friends” with their children, sitting around kitchen tables, talking about everything. Marta’s father would “explode” at the subject of dating, and she never felt comfortable speaking intimately with her mother.

Yasemin had dropped out of high school at age 16 and became a mother at 18. She worried that without sharing her time and support, her son Rafael would be bullied into joining a gang when he got older, like her nephew:

My mom, she works every day . . . she comes home tired . . . She never put attention to us. I’m gonna pay attention to Rafael, so he grows in a straight line, so he don’t crook his life. . . I want him to finish school. Get a diploma, go to college. . . Yeah, I’m his mom, but I think that I could be his friend, so he could talk to me and I could tell him what’s wrong, what’s right. What he could do, what he can’t do, so he stays out of trouble, you know?

Fabiana left high school after her parents divorced and was 16 years old when she had her daughter, Morgana. She wanted to communicate better with her own daughter than she could with her mother, hoping to prevent Morgana following the turbulent path she had forged through adolescence:

I feel like I can do what my mom didn’t do, and that’s because she’s very Mexican. In Mexico, it’s like her family, her mom, is very strict, very Mexican woman. My grandma never talked to my mom about drugs, sex, about friends, about anything because she had so many kids. How can you possibly give 8 kids attention? She couldn’t . . . but my mom never talked to me about sex or drugs because her mom never talked to her about sex or drugs. I will talk to her [daughter] . . . I don’t want her to get pregnant at 16 [like I did] . . .

Several of the young mothers felt improved communication included raising their sons to be more egalitarian toward women as they grew up, in contrast to their experiences and awareness of culturally negotiated male dominance over decision making. Yolanda described how panicked her grandmother was to hear of her youthful pregnancy, for fear her boyfriend was “not gonna let me go to school anymore.” It made her conscious of how she wished to raise her own son, therefore changing traditional cultural norms in her family:

Yeah. I don’t want him to grow up being Mr. Macho Man. I want him to give equal rights, I guess, to women as well. I want him to be respectful, and helpful. I don’t want him to think [because] he’s the man, he’s the dominant one. He’s the decision-maker. Because that’s not how it should be. It should be a little more equal in the family.

Subtheme: Being a young mother

Motherhood for these young women was as real and powerfully bonding as motherhood for women of any age. Even though mothers spoke about disadvantages and challenges of becoming mothers so young, they all expressed unmitigated love for their babies. Sometimes feeling young and “still kinda stupid” about parenting skills, young mothers also felt the advantages of a youthful mentality and having more energy than older mothers. Camila expressed,

Well, I can connect to him more, since I’m young. When he starts growing up I can understand him more. I’m young, and then he’s gonna grow up, and I’m still gonna be kinda young. He can trust me more, I think that’s a really good benefit of being a young mom.

Many young mothers felt glad they would share more years with their infants over the course of their lifetimes than older mothers get to share with their children. For instance, they anticipated young grand-motherhood, being able to play with their grandchildren while still healthy and energetic. Angelina shared,

Older moms, sometimes they’re exhausted and things like that. I feel like I would have more time to play-more energy with him. Also, to be trendy and hip when he gets older. I’ll be more understanding of his styles.

Feelings of lost youth, frustrations from emotional and financial dependency on fathers of their babies and families, softened into fervent, timeless maternal love expressed by mothers of all ages when thinking about their babies. These young mothers experienced existential moments, feeling themselves transition from being in oneself momentarily (living for oneself, in the moment-the paragon of adolescence), toward being in relation to the other (living in expanded time, for their babies—implicit in the relationality of motherhood). Esperanza found herself engulfed in such an existential epiphany when she attended a party with peers soon after her son Miguel was born:

It was weird because usually at parties I would talk about boys and, “Oh, where are we going next weekend?” I was actually talking about my baby at a party. We’re sharing stories and it’s like, “Wow.” I would think in my head, “Oh my god, I’m talking about my son. I have a son.”

Adolescent mothers worried about having enough money to provide essentials for their babies, such as formula and diapers. Mothers worried about protecting their infants from harm, now and in the future. Some mothers, like Patricia, would only trust family members to watch their babies, as a form of familismo, saying, “Who do you really trust with your baby? I know that if we were in Mexico, it’d be a lot easier.” Rosalie worried so much about leaving her baby while she attended class that she was ultimately expelled from high school, “I would go to school just sometimes. I wouldn’t really go a lot because I didn’t trust the babysitters. I wouldn’t make it through the day. I would just come back for my daughter.” Yasemin felt that her having her son, Rafael, “changed me into a better person”:

I feel changed. Before I was just I would say reckless. . . . I didn’t care about anything. I would just do whatever I wanted. Irresponsible. I was having such a great time. Now it’s like, I’m calm. I stay home all day. Mother 24/7.

Catalina graduated from an alternative high school, where many pregnant adolescents attended. She brought her baby son, Gabriel, to her graduation:

Even though I’m young and I gave up a lotta things for him, but it’s all worth it. There’s some people that give their babies up for adoption and stuff like that. I think that’s cruel. That’s your baby. How could you give him away? Being a teen mom gets really hard, but you could do it. If you could do other things, then you could be a mom, too. You could do it for your child. He should be your encouragement to become a better person. I never knew a little child like that could make me feel so happy. . . It’s really amazing that little boy- He’s my life!

This quote illustrates intense feelings of motherly love, acknowledging that young motherhood can steer teens on a challenging, yet rewarding life course.

Discussion

Merleau-Ponty (1945/2012) defined phenomenology as, “an attempt to describe the basic structures of human experience and understanding from a first-person point of view, in contrast to the reflective, third person perspective that tends to dominate scientific knowledge and common sense” (p. viii). For the second-generation Mexican American adolescent mothers in this study, their lived experience of young motherhood manifested in two essential interrelated themes: grounded ethnicity and authentic mothering. They embraced Mexican heritage mothering approaches to ensure their babies’ acceptance into their families and communities, fostering familismo. These adolescent mothers experienced motherhood with profound attachment to their babies, resembling mothers of any age.

Although the lived experience of Mexican American adolescent mothers is particularly theirs, these broad themes link to previous studies about adolescents, immigrants, and other ethnic young mothers. Adolescent mothers as loving caregivers to their babies has been discussed in other literature, especially for African American and White mothers (Berman et al., 2007; Dole & Shambley-Ebron, 2016; Hamilton et al., 2018; Koniak-Griffin, Logsdon, Hines-Martin, & Turner, 2006). However, in-depth meanings of motherhood derived phenomenologically from the stories of Mexican American adolescent mothers in the context of their ethnic identities is unique to our study. For instance, Hamilton et al. (2018) analyzed their findings through a feminist and neoliberal lens, arguing that adolescent mothers are supported both emotionally and financially in community programs mainly to fulfill their national duty as “can-do” girls (p. 1186) who must succeed economically for the benefit of their nation. The young mothers’ passion for mothering was interpreted by the authors largely as a form of political resistance to neoliberal discourses. Dole and Shambley-Ebron (2016) illustrated how everyday life stressors of their African American adolescent mother participants did not prevent them from being loving mothers to their babies. Although they used an intersectional approach regarding race, class, and gender, discrimination was never a topic espoused by the young mothers, and descriptions of African American culture were notably missing. In our study, the young mothers told stories showing that racial and ethnic discrimination was a vividly salient experience for them. In contrast to these other studies, we interpreted our research findings with the distinctive phenomenological approach of eschewing social theories, which are preladen with assumptions and suppositions (van Manen, 2016). Instead, we have made the effort to allow the textual meanings of young motherhood to emerge directly from the young mothers’ stories, using “abstemious reflection” (van Manen, 2016, p. 26), providing detailed accounts of interconnected cultural richness and profound mothering as described by the mothers, affording a substantive contribution to the fields of both motherhood and ethnic identity for Mexican American young mothers.

Collaborative reflection of our findings included noting that the young mothers in our study followed many traditional behaviors such as learning to prepare Mexican cuisine and perform other domestic duties, with the satisfaction that they were becoming a more idealized “Mexican woman and mother,” boosting their sense of mothering self-efficacy. Supporting this quest for ethnic inculcation was the young mothers’ almost nostalgic sense of re-creating her vision of a traditional Mexican family in a way she herself did not experience growing up. Although many of the young women in this study lacked traditional Mexican family role modeling, they often accessed first-generation family members, boyfriends/husbands, and even neighbors as extended kin networks to provide what Jiménez (2010) has described as “immigrant ethnic ground zero” (p. 118) to inform their attempts to provide optimal mothering within cultural norms (Zeiders, Umaña-Taylor, Jahromi, & Updegraff, 2015). Some young mothers had first-generation partners who defined the culturally scripted, gendered role behaviors they expected from the mother, based on their own upbringing (Gil & Vazquez, 1996; Updegraff et al., 2014; Vasquez, 2010).

Ensuring their babies spoke and understood Spanish would allow for closer bonds with grandparents and other first-generation family members, the people most able to further entrench the infant in Mexican culture, reinforcing familismo, and its sense of protection and belonging (Delgado et al., 2011; Jiménez, 2010; Valdivieso-Mora, Peet, Garnier-Villarreal, Salazar-Villanea, & Johnson, 2016; Zeiders et al., 2015). Previous studies have identified familismo as a cultural value that offers protection against internalizing and externalizing mental health problems for young mothers and their children (Delgado et al., 2011; Valdivieso-Mora et al., 2016; Zeiders et al., 2015).

Despite the strong desire to embrace Mexican culture to guide their mothering, these young mothers also felt responsible for changing unequal gender roles scripted by machismo and marianismo (traditional, culturally defined masculine and feminine characteristics; Gil & Vazquez, 1996; Kagawa, Deardorff, Esponda, Craig, & Fernald, 2017). In doing so, they reinforced the relationship between “cultural rights and women’s rights” (UN Office of the Special Adviser on Gender Issues, 2010, p. 1; Vasquez, 2010). This finding was consistent with a recent quantitative study that found a decline in traditional gender role attitudes for Mexican American adolescent mothers regarding the division of domestic chores, even if their own mothers were born and raised in Mexico (Toomey et al., 2015).

These young mothers also wished to enhance communication with their own children concerning intimate conversations such as menstruation and sexuality. Their own mothers had maintained the “cultural silence” (Garcia, 2012, p. 21) against parent–child communication about sexuality, which they felt had contributed to their own vulnerability toward early pregnancy. This theme was also identified in Asnong et al.’s (2018) research with adolescent mothers who were living as refugees on the Thailand–Myanmar border. Young mothers in Asnong et al.’s study described their parents’ cultural beliefs concerning sexual education as a taboo subject that would “corrupt their children’s minds” (p. 7) and induce them to engage in sexual activities.

For the young mothers in our study, the tension between their traditional Mexican values and what they perceived as Anglo (American) ideals can be regarded as a normative, somewhat fluid, acculturative process of adapting to mainstream values, expectations, and norms that occurs over time from living in a nonheritage country (Zeiders et al., 2015a). Young mothers described selectively retaining more collectivist values of their heritage culture, such as the Catholic religion, Spanish language, cuisine, music, and festivals, while also deciding to acquire some more idealistic, individualistic (American) values such as gender equality and open communication. Previous studies differ in their appraisal of the impact of incorporating American values. Some authors argue that accommodating these American child-rearing values could potentially become a source of acculturative stress with their natal families, especially when young mothers continue to reside in their parents’ homes (Padilla, 2006; Schwartz, Unger, Zamboanga, & Szapocnzik, 2010; Zeiders et al., 2015a, 2015b). However, other researchers with adult Mexican heritage parents and their adolescent children have shown that this “cultural overlap” (Nieri & Bermudez-Parsai, 2014, p. 430) is a source of resilience that brought parents closer to their more acculturated children, decreased conflicts due to generational differences, and did not weaken Mexican heritage identity for either generation.

An additional insight into the young mothers’ desire to maintain strong maternal and Mexican identities was their understanding that they were racialized as “culturally different.” As an adaptive approach, they formed positive resistance strategies to counter stereotypes of young Mexican mothers as low achieving and delinquent (Cammarota, 2004; Toomey et al., 2013). Becoming a mother gave these young women the motivation to resist these negative stereotypes by persevering to attain their high school diploma or an equivalent credential (General Education Development [GED]), role modeling responsible mothering behaviors with their babies and fostering close cultural bonds for their babies within their ethnic communities. Clarke’s (2015) qualitative study of non-Hispanic adolescent mothers (Black and White mothers) in the United Kingdom resonated with similar strategies to resist negative stereotypes as expressed by the young mothers. As with the young mothers in our study, their pleasure in motherhood enabled them to stand against the adversity in their lives and pursue education and self-esteem, investing in themselves as “good mothers.”

Stigma, and the conceptualization of adolescent pregnancy as a social problem, has been widely acknowledged in prior literature (Berman et al., 2007; Fearnley, 2018; Hamilton et al., 2018; SmithBattle, 2013, 2016; Solivan, Wallace, Kaplan, & Harville, 2015; Wiemann, Rickert, Berenson, & Volk, 2005). The young mothers in our study also expressed feeling a “stigmatizing gaze” (SmithBattle, 2009, p. 122) from people within and outside of their communities, based on both their young age and Mexican heritage. Adolescent African mothers who had immigrated to Australia voiced similar concerns, feeling that their race and youth made them highly visible and “pregnant in the street” (Watts, Liamputtong, & Mcmicheal, 2015, p. 7), bringing shame to their families and reflecting poorly on the entire African immigrant community.

The lived experience of authentic mothering was powerfully expressed by these young mothers. This intense mothering attachment of adolescent mothers is rarely reflected in literature concerning adolescent mothers. Much of the extant literature describing adolescent mothers focuses on the adverse effects of early parenting: describing mothers as inferior wage earners, deficient in their cognitive development, and unable to parent their own child (Furstenberg, 2007; Hotz, McElroy, & Sanders, 2005; Jutte et al., 2010; Pogarsky et al., 2006; Trad, 1995; Westman, 2009).

Our findings of deep mothering attachment for Mexican American adolescent mothers have echoes of Bergum’s (1997) research with Canadian young mothers. To describe young mothers’ close relationality to their babies, Bergum offered the metaphor of “quickening” to depict mothers’ existential awakening to the reality and importance of caring for another human being (p. 165). Although “quickening” describes a pregnant woman’s first awareness of her baby’s physical movement within the womb, Bergum expanded this meaning to portray the moment of self-awareness when mothers question themselves on what and how to do the right things for their children (p. 166). The Mexican American adolescents in this study sensed their young motherhood as a similar “quickening,” a turning point in their lives, as they absorbed the reality of motherhood, developing their mothering competence within the context of their ethnic identities for the benefit of their babies.

Limitations

Despite this study’s strong contributions, our research results are limited by the inclusion of solely the adolescent mothers and use of a single interview. Although our study focused intentionally on the adolescent mothers themselves, future studies that include partner and family member perspectives would provide valuable insights about additional factors influencing their young mothering in the context of their Mexican heritage. Future research should include qualitative, longitudinal studies to capture the process of culturally informed young motherhood that unfolds over time, and how this affects their children’s socioemotional development. Our study findings bring salient insights regarding other low-income, ethnic minority mothers. However, our narrow inclusion criteria may present limitations regarding Mexican American adolescent mothers from families living in higher income groups and residential locations outside of predominantly Hispanic communities. Although phenomenological research does not aim to generalize findings or frame hypotheses, patterns of meanings in our study findings may be recognizable by others as relatable experiences (van Manen, 2016).

Conclusion

Phenomenology, as our approach, allowed for gathering rich experiential accounts from Mexican American adolescent mothers. These interpreted meanings surrounding young motherhood and ethnic identity expand and provide distinctive depth to prior research reporting sociocultural stressors for this susceptible, at-risk group (e.g., Umaña-Taylor et al., 2011; Zeiders et al., 2015a, 2015b).

As a substantive contribution to literature related to this important vulnerable group, this study highlights the potency of strong ethnic identity for Mexican American adolescent mothers, which should be recognized as a proactive coping strategy for dealing with multiple stressors, and as a means for guidance with their child-rearing and proximal relationships.

The young mothers’ nostalgic sense of reconnecting with cultural traditions has been comparably described as a search for personal wholeness, moral ideals, and identity affirmation, essential tasks in the acculturation process (Pourtova, 2013). Heidegger explained,

. . . nostalgia is a pull to be home everywhere . . . To be home everywhere means always, and mainly, to feel wholeness as a whole. This feeling of wholeness as a whole we call peace of mind. (Heidegger; as cited in Pourtova, 2013, p. 40)

Confronting challenges similar to other low-income, socially marginalized young mothers, the Mexican American adolescent mothers in this study contributed their unique contexts, striving to develop their mothering competence while experiencing the profundity of becoming a mother, committing emotionally to their babies as mothers of any age or ethnicity.

The strengths of Mexican American adolescent mothers, as well as the hurdles they face, are critical findings that can inform health care and service providers toward facilitating young mothers’ sense of autonomy, dignity, and competence, acknowledging their human rights overall (Sternberg & Barry, 2011; UN, 2018; UN Office of the Special Adviser on Gender Issues, 2010). Findings from this study should also sensitize care providers to the importance of supporting familismo, by incorporating family members in professional services for Mexican American young mothers where appropriate. Using positive communication approaches such as motivational interviewing can enhance efficacy for taking action on goals created within trusting relationships with these young mothers, based on nonjudgmental interest and concern (Elwyn et al., 2014). Mexican American young mothers should be connected with culturally congruent support services (e.g., child care), which will complement their abilities to care for themselves and their infants. Service providers can encourage Mexican American young mothers to re-engage in the educational system, promoting achievement of their educational goals. This importance should not be underestimated, as these young mothers are less likely to re-engage than mothers in other ethnic groups, and more likely to live in poverty (Toomey et al., 2013). Providers also need to help alleviate stigmatization by respecting these marginalized adolescents’ sense of motherhood identity, which is as equally powerful and consequential compared with older mothers: a perspective not always acknowledged in extant literature. Focusing on adolescent mothers’ hidden strengths rather than on their apparent deficits affords providers a crucial opportunity to make a positive impact on the health and development of young mothers and their infants.

Author Biographies

Phyllis A. Sommer, PhD, MS, CNM, WHNP, is a research consultant in Chicago, Illinois, USA. At the time of the research, she was a doctoral student at the University of Illinois at Chicago College of Nursing, Department of Women, Children, and Family Health Science, Chicago, Illinois, USA. Her research interests include women’s health issues, especially in regard to reducing health disparities for low-income, ethnic minority women.

Michele A. Kelley, ScD, MSW, MA, is an associate professor at the University of Illinois at Chicago School of Public Health, Division of Community Health Sciences, Chicago, Illinois, USA. Her research interests are with youth engaged as collaborators in health promotion to foster health equity, more recently around healthy food access, and food justice.

Kathleen F. Norr, PhD, is a medical sociologist and Professor Emerita at the University of Illinois at Chicago College of Nursing, Department of Women, Children, and Family Health Science. Her research focuses on the development and testing of innovative community-based programs to address the needs of socially disadvantaged mothers in the United States and group prenatal care and HIV prevention for women, men, and youth in low-income countries globally.

Crystal L. Patil, PhD, is an anthropologist and an associate professor at the University of Illinois at Chicago College of Nursing, Department of Women, Children, and Family Health Science. Her research focuses on the development and testing of evidence-based strategies to reduce health inequities among women and children in Africa and marginalized communities in the United States using a broad conceptual model that integrates biology and social science.

Susan C. Vonderheid, PhD, RN, is a clinical assistant professor at the University of Illinois at Chicago College of Nursing, Department of Women, Children, and Family Health Science. Her research interests include the quality, effectiveness, and efficiency of maternal-child health care to reduce health disparities among low-income ethnic minority families.