UCSF

ABSTRACT

SHARING STORIES:

UNDERSTANDING EARLY CHILDBEARING

AMONG RESERVATION-BASED

NATIVE AMERICAN WOMEN

by

Janelle F. Palacios

Doctor of Philosophy in Nursing

University of California, San Francisco, 2008

Early child-bearing (ECB), or becoming pregnant at age 18 or younger, is a common and poorly understood event among the Native American population. In 2002 Native American ECB rates of 53.8 per 1,000 live births were higher than total United States ECB rates (42.9/1,000) and White ECB rates (28.6/1,000). In general, regardless of age at childbirth, Native American women have poor maternal/child outcomes compared to other populations, and minimal research has inquired into these women's ECB experiences.

This interpretive phenomenological study aimed to discover retrospectively the ECB experiences of adult, self-identified Native American women who lived on a particular reservation located in the Western United States. Specifically, this study sought to understand (a) the social context situating women's ECB experience, and (b) ECB effects on women's life trajectories.

The findings revealed that women's childhood contexts situated their entrée into ECB and affected the meanings women ascribed to their experience. Accounts of their childhoods revealed numerous exposures to traumatic events (e.g. parental substance use, neglect, abuse, death, and divorce) which often times contributed to risky behaviors and early pregnancy. Women embodied ECB according to their life situations. For some, ECB extended the chaos from their childhoods and became a challenge as they negotiated roles and responsibilities. Other women took up ECB as a means to heal emotional voids inherited from their youth. Additionally, some women felt their adulthood was confirmed through their mothering role and initiated changes in their lives that enabled them to refrain from engaging in risky behaviors.

The theories of Historical Trauma and Weathering are discussed in terms of how they contribute to women's childhoods and how ECB may serve as a protective factor enabling women to discontinue the intergenerational cycle of risk. Implications for health care, future research and clinical practice are presented.