Ethical Refelection paper and Business environmental analysis

1 Masters Research Proposal Faculty of Nursing University of Calgary Margaret Scaia Title of Research:

Understanding the Experience of Adolescent Motherhood: 1940-2000 Supervisor: Ms. Carol Ewashen Committee Members: Dr. Geertje Boschma, Ms. Carol Rogers 2 Table of Contents Problem statement / 3 Background Issues: The Social Construction of Adolescence / 4 Current issues / 5 Literature review / 5 Review of current research / 6 Review of secondary sources / 10 Purpose of the study / 11 Research questions / 13 Research design / 13 Description of participant selection / 14 Recruitment of participants / 15 Data gathering / 16 Data analysis / 18 Criteria for credibility of research / 20 Limitations of the study / 21 Ethical considerations / 22 Implications and outcomes for nursing practice / 24 References / 26 Appendices Appendix A: Adolescent motherhood: Interview guide / 31 Appendix B: Demographic questionnaire / 32 Appendix C: Poster for recruiting participants / 33 Appendix D: Informed consent / 34 Addendum to informed consent / 38 Appendix E: Time line / 40 Appendix F: Budget / 41 3 Title of Proposed Research Project:

Understanding the Experience of Adolescent Motherhood, 1940-2000 Problem Statement Our assumptions as nurses about the experience of adolescent motherhood are complex in their origins. They are grounded in our personal history, and include the social and historical events that have influenced our particular lives. Another important piece is the way that the largely female profession of nursing is influenced by society’s changing beliefs about the role of women in both the public and private sphere. These socially and historically constructed attitudes influence nursing policies and programs, and frame the ways in which we plan and evaluate the care we provide.

This research study uses a feminist oral history methodology to examine the social construction of adolescent motherhood. It is informed by the personal, social and historical themes that emerge from interviews with women between 18 and 75 years of age. In writing about the tradition of feminist oral history, Chanfrault-Duchet (1991) explains that this method allows us to examine and enrich our understanding of the complexity, interactiveness, and seemingly contradictory nature of women’s experiences. Oral history links the past to the present, and allows for an investigation of the interplay between the two. The goal of conducting and analyzing these interviews is to expand the reader’s insight in reference to the complex pathways by which nurses come to understand personally and socially significant events.

Feminist oral history methodology is chosen in an “attempt to understand and analyze, in the present and for the future, that which women, as social actors involved in history, have held as significant in the past and how they have perceived and interpreted this 4 through the ideological blueprints that they have internalized” (Chanfrault-Duchet,1991, p. 90).

In this research study, childbirth is both a significant social event, and a uniquely female experience.

Background Issues: The Social Construction of Adolescence In evaluating the effect of change over time in the social construction of adolescent motherhood, we must take into consideration how the concept of ‘adolescence’ has changed over the past 60 years. Today we generally define adolescence as the time between 11 and 20 years (Wong & Perry, 1998, p.1096). Inherent in our perception of adolescence as a unique developmental stage are assumptions that include socially acceptable standards of behavior for this age group. Generally, these assumptions relate to a series of behaviors, that ‘progress’ from mild rebellion, engaging in risk taking behaviors, obtaining an education, choosing a career, and finally forming a family consisting of mother, father and children. A popular nursing text states that between the years 11 to 20, there is a transition in terms of sexual development from “limited intimacy...[to]...a decisive turn toward heterosexuality...[to]...dating as a male-female pair” (Wong & Perry, 1998, p.1096). This means that parenting must wait until social maturity, often associated with financial security, is achieved. Benner (1994) explains that theories of adolescent development over the past forty years have thus presented the ‘tasks’ of adolescence and the ‘tasks; of motherhood to be in opposition “because of the teen’s failure to first achieve autonomy and become a differentiated self” (p. 143).

Less than one hundred years ago however, the imperative was for children to relieve parents of their physical and economic dependence at as early an age as possible. Status and independence within the adult community was gained primarily through marriage and childbearing at an early age. It was not unusual for marriage to occur as early as 15 years, which was the average age of puberty (Montessoro & Blixen, 1996; Apple & Golden, 1997). In contrast, this modern day latency period of adolescence is constructed by economic and social influences such as the desire to achieve greater financial and social status through extended 5 education and job training, and through opportunities for women outside traditional domestic roles. Thus, for the dominant culture there are increasing expectations that parents will promote both son’s and daughter’s future well-being by supporting them economically until they are finished post-secondary training. This relationship assumes that the child will remain single and childless until a career is established or well underway. Parents likewise obtain social status by providing this opportunity for their children. While children continue to pass through the period between 11 and 20 years, society’s beliefs about appropriate behavior for youth in regard to sexuality and the appropriate age for parenting, have changed. Young women at both ends of the historical period, that is those who were ‘adolescents’ in the 1940’s and chose not to fulfill society’s expectation to become mothers were sanctioned, while young women today who choose to do so at an early age, have also raised concerns about their ‘well-being’. According to Montessoro and Blixen (1996) “ the phenomenon of adolescent pregnancy needs to be viewed within the context of an increasing female independence challenging traditional social norms and expectations about appropriate female behavior” (p.34). Thus for a number of reasons it is difficult to critically examine the research on this subject without an understanding of the historical and social factors that have shaped our beliefs and assumptions about adolescence and sexuality. Literature Review Research on the topic of adolescent motherhood continues to be funded. In the last twenty years it has shifted focus from the alleged moral inappropriateness of ‘children having children’, to the impact of teenage parenting on the stability of the nuclear family, the cost to the public health care system of low birth weight infants, and the perception of increased maternal/infant morbidity (Alpers,1998; Arenson,1994; Camarena & Minor,1998; Carey, Ratliff & Lyle,1998; Furstenberg, Brooks-Gunn & Morgan,1987). Research statistics contribute ‘scientific’ validity to the perception that adolescents having children are more likely to become burdens to society, and that their children are more likely to be less productive members of 6 society than children of older, married, and better educated women. These assumptions form the building blocks of the present ‘social construction’ of adolescent motherhood. The emphasis here is on the interpretation of the modern day usage of the word ‘adolescent’ which implies economic and emotional dependency. This perception of dependency however has not always been pervasive. A review of the literature for this research study examines quantitative and qualitative research studies, as well as a number of secondary sources that explore the social and historical construction of the roles of women in society over the previous century. Review of Current Research A review of research on the topic of adolescent pregnancy and motherhood was conducted for the years 1980-2000. This period represents a time of significant increase in government funding for research, and a resulting increase in the number and variety of studies devoted to this area of social concern (Montessoro & Blixen, 1996). The social and political concerns of the past twenty years are reflected in the choice of research questions, and in the methods used to address those questions. On the topic of adolescent motherhood, these studies have focused on the determinants of health (economic well being, access to health care, substance use, education, housing) and their value in predicting early pregnancy. The ability of researchers to generalize findings and predict outcomes are qualities that are valued in both quantitative and qualitative traditions. Yet it is difficult to make generalizations and conclusions about an experience that is so individually and socially complex. Quantitative studies in this review primarily examined the relationship between the determinants of health and the risk for adolescent motherhood. Discussion and dissemination of results most often follows with suggestions for changes in government and social policy directed at equipping young women with the information needed to avoid pregnancy (Farber, 1991; Gillmore, Spencer, Larson, Tran, & Gilchrist 1998; Nord, Moore, Morrison, Brown, & Myers, 1992; Renker, 1999; Unger, Molina, & Teran, 2000 ). A criticism of this research has been that it fails to consider the importance of social relationships, the complexity of modern adolescent development, and the ways in which boys and girls are socialized differently (Ford-Gilboe & 7 Campbell, 1996; Gilligan, 1982). For example, much of the quantitative research reviewed infers that the act of becoming a mother at a young age is made independently of the context of the young girl’s social and cultural environment. In a sense, suggesting that it is an independent and poor ‘life-style’ choice given today’s middle class emphasis on education and economic well- being (Ford-Gilboe & Campbell, 1996; Gilligan, 1982; Mulhall, LeMay & Alexander, 1999). Another body of research combines quantitative methods (tables, questionnaires, surveys) and qualitative methods (focus groups, in-depth interviews, group interviews). Using a small group of participants, and referring to national data banks or previous research findings containing sociodemographic information about similar populations, these findings create a more comprehensive portrait of the adolescent mother (Alpers, 1998; Arenson, 1994; Camarena, 1998; Mercer, 1980; Smith, 1984). Key findings however are most often directed toward identifying the presence of risk factors for pregnancy and suggesting preventative strategies. In contrast, studies with a mainly qualitative focus considers contextual factors such as culture and ethnicity, and include the ways that significant relationships such as family, religion, and community impact the choices individuals make (Ford-Gilboe & Campbell, 1996; Mulhall, LeMay, & Alexander,1999; Porter, 1990). According to Sandelowski (1995), qualitative methods allow for a greater depth of understanding of the individual as opposed to the collective experience. The emphasis is on contextuality, rather than on cause and effect relationships and generalizability. Consistent with the aims of qualitative research methods expressed here, feminist oral history, according to Chanfrault-Duchet (1991) emphasizes the importance of relationships, and the personal and social complexity of life events. In examining the experience of adolescent motherhood, feminist oral history therefore can be used as a research method to examine the meaning of experience “as viewed through the distance between, or conformity to, the image of woman that is in current use in [her] family circle or social group... and the hegemonic social model [of women]” (Chanfrault-Duchet, 1991, p.80). The in-depth interview is the primary tool that will be used in this feminist oral history research.

A number of important qualitative studies used the in-depth interview as a primary 8 method of inquiry. These research studies place the individual within her family, cultural, and historical context, and examine how the choice to become a mother fits within the individual’s life-world (Arenson, 1994; Carey, Ratliff, & Lyle, 1998; Farber, 1991; Lesser, Anderson, & Koniak-Griffin, 1998; SmithBattle, 1995; SmithBattle & Leonard, 1998; Williams & Vines,1999;). Carey, Ratliff and Lyle (1998) for example, in a purposeful sample of 42 adolescent mothers chose to focus on ‘successful’ teen mothers, using in-depth interviews to develop a hypothesis “about resiliency and strength in adolescent mothers” (p.350). According to the researchers, “adolescent mothers are the experts on the experience of their own resiliency.

Their personal stories of creative adaptation and strength will enhance the understanding of the process of resiliency in adolescent motherhood” (p.349). Likewise, Farber (1991) conducted 28 in-depth interviews with unmarried adolescent mothers between the ages of 15-20 years from mixed cultural and ethnic backgrounds. Findings describe the importance of “family members and other significant adults in the decision process [to become a mother]” (p.697). In reviewing the literature, Farber (1991) states that current research “does provide a reasonable assessment of relative risk of early motherhood in the general population...however, very little research on pregnancy resolution realistically portrays the complex nature of the many factors that influence a pregnant teen’s ultimate decision to be a mother” (p. 699). In challenging previous findings Williams and Vines (1999) conclude from in-depth interviews conducted with seven first-time mothers who had histories of childhood abuse, that contrary to expectations, all delivered healthy newborns. They suggest that “not all adolescent mothers are at risk for maladaptive parenting” (p. 15), and that for some becoming a mother “may promote personal growth and maturity” (p.15). Finally, SmithBattle (1995) and SmithBattle and Leonard’s (1998) research which most closely resembles feminist oral history, state in their findings that “the conventional wisdom that teenage mothering risks the future disregards the fact that the young mother’s experience and understanding of her past as well as her anticipation of the future are intimately tied to the social world she inhabits” (SmithBattle, 1995, p.22). SmithBattle reviews the social history of adolescent motherhood beginning with the 1960’s and traces the evolution of research on the 9 topic of adolescent sexuality and social influences. She brings attention to the fact that much of the research focused on women from impoverished confirms the perception that all young mothers are failures, and that their children have generally poor outcomes including poor health, poverty, and unemployment. According to SmithBattle (1995) “this perspective privileges the scientific practices of unitizing and generalizing for explaining young mothers’ lives and has held enormou sway among policy makers and researchers” (p.23). In the most recent research study reviewed, SmithBattle and Leonard (1998) extended previous research work with a group of adolescent mothers and looked at changes over time in the meaning of the experience. They did this using in-depth interviews to look at “life history accounts of the intervening 4 years” (p.36). In their interviews, they emphasize the change that occurs to a woman in which an image of the self as a mother is formed. This is not a process in which the self is at one point not a mother, and then by an act of biology, suddenly a mother, but rather through a gradual process mediated by “socially embedded action” (p. 37). They suggest that “empirical-rational studies...

impose normative ideals that differ substantially from the ways in which young mothers live and understand their lives” (p. 37). Thus it is important to understand how decisions are made by women, and how roles are created, through the interaction of the self and the unique social and historical context in which we live our lives. This understanding can be further enriched by reviewing a number of secondary sources related to the social history of women’s lives.

Review of Secondary Sources The body of literature examine as secondary sources reflects a growing interest by historians and the public in the everyday lives of women. Experiences related to pregnancy, childbirth and motherhood are prominent in this literature (Apple & Golden, 1997; Arnup, 1990; Comacchio, 1999; Creese & Strong-Boag, 1992; Strange & Loo, 1997; Strong-Boag & Fellman,1997 ). Relevant themes include women’s economic dependency, beliefs and assumptions about the role of women and the family, women’s lack of control over reproductive function, the rise of professional ‘regulatory’ agencies, and the influence of state power in implementing legal sanctions that shape and regulate women’s reproductive choices. Leavitt’s 10 (1986) history of childbirth practices emphasizes the unique role that women’s reproductive function plays in determining the choices of roles for women that have been historically available. Leavitt (1986) states that “historically, women’s physiological ability to bear children and men’s inability to do so have contributed to defining the places each held in the social order...by understanding childbirth we can understand significant parts of the female experience” (p.3). Also, Strange and Loo (1997) examine the moral regulation of women’s private lives and the policing of women’s behavior through legally, culturally, and socially sanctioned surveillance. Another important source is Levesque (1997) who analyzes the history of the professionalizaton of social work and identifies the ways that social work developed as a legally sanctioned arm of society to enable the dominant class to protect itself against sexually errant women. In examining the role of the state in the moral regulation of women between 1920-1940 in Ontario, Hillyard-Little (1999) discusses how a government allowance for single mothers was distributed. Government workers were permitted to enter a single woman’s home at any time of the day or night to look for signs of male ‘visitors’. A woman could be denied benefits for any behavior that included visiting, dating, or being seen in the company of a man outside the family.

Unmarried women with children, (and this included widows, women who had been deserted by their husbands, as well as those with “illegitimate children”, p. 132) were thus denied the mother’s allowance on the basis of society’s perception of moral decrepitude. Other relevant works include Noddings (1989), Tuana (1993), and Nicholson’s (1999) analysis of the ways women have been evaluated on the basis of their sexual distinction from men through religious and historical texts. The themes derived from these secondary sources will inform the historical framework that will guide the data analysis of this proposed study.

Purpose of the Study The purpose of this feminist oral history study is to discover and understand the social construction of the experience of motherhood of women who were between the ages of 13-20 years old, between the years 1940-2000. Therefore, interviews will include women who are now 18 years to those who are in their 70’s. This time period was chosen because it covers what is 11 considered a life-span. These women can reflect not only on the experience of becoming a mother, but on the meaning of that event over a life time. The choices that many young women face today, including increased educational opportunities, careers, non-traditional occupations, and family planning, were just beginning to present themselves when the oldest participants were teenagers. The value of this oral history methodology is the analysis of interviews with living persons who are able to express the complexity of the interaction of past and present experiences.

At this stage of the research, the experience of adolescent motherhood will be defined as the personal meaning of the experience as described by the participant (narrator). The term ‘adolescent’ will be used to denote the age span between 13 and 20 years old. This research uses interviews and journals as the primary data sources, as well as related relevant literature as secondary data sources. The research analysis will further understanding of how meaning is created and influenced by the social and historical context in which the experience occurs. In this way, the personal and historical factors that have shaped beliefs about women experiencing motherhood at a young age can be examined. The personal and societal significance of birth, and the social construction of motherhood remain central to the moral and cultural regulation and stability of our society. Adolescent motherhood often challenges societal norms and values about sexual behavior by women in relation to women’s role as mother. This research study will provide a forum for the exploration of the interplay of historical and social factors related to this event as well as the interpersonal relationships that give meaning and context to the individual’s experience of one of society’s most important passages. Research Questions The following questions will guide the research process:

1. How has the experience of adolescent motherhood changed over over the period 1940-2000?

2. What social factors and historical issues have affected these women’s 12 particular experiences of adolescent motherhood?

3. How does the individual define and interpret these events within the past and presentcontext of the event? Research Design Feminist oral history is a methodological approach that has produced a substantive body of knowledge within the qualitative research tradition (Anderson & Jack, 1991; Gluck & Patai, 1991; Reinarz, 1992; Thompson & Barrett, 1997; Yow, 1994). Feminist oral history is interdisciplinary in nature, drawing on methodologies from history, psychology and sociology. In particular, it allows the narrator to reflect on the past within the context of the present. The narrator becomes a performer of and in his or her life-story (Yow, 1994). Unlike written records, the text transcribed from a verbal exchange between the narrator and the interviewer creates the historical text. In preserving the spoken word on tape, and transcribing it to paper, the nuances of language and other verbal expressions can be analyzed. The narrator has the freedom to express ideas and thoughts in a way that may not otherwise have been preserved in a written form, and about subjects that have not traditionally been topics of historical investigation (Reinnarz, 1992).

These non-traditional topics include the lived experience of women’s everyday lives. In feminist oral history, there is no ‘script’ to follow. It is the narrator’s experience that is sought in all it’s complexity, ambiguity and possible inconsistencies. Rather than focusing on grand historical events and asking the narrator to comment on how she has been affected by these events, it is the story of the narrator that is the focus of the interview. In the case of adolescent motherhood, the personal experience of the narrator is at the center of the story. Social and historical events form the backdrop to the experience. Much of the experience of the day to day lives of ordinary people has not been recorded in historical documents. Women’s lives in particular are almost invisible in historical records. Increasing numbers of women in academia, and the rise of the feminist movement have contributed to a re-examination of the social significance of women’s role in shaping history, and in determining rules of social order. In the oral history tradition, the interviewer and the narrator participate in an interactive process either in a single conversation, 13 or in a series of conversations (Anderson & Jack 1991; Rafael,1997; Thompson & Barrett, 1997; Yow, 1994). The interview transcript is then analyzed for meaning with attention to factors such as language structure, effects of time on past and present meaning, chronological structuring of the narrative, and social and historical context. The interviewer is an active participant in creating meaning in the research process. Listening, reading, writing, journalling and reflecting are all part of the research design.

Description of Participant Selection The method of selecting participants for this study is purposeful sampling. According to Sandelowski (1995), participation in purposeful sampling is ‘case-oriented’ rather than ‘variable’ oriented. That is, it is the representativeness of the experience under study that is sought, not the generalizability of the data. The criteria for sample selection reflects the intent of the research, which is to discover and understand the social construction of women’s experience of adolescent motherhood between years 1940-2000. Purposeful sampling includes individuals on the basis of personal knowledge of the event or phenomenon, as well as the ability and willingness to communicate this experience to others (Sandelowski, 1995). In this study, the criterion of interest is the experience of adolescent motherhood between 1940 and 2000. Purposeful sampling seeks a rich and varied representation of women’s experience of the phenomenon, over the time frame indicated. Participants will be selected on the basis of representing four different time periods. It is anticipated that the sample will include two representatives from each time period. Recruitment of Participants The researcher will recruit participants through a third party. In other words, the researcher will ask professional and personal contacts who are likely to know suitable participants to have the potential participants contact the researcher if they are interested in participating in the research study. The third party contact person will be someone who is in a position to know potential participants, and who is interested and supportive of the research project. Recruitment will include both oral and written components. The oral component of the recruitment process will be in the form of detailed information 14 given to the third party by the researcher, which can be conveyed verbally to potential participants. This information will include the nature and purpose of the study, expectations of participants, information about the researcher, and guarantees of confidentiality and anonymity.

The emphasis in this verbal information will be to convey a sense of the importance of the participant’s story, the researcher’s respect for the experience of the participant, and the interest of oral historians in the stories of women’s lives. The third party contact will give the potential participant the name and contact number of the researcher and will instruct the potential participant to contact the researcher who will answer questions and explain the research project in more detail. This detailed information will include material related to signed informed consent, supervision of research project, resources for participants in the event that issues raised cause any emotional discomfort for the participant, risks and benefits of the research, confidentiality and anonymity, description of the interview process, and the right of the participant to terminate the interview at any time. The written component of the recruitment process will be in the form of a poster (Appendix C). This information will be posted in public places at agencies were potential participants may be found. These agencies and programs will be the Banff and Canmore General Hospitals, as well as the extended care facility at these same hospitals, the Healthy Moms and Healthy Babies Program at the Banff and Canmore Public Health Clinic and student notice boards at the undergraduate and graduate areas within the Faculty of Nursing, University of Calgary. Each poster will include the name of a facility contact person who is familiar and supportive of the research and who will provide additional verbal information as requested as well the name and contact number of the researcher.

Data Gathering Data gathering and analysis will occur simultaneously and is guided by the procedural methods of feminist oral history as outlined by Gluck and Patai (1991). Primary sources in this study include taped recorded interviews, transcripts of interviews, and journal material kept by the researcher. Secondary sources include literature relevant to establishing an historical 15 framework for the time period discussed in each interview. One interview is planned with each participant. This interview will record the experiences of the narrator as they relate to the experience of adolescent motherhood. If necessary, a second interview will clarify or elaborate on themes identified in the first interview. The interview process will be guided by an interview guide. According to Yow (1994) this guide must support the flow of questions between the narrator and the interviewer. To facilitate this process, Minister (1991) recommends that the interviewer be well informed about important historical and social issues related to the topic, and include on a piece of paper “an open-ended random scattering of potential issues” (p.37). These can be referred to, added to, or crossed off. For the purposes of this study, a list of issues was generated in order to explore both the general and particular nature of the experience (see Appendix A). This list will be revised during the interview so that it reflects the spirit and guidelines of feminist oral history interview techniques as described by Gluck and Patai (1991). Prior to beginning the conversational part of the interview, demographic data will be gathered and will be incorporated into the process of developing rapport between the narrator and the researcher (see Appendix B). A personal journal kept by the researcher will provide additional data material. Alvesson and Skoldberg (2000) and Borland (1991) explain that we must pay particular attention in data gathering and analysis to the ways in which our own personal language, politics, social values, and historical background influence how we as interviewers construct and interpret the ‘knowledge’ we seek and generate. Journalling will allow the researcher to reflect on the progress of the research, the personal meaning generated by the process, as well as the influence that the relationship between the narrator and interview has on the narration and interpretation of the story.

Finally, information gathered from secondary sources relevant to the historical period in which the narrator lives will be reviewed and developed as a framework by the researcher, and will contribute to the development of the interview guide. This historical framework will facilitate the aims of feminist oral historians to describe the experience of women within the 16 context of the social and historical expectations that society imposes on them at a particular time in their lives and over the lifespan. This framework is woven into and around the analysis and interpretation of the particular woman’s story. According to Chanfrault-Duchet (1991), the process of gathering data in the feminist oral history tradition seeks to establish a convincing and meaningful matrix of understanding in which “facts and events are inscribed in patterns that relate to their socio-symbolic contents and that reflect, through complex processes, women’s mentalities” (p. 90).

Data Analysis Data analysis will be concurrent with data gathering, and will flow from the content of the interview, the historical framework derived from secondary sources, and reflections on meaning developed through journalling. The primary source of data analysis will be the taped recorded interviews. This analysis will include ways in which the narrator uses language to express and convey meaning, the way meaning is affected by the passage of time, and the themes that emerge from the narration of the experience.

Gluck and Patai (1991) state that the act of listening with attention is key in the process of analyzing the content of the feminist in-depth interview. Rather than listening with the goal of fitting what women are saying into an existing paradigm, the researcher listens with a critical ear to what is said and what is not said by the narrator. This includes both verbal and non-verbal communication. In this way, the meaning of the experience is honored, and the woman and her story emerge with the integrity and complexity of the life preserved. Anderson and Jack (1991) suggest that the first step in active listening is to immerse oneself in the interview and try to understand the vantage point of the narrator. Chanfrault-Duchet (1991) explains that in analyzing the text of the narrative, the interviewer pays attention to the particular way language is used by the narrator, including key phrases that indicate unique ways in which the narrator interprets meaning, and key patterns that indicate dominant behavioral responses to life events.

An examination of these key phrases and patterns contributes to a developing understanding of 17 the how the narrator has created a sense of self, and how that self image fits within the particular social, cultural and historical context of the narrator’s life experience. The concept of time is also important in the analysis of interview data. Sandelowski (1999) proposes a number of meta frameworks for viewing how people reflect on events that occurred at recent and at distant points in their lives. She states that listening to the ways that people tell their story, and accounting for the ways they address change over time, “contributes to the ...discovery of patterns and regularities in lives lived in time, place, and in relationships” (p.84). The ways in which meaning changes over time is revealed not only in the text of the story, but also in the way the story is organized chronologically, and the temporal emphasis that is placed on particular events. A discussion with the narrator about how meaning has changed over time will be included in the interview guide. In addition to examining emerging themes through the use of language and time, the researcher will keep a written journal in order to reflect on the progress of the research, and personal meanings as they develop. An important consideration in understanding this personal meaning is an acknowledgment by the researcher of the ways that the narrative is affected by the researcher’s personal presence and participation in the interview. The researcher will engage in ongoing reflection on the relationship between the narrator’s ways of knowing, and the interviewer’s ways of knowing. Thus the researcher becomes aware of the act of ‘interpreting the interpretation’ of the narrator’s story (Alvesson & Skoldberg, 2000; Borland,1991). Borland (1991) explains that at the same time as we listen to the narrator and transcribe the narrative event, we also subject the story to our own interpretation, according to “our own experience of the performance” (p. 63). This interplay creates a “second-level narrative based upon, but at the same time reshaping, the first” (p.63), which must be acknowledged in the process of data analysis.

Criteria for Credibility of Research Oral history as a method of historical research is unique in that data is generated in ways that differ from other historical research methods. First, data is generated in response to inquiries 18 about events that occurred in the past in the interview setting. For this reason, ‘evidence’ of the historical event does not occur before the interview takes place. Secondly, data is generated as a result of the interview process itself. Apart from the story being recalled by the narrator, the interaction between the narrator and the researcher also impacts the way the story is told, constructed, and even the themes that emerge (Borland, 1991). As the narrator recalls past events, the narration of the events and even the meaning that these events has for the narrator is affected and changed by the present telling of the story, including the environment in which the story is told, important events occurring presently for the narrator, and the nature of the relationship between the narrator and the researcher. The interviewer must, in the analysis of the narrative be sensitive to the ways in which these factors impact the narrative, and must include an analysis of these factors in the interpretation of the interview (Borland,1991; Yow,1994).

In the feminist oral history interview, the text produced by the interpretation of primary and secondary sources is not an adjunct to written historical records, and as such cannot be judged by the standards of written historical records. In coming to understand the paradigm of the narrator through the interview process, Grele (1999) states that “we find the synthesis of all of the various structural relationships of the interview, as well as the particular relation of the individual to his vision of history” (p. 45). In order to achieve this goal, feminist oral historians engage in a reflexive and interactive process with the interview material and the narrator. Part of the process of creating meaning for the reader is to place the narrative within the larger social and historical context of the period described, not to verify the historical accuracy of the narrator’s memory of events. For this reason, it is important that the researcher communicate the meaning and nature of the interplay between history, society, and the individual in relation to the narrative. In establishing the credibility of this interpretation, feminist oral historians contribute to the present and future understating of the ways in which women have experienced and interpreted the personal and historical meaning of their lives. The quality of the research study depends on the researcher’s ability to communicate the meaning of the experience so that the reader comes to an understanding of the narrator’s life-world in all it’s complexity (Chanfrault- 19 Duchet, 1991).

Limitations of the Research Study The limitations of this research study relate to the nature of qualitative research methods in general, and feminist oral history interviewing in particular. The small sample size often associated with qualitative research methods and the lack of ‘scientific’ rigor in the research design (including the absence of random sampling, lack of a control group, and the disregard for ‘objectivity’ in the collecting and interpretation of research data) often leads to skepticism about the quality, generalizability, and reliability of research findings. The implication is that ‘results’ obtained by purely qualitative methods do not allow the reader or the scientific community to establish a relationship between ‘cause and effect’ or to predict outcomes based on the existence of distinct variables within similar populations. Thus for example, a goal of establishing a relationship between predisposing factors that contribute to a specified condition (i.e. adolescent motherhood) with the aim of resolving the ‘problem’ will not be accomplished. Oral history research as a type of qualitative research experiences similar limitations when viewed from the traditional positive perspective. Predicting adolescent motherhood and solving this social ‘problem’ is not the aim of this qualitative research study. The tape recorded stories of a small number of women about the experience of adolescent motherhood does not lend itself to the accumulation of discrete units of data or the prediction of outcomes. SmithBattle (1994) addresses this limitation by explaining that “narratives play [a role] in showing lives to be situated and organized by practical, rather than disengaged, rationality” (p. 141). This research study will thus not meet the expectation that any particular ‘cause’ of adolescent motherhood will be sought, nor any ‘solution’ determined.

Participants will not be chosen for their representativeness of any particular economic, cultural or ethnic group, but rather for the fact that they have had the experience of adolescent motherhood.

Therefore it will not be possible to generalize the findings of this study to any other ‘similar’ population. The focus of the interviews will be on the contextuality of the stories as narrated by the individual. There will not be an attempt to draw parallels between stories or compare the 20 sociocultural or economic backgrounds of participants. The reader will also find that the historic events ‘recorded’ during the interview will not be subjected to verification, instead relevant historical events will be woven into the interpretation. In explaining this limitation, Portelli (1999) explains that the value of the oral history narrative is not to explicate historical events, but rather to show how events are changed by memory: “these changes reveal the narrators’ effort to make sense of the past and to give a form to their lives” (p.68).

Ethical Considerations Before participants are recruited, ethical approval will be obtained from the Conjoint Health Research Ethics Board. Signed informed consent and information about the nature and purpose of the research study will be according to the protocols of ethical research (see Appendix D). In addition to informed consent, participants will be offered the option to have their interview and/or transcript of the interview deposited in the University of Calgary Archives (see Addendum to Informed Consent) after they have listened to and read a transcript of that interview. Confidentiality will be guaranteed. Participants may choose not to answer questions on any sensitive topic, and may stop the interview at any time. Participants may withdraw at any time, just as investigators may terminate their research in the interest of the subjects, the project, or themselves. The risks associated with this research project are estimated to be low, however, the participant will be given the name and contact number of a medical practitioner who will be able to make appropriate referrals should the participant experience any undue emotional discomfort during or after the interview. Interviews will be tape recorded and transcribed, but identifying information will be kept separate from the tape recording and transcription. Data will be stored in a locked and secure container, and the key will be kept by the researcher with data available only to those directly involved in the research project.

It is a common practice in the field of history to preserve tapes and transcriptions of interviews for future research by depositing these materials in an archive. In this research study, participants will be provided the option of having tapes and transcripts deposited in the University of Calgary Archives. Participants will have the option of having both tape and 21 transcript deposited, or only the transcript from which all identifying information has been edited out. Participants will be offered the following options in relation to the tape and transcript of the interview: use of tape and transcript to be cited in the written documents or presentations of the researcher; taped interview and transcript to be eventually deposited in University of Calgary Archives and used for research or educational purposes only; transcript only which has no identifying information including name, to be deposited in University of Calgary Archives; use of tape and transcript only for the purposes of the researcher, and tape and transcript to be destroyed three years after research work is completed. The participant will also be offered the option of placing time restrictions in terms of access to tape and transcript. For example, tape and/or transcript (or edited transcript with corrections made by narrator) cannot be accessed for a specified number of years after being deposited in the University of Calgary Archives. The narrator will be given a copy of the transcription in order to make corrections. These corrections will be included in the edited transcript. In this case, only the edited transcript will be considered for future preservation. If taped interviews are not to be deposited in the University of Calgary Archives, they will be erased after three years and the transcript destroyed. Implications and Outcomes for Nursing Practice This research study seeks to discover and understand the complex origins of our assumptions and beliefs about the experience of adolescent motherhood. Through oral history interviews, this research project will investigate the private, social and historical impact that having a child in the teenage years has had for the women interviewed. While the text produced by oral history interviews cannot be generalized to populations in the way that large sample size research studies attempt to do, neither is it the intent of this project. Instead, by examining the personal and historical meaning of adolescent motherhood, it is hoped that a pattern of meaningful similarities in the development of the meaning of experience will emerge that invites us to examine how our own personal and professional beliefs about young motherhood are shaped. The care that nurses provide is to primarily to individuals who are often at a vulnerable point in their lives both physically and psychologically. Providing a therapeutic healing 22 environment demands of us the ability to empathize and communicate a positive unconditional regard, and has been a tool that has informed nursing practice since its inception. Understanding the uniqueness of each individual’s experience, and the ways that beliefs and values are shaped and transmitted by social and historical factors may serve to challenge those personal and professional attitudes that do not preserve personhood and maintain dignity for clients to the standards we expect of ourselves and our colleagues.

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28 Appendix A Adolescent Motherhood: Interview Guide Interviews will include gathering demographic data such as the date of birth of the narrator, date of birth of the child, health of the narrator at time of child’s birth, other children born to the narrator. The direction of the interview will be guided by the narrator in a discussion of the events and issues surrounding pregnancy and birth. Following this discussion, the interviewer will ask the narrator to reflect on how she sees the meaning of this experience today in comparison with the meaning it had for her when the birth occurred. The assumption made by the interviewer is that the narrator will lead the story about her experience of being an adolescent mother. Questioning, clarification and elaboration will follow the direction of the narrator.The interviewer will explore themes as they arise with the narrator. The interviewer will prepare a guide which will include an unstructured grouping of issues and topics that may be relevant to the experience or to the historical period. This grouping of issues will be for reference only, and topics and issues may be deleted or added to according to the direction and content of the interview. In addition, the interviewer will provide the name and contact number of a medical practitioner who will be able to make appropriate referrals should emotional issues arise that are of concern to the narrator during or after the interview.

29 Appendix B Demographic Questionnaire Date of birth of narrator: ________________________________________________ Date of birth of child: __________________________________________________ Date of birth of other children: ___________________________________________ Age at birth of first child: ________________________________________________ Support people at time of birth: __________________________________________ Circle: child born at home / child born in hospital / other ______________________ Health of narrator at time of birth: _________________________________________ Health of child at time of birth: ___________________________________________ Primary care person of child following birth: _________________________________ Living arrangements at time of child’s birth:_________________________________ Education obtained at time of child’s birth: __________________________________ Current education attained: _____________________________________________ Occupation at time of child’s birth: ________________________________________ Current occupation: ___________________________________________________ Current domestic living situation: _________________________________________ Number of children living: ______________________________________________ Current health issues: _________________________________________________ Other comments related to birth: _________________________________________ __________________________________________________________________ __________________________________________________________________ 30 Appendix C Poster for Recruiting Participants Your story is requested!

Where you a teenage mother between the years 1940 to 2000?

I am a masters of nursing degree student at the University of Calgary interested in the stories of women who experienced childbirth when they were teenagers. These stories form an important and unique part of women’s history and have not been widely told in the past. I would like to invite you to contribute your story to a growing interest in this area of women’s lives. The recording of your story will be done over one, possibly two hour long interviews using a tape recorder. A written record will be made from the recording. Confidentiality and anonymity will be guaranteed. You may end your participation at any time. No costs will be incurred by you.

You may choose to not talk about any issues that your are not comfortable talking about. The interview will be in the form of a conversation at a time and place that you choose. All questions related to the interview, the recording process and the research study itself will be answered to your satisfaction before, during and after the interview. A signed consent form will be requested for participation in this study. If you are interested in obtaining more information about this project, please contact:

__________________________ at _________________________________ You will then be given the name and contact number of the researcher.

31 Appendix D Informed Consent Form UNIVERSITY OF CALGARY