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Ajayi AI, Athero S, Muga W, Kabiru CW. Lived experiences of pregnant and parenting adolescents in Africa: A scoping review. Reprod Health 2023; 20:113. [PMID: 37537592 PMCID: PMC10401816 DOI: 10.1186/s12978-023-01654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/26/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Previous studies have not synthesized existing literature on the lived experiences of pregnant and parenting adolescents (aged 10-19) in Africa. Such evidence synthesis is needed to inform policies, programs, and future research to improve the well-being of the millions of pregnant or parenting adolescents in the region. Our study fills this gap by reviewing the literature on pregnant and parenting adolescents in Africa. We mapped existing research in terms of their substantive focus, and geographical distribution. We synthesized these studies based on thematic focus and identified gaps for future research. METHODS We used a three-step search strategy to find articles, theses, and technical reports reporting primary research published in English between January 2000 and June 2021 in PubMed, Jstor, AJOL, EBSCO Host, and Google Scholar. Three researchers screened all articles, including titles, abstracts, and full text, for eligibility. Relevant data were extracted using a template designed for the study. Overall, 116 studies met the inclusion criteria and were included in the study. Data were analyzed using descriptive and thematic analyses. RESULTS Research on pregnant and parenting adolescents is limited in volume and skewed to a few countries, with two-fifths of papers focusing on South Africa (41.4%). Most of the studies were African-led (81.9%), received no funding (60.3%), adopted qualitative designs (58.6%), and were published between 2016 and 2021 (48.3%). The studies highlighted how pregnancy initiates a cycle of social exclusion of girls with grave implications for their physical and mental health and social and economic well-being. Only 4.3% of the studies described an intervention. None of these studies employed a robust research design (e.g., randomized controlled trial) to assess the intervention's effectiveness. Adolescent mothers' experiences (26.7%) and their education (36.2%) were the most studied topics, while repeat pregnancy received the least research attention. CONCLUSION Research on issues affecting pregnant and parenting adolescents is still limited in scope and skewed geographically despite the large burden of adolescent childbearing in many African countries. While studies have documented how early pregnancy could result in girls' social and educational exclusion, few interventions to support pregnant and parenting adolescents exist. Further research to address these gaps is warranted.
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Affiliation(s)
- Anthony Idowu Ajayi
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya.
| | - Sherine Athero
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Winstoun Muga
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Caroline W Kabiru
- Sexual, Reproductive, Maternal, New-Born, Child, and Adolescent Health (SRMNCAH) Unit, African Population and Health Research Center, Nairobi, Kenya
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Zungu P, Louw KA, Slabbert P, Bantjes J. 'They Sent Me Out to School, and I Came Back with a Baby': Perinatal Women's Experiences of Biographical Disruption and Nonfatal Suicidal Behaviour. QUALITATIVE HEALTH RESEARCH 2022; 32:1767-1779. [PMID: 35938716 DOI: 10.1177/10497323221119314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Exploring perinatal women's experience of nonfatal suicidal behaviour (NFSB) could help illuminate the contexts in which perinatal suicide occurs and new ways to conceptualise maternal suicide prevention. Our aim was to explore perinatal women's subjective experience of NFSB in South Africa. Data were collected via in-depth interviews with seven perinatal women hospitalised following NFSB. Thematic analysis showed how poverty and gender norms shape experiences of pregnancy and highlighted the need for eco-systemic interventions for perinatal women in resource scarce environments to increase social support, assist with childcare, improve educational retention, challenge gender norms and increase paternal involvement. Pregnancy can precipitate biographical disruption by disturbing women's view of themselves and their futures. An inability to reconstruct a coherent narrative and re-imagine the future impedes the transition to motherhood and provides a context for suicide. Using the concept of biographical disruption to frame perinatal suicide, could identify novel approaches to suicide prevention.
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Affiliation(s)
- Pamela Zungu
- Department of Psychiatry, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, South Africa
| | - Kerry-Ann Louw
- Department of Psychiatry, Faculty of Medicine and Health Sciences, 26697Stellenbosch University, South Africa
| | - Philip Slabbert
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
- Alcohol, Tobacco and Other Drug Research Unit, 59097South African Medical Research Council, South Africa
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Crooks R, Bedwell C, Lavender T. Adolescent experiences of pregnancy in low-and middle-income countries: a meta-synthesis of qualitative studies. BMC Pregnancy Childbirth 2022; 22:702. [PMID: 36096763 PMCID: PMC9469636 DOI: 10.1186/s12884-022-05022-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background Fertility rates among adolescents have fallen globally, yet the greatest incidence remains in low-and middle-income countries (LMICs). Gaining insight into adolescents needs and experiences of pregnancy will help identify if context specific services meet their needs and how to optimise pregnancy experiences. A meta-synthesis of qualitative studies considering adolescent experiences of pregnancy in LMICs has not yet been published. Aim To synthesise available qualitative evidence to provide greater understanding of the needs and experiences of adolescents who become pregnant in low-and middle-income countries. Methods An extensive search utilised six databases and citations searching. Studies were included if they were of a qualitative or mixed methods design. Participants lived in LMICs and were adolescents who were pregnant, had experienced pregnancy during adolescence or were an adolescent male partner. Relevant studies were assessed for quality to determine suitability for inclusion. A meta-ethnography approach was used to generate themes and a final line of argument. Results After screening and quality assessment 21 studies were included. The meta-ethnography generated four themes, A wealth of emotions, I am not ready, Impactful relationships and Respectful and disrespectful care. Unplanned, unwanted and unacceptable pregnancies were a source of shame, with subsequent challenging personal relationships and frequently a lack of needed support. Even when pregnancy was wanted, adolescents faced the internal conflict of their desires not always aligning with socio-cultural, religious and family expectations. Access, utilisation and experiences of care were significantly impacted by adolescents’ relationships with others, the level of respectful care experienced, and engagement with adolescent friendly services. Conclusions Adolescents who experience pregnancy in LMICs deserve support to meet their personal and pregnancy needs; efforts are needed to tailor the support provided. A lack of a health care provider knowledge and skills is an obstacle to optimal support, with more and better training integral to increasing the availability of adolescent friendly and respectful care. Adolescents should be involved in the planning of health care services and supported to make decisions about their care. The diversity across countries mean policy makers and other stakeholders need to consider how these implications can be realised in each context. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05022-1.
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Affiliation(s)
- Rachel Crooks
- Liverpool School of Tropical Medicine, Liverpool, UK.
| | - Carol Bedwell
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tina Lavender
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Reid HE, Pratt D, Edge D, Wittkowski A. Maternal Suicide Ideation and Behaviour During Pregnancy and the First Postpartum Year: A Systematic Review of Psychological and Psychosocial Risk Factors. Front Psychiatry 2022; 13:765118. [PMID: 35401283 PMCID: PMC8987004 DOI: 10.3389/fpsyt.2022.765118] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Suicide is a leading cause of maternal death during pregnancy and up to a year after birth (perinatal period). Many psychological and psychosocial risk factors for maternal suicidal ideation and behaviour have been investigated. Despite this, there have been no attempts to systematically search the literature on these risk factors. Additionally, few studies have described how the risk factors for suicidal ideation, attempted suicides and suicide deaths differ, which is essential for the development of tools to detect and target suicidal ideation and behaviour. Seven databases were searched up to June 2021 for studies that investigated the association between suicidal ideation and/or suicidal behaviour and psychological/psychosocial risk factors in pregnant and postpartum women. The search identified 17,338 records, of which 59 were included. These 59 studies sampled a total of 49,929 participants and investigated 32 different risk factors. Associations between abuse, experienced recently or during childhood, and maternal suicide ideation, attempted suicide and death were consistently reported. Social support was found to be less associated with suicide ideation but more so with suicide attempts. Identifying women who have experienced domestic violence or childhood abuse and ensuring all women have adequate emotional and practical support during the perinatal period may help to reduce the likelihood of suicidal behaviour.
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Affiliation(s)
- Holly E. Reid
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Dawn Edge
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Ajayi AI, Odunga SA, Oduor C, Ouedraogo R, Ushie BA, Wado YD. "I was tricked": understanding reasons for unintended pregnancy among sexually active adolescent girls. Reprod Health 2021; 18:19. [PMID: 33482843 PMCID: PMC7821647 DOI: 10.1186/s12978-021-01078-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 01/11/2021] [Indexed: 12/03/2022] Open
Abstract
Background While the Kenya government is mobilizing high-level strategies to end adolescent pregnancy by 2030, a clear understanding of drivers of early unintended pregnancy in the country is a necessary precursor. In this study, we determine the prevalence, associated factors, and reasons for unintended pregnancy among sexually active adolescent girls (aged 15–19 in two Kenya counties with the highest rate of teenage pregnancy. Methods We used the “In Their Hands” (ITH) program's baseline evaluation data. The study adopted a mixed-methods design with 1110 sexually active adolescent girls in the quantitative component and 19 girls who were either pregnant or nursing a child in the qualitative. We used adjusted and unadjusted logistic regression to model factors associated with unintended pregnancy among respondents. We used a thematic analysis of qualitative data to examine girls’ reasons for having unintended pregnancy. Results Overall, 42% of respondents have had an unintended pregnancy; however, higher proportions were observed among girls who were 19 years (49.4%), double orphans (53.6%), never used contraceptive (49.9%), out-of-school (53.8%), and married (55.6%). After adjusting for relevant covariates, the odds of unintended pregnancy were higher among girls who resided in rural areas (AOR 1.64, 95% CI 1.22–2.20), had primary or no formal education (AOR 1.50 95% CI 1.11–2.02), and had never used contraceptive (AOR 1.69 95% CI 1.25–2.29) compared with their counterparts. Current school attendance was associated with a 66% reduction in the probability of having an unintended pregnancy. Participants of the qualitative study stated that the desire to maintain a relationship, poor contraceptive knowledge, misinformation about contraceptive side effects, and lack of trusted mentors were the main reasons for their unintended pregnancies. Conclusion A massive burden of unintended pregnancy exists among sexually active adolescent girls in the study setting. Adolescent boys and girls need better access to sexuality education and contraceptives in the study setting to reduce early unintended pregnancy.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya.
| | - Sally Atieno Odunga
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Clement Oduor
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Ramatou Ouedraogo
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Boniface Ayanbekongshie Ushie
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
| | - Yohannes Dibaba Wado
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Off Kirawa Road, Manga Close, Kenya
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Twintoh RF, Anku PJ, Amu H, Darteh EKM, Korsah KK. Childcare practices among teenage mothers in Ghana: a qualitative study using the ecological systems theory. BMC Public Health 2021; 21:16. [PMID: 33397329 PMCID: PMC7783965 DOI: 10.1186/s12889-020-09889-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While appropriate care for children is essential for optimal growth and protection against child morbidity and mortality, teenage mothers have been shown to deviate from the recommended childcare practices. This study explored the childcare practices among teenage mothers in Ghana using Ecological Systems Theory by Bronfenbrenner as a theoretical framework. METHODS Employing qualitative approach to inquiry, evidence was drawn from 30 teenage mothers using in-depth interviews. The data were analysed and presented following systematic qualitative-oriented text analysis strategy with verbatim quotes from study participants to support the emergent themes. RESULTS It was evident that teenage mothers have limited skills in childcare practices and often resorted to practices with potentially adverse health outcomes for their children. They, for instance, applied hot towels they had heated with hot stones to the children's umbilical stump. We found that teenage mothers were not in sync with their macro- and exo-systems, thereby depriving themselves and their babies of the much-needed guidance and support in caring for their babies. Teenage mothers were often confused and sometimes clueless about best childcare practices at a given point in time. CONCLUSIONS Childcare practices by teenage mothers are far from the ideal. To improve on child health (especially children born to teenage mothers), efforts at both the macro- and exo-systems should be directed at exposing teenage mothers to best child care practices that inure to the benefits of their children. Ante- and postnatal visits should be used to provide specific education for mothers, especially first-time teenage mothers on the care needs of babies and how to provide these needs.
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Affiliation(s)
- Reuben Foster Twintoh
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Prince Justin Anku
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
| | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Eugene Kofour Maafo Darteh
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Kwaku Kissah Korsah
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
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Sheeran N, Jones L, Perolini J. Intersecting identities: How race and age influence perceptions of mothers. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nicola Sheeran
- School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia,
| | - Liz Jones
- Centre for Work Organisation and Wellbeing, School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia,
| | - Joanne Perolini
- School of Applied Psychology, Mt Gravatt Campus, Griffith University, Brisbane, Queensland, Australia,
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Tetteh J, Nuertey BD, Dwomoh D, Udofia EA, Mohammed S, Adjei-Mensah E, Yawson AE. Teenage pregnancy and experience of physical violence among women aged 15-19 years in five African countries: Analysis of complex survey data. PLoS One 2020; 15:e0241348. [PMID: 33108400 PMCID: PMC7591093 DOI: 10.1371/journal.pone.0241348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/13/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Pregnant teenage women are prime targets of violence against women perpetrated by intimate partners, family members, and miscreants in their neighborhoods. This study estimated the prevalence of Teenage pregnancy (TP) and Physical Violence (PV) and further assessed the relationship between TP and PV in five Low-and-Middle-Income Countries (LMICs). METHODS The study was conducted among five LIMCs (Burkina Faso, Kenya, Malawi, Nigeria, and Tanzania) using data from the most recent Demographic and Health Surveys conducted in these countries. Modified Poisson with the robust standard error was used to quantify the association between TP and PV. All analyses adjusted for the complex survey design structure (clustering, weighting, and stratification). RESULTS The analysis involved a total of 26055 adolescent women aged 15-19 years across the five countries. The overall prevalence of TP was 25.4% (95%CI = 24.4-26.4) with the highest prevalence occurring among Malawians [29.0% (95%CI = 27.4-30.7)]. Meanwhile, the prevalence of TP among older adolescents (18-19 years) was approximately two-thirds significantly higher compared with young adolescents [aPR(95%CI) = 1.60[1.49-1.71)]. The prevalence of PV among teenagers across the five countries was 24.2% (95%CI = 22.3-26.2). The highest prevalence of PV was recorded among Nigerian adolescent women [31.8% (95%CI = 28.5-35.3)]. The prevalence of PV among adolescent women who were pregnant was approximately 5-folds significant compared to those who were not pregnant (adjusted prevalence ratio; aPR = 4.70; 95% CI: 3.86-5.73; p<0.0001). CONCLUSION There was a high prevalence of pregnancy among older teenagers aged 18-19 years. Close to a quarter of teenage women ever experienced physical violence. Pregnant teenage women ever experience of physical violence was very high compared to non-pregnant peers. Intervention should target PV and TP by adopting a gender-sensitive approach to eliminate physical violence, particularly among teenagers to prevent TP.
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Affiliation(s)
- John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Benjamin D. Nuertey
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Duah Dwomoh
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emilia Asuquo Udofia
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sheriff Mohammed
- National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Evelyn Adjei-Mensah
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Herbell K, Bloom T. A Qualitative Metasynthesis of Mothers' Adverse Childhood Experiences and Parenting Practices. J Pediatr Health Care 2020; 34:409-417. [PMID: 32674884 DOI: 10.1016/j.pedhc.2020.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/03/2020] [Accepted: 03/20/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Despite the known prevalence and detrimental health outcomes associated with adverse childhood experiences (ACEs), extant literature has rarely focused on the impact of ACEs on mothers' parenting practices. The purpose of this metasynthesis was to synthesize qualitative studies to understand how mothers with a history of ACEs parent their children. METHOD A systematic search was conducted across five databases with 11 studies meeting eligibilty criteria. Relevant data were extracted and analyzed with qualitative description. RESULTS Six subthemes and three themes emerged from the data. Themes included breaking the cycle, parent and child well-being, and supporting mothers. All mothers described strategies to protect their children, with some describing hypervigilant parenting practices. Mothers discussed worries about appropriate discipline and a pervasive fear of community-based services for fear of removal of the child. Across studies, mothers described their current support system and offered several suggestions for formal support services. DISCUSSION This metasynthesis provides the synthesized perspectives of traumatized mothers' parenting practices, which may inform future interventions.
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Sheeran N, Jones L, Bernardin S, Wood M, Doherty L. Immoral, Incompetent, and Lacking Warmth: How Stereotypes of Teenage Fathers Compare to Those of Other Parents. SEX ROLES 2020. [DOI: 10.1007/s11199-020-01172-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nkhoma DE, Lin CP, Katengeza HL, Soko CJ, Estinfort W, Wang YC, Juan SH, Jian WS, Iqbal U. Girls' Empowerment and Adolescent Pregnancy: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1664. [PMID: 32143390 PMCID: PMC7084341 DOI: 10.3390/ijerph17051664] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 12/12/2022]
Abstract
Background: 21 million girls get pregnant every year. Many initiatives are empowering girls. Various studies have looked at girl empowerment, however, there is contradicting evidence, and even less literature from developing countries. Methods: We searched articles published between January 2000 to January 2019. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered our protocol on the International Prospective Register of Systematic Reviews PROSPERO (CRD42019117414). Nine articles were selected for review. Quality appraisal was done using separate tools for qualitative studies, cohort and cross-sectional studies and randomized control trials. Results: Eight studies included educational empowerment, four studies included community empowerment, three studies included economic empowerment, while two studies discussed policy empowerment. Three studies were of fair quality; two qualitative and one cross-sectional study were of high quality, while three studies had low quality. Discussion. Studies showed a favorable impact of girl empowerment on adolescent pregnancies and risky sexual behaviors. Education empowerment came through formal education or health systems such as in family planning clinics. Community empowerment was seen as crucial in girls' development, from interactions with parents to cultural practices. Economic empowerment was direct like cash transfer programs or indirect through benefits of economic growth. Policies such as contraceptive availability or compulsory school helped reduce pregnancies.
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Affiliation(s)
- Dumisani Enricho Nkhoma
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Daan District, Taipei 106, Taiwan; (D.E.N.); (C.-P.L.); (H.L.K.); (C.J.S.); (W.E.)
- Nkhata Bay District Hospital, Nkhata Bay District Health Office, P.O. Box 4, Mkondezi, Nkhata Bay, Malawi
| | - Chia-Ping Lin
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Daan District, Taipei 106, Taiwan; (D.E.N.); (C.-P.L.); (H.L.K.); (C.J.S.); (W.E.)
| | - Hexin Latumer Katengeza
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Daan District, Taipei 106, Taiwan; (D.E.N.); (C.-P.L.); (H.L.K.); (C.J.S.); (W.E.)
| | - Charles Jenya Soko
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Daan District, Taipei 106, Taiwan; (D.E.N.); (C.-P.L.); (H.L.K.); (C.J.S.); (W.E.)
| | - Wanda Estinfort
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Daan District, Taipei 106, Taiwan; (D.E.N.); (C.-P.L.); (H.L.K.); (C.J.S.); (W.E.)
| | - Yao-Chin Wang
- Department of Emergency, Min-Sheng General Hospital, Taoyuan District, Taoyuan 330, Taiwan;
- Graduate Institute of Biomedical Informatics, College of Medicine Science and Technology, Taipei Medical University, Daan District, Taipei 106, Taiwan
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Xinyi District, Taipei 106, Taiwan
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Daan District, Taipei 106, Taiwan
| | - Shing-Hwa Juan
- Department of Administration, Yuan’s General Hospital, Lingya District, Kaohsiung 802, Taiwan
| | - Wen-Shan Jian
- School of Health Care Administration, College of Management, Taipei Medical University, Daan District, Taipei 106, Taiwan;
| | - Usman Iqbal
- Master Program in Global Health and Development Department, College of Public Health, Taipei Medical University, Daan District, Taipei 106, Taiwan; (D.E.N.); (C.-P.L.); (H.L.K.); (C.J.S.); (W.E.)
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Daan District, Taipei 106, Taiwan
- PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Daan District, Taipei 106, Taiwan
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12
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Williams LR. The impact of infant carrying on adolescent mother–infant interactions during the still‐face task. INFANT AND CHILD DEVELOPMENT 2020. [DOI: 10.1002/icd.2169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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13
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Williams LR, Turner PR. Infant carrying as a tool to promote secure attachments in young mothers: Comparing intervention and control infants during the still-face paradigm. Infant Behav Dev 2020; 58:101413. [DOI: 10.1016/j.infbeh.2019.101413] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/16/2019] [Accepted: 12/16/2019] [Indexed: 01/24/2023]
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Johnstone M, Mulherin K. From distress to flourishing: towards a strengths-based approach for young mothers. J Reprod Infant Psychol 2019; 38:166-183. [PMID: 31271298 DOI: 10.1080/02646838.2019.1621277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The current study aims to better understand the predictors of flourishing, as well as the predictors of distress, among first-time Australian mothers in their teens and early 20s in the first year postpartum.Background: Past research has linked early motherhood with poor outcomes for mother and baby. However, other research has demonstrated that disadvantage often precedes early motherhood, rather than results from it, and there has been a consistent body of qualitative research highlighting positive outcomes for young mothers. In this paper, we investigate who is doing well amongst a sample of young mothers.Methods: Through quantitative analysis of survey data of 86 women aged 16-24 years who had transitioned to motherhood in the past 12 months, we investigate the predictors of flourishing, along with postnatal distress.Results: Our findings suggest that this sample of women was doing well, with relatively high scores on flourishing and low scores on distress. As expected, the two constructs were negatively correlated.Conclusion: Whilst self-esteem was a consistent predictor of both distress and flourishing, and acted as a mediating factor, this research also showed that there are unique and independent predictors for distress and flourishing, which can be used to inform tailored programs for young mothers.
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Affiliation(s)
- Melissa Johnstone
- Department of Educational Studies, Macquarie University, Sydney, Australia
| | - Kate Mulherin
- School of Psychology, The University of Queensland, Brisbane, Australia
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15
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Meireles A, Costa ME. Body experience and the mother-child relationship in pregnancy: a cross-sectional study of pregnant Portuguese women. J Reprod Infant Psychol 2019; 37:527-538. [PMID: 31204493 DOI: 10.1080/02646838.2019.1626009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: In spite of the huge physical transformations that occur during pregnancy, there is little research on the role of body experience in the establishment of the mother-child relationship in pregnancy. The aim of the present study was to address this gap. Method: A sample of 330 pregnant women completed questionnaires assessing mother-child relationship (the Maternal-Fetal Attachment Scale), body experience, and other demographic and pregnancy variables. Results: Pearson's correlations revealed a number of variables were related to mother-child relationship in pregnancy, and t-tests and ANOVAs showed some between-subjects differences based on demographic variables. After controlling for these variables, regression analyses revealed that body experience was a significant predictor of both subscales of the Maternal-Fetal Attachment Scale: emotional investment in the baby and maternal role-taking. Conclusion: These findings highlight the connection between body experience and the psychological tasks of pregnancy and draw attention to new ways of assessing and improving mother-child relationships as early as in pregnancy. Results are discussed in terms of their clinical implications.
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Affiliation(s)
- Ana Meireles
- Instituto de Psicologia e Ciências da Educação, Universidade Lusíada Norte , Porto , Portugal
| | - Maria Emília Costa
- Instituto de Psicologia e Ciências da Educação, Universidade Lusíada Norte , Porto , Portugal
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Jones L, Sheeran N, Lanyon H, Evans K, Martincovic T. Nurses’ perceptions of communicating with minority parents in a neonatal nursery: a communication accommodation theory approach. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/17538068.2018.1460959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Liz Jones
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Nicola Sheeran
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Hanna Lanyon
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Karina Evans
- School of Applied Psychology, Griffith University, Brisbane, Australia
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Jaques ML, Weaver TL, Weaver NL, Willoughby L. The association between pediatric injury risks and parenting behaviours. Child Care Health Dev 2018; 44:297-303. [PMID: 28983939 DOI: 10.1111/cch.12528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/31/2017] [Accepted: 09/18/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Unintentional injuries are the leading cause of death in children ages 1-18 years. Many of these injuries to young children occur in their own homes. Although research has explored injury risk prevention strategies, historically, much of this research has focused on environmental changes and teaching safety practices. Currently, there appears to be a gap in current research exploring how parenting influences children's risk of injury. METHODS Mothers (n = 119) of children 5 years and younger were recruited from a paediatric clinic as a part of a larger study and completed measures of parenting challenges, developmentally sensitive parenting, child neglect, parental efficacy, and risk of potential injury situations. Hierarchical logistic regression was used to explore the extent to which developmentally insensitive parenting behaviours put parents at higher risk for behaviours that lead to unintentional injury in children and whether developmentally sensitive parenting behaviours protects children from injury. The association between demographic characteristics and injury risk behaviours was also examined. RESULTS Parents who reported more frequent insensitive parenting behaviours (i.e., yelling, spanking, and putting child in time out) were more likely to report putting their child in an incorrect car seat or taking their child out of a car seat while the car is still moving. In addition, younger parents were at greater risk of storing cleaners and medications unsafely. CONCLUSION Results from this study highlight the importance of supporting younger mothers and educating parents on effective parenting strategies when trying to prevent unintentional injury risks.
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Affiliation(s)
- M L Jaques
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - T L Weaver
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
| | - N L Weaver
- Department of Behavioral Science and Health Education, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - L Willoughby
- Department of Psychology, Saint Louis University, St. Louis, MO, USA
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Iqbal AM, Schwenk WF, Theall KP. A Rare Presentation of the Syndrome of Inappropriate Antidiuretic Hormone in a 12-Year-Old Girl as the Initial Presentation of an Immature Ovarian Teratoma. J Pediatr Adolesc Gynecol 2018; 31:62-63. [PMID: 28818586 DOI: 10.1016/j.jpag.2017.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 08/01/2017] [Accepted: 08/06/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Immature ovarian teratoma is very rare in childhood. We report on a 12-year-old girl with immature ovarian teratoma who presented initially with syndrome of inappropriate antidiuretic hormone. CASE A 12-year-old girl presented with acute abdomen and distention. Initial laboratory tests showed hyponatremia (sodium, 123 mmol/L), that did not respond to fluid management. Computed tomography imaging showed a 15 cm × 9 cm × 20 cm mass in the right ovary with multifocal internal fat, and dystrophic calcifications. She underwent exploratory laparotomy with a right salpingo-oophorectomy, omentectomy, and peritoneal stripping. The pathology revealed metastatic immature teratoma. Hyponatremia resolved soon after the surgery. SUMMARY AND CONCLUSION Although a rare diagnosis, immature ovarian teratoma must be considered in a girl who presents with abdominal mass and hyponatremia.
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Affiliation(s)
- Anoop Mohamed Iqbal
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.
| | - W Frederick Schwenk
- Division of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
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19
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A comparison between pregnancy outcome in women in 15 to 19 and 20 to 35 years age group. Med J Islam Repub Iran 2017; 31:140. [PMID: 29951440 PMCID: PMC6014772 DOI: 10.14196/mjiri.31.140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Pregnancy is one of the most important periods of a woman’s life and is influenced by many different factors. For
years, it was assumed that teenage pregnancy can cause poor pregnancy outcome.
The purpose of this study was to compare some pregnancy complications between 2 groups of 15 to 19 and 20 to 35 year- old primigravida
pregnant women
Methods: This was a cross- sectional study conducted on the data sheets of primigravida women who delivered their babies in a
teaching hospital. A total of 3040 eligible women entered the study; of them, 280 (9.3%) were in the 15 to 19 years age group and
2756 in the 20 to 35 years age group. The 2 groups were compared for preeclampsia, PROM, preterm birth, SGA, placental abruption,
and placenta previa. A logistic regression model was used for data analysis.
Results: The women of the 2 groups significantly differed in BMI and socioeconomic background. The rate of preeclampsia
(p=0.008), PROM (p=0.002), and preterm delivery (p=0.001) were less in the 15 to 19 years age group. The rate of placental abruption,
placenta previa, IUFD, and SGA was not significantly different between the 2 groups. After multivariate regression analysis,
preeclampsia (adjusted odd ratio= 2.157; 95% CI= 1.38- 4.21) and preterm delivery (adjusted odd ratio= 2.443; 95% CI= 1.78- 5.13)
were found to be higher in the 20 to 35 years group.
Conclusion: The risk of poor pregnancy outcome is not higher in teenage pregnancies compared to pregnancies in the 20 to 35 years
age group if confounding factors, including socioeconomic factors, are carefully controlled.
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20
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Maravilla JC, Betts KS, Couto e Cruz C, Alati R. Factors influencing repeated teenage pregnancy: a review and meta-analysis. Am J Obstet Gynecol 2017; 217:527-545.e31. [PMID: 28433733 DOI: 10.1016/j.ajog.2017.04.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/09/2017] [Accepted: 04/11/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Existing evidence of predictors of repeated teenage pregnancy has not been assessed rigorously. This systematic review provides a comprehensive evaluation of protective and risk factors that are associated with repeated teenage pregnancy through a metaanalytical consensus. DATA SOURCES We used PubMed, EMBASE, CINAHL, ProQuest, PsychINFO, ScienceDirect, Scopus, and Web of Science databases from 1997-2015 and the reference list of other relevant research papers and related reviews. STUDY ELIGIBILITY CRITERIA Eligibility criteria included (1) epidemiologic studies that analyzed factors associated with repeated pregnancy or birth among adolescents <20 years of age who were nulliparous or experienced at least 1 pregnancy, and (2) experimental studies with an observational component that was adjusted for the intervention. STUDY APPRAISAL AND SYNTHESIS METHODS We performed narrative synthesis of study characteristics, participant characteristics, study results, and quality assessment. We also conducted random-effects and quality-effects metaanalyses with meta-regression to obtain pooled odds ratios of identified factors and to determine sources of between-study heterogeneity. RESULTS Twenty-six eligible epidemiologic studies, most from the United States (n=24), showed >47 factors with no evidence of publication bias for each metaanalysis. Use of contraception (pooled odds ratio, 0.60; 95% confidence interval, 0.35-1.02), particularly long-acting reversible contraceptives (pooled odds ratio, 0.19; 95% confidence interval, 0.08-0.45), considerably reduced repeated teenage pregnancy risk. Among studies about contraception, the number of follow-up visits (adjusted coefficient, 0.72; P=.102) and country of study (unadjusted coefficient, 2.57; permuted P=.071) explained between-study heterogeneity. Education-related factors, which included higher level of education (pooled odds ratio, 0.74; 95% confidence interval, 0.60-0.91) and school continuation (pooled odds ratio, 0.53; 95% confidence interval, 0.33-0.84), were found to be protective. Conversely, depression (pooled odds ratio, 1.46; 95% confidence interval, 1.14-1.87), history of abortion (pooled odds ratio, 1.66; 95% confidence interval, 1.08-2.54), and relationship factors, such as partner support, increased the repeated teenage pregnancy risk. CONCLUSION Contraceptive use, educational factors, depression, and a history of abortion are the highly influential predictors of repeated teenage pregnancy. However, there is a lack of epidemiologic studies in low- and middle-income countries to measure the extent and characteristics of repeated teenage pregnancy across more varied settings.
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21
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Kumar NR, Raker CA, Ware CF, Phipps MG. Characterizing Social Determinants of Health for Adolescent Mothers during the Prenatal and Postpartum Periods. Womens Health Issues 2017; 27:565-572. [PMID: 28462813 DOI: 10.1016/j.whi.2017.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/16/2017] [Accepted: 03/20/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE Significant racial disparities and continuing poor birth outcomes make adolescent pregnancy a significant public health concern in the United States despite declining pregnancy rates. Social determinants of health are associated with increased likelihood of pregnancy and poor maternal and child health outcomes. This study aims to characterize specific elements of social determinants of health in a cohort of predominantly Latina adolescent mothers. METHODS Between February 2007 and August 2008, 106 pregnant adolescents participated in a study with assessments at 20 to 24 weeks of gestation, and at 3 and 6 months postpartum. Survey questions addressed residential mobility, financial support and childcare, and perceived need for and use of community resources. Comparative analysis assessed differences between adolescents by age (<16 vs. ≥16 years old) and ethnicity (Latina vs. non-Latina). FINDINGS Adolescent mothers experienced high rates of residential mobility, with 59.4% moving at least once in the year before their prenatal survey. Participants relied primarily on public aid (94-96%) and their parents (81-85%) for financial support. Latina participants were more likely than non-Latinas to rely on public aid. Although many participants reported needing financial support and housing, few used available services. Younger adolescents relied less often on the father of the baby for support than older adolescents. CONCLUSIONS Adolescent mothers' high rates of residential mobility and increasing reliance on public assistance highlight resource gaps that potentially put them and their children at risk for poor outcomes. Targeted efforts to augment systemic support in these domains are a critical component of addressing health disparities for this population.
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Affiliation(s)
- Natasha R Kumar
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
| | - Christina A Raker
- Department of Obstetrics and Gynecology, Division of Research, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Crystal F Ware
- Department of Obstetrics and Gynecology, Division of Research, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
| | - Maureen G Phipps
- Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Obstetrics and Gynecology, Division of Research, Women and Infants Hospital of Rhode Island, Providence, Rhode Island
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Gubrium AC, Fiddian-Green A, Lowe S, DiFulvio G, Del Toro-Mejías L. Measuring Down: Evaluating Digital Storytelling as a Process for Narrative Health Promotion. QUALITATIVE HEALTH RESEARCH 2016; 26:1787-1801. [PMID: 27184518 DOI: 10.1177/1049732316649353] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Digital storytelling (DST) engages participants in a group-based process to create and share narrative accounts of life events. We present key evaluation findings of a 2-year, mixed-methods study that focused on effects of participating in the DST process on young Puerto Rican Latina's self-esteem, social support, empowerment, and sexual attitudes and behaviors. Quantitative results did not show significant changes in the expected outcomes. However, in our qualitative findings we identified several ways in which the DST made positive, health-bearing effects. We argue for the importance of "measuring down" to reflect the locally grounded, felt experiences of participants who engage in the process, as current quantitative scales do not "measure up" to accurately capture these effects. We end by suggesting the need to develop mixed-methods, culturally relevant, and sensitive evaluation tools that prioritize process effects as they inform intervention and health promotion.
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Affiliation(s)
| | | | - Sarah Lowe
- 1 University of Massachusetts Amherst, Massachusetts, USA
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23
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Reszel J, Peterson WE, Moreau D. Young women's experiences of expected health behaviors during pregnancy: the importance of emotional support. J Community Health Nurs 2016; 31:198-211. [PMID: 25356990 DOI: 10.1080/07370016.2014.958395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Young women often have access to fewer resources to make expected behavior changes during pregnancy. This qualitative study aimed to explore the experiences of young pregnant and parenting women regarding behavioral expectations and behavior change during pregnancy. Nine women (aged 15 to 24) participated in individual semistructured photo-elicitation interviews and data was analyzed using qualitative content analysis. The findings of this study suggest that although these young women received informational support throughout their pregnancies, there is a need to integrate emotional support into prenatal care for young pregnant women to facilitate their experience as one of empowerment rather than oppression.
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Affiliation(s)
- Jessica Reszel
- a Children's Hospital of Eastern Ontario Research Institute , Ottawa , Ontario , Canada
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24
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Sheeran N, Jones L, Rowe J. Motherhood as the Vehicle for Change in Australian Adolescent Women of Preterm and Full-Term Infants. JOURNAL OF ADOLESCENT RESEARCH 2016. [DOI: 10.1177/0743558415615942] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Preterm birth represents an interruption to the normal development of maternal identity and is considered a highly stressful event for adult mothers. However, no research has investigated whether or how preterm birth affects the adolescent mother’s transition to motherhood. The current study aimed to explicate the experience of being a mother for adolescent women who experienced a preterm or term birth in Australia. This Interpretative Phenomenological Analysis Study analyzed interviews with 14 primiparous, English-speaking adolescent mothers (15-19 years; 10 preterm and 4 full term) who participated in three interviews over a 12-month period. Findings suggested few differences in the experience of being a mother due to infant birth status. Instead, the experience of being a mother was fundamentally about transformations to the self. The young women constructed themselves differently as a result of being mothers. Changes included moving away from delinquent behaviors, development of internal resources, growth of a positive view of self, gaining meaning in their lives, and reconciling idealized and actual notions of self and other. This research adds to our understanding of how motherhood shapes the adolescent women’s lives, while also challenging our assumptions about the impact of preterm and full-term birth for adolescent mothers.
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Affiliation(s)
| | - Liz Jones
- Griffith University, Brisbane, Queensland, Australia
| | - Jennifer Rowe
- University of the Sunshine Coast, Queensland, Australia
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25
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Henderson J, Redshaw M. Worries About Labor and Birth: A Population-Based Study of Outcomes for Young Primiparous Women. Birth 2016; 43:151-8. [PMID: 26806273 DOI: 10.1111/birt.12219] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Pregnancy at a young age is a continuing public health concern strongly associated with socioeconomic deprivation, social isolation, and stigma. The objectives were to see whether, compared with women aged 21 or more, women aged 20 years or younger worried more about labor and birth, and had poorer maternal outcomes. Another objective was to investigate the extent to which worries about labor and birth mediated the associations between young age and outcomes. METHODS A secondary analysis of data was conducted relating to 2,598 primiparous women's experience of maternity care in England in 2010. The survey collected data on care in the antenatal, intrapartum, and postnatal periods, and sociodemographic factors. A validated checklist measured worries about labor and birth. RESULTS Compared with women aged 21 or more, women aged 20 years or younger worried more about labor and birth. The pain and duration of labor worried all women and those aged 20 years or younger were particularly worried about the uncertainty of labor onset, cesarean section birth, and about embarrassment. In logistic regression, after adjusting for potential confounders, young age was a significant independent risk factor for worries about pain and distress in labor, and self-reported depression at 1 and 3 months. However, young age was also significantly associated with having a normal vaginal delivery. CONCLUSIONS It may be appropriate to focus support on women experiencing multiple disadvantage, rather than young age alone.
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Affiliation(s)
- Jane Henderson
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Maggie Redshaw
- Policy Research Unit in Maternal Health and Care, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
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26
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Kanhadilok S, McCain NL, McGrath JM, Jallo N, Price SK, Chiaranai C. Factors Associated With Exclusive Breastfeeding Through Four Weeks Postpartum in Thai Adolescent Mothers. J Perinat Educ 2016; 25:150-161. [PMID: 30538412 DOI: 10.1891/1058-1243.25.3.150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Breastfeeding initiation and duration are decreased in adolescent mothers compared to older mothers. A prospective descriptive cohort design was used to explore personal, social, cultural, and infant factors that explain and predict breastfeeding initiation and maintenance at 4 weeks postpartum. Adolescent mothers (N = 120) were recruited at prenatal clinics in Thailand. Data were collected at enrollment, during birth hospitalization (N = 102), and at 4 weeks postpartum (N = 96). Findings revealed breastfeeding attitudes, social support, and cultural beliefs about "being a good mother" were positively correlated with breastfeeding initiation. Furthermore, breastfeeding attitudes and social support were significant positive predictors of exclusive breastfeeding (both p ≥ .01) continuation through 4 weeks, whereas infant temperament was a significant negative predictor (p ≥ .04). Maternal competence at 4 weeks postpartum was also positively correlated with exclusive breastfeeding continuation.
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Ngum Chi Watts MC, Liamputtong P, Mcmichael C. Early motherhood: a qualitative study exploring the experiences of African Australian teenage mothers in greater Melbourne, Australia. BMC Public Health 2015; 15:873. [PMID: 26358465 PMCID: PMC4566485 DOI: 10.1186/s12889-015-2215-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 09/02/2015] [Indexed: 11/10/2022] Open
Abstract
Background Motherhood is a significant and important aspect of life for many women around the globe. For women in communities where motherhood is highly desired, motherhood is considered crucial to the woman’s identity. Teenage motherhood, occurring at a critical developmental stage of teenagers’ lives, has been identified as having adverse social and health consequences. This research aimed to solicit the lived experiences of African Australian young refugee women who have experienced early motherhood in Australia. Methods This qualitative research used in-depth interviews. The research methods and analysis were informed by intersectionality theory, phenomenology and a cultural competency framework. Sixteen African born refugee young women who had experienced teenage pregnancy and early motherhood in Greater Melbourne, Australia took part in this research. Interviews were audio recorded, transcribed and data analysed using thematic content analysis. Ethics approval for this research was granted by Victoria University Human Research Ethics committee. Results Motherhood brings increased responsibilities, social recognition, and a sense of purpose for young mothers. Despite the positive aspects of motherhood, participants faced challenges that affected their lives. Most often, the challenges included coping with increased responsibilities following the birth of the baby, managing the competing demands of schooling, work and taking care of a baby in a site of settlement. The young mothers indicated they received good support from their mothers, siblings and close friends, but rarely from the father of their baby and the wider community. Participants felt that teenage mothers are frowned upon by their wider ethnic communities, which left them with feelings of shame and embarrassment, despite the personal perceived benefits of achieving motherhood. Conclusions We propose that service providers and policy makers support the role of the young mothers’ own mother, sisters, their grandmothers and aunts following early motherhood. Such support from significant females will help facilitate young mothers’ re-engagement with education, work and other aspects of life. For young migrant mothers, this is particularly important in order to facilitate settlement in a new country and reduce the risk of subsequent mistimed pregnancies. Service providers need to expand their knowledge and awareness of the specific needs of refugee teen mothers living in ‘new settings’.
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Affiliation(s)
| | - Pranee Liamputtong
- School of Public Health & Human Biosciences, Faculty of Health Sciences, La Trobe University, Bundoora, Victoria, Australia.
| | - Celia Mcmichael
- School of Social Sciences and Communications, Faculty of Humanities and Social Sciences, La Trobe University, Bundoora, Victoria, Australia.
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28
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Mulherin K, Johnstone M. Qualitative accounts of teenage and emerging adult women adjusting to motherhood. J Reprod Infant Psychol 2015. [DOI: 10.1080/02646838.2015.1042963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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Brand G, Morrison P, Down B. “You don’t know half the story”: deepening the dialogue with young mothers in Australia. J Res Nurs 2015. [DOI: 10.1177/1744987114565223] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Pregnant and young mothers’ stories often go untold or are poorly represented within dominant health and social care discourses. Consequently, narratives of young mothers are largely absent from social and health care literature, especially in relation to how young women make sense, understand, and experience young motherhood. Drawing on 7 months of participant observation fieldwork at a community service, and 11 in-depth interviews, we discuss six metaphorical themes which capture the experiences of young mothers using a narrative approach. These include: Picking up the Pieces; Walking a Narrow and Familiar Path; Jumping over Puddles; Riding the Rapids to Motherhood; Living with Dirty Looks; and Asking for Directions. Contrary to the wider community’s deficit view and stereotypes of young mothers, what emerged from the narratives was quite a different story. Becoming a young mother meant taking a stand against stigma from the wider community; recognising motherhood as a significant and transformational turning point in their lives, one that opened doors to alternative storylines of hope, autonomy and agency, especially given a supportive context. These findings enhance our understandings by widening the lens to diverse realities that exist in young mothers’ lives and present a strong case for using a narrative approach to research and practice when working with young mothers.
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Affiliation(s)
- Gabrielle Brand
- Assistant Professor, Murdoch University School of Health Professions, Murdoch University, Mandurah, Australia; Education Centre, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Crawley, Australia
| | - Paul Morrison
- Dean – School of Health Professions, Murdoch University, Education Drive, Mandurah, Australia
| | - Barry Down
- City of Rockingham, Chair of Education, Murdoch University, Dixon Road, Rockingham, Australia
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Begun S. The paradox of homeless youth pregnancy: a review of challenges and opportunities. SOCIAL WORK IN HEALTH CARE 2015; 54:444-460. [PMID: 25985287 DOI: 10.1080/00981389.2015.1030058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Compared to their housed counterparts, homeless youth become pregnant at exceptionally high rates. Causes of such pregnancies are multifaceted, while a paradoxically high proportion of these pregnancies are intended. This review discusses causes and risk factors associated with homeless youth pregnancies, and notes experiences of pregnancy decision-making discord, challenges encountered during and following pregnancy, and difficulties faced by homeless youth when or if they become parents. Because homeless youth face a wide array of unique risks, future research would benefit from exploring alternative approaches to prevention to reduce pregnancies and improve sexual and reproductive health outcomes among this population.
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Affiliation(s)
- Stephanie Begun
- a Graduate School of Social Work, University of Denver , Denver , Colorado , USA
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31
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Brand G, Morrison P, Down B, WestBrook B. Scaffolding young Australian women's journey to motherhood: a narrative understanding. HEALTH & SOCIAL CARE IN THE COMMUNITY 2014; 22:497-505. [PMID: 24703272 DOI: 10.1111/hsc.12106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/08/2014] [Indexed: 06/03/2023]
Abstract
Pregnant and young mothers' stories often go untold within community social and health service policy, planning and practice. Consequently, there is a significant gap between young women's experiences of motherhood and current service provision. This study was undertaken in response to a paucity of observational and contextually rich research that explores young women's experiences of pregnancy and motherhood, including the role a community service played in scaffolding their motherhood journeys. Fundamental to this study's purpose was the premise that to improve planning and delivery of more appropriate services for this group, we need to listen, consult and consider what life is like for young mothers. The purpose of this paper is to describe the role a community service played in scaffolding young women's experiences as they transitioned to motherhood. Using a narrative approach, this study draws on data collected from contextual observations of 31 informants and 11 in-depth interviews over 7 months of fieldwork in 2010 at a community service in the Peel region of Western Australia. The integral role a community service played in the young women's transition to motherhood was analysed thematically and captured in three metaphorical themes, finding a circle of friends, weaving a tapestry and turning the page. The young women's storied experiences of motherhood present a strong argument for radical re-visioning of community and social health policy, practice and service delivery for young mothers. The findings revealed that judgement-free services that foster social and supportive relationships were integral in developing positive motherhood identities. The power of narrative and social learning when working with young mothers suggests that social models of health that foster a relational, narrative approach to practice are fundamental to young mothers finding their own voices and solutions and becoming active agents in re-authoring future narratives of hope, autonomy and agency.
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Affiliation(s)
- Gabrielle Brand
- Murdoch University School of Health Professions, Murdoch University, Mandurah, Western Australia, Australia; Education Centre, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Crawley, Western Australia, Australia
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Maternal adjustment and maternal attitudes in adolescent and adult pregnant women. J Pediatr Adolesc Gynecol 2014; 27:194-201. [PMID: 24656707 DOI: 10.1016/j.jpag.2013.09.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 09/23/2013] [Accepted: 09/23/2013] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. DESIGN, SETTING, AND PARTICIPANTS A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24(th) and 36(th) weeks of gestation. MAIN OUTCOME MEASURES Maternal Adjustment and Maternal Attitudes Questionnaire(1) RESULTS: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education. CONCLUSION Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances.
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Brand G, Morrison P, Down B. How do health professionals support pregnant and young mothers in the community? A selective review of the research literature. Women Birth 2014; 27:174-8. [PMID: 24933525 DOI: 10.1016/j.wombi.2014.05.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 05/12/2014] [Accepted: 05/13/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND The cultural phenomenon of "teenage pregnancy and motherhood" has been socially constructed and (mis)represented in social and health care discourses for several decades. Despite a growing body of qualitative research that presents an alternative and positive view of young motherhood, there remains a significant gap between pregnant and young women's experience of young motherhood and current global health and social policy that directs service delivery and practice. AIM This paper aims to heighten awareness of how a negative social construction of young motherhood influences global health and social policy that directs current community health models of practice and care for young mothers in the community. DISCUSSION There is clear evidence on the vital role social support plays in young women's experience of pregnancy and motherhood, particularly in forming a positive motherhood identity. This discussion paper calls us to start open and honest dialogue on how we may begin to re-vision the 'deficit view' of young motherhood in order to address this contradiction between research evidence, policy discourse and current practice and service provision. Qualitative research that privileges young women's voices by considering the multidimensional experiences of young motherhood is an important step towards moving away from universally prescribed interventions to a non-standard approach that fosters relational and responsive relationships with young mothers that includes addressing the immediate needs of young mothers at the particular time.
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Affiliation(s)
- Gabrielle Brand
- School of Health Professions, Murdoch University, Mandurah, Western Australia, Australia; Education Centre, The University of Western Australia, Faculty of Medicine, Dentistry & Health Science, Crawley, Western Australia, Australia.
| | - Paul Morrison
- School of Health Professions, Murdoch University, Mandurah, Western Australia, Australia
| | - Barry Down
- School of Education, Murdoch University, Rockingham, Western Australia, Australia
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Redshaw M, Miller YD, Hennegan J. Young women's experiences as consumers of maternity care in Queensland. Birth 2014; 41:56-63. [PMID: 24571204 DOI: 10.1111/birt.12084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Young motherhood is commonly associated with vulnerabilities, stereotyping of young women's behavior, and poor outcomes for them and their children. The objective was to understand how maternity care is experienced by this group in the transition to parenthood. METHODS Data from a large-scale 2010 survey of women's experience of maternity care were analyzed using qualitative methods with open text responses. RESULTS Overall, 7,193 women responded to the survey: 237 were aged 20 years or less. Most (83%) of these young women provided open text responses. The main themes were: "being a consumer," "the quality of care," "needing support," and "pride in parenthood" whereas subthemes included "being young" and "how staff made me feel," "testimonials for staff," "not being left," and "it is all worthwhile." CONCLUSION Many young women responding described a positive experience. For many first-time mothers this feeling marked a change in their identity. Nevertheless, staff perceptions and attitudes affected how they saw themselves and what they took away from their experience of maternity care. A key message for other women is offered, supporting and reinforcing their role as active and involved consumers who, in engaging with services, have to stand up for themselves and make their needs and wishes known.
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Affiliation(s)
- Maggie Redshaw
- Policy Research Unit for Maternal Health and Care, National Perinatal and Epidemiological Unit, University of Oxford, Oxford, UK; Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Brisbane, Qld, Australia
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Shah MK, Gee RE, Theall KP. Partner support and impact on birth outcomes among teen pregnancies in the United States. J Pediatr Adolesc Gynecol 2014; 27:14-9. [PMID: 24316120 PMCID: PMC3947023 DOI: 10.1016/j.jpag.2013.08.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 06/07/2013] [Accepted: 08/02/2013] [Indexed: 10/25/2022]
Abstract
PURPOSE Despite hypothesized relationships between lack of partner support during a woman's pregnancy and adverse birth outcomes, few studies have examined partner support among teens. We examined a potential proxy measure of partner support and its impact on adverse birth outcomes (low birth weight (LBW), preterm birth (PTB) and pregnancy loss) among women who have had a teenage pregnancy in the United States. METHODS In a secondary data analysis utilizing cross-sectional data from 5609 women who experienced a teen pregnancy from the 2006-2010 National Survey of Family Growth (NSFG), we examined an alternative measure of partner support and its impact on adverse birth outcomes. Bivariate and multivariable logistic regression were used to assess differences in women who were teens at time of conception who had partner support during their pregnancy and those who did not, and their birth outcomes. RESULTS Even after controlling for potential confounding factors, women with a supportive partner were 63% less likely to experience LBW [aOR: 0.37, 95% CI: (0.26-0.54)] and nearly 2 times less likely to have pregnancy loss [aOR: 0.48, 95% CI: (0.32-0.72)] compared to those with no partner support. CONCLUSIONS Having partner support or involvement during a teenager's pregnancy may reduce the likelihood of having a poor birth outcome.
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Affiliation(s)
- Monisha K Shah
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Rebekah E Gee
- Louisiana State University School of Public Health, New Orleans, LA; Louisiana State University School Medicine, Department of Obstetrics and Gynecology, New Orleans, LA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
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Palacios JF, Strickland CJ, Chesla CA, Kennedy HP, Portillo CJ. Weaving dreamcatchers: mothering among American Indian women who were teen mothers. J Adv Nurs 2014; 70:153-63. [PMID: 23713884 PMCID: PMC3815508 DOI: 10.1111/jan.12180] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2013] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to explore the mothering experience and practice among reservation-based adult American Indian women who had been adolescent mothers. BACKGROUND Adolescent American Indian women are at an elevated risk for teen pregnancy and poor maternal/child outcomes. Identifying mothering practices among this population may help guide intervention development that will improve health outcomes. DESIGN A collaborative orientation to community-based participatory research approach. METHODS Employing interpretive phenomenology, 30 adult American Indian women who resided on a Northwestern reservation were recruited. In-depth, face-to-face and telephone interviews were conducted between 2007-2008. FINDINGS Women shared their mothering experience and practice, which encompassed a lifespan perspective grounded in their American Indian cultural tradition. Four themes were identified as follows: mother hen, interrupted mothering and second chances, breaking cycles and mothering a community. Mothering originated in childhood, extended across their lifespan and moved beyond mothering their biological offspring. CONCLUSION These findings challenge the Western construct of mothering and charge nurses to seek culturally sensitive interventions that reinforce positive mothering practices and identify when additional mothering support is needed across a woman's lifespan.
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Affiliation(s)
- Janelle F. Palacios
- Postdoctoral Fellow in the Center for Vulnerable Populations/Health Disparities, University of California-Los Angeles School of Nursing
| | - Carolyn J. Strickland
- Associate Professor, Psychosocial & Community Health, University of Washington School of Nursing
| | - Catherine A. Chesla
- Thelma Shobe Professor, Department of Family Health Care Nursing, University of California- San Francisco School of Nursing
| | | | - Carmen J. Portillo
- Professor and Chair, Department of Community Health Systems, University of California-San Francisco School of Nursing
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Sheeran N, Jones L, Rowe J. The relationship between maternal age, communication and supportive relationships in the neonatal nursery for mothers of preterm infants. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jnn.2013.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rowe HJ, Wynter KH, Steele A, Fisher JRW, Quinlivan JA. The growth of maternal-fetal emotional attachment in pregnant adolescents: a prospective cohort study. J Pediatr Adolesc Gynecol 2013; 26:327-33. [PMID: 24075091 DOI: 10.1016/j.jpag.2013.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 04/23/2013] [Accepted: 06/08/2013] [Indexed: 10/26/2022]
Abstract
STUDY OBJECTIVE To describe self-reported maternal-fetal emotional attachment in adolescent women over the course of pregnancy, compare it with adult pregnant women, and identify risk factors for poor attachment. DESIGN A prospective cohort study. SETTING Young mothers' clinics in 2 public hospitals in metropolitan Melbourne, Australia. PARTICIPANTS English-speaking young women aged 20 years and under attending their first antenatal visit. METHODS Self-report questionnaires were completed in each trimester. Validated measures were used to assess anxiety and depression symptoms and maternal-fetal emotional attachment. Data were analyzed with existing data from pregnant adults. Regression analyses were conducted to establish factors independently associated with higher mean first-trimester attachment score and lowest-quartile third trimester score adjusting for confounding variables. MAIN OUTCOME MEASURE Maternal-fetal emotional attachment, assessed by the Quality and Intensity subscales and Global score on Maternal Antenatal Attachment Scale (MAAS). RESULTS 165/194 (85%) completed the first questionnaire; 130/165 (79%) provided complete data. Mean anxiety but not depression scores were significantly higher in adolescents than adults across pregnancy. Mean (95%CI) first-trimester adolescent Global MAAS was significantly lower than adults (70.3 (68.4, 72.2) vs 76.8 (75.4, 78.2) P < .01), but there were no significant second- or third-trimester between-group differences. Adjusted odds of a lowest-quartile third-trimester MAAS score was significantly associated with lower first-trimester score (P < .001), previous abortion (P = .02) and being born overseas (P = .002). CONCLUSION Adolescents report slower development of antenatal emotional attachment than adults. Women with risk factors for poor attachment in late pregnancy are identifiable in early pregnancy and may benefit from additional multidisciplinary care.
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Affiliation(s)
- Heather J Rowe
- Centre for Women's Health Gender and Society, University of Melbourne, Melbourne, Victoria, Australia; Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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Gyesaw NYK, Ankomah A. Experiences of pregnancy and motherhood among teenage mothers in a suburb of Accra, Ghana: a qualitative study. Int J Womens Health 2013; 5:773-80. [PMID: 24250233 PMCID: PMC3829679 DOI: 10.2147/ijwh.s51528] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The proportion of teenage girls who are mothers or who are currently pregnant in sub-Saharan African countries is staggering. There are many studies regarding teenage pregnancy, unsafe abortions, and family planning among teenagers, but very little is known about what happens after pregnancy, ie, the experience of teenage motherhood. Several studies in Ghana have identified the determinants of early sexual activity, contraception, and unsafe abortion, with teenage motherhood only mentioned in passing. Few studies have explored the experiences of adolescent mothers in detail with regard to their pregnancy and childbirth. This qualitative study explores the experiences of adolescent mothers during pregnancy, childbirth, and care of their newborns. METHODS This qualitative study was based on data from focus group discussions and indepth interviews with teenage mothers in a suburb in Accra. Participants were recruited from health facilities as well as by snowball sampling. RESULTS Some of the participants became pregnant as a result of transactional sex in order to meet their basic needs, while others became pregnant as a result of sexual violence and exploitation. A few others wanted to become pregnant to command respect from people in society. In nearly all cases, parents and guardians of the adolescent mothers were upset in the initial stages when they heard the news of the pregnancy. One key finding, quite different from in other societies, was how often teenage pregnancies are eventually accepted, by both the young women and their families. Also observed was a rarity of willingness to resort to induced abortion. CONCLUSION Special programs should be initiated by the government and the various responsible departments to address ignorance on sexual matters, and the challenges and risks associated with pregnancy and parenting by adolescents. Parenting techniques should be taught in sex education programs.
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Affiliation(s)
- Nana Yaa Konadu Gyesaw
- Regional Health Directorate, Ghana Health Service, Koforidua, Eastern Region, Accra, Ghana
| | - Augustine Ankomah
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
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Boath EH, Henshaw C, Bradley E. Meeting the challenges of teenage mothers with postpartum depression: overcoming stigma through support. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2013.800635] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Robb Y, McInery D, Hollins Martin CJ. Exploration of the experiences of young mothers seeking and accessing health services. J Reprod Infant Psychol 2013. [DOI: 10.1080/02646838.2013.832181] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Redshaw M, Hennegan J, Miller Y. Young women's recent experience of labour and birth care in Queensland. Midwifery 2013; 30:810-6. [PMID: 23916403 DOI: 10.1016/j.midw.2013.06.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 06/20/2013] [Accepted: 06/30/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND young parenthood continues to be an issue of concern in terms of clinical and psychosocial outcomes for mothers and their babies, with higher rates of medical complications such as preterm labour and hypertensive disease and a higher risk of depression. The aim of this study was to investigate how young age impacts on women's experience of intrapartum care. METHODS secondary analysis of data collected in a population based survey of women who had recently given birth in Queensland, comparing clinical and interpersonal aspects of the intrapartum maternity care experience for 237 eligible women aged 15-20 years and 6534 aged more than 20 years. Descriptive and multivariate analyses were undertaken. RESULTS in the univariate analysis a number of variables were significantly associated with clinical aspects of labour and birth and perceptions of care: young women were more likely to birth in a public facility, to travel for birth and to live in less economically advantaged areas, to have a normal vaginal birth and to have one carer through labour. They were also less likely to report being treated with respect and kindness and talked to in a way they could understand. In logistic regression models, after adjustment for parity, other socio-demographic factors and mode of birth, younger mothers were still more likely to birth in a public facility, to travel for birth, to be more critical about interpersonal and aspects of care and the hospital or birth centre environment. CONCLUSION this study shows how experience of care during labour and birth is different for young women. Young women reported poorer quality interpersonal care which may well reflect an inferior care experience and stereotyping by health professionals, indicating a need for more effective staff engagement with young women at this time.
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Affiliation(s)
- Maggie Redshaw
- National Perinatal and Epidemiological Unit, University of Oxford, Old Road, Oxford OX3 7LF, United Kingdom; Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Julie Hennegan
- Queensland Centre for Mothers & Babies, School of Psychology, The University of Queensland, Brisbane, Australia
| | - Yvette Miller
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia
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Osaikhuwuomwan JA, Osemwenkha AP. Adolescents' perspective regarding adolescent pregnancy, sexuality and contraception. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2013. [DOI: 10.1016/s2305-0500(13)60118-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Effects of Age and the Pre-Term Birth of an Infant on Adolescent Mothers' Psychological Adjustment. CHILDRENS HEALTH CARE 2012. [DOI: 10.1080/02739615.2012.721713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Palacios J, Chesla C, Kennedy H, Strickland J. Embodied meanings of early childbearing among American Indian women: a turning point. J Midwifery Womens Health 2012; 57:502-8. [PMID: 22909397 PMCID: PMC3564516 DOI: 10.1111/j.1542-2011.2012.00165.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION American Indian women often have poor perinatal outcomes and are at risk for early childbearing. The purpose of this qualitative study was to understand the experience and meaning of early childbearing among American Indian women. METHODS Employing interpretive phenomenology and a semistructured interview guide, we interviewed 30 adult American Indian women residing in a northwestern American Indian reservation about their experiences and meaning of early childbearing. RESULTS Three overarching themes were tied to their eventual positive evaluation of the experience: 1) mourning a lost childhood, 2) seeking fulfillment, and 3) embodying responsibility. DISCUSSION Women indicated that despite their tumultuous childhoods, early childbearing presented an opportunity to effect positive change in their lives. Women's health care providers are positioned to help women change their lives, thereby, improving health outcomes.
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Affiliation(s)
- Janelle Palacios
- Center for Vulnerable Populations/Health Disparities, University of California-Los Angeles School of Nursing, Los Angeles, CA 90095-1702, USA.
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Roberts S, Graham M, Barter-Godfrey S. Young mothers' lived experiences prior to becoming pregnant in rural Victoria: a phenomenological study. Aust J Rural Health 2012; 19:312-7. [PMID: 22098215 DOI: 10.1111/j.1440-1584.2011.01228.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To explore the lived experiences and social context prior to becoming pregnant, of women who became mothers during adolescence in rural Victoria. DESIGN Qualitative interpretive phenomenological study using semistructured interviews. SETTING Rural community in North East Victoria, Australia. PARTICIPANTS Four rural women who gave birth to a child between the ages of 15 and 19. RESULTS Five themes emerged from the data as being essential to the participants' experiences prior to pregnancy. These included feeling isolated; life change: transition into adulthood; support and understanding in sexual relationships; feeling dissatisfied; and overcoming adversity. Participants' provided practical recommendations to improve life for young people in rural areas through reflecting on their own experiences. CONCLUSION These findings highlight the complex nature of rural young women's experiences leading up to pregnancy and suggest that early motherhood might be largely reflective of the social environment in which one lives prior to pregnancy. Providing somewhere safe to go, organised and appropriate social activities and increasing access to health services were identified as being pertinent to improving experiences for rural young people prior to pregnancy. Health professionals should consider the importance of supporting young women through non-judgemental, approachable and accessible services.
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Affiliation(s)
- Sarah Roberts
- Centre for Health through Action on Social Exclusion (CHASE), School of Health and Social Development, Deakin University, Burwood, Victoria, Australia
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Affiliation(s)
- Anne Katz
- Prostate Centre of CancerCare in Winnipeg, Manitoba, Canada
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Are adolescents' decisions about prenatal screening for Down syndrome informed? A controlled, prospective study. J Pediatr Adolesc Gynecol 2011; 24:29-34. [PMID: 20709585 DOI: 10.1016/j.jpag.2010.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 06/14/2010] [Accepted: 07/25/2010] [Indexed: 11/21/2022]
Abstract
STUDY OBJECTIVE Maternal serum screening is routinely offered to pregnant women in public hospitals in Victoria, Australia, regardless of their age. The aim of this study was to determine whether pregnant adolescents are less likely to make informed choices about undertaking this test than adult pregnant women. DESIGN Controlled, prospective design. SETTING Public hospital antenatal clinics in Victoria, Australia. PARTICIPANTS Adolescents up to 20 years of age were recruited at young mothers' clinics before they were offered second trimester maternal screening. They completed self-report questionnaires prior to maternal serum screening and again after the screening result was known. MAIN OUTCOME MEASURES A validated measure of informed choice was used to determine whether adolescents made informed choices about undertaking second trimester maternal serum screening. RESULTS Complete data were available for 147 adolescents. These data were combined with data from 85 adults which had been collected in an identical way. Ten percent of the adolescents made informed decisions about having the maternal serum screening, compared with 37% of the adult participant group (P < 0.05). Adolescent women were significantly less likely to make an informed choice than adult women, when relevant demographic and reproductive history variables were controlled for (adjusted OR = 0.25; P = 0.004; 95% CI for OR: 0.10, 0.63). CONCLUSION Few pregnant adolescents made informed decisions about maternal serum screening. Clinicians face a challenge to improve adolescents' knowledge about maternal serum screening.
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Hunt G, Moloney M, Joe-Laidler K, McKenzie K. Young Mother (in the) Hood: Gang Girls' Negotiation of New Identities. JOURNAL OF YOUTH STUDIES 2011; 14:1-19. [PMID: 21116461 PMCID: PMC2992318 DOI: 10.1080/13676261.2010.506531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This article examines the experiences of young women in street gangs who become mothers. Drawing on qualitative interviews with 65 young women in the San Francisco, CA, Bay Area, we examine their narratives about the transition to motherhood. In particular, we focus on the ways these young women negotiate femininities and attempt to reconcile their identities as young mothers and gang girls-both stigmatized identities. For many of the young women, motherhood entails a retreat from the street and a renewed emphasis on time spent in the home. While many receive (financial and childcare) support from their families, this also often means a diminution of the autonomy they experienced while more heavily involved in the gang. Issues of respect and respectability remain important for the young women, but the dimensions on which these are based change.
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Affiliation(s)
- Geoffrey Hunt
- Institute for Scientific Analysis, 1150 Ballena Blvd, Suite 211, Alameda, CA. 94501, Tel: 510 865 6225, Fax: 510 865 2467,
| | - Molly Moloney
- Institute for Scientific Analysis, 1150 Ballena Blvd, Suite 211, Alameda, CA. 94501, Tel: 510 865 6225, Fax: 510 865 2467,
| | | | - Kathleen McKenzie
- Institute for Scientific Analysis, 1150 Ballena Blvd, Suite 211, Alameda, CA. 94501, Tel: 510 865 6225, Fax: 510 865 2467,
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Copeland DB, Harbaugh BL. Psychosocial Differences Related to Parenting Infants Among Single and Married Mothers. ACTA ACUST UNITED AC 2010; 33:129-48. [DOI: 10.3109/01460862.2010.498330] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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