Caring for the Pregnant Teenager
Published on the 25 June 2019
Published on the 25 June 2019
Did you know that complications during pregnancy and birth result in the second largest cause of death in 15 - 19-year-old females, globally? (McCarthy et al. 2014).
High rates of teenage pregnancy remain a worldwide public health concern. How can maternity care be improved to meet these challenges and provide optimal care for the pregnant teenager?
McCarthy et al. (2014) define teenage pregnancy as occurring between the ages of 13 - 19 years. The World Health Organization, on the other hand, suggest that teenage pregnancy occurs anywhere between 10 - 19 years of age based on the mothers’ age at delivery (Yasmin et al. 2014).
Research from both Australia (Marino et al. 2016) and the UK (Whitworth 2017) show that teenage mothers are more likely to experience violence, family disruption, and socioeconomic disadvantage prior to conception.
Negative impacts on educational achievements; social isolation; poverty; and increased challenges to physical and mental health are all more likely to occur to teenage mothers (Cantlay 2015).
Extensive research conducted by The Teenage Pregnancy Independent Advisory Group (2010), expands on these general points and suggests specific groups of teenagers who are at particularly high risk of early pregnancy. Their list includes:
Marino et al. (2016) suggest that outcomes on a range of peripartum measures are also worse for teenage mothers as well as their babies. Longer term risks for the mother are known to include depression and rapid repeat pregnancy. Yet other researchers point out that women aged under 20 have one of the lowest rates of maternal mortality of all age groups.
It’s a different picture, however, for the babies born to teenage mothers. Multiple research studies all point to the fact that babies born to mothers under the age of 20 are at higher risk of stillbirths, higher rates of perinatal deaths and higher rates of neonatal deaths (Morecambe Bay NHS Foundation Trust 2012).
Teenage mothers are known to be:
Babies born to teenage mothers are also known to have worse health outcomes than those born to older mothers. For example:
As well as the higher risk factors known to be associated with teenage birth, teenage parents, as well as their children, are at greater risk of social exclusion and lower health outcomes, physically and emotionally.
In practice, this means that becoming a teenage parent, whether planned or not, can be a time of great vulnerability and it’s essential that accessible and relevant support networks are in place (Morecambe Bay NHS Foundation Trust 2012).
This means that midwives, along with other members of the maternity team are ideally placed to help pregnant teenagers build up their confidence, and to help them navigate the many choices and life transitions that come with parenthood.
McCarthy et al. (2014) echoes these thoughts and suggests the following practical steps to improve pregnancy outcomes:
One of the most common concerns of teenage mothers is the fear of being judged; while for young fathers, feelings of not being included in the care provided for their unborn child is frequently reported.
These experiences can result in feelings of rejection, which can deter young parents from using the full range of services offered to them.
Taken together, these factors can present a particular test for the maternity team, especially as additional life factors may need to be considered to prevent young mothers from being disadvantaged. For example:
Even though teenage pregnancy rates are falling in many developed countries, they still represent an important public health problem and are considered to be high-risk pregnancies.
To help meet this challenge, Lehmann (2017), suggests that where possible community-based group antenatal care should be offered. This has been shown to help empower young women and improve their wellbeing through continuity of care and peer support. This, in turn, can help to improve emotional wellbeing and reduce feelings of vulnerability and isolation.
There is no doubt that modern maternity and neonatal care has already gone a long way in reducing adverse outcomes for the teenage mother and her baby.
The challenge remains for maternity teams to think of even more creative care packages that can give the pregnant teenager the best possible start on her journey towards motherhood.
Teenage pregnancy - supporting your child: Resources specifically for those supporting a teenage child who is pregnant.
Anne is a freelance lecturer and medical writer at Mind Body Ink. She is a former midwife and nurse teacher with over 25 years’ experience working in the fields of healthcare, stress management and medical hypnosis. Her background includes working as a hospital midwife, Critical Care nurse, lecturer in Neonatal Intensive Care, and as a Clinical Nurse Specialist for a company making life support equipment. Anne has also studied many forms of complementary medicine and has extensive experience in the field of clinical hypnosis. She has a special interest in integrating complementary medicine into conventional healthcare settings and is currently an Associate Tutor, lecturing in Health Coaching and Medical Hypnosis at Exeter University in the UK. As a former Midwife, Anne has a natural passion for writing about fertility, pregnancy, birthing and baby care. Her recent publications include The Health Factor, Coach Yourself To Better Health and Positive Thinking For Kids. You can read more about her work at www.MindBodyInk.com.